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At least 865 records · Page 48Linked to original sources
PubMed2003

Implantation of a single-piece, hydrophilic, acrylic, minus-power foldable posterior chamber intraocular lens in a rabbit model: clinicopathologic study of posterior capsule opacification.

PURPOSE: To compare the extent of posterior capsule opacification (PCO) after implantation of a standard-power biconvex Centerflex intraocular lens (IOL) and a newly introduced biconcave high-minus-power Centerflex design in rabbit eyes. SETTING: The Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, and the David J. Apple, MD, Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah, USA. METHODS: Twelve rabbits had phacoemulsification and implantation of 2 foldable single-piece hydrophilic acrylic Centerflex posterior chamber IOLs. The right eyes received a standard-power (+21.00 diopters [D]) biconvex-optic lens and the left eyes, a minus-power (-7.00 D) biconcave-optic IOL. Formation of PCO was evaluated 3 weeks after surgery using the Miyake-Apple posterior photography technique. Histological sections from each globe were prepared to analyze capsular bag status and assess postsurgical intracapsular lens epithelial cell (LEC) proliferation, especially ingrowth of LECs across the visual axis. The data were analyzed using the Kruskal-Wallis 1-way analysis of variance for nonparametric measurements and the Mann-Whitney rank sum test. RESULTS: There was no significant difference in Soemmering's ring formation between the 2 IOL models. The biconcave minus-power IOL showed significantly lower central and peripheral PCO scores than the biconvex standard-power lens (P<.05). Pathological evaluations revealed that the effective site of blockage of LECs was at the truncated optic edge of both lenses, even in the presence of retained and/or regenerative cortical material. CONCLUSIONS: This study confirms the efficacy of a truncated IOL optic in helping reduce the incidence of PCO. Both IOL designs have optic geometries that create clear-cut barrier effects. However, the biconcave minus-power IOL, which has a thicker, square, truncated optic edge with a ridge that encircles the periphery of the optic for 360 degrees, appears to have an enhanced barrier effect, especially at the optic-haptic junction. This further minimizes the ingrowth of migrating LECs toward the visual axis.

Acrylic Resins↗
PubMed2003

Indocyanine green staining of anteriorly placed zonules.

The anatomy of the capsules and zonules varies with each patient, particularly in the zonule-free zone. We present a case in which indocyanine green dye highlighted the anterior lens capsule and centrally encroaching zonular fibers within a 2.0 mm zonule-free zone. We suggest technique modifications to reduce the risk for capsule extensions and related complications.

Adult↗
PubMed2004

Capsular tension ring use in a patient with congenital coloboma of the lens.

Cataract surgery was performed in a 63-year-old man with bilateral coloboma of the lens. There was no traumatic history, but the patient had lower zonule deficiency and zonular weakness in both eyes, leading us to suspect congenital coloboma of the lens. In the first eye having cataract surgery, it was impossible to rotate the cataractous lens and place the intraocular lens (IOL) centrally in the capsular bag because the lens capsule was not round. The second eye had similar problems, and capsular tension ring implantation improved cataract lens rotation and phacodonesis, enabling central IOL implantation in the capsular bag. The visual acuity recovered to 20/20 in both eyes. Capsular tension ring implantation can facilitate cataract surgery in coloboma of the lens, even in long-term and continuous lens capsule deformity.

Capsulorhexis↗
PubMed2003

Floaterectomy.

Explore the source record for details and available documents.

Capsulorhexis↗
PubMed2004

Unsutured posterior chamber lens implantation in eyes requiring lens extraction at the time of pars plana vitrectomy with silicone oil tamponade.

PURPOSE: To describe a technique for the subsequent placement of an unsutured posterior chamber lens intraocular lens (PC IOL) in eyes requiring cataract or clear lens extraction at the time of pars plana vitrectomy (PPV) with silicone oil tamponade. SETTING: Department of Vitreoretinal Surgery, St. Thomas' Hospital, London, United Kingdom. METHODS: This retrospective review comprised 25 patients who had phacoemulsification to allow an adequate intraoperative retinal view or adequate access to anterior retinal pathology. Anterior and posterior capsulorhexes were combined with an inferior radial capsulectomy to fashion a keyhole-shaped capsule. RESULTS: The mean follow-up was 15.9 months +/- 8.0 (SD) (range 3 to 34 months). Silicone oil was removed and IOLs were implanted in 15 eyes (60.0%). Posterior chamber IOLs were implanted in 10 eyes (66.7% of those receiving an IOL), and anterior chamber AC IOLs were implanted in 5 eyes (33.3%). Nine of the 10 eyes receiving a PC IOL (60.0% of all IOLs) had uneventful surgery. In 1 eye, the PC IOL subluxated inferiorly. Two eyes developed pupil block that required further surgery. CONCLUSIONS: This technique allowed PC IOL implantation in 60% of eyes that received an IOL, showing that in selected patients who require simultaneous lens extraction and silicone oil tamponade, a keyhole-shaped capsulectomy provides for subsequent unsutured PC IOL insertion. The pupil block rate of 8% compares favorably with published rates. Refining the technique may allow it to be used in a greater proportion of eyes that would benefit from safe refractive correction.

