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IOL Implantation (iol + implantation)
Selected Abstracts3425: Influence of cataract morphology on retinal straylight and straylight changes due to cataract surgery using the Morcher 89A Bag in the LensTMACTA OPHTHALMOLOGICA, Issue 2010MJ TASSIGNON Purpose To evaluate straylight and contrast sensitivity (CS) in eyes with various cataract morphologies, to determine which type of cataract presents a higher impairment of visual function with respect to proposed norms car driver safety and to compare retinal straylight and CS before and after implantation of a Morcher 89A IOL. Methods BCVA, CS and straylight were measured in 97 cataractous eyes using respectively a Snellen chart, a Pelli-Robson chart and the C-Quant. Cataracts were graded using the LOCS III scale and divided into four groups: nuclear, cortical, nuclear-cortical and posterior subcapsular cataract. These results were compared to data from 38 cataract-free control subjects. A separate group of 71 eyes had their straylight measured before and after cataract surgery. Results CS was reduced and straylight increased in all cataract patients, most notably in posterior subcapsular and nuclear-cortical cataract. CS and BCVA were correlated (r=0.44), whereas straylight and BCVA were not. Applying cut-off values as proposed by European drivers studies of l.25 log CS and 1.4 log straylight as safe margins for driving, 31% would be considered unfit to drive on the basis of CS and 78% on the basis of straylight although their visual acuity was still above the current European visual acuity requirement for driving. Retinal straylight reduced significantly from 1.560.26 to 1.250.22logunits (P<0.001) after IOL implantation . Conclusion Straylight and, to a lesser extent, CS are complementary to BCVA and should be taken into account when considering driving eligibility. After IOL implantation straylight reduces significantly, resulting in a significant increase in driving eligibility. [source] 4243: Capsular peeling in premium IOLs to improve visual outcomeACTA OPHTHALMOLOGICA, Issue 2010MJ TASSIGNON Purpose To demonstrate that capsular peeling may improve quality of vision of patients who experienced reduced vision in the short postoperative period after premium IOL implantation due to decentration of the IOL secondary to PCO. Methods Patients who were refered to our centre because of unsatisfactory quality of vision after premium IOL implantation (more specifically after multifocal IOLs) were scheduled for surgery aiming at peeling the capsular bag. The conditions which the patient needed to meet were: increased higher order aberrations, evidence of tilt or decentration of the IOL, important fibrotic proliferation in the capsular bag, no YAG laser capsulotomy performed. Results After capsular peeling, it was possible to demonstrate that the quality of vision of the patient improved, the higher order aberrations reduced and it was often unnecessary to explant the premium IOL. Although there was an obvious improvement of the quality of vision, this improvement still did not reached the high standard of vision as measured after monofcal IOLs. Conclusion This paper shows how important the role is of PCO on quality of vision. Because contrast sensitivity is already reduced after premium IOL implantation, patients will be very sensitive to an additional reduction as it appears after PCO. [source] Longterm results after phacovitrectomy and foldable intraocular lens implantationACTA OPHTHALMOLOGICA, Issue 8 2009Wensheng Li Abstract. Purpose:, This study aimed to evaluate the longterm results of phacovitrectomy and foldable intraocular lens (IOL) implantation in eyes with significant cataract and co-existing vitreoretinal diseases. Methods:, We carried out a retrospective study of 186 eyes of 149 patients with various vitreoretinal abnormalities and visually significant cataracts. Vitreoretinal surgery was combined with phacoemulsification and foldable IOL implantation. Main outcome measures were visual acuity (VA), preoperative data, and intraoperative and postoperative complications. Results:, The most common indications for surgery were non-diabetic vitreous haemorrhage and proliferative diabetic retinopathy. Preoperative vision ranged from 0.6 to light perception; postoperative vision ranged from 1.2 to no light perception. Postoperatively, in 162 eyes (87.1%) VA improved by , 3 lines on the decimal chart. In 14 eyes (7.5%), vision remained within 3 lines of preoperative levels and in 10 eyes (5.3%), vision had decreased by the last follow-up. Postoperative complications included elevated intraocular pressure and posterior capsule