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Modified Vitrectomy Technique for Phakic Rhegmatogenous Retinal Detachment with Intermediate Break
摘要： Purpose. To evaluate the effects of a modification of the traditional 25-gauge pars plana vitrectomy technique in the treatment of uncomplicated macula-on rhegmatogenous retinal detachment (RRD) with intermediate retinal break(s) and marked vitreous traction in the phakic eye. Methods. Prospective, noncomparative, and interventional case series. All consecutive phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, with at least 1 year of postoperative follow-up, were enrolled. In all eyes, “localized 25-gauge vitrectomy” under air infusion with localized removal of the vitreous surrounding the retinal break(s), in association with laser photocoagulation and air tamponade, was performed. The primary end point was the rate of primary retinal attachment. Secondary end points were cataract progression and assessed by digital Scheimpflug lens photography (mean change of nuclear density units) and the rate of complications. Results. Thirty-two phakic eyes were included in the final analysis. At 12 months, the primary outcome of anatomical success was achieved in 94% of eyes. The mean nuclear density units did not change significantly at any time point during the follow-up. After localized vitrectomy, one eye developed an epiretinal membrane, and one eye developed cystoid macular edema; no other significant complications were reported. Conclusions. “Localized vitrectomy” has a high anatomical success rate in phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, without causing progression of cataract.
关键词： vitrectomy,cataract progression,rhegmatogenous retinal detachment,intermediate retinal break,phakic eye
更新于2025-09-10 09:29:36
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Straylight in posterior polar cataract
摘要： To study straylight before and after posterior polar cataract removal. Patients diagnosed with posterior polar cataract who agreed to cataract surgery were included in the study. Intraocular straylight was measured before and after surgery with the compensation comparison method using a straylight meter (C-Quant). Measurements were performed on 8 eyes of 4 patients. The mean preoperative corrected distance visual acuity was relatively good (0.15 logarithm of the minimum angle of resolution [logMAR] G 0.18 (SD). The mean postoperative CDVA was (cid:1)0.08 G 0.09 logMAR (P < .01). The mean preoperative straylight was extreme (2.01 G 0.38 log[s]), 13 times that of a young normal eye; however, it improved postoperatively to 1.04 G 0.26 log(s) (P < .01). Straylight in eyes with posterior polar cataract patients can be extremely bothersome, while visual acuity is relatively well preserved. Surgery was effective in lowering straylight levels. For these patients, straylight measurements can help objectively measure the quality of vision complaints, and elevated straylight levels can be an indication for surgery independent of visual acuity.
关键词： visual acuity,straylight,posterior polar cataract,quality of vision,cataract surgery
更新于2025-09-09 09:28:46
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Biomechanical changes in the cornea following cataract surgery: a prospective assessment with the Corvis-ST
摘要： Importance: Intraocular pressure is often reduced following cataract surgery. Postoperative changes in corneal stiffness are likely to be at least partly responsible for any reduction in IOP measured with applanation tonometry. Background: To determine the effect of cataract surgery and corneal incision size on corneal biomechanics. Design: Prospective randomised trial Participants: One-hundred prospectively enrolled patients qualifying for cataract surgery Methods: Participants were randomised to clear corneal incisions with a 2.20 or 2.85mm keratome. Corvis-ST tonometry and dynamic corneal response measurements were obtained preoperatively, and 3-months postoperatively. Multiple regression analysis was completed using R software. Main Outcome Measures: Corvis-ST biomechanical parameters Results: Ninety-three eyes of 93 patients were included in the final analysis. Mean Corvis-ST biomechanically corrected intraocular pressure decreased by 3.63 mmHg postoperatively (95% confidence interval = 2.97 – 4.35, P ≤0.01), and central pachymetry increased by 6.96μm (4.33 – 9.59, P ≤0.01). Independent of IOP and pachymetry changes, mean (± standard error) corneal first applanation stiffness parameter reduced by 9.761±3.729 (P = 0.01) postoperatively. First applanation velocity increased by 0.007±0.002ms, second applanation velocity increased by 0.012±0.004ms (P ≤0.01), the first applanation deformation amplitude increased by 0.008±0.002mm (P ≤0.01), and the deflection amplitude at highest concavity increased by 0.030±0.069 (P ≤0.01). There were no significant differences between different incision size groups. Conclusions and Relevance: Corneal stiffness is reduced three months following cataract surgery and is associated with falsely low intraocular pressure measurements. This finding may be important for glaucoma patients and in particular when assessing the effectivity of Minimally Invasive Glaucoma Surgery devices.