Adult↗
PubMed2004

Refractive outcomes after bilateral multifocal intraocular lens implantation.

PURPOSE: To evaluate the efficacy and safety of bilateral multifocal intraocular lens (IOL) implantation after cataract surgery. SETTING: Oftalmológico de Valencia-CEOVAL, Valencia, Venezuela. METHODS: This retrospective study evaluated patient charts for the patient selection method, preoperative evaluation, surgical technique, postoperative visual and refractive outcomes, and complications. It included 70 eyes of 35 patients who had lens extraction with bilateral implantation of an Array multifocal IOL. Fourteen eyes of 7 patients had hyperopia with presbyopia, and 56 eyes of 28 patients had cataract. RESULTS: All eyes achieved an uncorrected distance acuity of 20/40 or better and an uncorrected near acuity of J5 or better. Six patients (18%) reported moderate halos, and 22 patients (63%) occasionally wore glasses. CONCLUSION: Bilateral multifocal IOL implantation was effective and safe in cataract and hyperopic patients with presbyopia, providing good uncorrected distance and near acuities.

Aged↗
PubMed2004

Goniosynechialysis with lens aspiration and posterior chamber intraocular lens implantation for glaucoma in spherophakia.

A 17-year-old girl presented with bilateral angle-closure glaucoma associated with spherophakia. A previous bilateral laser iridotomy failed to control intraocular pressure (IOP). Goniosynechialysis with lens aspiration and posterior chamber intraocular lens implantation were performed in both eyes. Peripheral iridoplasty was performed 3 days later. The postoperative IOP was controlled without medication for 12 months in the right eye and 24 months in the left eye. By restructuring the physiologic aqueous outflow route, goniosynechialysis safely and effectively treated secondary glaucoma from spherophakia.

Adolescent↗
PubMed1997

Capsular bag shrinkage after implantation of an open-loop silicone lens and a poly(methyl methacrylate) capsule tension ring.

PURPOSE: To quantify the dynamics of capsular bag shrinkage after cataract surgery. SETTING: University Eye Hospital, Vienna, Austria. METHODS: Nineteen eyes in 13 patients had clear corneal cataract surgery with implantation of a foldable, open-loop, silicone posterior chamber intraocular lens (IOL) (AMO SI-30). At the same time, an open, poly(methyl methacrylate) capsule tension ring (Morcher type 14 or 14A) was inserted to allow measurement of capsular bag circumference and diameter. After surgery, capsular bag shrinkage was quantified by measuring anterior chamber depth (ACD), iris-lens distance (ILD), and distance between the eyelets of the capsule tension ring using optical methods. Capsular bag circumference (CBC) was deduced from these measurements, which were taken 1 day (baseline), 1 week, and 1 and 3 months postoperatively. RESULTS: Between 1 day and 3 months, all three parameters decreased significantly. During the first postoperative week, ACD and ILD did not change, while both parameters decreased between 1 week and 1 month. After 1 month, ACD did not decrease further; ILD continued to decrease. The CBC decreased during the entire postoperative period. CONCLUSION: Besides ACD and ILD, CBC significantly decreased during the first 3 months after cataract surgery with in-the-bag posterior chamber IOL implantation. The CBC can be calculated from the distance between the ends of the capsule tension ring, which can be measured gonioscopically. From this, the diameter of the capsular bag can be calculated in the living eye. The influence of the capsule tension ring itself on capsular bag shrinkage remains to be established.

Anterior Chamber↗
PubMed1998

Relationship between preoperative axis of astigmatism and postoperative astigmatic change after superior scleral incision phacoemulsification.

PURPOSE: To evaluate the effect of the preoperative axis of astigmatism on the outcome of corneal astigmatism after sutured 5.2 to 5.7 mm superior incision phacoemulsification. SETTING: Departments of Opthalmology, Odense and Vejle Hospitals, Denmark. METHODS: Seventy-three consecutive patients with preoperative corneal astigmatism of 2.0 diopters (D) or less, axial length between 20.0 and 25.5 mm, and no eye disease except cataract were grouped according to preoperative with-the-rule (WTR) or against-the-rule (ATR) astigmatism. The keratometric cylinder, induced keratometric cylinder (subtraction), and induced cylinder (Jaffe) were measured and calculated 10 to 12 months postoperatively. RESULTS: The postoperative keratometric cylinder and induced keratometric cylinder were significantly higher in the ATR group (P < .00001; mean difference [95% confidence limits]: 0.76 D [0.54; 0.98] and 0.69 D [0.46; 0.92], respectively). There was no significant difference between groups in induced cylinder (Jaffe). CONCLUSION: The estimated differences were significantly in favor of patients with preoperative WTR astigmatism. The findings support using temporal incision in cases with a preoperative ATR axis of astigmatism.

