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Results for “Aphakia, Postcataract”

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PubMed1979

Strabismus in the aphakic patient.

Fifty patients with aphakia and strabismus were studied. The chief complaint was diplopia following full optical correction. Prism therapy was recommended if the diplopia persisted after 3 to 4 months. When prism therapy was ineffective or impractical, surgery was recommended. The result of therapy was not influenced by the cause of the cataract treatment was considered successful in approximately 80% of patients. Patients who had convergence insufficiency did well with prism therapy alone. Half of the patients who had divergence excess needed extraocular-muscle surgery. One fourth of the patients had esotropia, nearly half associated with lateral rectus palsy. While prism therapy resulted in fusion, a reduction in prism power was not tolerated in this group. For this reason, surgery was suggested for all patients who had esotropia.

Adolescent↗
PubMed1979

Use of silicone lenses in infants and children.

A contact lens made from silicone rubber has been fitted successfully for extended wear in children. The lens has been used primarily with aphakic children, but it has also been tolerated by children with anisometropia, high myopia, and keratoconus. The lens can be handled like a hard contact lens and can be fitted by a variety of methods. The eye shows excellent tolerance of the lens and complications or failures to wear the lens have been due primarily to discomfort. After about a year of wear the lens surface can no longer be cleaned.

Adolescent↗
PubMed1979

The Copeland intraocular lens: five to ten years later.

Fifty-seven eyes with extracapsular surgery and Copeland lenses and the same number of intracapsular cataract extractions without lenses are described. All properly chosen lens cases have 6/12 vision or better. Forty percent required capsulotomy because of 6/12 vision or less. Possible cystoid macular edema occurred in two cases. No endothelial changes were present that were not present preoperatively. Five lenses dislocated. Two glaucomas appeared. There was no retinal separation, endophthalmitis, or lens removal for lens-induced irritation.

Adolescent↗
PubMed1979

Complications associated with aphakic contact lenses.

Complications associated with rigid contact lenses are more frequent in aphakia. The limited dexterity of older patients not only may prove an insurmountable barrier to the mastery of daily contact lens insertion and removal, but also may produce significant direct eye trauma, its seriousness determined by the integrity of the cataract wound. Since prolonged wear of aphakic contact lenses is the rule rather than the exception, the risk of irreversible corneal changes such as vascularization and erosions is greater. A poorly fitted aphakic contact lens that does not permit adequate oxygenation of all corneal areas makes such complications even more likely to occur. Decreased corneal sensitivity associated with cataract surgery permits continued wear of a poorly fitted lens, which does not allow the cornea to recover between wearing periods. Detection of keratoconjunctivitis sicca, more prevalent in the older age group, may prevent the associated complications of corneal erosion, iritis, and infection. Complications of aphakic contact lenses can be controlled by patient instruction, appropriate contact lens adjustments, and regularly scheduled follow-up examinations.

Aged↗
PubMed1979

Physiology of monocular aphakia.

The refraction of the unilateral aphakic patient has been aided by recent improvements in the ophthalmometer. New techniques simplify retinoscopic assessment of the patient. Choice of the type of correction, ie, spectacle, contact lens, contact lens-spectacle combination, or intraocular lens, depends on several factors. One factor is image size difference in aphakic and phakic eyes, particularly if removal of a second cataract is not imminent and vision is good in both eyes. Simple approaches that allow approximate size correction and effective restoration of binocularity are described. The current status of correction of vision in unilateral aphakic infants and young children is also discussed.

Adult↗
PubMed1979

Newer designs of aphakic spectacle eyeglasses.

This paper discusses the four available types of plastic aphakic spectacle lenses, which include (1) nonaspheric nonlineticular, (2)hardly aspheric lenticular and moderately aspheric lenticular, (3) mildly aspheric nonlenticular, and (4) highly aspheric nonlenticular in much larger eye size but adjusted closer to the eye to produce an enlarged visual field and suppress the "jack-in-the-box" phenomenon. Absolute size of the refracted peripheral visual fields through these types will be compared for the stationary eye in primary fixation. These visual fields were performed on the Amark projection perimeter. Helpful hints will be presented on how to determine if the patient has obtained the types of lenses prescribed and how to best prescribe each of these lenses.

Aphakia, Postcataract↗
PubMed1979

Defects of vision through aphakic spectacle lenses.

The following defects of aphakic vision will be reviewed: (1) magnification, which causes false orientation (due to excessive overall magnification of aphakic spectacles, resulting in false depth, and false projection) and distortion (due to excessive peripheral magnification of aphakic spectacles, resulting in pincushioning and concave contracture of the peripheral visual field); (2) swim; (3) image aberrations due to defects of focus through the periphery of aphakic spectacle lenses, resulting from radial astigmatism, curvature of image plane, spherical aberration, coma, and chromatic aberration; (4) restricted peripheral visual field due to small lens size, the roving ring scotoma, and the unrefracted area outside the field of view of aphakic spectacle lenses; (5) near vision problems; (6) weight, thickness, and cosmetic appearance of aphakic eyeglasses; and (7) inaccurate spectacle prescription due to faulty measurement of vertex distance, inaccurate lens duplication, pantoscopic tilt, turning of head during refraction, and rotation of eye during refraction.

Aged↗
PubMed1979

Applied optical principles: keratometry.