关键词： Corneal biomechanics,Corvis-ST,Cataract surgery
更新于2025-09-09 09:28:46
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Comparison of Ocular Aberration and Clinical Outcome between Different Aspheric Intraocular Lenses in Both Eyes
摘要： Purpose: We compared the ocular aberration and clinical outcome between different aspheric intraocular lenses (IOL) in both eyes. Methods: This prospective randomized controlled study was comprised of patients with bilateral cataract who received two different aspheric IOLs implanted in both eyes: negatively aspheric Tecnis? ZCB00 and spherically neutral Akreos? MI60. Total and corneal aberrations computed by Wavescan? and Pentacam? were assessed at 6 months to investigate the effects of the IOL’s spherical aberration on the eye and to analyze the incidence and degree of posterior capsule opacification. By using spherical aberration of the cornea and the IOLs, values calculated via Ray-tracing software and Wavescan? were compared. Total spherical aberration was analyzed by the MATLAB program and converting the pupil size to 6.0, 4.5, 3.0 mm. Results: A total of 25 patients were included. Regarding pre-operative corneal aberration, ZCB00 group was 0.232 ± 0.119 μm while MI60 group was 0.240 ± 0.117 μm, and there was no difference between the two IOLs. At 6 months after total ocular spherical aberration, MI60 group (pupil size 6.0 mm; 0.296 ± 0.097 μm, 4.5 mm; 0.094 ± 0.032 μm, 3.0 mm; 0.019 ± 0.006 μm) had more positive values than ZCB00 group (pupil size 6.0 mm; 0.051 ± 0.105 μm, 4.5 mm; 0.009 ± 0.034 μm, 3.0 mm; 0.002 ± 0.007 μm) (p < 0.001). When calculated using the ray tracing method, based on the results after surgery, MI60 group’s total spherical aberrations were higher than ZCB00 group. However, from 1 month to 6 months after surgery, the uncorrected distance visual acuity, spherical equivalent and posterior capsule opacification showed no differences between the two IOLs. Conclusions: In eyes with aspheric IOLs with negative spherical aberration, spherical aberration was lower than spherically neutral aspheric IOLs. Regarding postoperative visual acuity, spherical equivalent and posterior capsule opacification, there were no significant differences between the two groups.
关键词： Posterior capsular opacity,Aspheric intraocular lens,Ocular aberrations,Cataract surgery
更新于2025-09-09 09:28:46
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Clinical Evaluation of Functional Vision of +1.5 Diopters near Addition, Aspheric, Rotational Asymmetric Multifocal Intraocular Lens
摘要： To evaluate postoperative outcomes and visual performance in intermediate distance after implantation of a +1.5 diopters (D) addition, aspheric, rotational asymmetric multifocal intraocular lens (MIOL). Patients underwent bilateral cataract surgery with implantation of an aspheric, asymmetric MIOL with +1.5 D near addition. A complete ophthalmological examination was performed preoperatively and 3 months postoperatively. The main outcome measures were monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance corrected intermediate visual acuity (DCIVA), uncorrected near visual acuity (UNVA) and distance corrected keratometry, and manifest refraction. The Salzburg Reading Desk was used to analyze unilateral and bilateral functional vision with uncorrected and corrected reading acuity, reading distance, reading speed, and the smallest log-scaled print size that could be read effectively at near and intermediate distances. The study comprised 60 eyes of 30 patients (mean age, 68.30 ± 9.26 years; range, 34 to 80 years). There was significant improvement in UDVA and CDVA. Mean UIVA was 0.01 ± 0.09 logarithm of the minimum angle of resolution (logMAR) and mean DCIVA was -0.02 ± 0.11 logMAR. In Salzburg Reading Desk analysis for UIVA, the mean subjective intermediate distance was 67.58 ± 8.59 cm with mean UIVA of -0.02 ± 0.09 logMAR and mean word count of 96.38 ± 28.32 words/min. The new aspheric, asymmetric, +1.5 D near addition MIOL offers good results for distance visual function in combination with good performance for intermediate distances and functional results for near distance.