opacification, corneal edema, macular edema, fibrinous reaction, vitreous hemorrhage, corneal epithelial defects, anterior chamber hyphema, choroidal detachment, persistent macular hole, posterior synechiae, recurrent retinal detachment, rubeosis iridis, neovascular glaucoma. Conclusions:, Combined vitreoretinal surgery and phacoemulsification with foldable IOL implantation is safe and effective in treating vitreoretinal abnormalities co-existing with cataract. Based on extensive experience with the combined procedure, we suggest that combined surgery is recommended in selected patients with simultaneous vitreoretinal pathological changes and cataract. [source] Anterior chamber parameters measured by the Pentacam CES after uneventful phacoemulsification in normotensive eyesACTA OPHTHALMOLOGICA, Issue 5 2009Özlenen Ö. Uçakhan Abstract. Purpose:, We set out to quantify changes in the anterior chamber volume (ACV), anterior chamber depth (ACD) and anterior chamber angle (ACA) measurements obtained by the Pentacam rotating Scheimpflug camera following uneventful phacoemulsification surgery in normotensive eyes with open iridocorneal angles. Methods:, We enrolled 44 eyes of 44 consecutive patients undergoing cataract extraction in this prospective study. Patients with a history of glaucoma, angle-closure glaucoma or any other concurrent ocular disease were excluded. A detailed eye examination including intraocular pressure (IOP) measurement was performed and ACV, ACD and inferior, superior, temporal and nasal ACA measurements were obtained in each patient eye using the Pentacam Comprehensive Eye Scanner (Pentacam CES) before and 3 months after phacoemulsification and intraocular lens (IOL) implantation with temporal clear corneal incision. Data were compared using paired t -test and one-way anova. Results:, Mean preoperative ACV, ACD, ACA and IOP measurements were 164.7 ± 49.8 mm3, 3.0 ± 0.8 mm, 35.7 ± 10.2 ° and 15.8 ± 3.7 mmHg, respectively. Three months postoperatively, mean ACV, ACD, ACA and IOP measurements were 200.9 ± 33.3 mm3, 3.9 ± 0.9 mm, 41.5 ± 6.5 ° and 13.2 ± 3.9 mmHg, respectively. Postoperative mean ACV, ACD and ACA values in all four quadrants were significantly increased (p < 0.0001, p < 0.0001, p < 0.0001, respectively), whereas IOP was significantly reduced (p < 0.0001). Conclusions:, The Pentacam CES allowed very easy, fast, automatic and non-contact quantification of the anterior chamber parameters pre- and postoperatively in all patient eyes. Measurements obtained confirm that in normotensive eyes with open iridocorneal angles, the ACV and ACD increase and the ACA widens in all quadrants 3 months after uneventful phacoemulsification and IOL implantation. These changes are accompanied by a significant fall in IOP in the short term. [source] Paediatric pseudophakia: analysis of intraocular lens power and myopic shiftCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2007William F Astle MD Abstract Background: At the Alberta Children's Hospital, the authors have been performing paediatric cataract extraction with intraocular lens (IOL) implant for over 10 years. The authors examined the amount of myopic shift that occurs in various age groups and cataract types, in order to evaluate the success of predicting the appropriate power of IOL to implant. Methods: This study is a retrospective review children undergoing small incision posterior chamber foldable IOL implantation between age 1 month and 18 years, from 1995 to 2005. 163 eyes of 126 patients underwent surgery. All patients were followed for a minimum of 6 months postoperatively. The children were divided into four groups at time of surgery: Group A: 1,24 months, Group B: 25,48 months, Group C: 49,84 months, Group D: 85 months,18 years. Results: The mean target refraction for the groups were: Group A: +6.37 D, Group B: +4.66 D, Group C: +1.95 D, and Group D: +0.97 D. Children under 4 years experienced the most myopic shift and the largest mean rate of refractive change per year. Mean change Group A: ,5.43 D, Group B: ,4.16 D, Group C: ,1.58 D, Group D: ,0.71 D. Eighty-nine per cent of patients with unilateral cataracts had a postoperative refraction within 3.00 D of the fellow eye at last follow-up visit (mean = 3.16 years). Conclusions: The rate of myopic shift is high in children under age 4 years at time of surgery, shifting as much as ,12.00 D. The mean postoperative target refraction should probably be increased from previous literature recommendations. The patient's age at time of cataract surgery and the refractive power of fellow eye are all factors to consider when deciding what power IOL to surgically implant in a paediatric patient. [source] | ||||||||||