The optical correction of the aphakic eye requires the addition of a significant amount of vergence power to the corneal interface by one of three modalities: spectacle, contact lens, or intraocular lens. No matter which modality is chosen, based upon Gullstrand's parameters, the corneal interface provides approximately 74% of the effective vergence power of the eye; therefore, it is essential to understand the principles underlying the clinical assessment of the refracting power of the cornea. This presentation briefly reviews selected principles underlying the determination of corneal curvature and toricity by keratometry, as well as their relationship to the correcting spectacle lenses, and emphasizes the necessity of surveying the topography of the cornea for the greatest accuracy in these measurements.

Anthropometry↗
PubMed1979

Extended wear of CAB contact lenses in aphakic patients.

In order to assess the applicability and safety of cellulose acetate buterate (CAB) contact lenses for extended wear in aphakia, 139 lenses were fitted in 102 aphakic patients. These lenses were removed periodically for cleaning only. There has been an average follow-up of 24.75 months on 99 patients (135 lenses), with a success rate of 80%. No serious complications or corneal vascularization have occurred. The major problems encountered were due to lack of tint, increased tendency to accumulate mucus, and the need for periodic insertion and removal.

Acetates↗
PubMed1979

Retinal detachment and pseudophakia.

A consecutive series of pseudophakic retinal detachments was statistically compared with a matched group of aphakic retinal detachments. Distribution of breaks, anatomic results, and final visual acuities were tabulated. Success in reattachment was equal in the two groups, but final visual acuities were better in the aphakic group. Emphasis was placed on the intraoperative ophthalmoscopic examination of pseudophakic eyes with compromised peripheral fundus visibility.

Aphakia, Postcataract↗
PubMed1979

Retinal detachments and topical ocular miotics.

There is increasing suspicion that topical ocular miotic therapy in selected persons may precipitate retinal detachments. This is a rare event and probably does not occur in patients free of retinal pathology. Data supporting a possible cause and effect relationship, obtained from the National Registry of Drug-Induced Ocular Side Effects, a survey of the Retina Society, medicolegal decisions, and a review of the literature, is presented.

Administration, Topical↗
PubMed1980

Visual acuities of monocular IOL and non-IOL aphakic children.

The vision of 341 monocular aphakic children was corrected with contact lens, intraocular lens, or spectacles and the visual results of each series were compared. The acquired and infantile contact lens and IOL cataract patients achieved similar levels of aphakic visual acuities. Seventy percent of the IOL and 64% of the contact lens-acquired cataract patients achieved 20/20 to 20/40, while 22% of the IOL and 16% of the contact lens infantile cataract patients also reached this level. Twenty patients wore monocular spectacles and none achieved adequate levels of visual rehabilitation. Forty-six patients were unable to wear or did not receive aphakic correction because of patient or parental refusal or ocular pathologic contraindications.

Aphakia, Postcataract↗
PubMed1980

Extended wear silicone contact lenses in children with cataracts.

Thirty-twop patients, ranging in age from three weeks to 22 years, were fitted with an extended wear 100% silicone lens. The longest period of time a lens remained in the eye without being removed was 120 days. Most lenses were worn an average of six weeks before cleaning was required. No cases of infection or corneal edema were observed that required discontinuing use of the lens.

Adolescent↗
PubMed1980

Normal endothelial cell count range.

It was the purpose of this study to determine whether age could be used to predict central endothelial cell count in preoperative cataract patients aged 40 to 90. Three separate series of cell counts on a total of almost 3,000 eyes were performed and analyzed regarding age relationship. Although statistically endothelial cell count appears to decrease with age, the decrease is so small that a large range of cell counts was noted for each age. The results of this study indicate that age is not useful in estimating endothelial cell count in this population.

Adult↗
PubMed1980

Extended wear hydrogel lenses. Long-term effectiveness and costs.

During the period 1976-79, 1,201 of 1,552 aphakic patients were successfully fitted with third generation extended wear hydrogen lenses of thin-membrane design (CSI¿ lens) and highly hydrated polymer design (Permalens,¿Sauflon¿) without significant or permanent visula loss. Between 79% and 82% of the patients who failed did so in the first 90 days, and thereafter failure rates declined with time. Replacement rates for lenses approximated one lens per eye per year. Rates of required removal for cleaning varied. Ten to 13% of patients required cleaning at less than three-month intervals, and 5-6% at less than one month. For average patients with unilateral devices and no complication, extended wear lenses in Georgia are estimated to cost approximately three times as much as an intraocular lens over a 20-year follow-up period. General advantages ofextended wear third generation lenses include: (1) an acceptably savce and visually effective way to correct aphakia when patients are carefully selected, fitted, educated, and followed; (2) can be easily removeed, refitted or updated as technology advances; and (3) will not replace intraocular lenses, but can be used when implantation is contraindicated and should prevent the need for secondary or bilateral implantation or keratophakia in most cases.

Aged↗
PubMed1980

Corneal and retinal complications after cataract extraction. The mechanical aspect of endophthalmodonesis.

Removal of the crystalline lens deprives the eye of the stabilizing effect of the lens-zonule barrier. Intracapsular extraction also causes loss of stability inside the vitreous cavity itself (vitreodonesis). The lack of stability inside the aphakic eye is defined as endophthalmodonesis. Oscillations induced by saccadic eye movements cause turbulences in the aqueous humor and in liquid pools present in the vitreous cavity. Therefore, endophthalmodonesis is a continuing trauma to the eye. The hypothesis that corneal and retinal complications of cataract extraction, other than those of surgical origin, are due to the mechanical aspect of endophthalmodonesis is discussed. This hypothesis explains why, after complete removal of the lens-zonule barrier, the intracapsular aphakic eye suffers more from "barrier deprivation, than the extracapsular aphakic eye after incomplete removal of this barrier.

Anterior Chamber↗