关键词： Low-add,Presbyopia,Multifocal intraocular lens,Cataract
更新于2025-09-09 09:28:46
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Therapeutic effect of dexamethasone implant in retinal vein occlusions resistant to anti-VEGF therapy
摘要： Purpose: To test the efficacy of the intravitreal dexamethasone (DEX) implant in patients with retinal vein occlusions (RVOs) who have failed multiple anti-vascular endothelial growth factor (anti-VEGF) treatments. Methods: A randomized exploratory study of ten patients with branch RVO or central RVO who received at least two previous anti-VEGF treatments and had persistent or unresponsive cystoid macular edema. Treatment with the DEX implant was either every 4 months or pro re nata (PRN) depending on their group assignment for 1 year. Multifocal electroretinography and microperimetry were the primary end points, with high-resolution optical coherence tomography and best-corrected visual acuity as the secondary end points. Results: All patients in both the every 4 month and PRN cohorts who completed the study received the three maximal injections of DEX; therefore, the data from both cohorts were combined and reported as a case series. On average, the multifocal electroretinography amplitude increased significantly from 5.11±0.66 to 24.19±5.30 nV/deg2 at 12 months (P,0.005), mean macular sensitivity increased from 7.67±2.10 to 8.01±1.98 dB at 4 months (P=0.32), best-corrected visual acuity increased significantly from 51.0±5.1 to 55.4±5.1 early treatment of diabetic retinopathy study letters at 2 months (P,0.05), and central retinal thickness decreased from 427.6±39.5 to 367.1±37.8 μm at 4 months (P,0.05). Intraocular pressure increased significantly in one patient, with that patient requiring an additional glaucoma medication for management. Additionally, cataract progression increased significantly (P,0.05) in this patient population and partially limited analysis of other end points. Conclusion: DEX should be considered as a treatment option in patients with RVOs who have failed anti-VEGF therapy, as the results of this study demonstrated an improvement in retinal morphology and macular function. Cataract progression did occur following multiple consecutive injections; however, steroid-induced glaucoma was not a limiting factor.
关键词： intravitreal dexamethasone implant,multifocal electroretinography,retinal vein occlusion,anti-VEGF,cataract progression
更新于2025-09-09 09:28:46
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Clinical Outcomes of Patients with Refractive Aspheric Multifocal IOL Implantation
摘要： ??: ??? ??? ??? ?????(Lentis Mplus? LS-313)? ??? ???? ??? ? ??? ????? ????? ???. ??? ??: Lentis Mplus? LS-313? ??? 53? 68?? ???? ? ? 1?, 2?, 1?3?6??? ?? ???????????? ??, ???? ? ? ? 3??? Optical Quality Analysis System Ⅱ (OQAS II)? ??? ??? ??, ????? ?????? ??? ????? ?????. ??: ? ? 6??? ?? ????? ??? 0.06 ± 0.07, ???? 63 cm 0.18 ± 0.14, ???? 100 cm 0.15 ± 0.13, ??? 0.11 ± 0.10 (logMAR)???. OQAS II ??? ?? ??? ????(Objective scatter index, OSI)? 1.20 ± 0.69, ??????(MTF cut off value)? 34.15 ± 9.53 cpd, Strehl ??? 0.17 ± 0.05??? ????? 3.09 ± 0.25D??. ????? 5 mm 0.61 ± 0.14, 6 mm 1.07 ± 0.20???. ? ? 82%?? ????? 71%? ?????? ?????? ??? 24%??. ??: Lentis Mplus? LS-313? ??? ???, ???? ? ??? ??? ??? ?? ???? ??? ???? ??? ?? ??? ? ?? ??? ?????? ????.