Aged↗
PubMed1998

Posterior capsule opacification and neodymium: YAG capsulotomy with heparin-surface-modified intraocular lenses.

PURPOSE: To compare the effect of heparin-surface-modified (HSM) and conventional unmodified poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) on the formation of posterior capsule opacification (PCO). SETTING: Department of Ophthalmology, Vejle Hospital, Denmark. METHODS: This prospective, randomized, double-blind study comprised 250 eyes of 246 patients who had uneventful extracapsular cataract extraction in otherwise healthy eyes with implantation of a biconvex IOL or a convex-plano lens with a continuous laser ridge. Patients were examined once a year for 3 years, at which time the degree of PCO was recorded. A neodymium:YAG laser capsulotomy was performed if certain criteria were met. RESULTS: The incidence of PCO was statistically significantly higher in eyes with an HSM convex-plano laser-ridge IOL than in those with an unmodified convex-plano lens (P < .005). There were no significant differences between any other groups. CONCLUSION: The incidence of PCO was higher in eyes with an HSM convex-plano IOL with a laser ridge.

Aged↗
PubMed1998

Vitreous-stabilizing, single-piece, mini-loop, plate-haptic silicone intraocular lens.

PURPOSE: To evaluate the clinical and visual results of the Medevec VS5 intraocular lens (IOL) with mini-loops, determine the incision size required for its implantation and its usable optical zone size, and compare the sizes with those of other foldable lenses. SETTING: Ophthalmology Department, St. Johannes Hospitals, Dortmund, Germany. METHODS: The VS5 lens was folded with a forceps and implanted into an intact bag in 27 patients; incision size was measured. Postoperatively, centration was recorded after dilation and the lens periphery observed to ascertain whether the loops were fixed in the capsular bag. Postoperative A-scans were done in 22 eyes, and the preoperative and postoperative vitreous cavity lengths were compared. The size of the optical zone was compared with that of other foldable lenses. RESULTS: Forceps implantation of the VS5 lens required a 2.7 to 3.0 mm incision; all lenses were fixated in the bag. A-scans in 22 eyes showed that the vitreous cavity was shortened by an average of 0.51 mm. Uncorrected visual acuity was 20/40 or better in 96% of eyes. One week postoperatively, the IOLs remained centered and there was no flare or cells. The usable optical zone was larger than that of the staked long-loop lenses. CONCLUSION: The Medevec VS5 fixated in the bag, consistently locating in the posterior bag space and stabilizing the vitreous. It had a full 5.0 mm optical zone and could be implanted through an incision smaller that that required by other foldable IOLs.

Aged↗
PubMed1998

Evaluation of local anesthesia techniques for small incision cataract surgery.

PURPOSE: To evaluate the surgical experiences and patient preference with 3 local anesthesia techniques for small incision cataract surgery. SETTING: Department of Ophthalmology, Hjørring Hospital, Denmark. METHODS: This prospective, randomized study included 66 patients having simultaneous bilateral cataract surgery. There were 3 test groups, each containing 2 of the following local anesthesia techniques: retro/peribulbar (RBA), sub-Tenon's (STA), or topical (TA). Each patient served as his or her own control. No medical sedation was used. Patient response to each anesthesia technique was evaluated by the surgeon based on surgical difficulties, a nurse using hand-holding tension and verbal interaction, and a visual analog pain score. Patients were also asked which of the 2 techniques they preferred and their reasons. RESULTS: No local anesthesia techniques interfered with surgery. The order of a positive pain/discomfort response during surgery was TA > STA > RBA. Significantly more pain occurred with application of RBA than with STA or TA. No postoperative pain was recorded with any method. Fifty-six percent of patients said they preferred 1 technique over the other; 16% of patients having STA would not do so again, 19% would not have TA again, and 40% would not have RBA again. The main reasons for preferring STA and TA were fear of or pain from a retrobulbar injection. The main reasons for preferring RBA were less awareness, anxiety, and surgical pain. Immediate visual recovery seemed to be of minor importance in patients' choice of an anesthesia technique. CONCLUSION: Although less discomfort/pain occurred during surgery with RBA, patients preferred STA and TA primarily because of the inconvenience or pain of the retrobulbar injection. Although medical sedation was not used in this study, the pain/discomfort ratio from surgery was not greater than in studies using intravenous sedation, indicating that the use of medical sedation should be re-evaluated.

Aged↗
PubMed1998

Capsular tension ring in a patient with Weill-Marchesani syndrome.

Weill-Marchesani patients with cataractous lenses may presnet a surgical challenge in the presence of zonular weakness and microsherophakia. A 52-year-old Weill-Marchesani patient developed zonular dehiscence during capsule contraction after cataract extraction in her right eye. Use of a poly(methyl methacrylate) capsular tension ring in the second eye facilitated lens removal and intraocular lens placement. Postoperative results suggest the capsular tension ring provides long-term zonular stabilization by maintaining an internal force against the capsule.

Abnormalities, Multiple↗