关键词： Cataract,Multifocal intraocular lens,Satisfaction,Lentis Mplus
更新于2025-09-09 09:28:46
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The role of sideport incision in astigmatism change after cataract surgery
摘要： Purpose: To study the changes in corneal astigmatism after cataract surgery when the sideport incision is performed at a predetermined location away from the tunnel incision. Setting: General Hospital of Piraeus “Tzaneio”, Attiki, Greece. Materials and methods: A total of 333 eyes with corneal astigmatism #1.5 diopters (D) underwent cataract surgery. A three-step superotemporal clear corneal incision for the right eye and a superonasal clear corneal incision for the left eye (3.0 mm) was made, while the sideport incision was located at ,90°, 90°–110°, and .110°. Keratometric data were measured with corneal topography EyeSys Vista 2000 pre- and postoperatively at the 1st and 6th month. Surgically induced astigmatism was calculated by vector analysis. We noted all cases in which a change .0.5 D in corneal astigmatic power occurred, as well as a change .20° in axis torque, despite axis direction. Results: After multiple logistic regression analysis was conducted, cases with .110° distance between the tunnel and sideport incision had 2.22 times (P=0.021) greater likelihood for having changed .0.5 D in astigmatic power at the 1st month and 3.45 times (P=0.031) at the 6th month postoperatively, as compared with cases with a 90°–110° distance between the tunnel and sideport incision. As for the change in the astigmatic axis, cases with ,90° distance had a 4.18 times greater likelihood for having a change .20° (P,0.001) (preoperative to 1st month) as compared with cases having 90°–110° of distance. Conclusion: For surgeons that operate only from the superior position, we propose that in order to produce an incision that is as “astigmatically neutral” as possible, they should perform the sideport incision at a 90°–110° distance.
关键词： tunnel incision,sideport incision,astigmatism,cataract surgery
更新于2025-09-04 15:30:14
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Heterochromatic Flicker Photometry for Objective Lens Density Quantification
摘要： PURPOSE. Although several methods have been proposed to evaluate lens transmittance, to date there is no consensual in vivo approach in clinical practice. The aim of this study was to compare ocular lens density and transmittance measurements obtained by an improved psychophysical scotopic heterochromatic flicker photometry (sHFP) technique to the results obtained by three other measures: a psychophysical threshold technique, a Scheimpflug imaging technique, and a clinical assessment using a validated subjective scale. METHODS. Forty-three subjects (18 young, 9 middle aged, and 16 older) were included in the study. Individual lens densities were measured and transmittance curves were derived from sHFP indexes. Ocular lens densities were compared across methods by using linear regression analysis. RESULTS. The four approaches showed a quadratic increase in lens opacification with age. The sHFP technique revealed that transmittance decreased with age over the entire visual spectrum. This decrease was particularly pronounced between young and older participants in the short (53.03% decrease in the 400–500 nm range) wavelength regions of the light spectrum. Lens density derived from sHFP highly correlated with the values obtained with the other approaches. Compared to other objective measures, sHFP also showed the lowest variability and the best fit with a quadratic trend (r2 ? 0.71) of lens density increase as a function of age. CONCLUSIONS. The sHFP technique offers a practical, reliable, and accurate method to measure lens density in vivo and predict lens transmittance over the visible spectrum. An accurate quantification of lens transmittance should be obtained in clinical practice, but also in research in visual and nonvisual photoreception.
关键词： non-image forming,circadian light,ocular media,psychophysics,heterochromatic flicker photometry,cataract,clinical,lens density,photoreception
更新于2025-09-04 15:30:14
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Objective Clinical Evaluation of Ocular Optical Instrument According to the Type of Lens Opacity
摘要： To investigate the results using the OQAS and the Pentacam in cataract patients classified according to the type of lens opacity. Methods: The present study included 124 eyes of 92 patients who had cataract surgery at Seoul St. Mary’s Hospital from December 2011 to January 2012 and were classified into nuclear, cortical, and posterior subcapsular cataract patients. The lens opacity was determined with OSI, MTF, Strehl ratio, width 10%, width 50% and the opacity of Scheimpflug image by the OQAS and the Pentacam. Additionally, the correlation between subjective cataract classification and objective opacity value was analyzed. Results: The nuclear cataract group showed a 6.40 ± 2.41 OSI value and had high opacity. The cortical cataract group showed the highest MTF cut-off value (12.02 ± 6.19 C/deg). When evaluating Pentacam results, the posterior subcapsular cataract group had the lowest average level of lens opacity (9.12 ± 1.08) followed by in increasing order, the cortical cataract group (9.79 ± 1.67) and the nuclear cataract group (11.08 ± 1.84). The results were statistically significant (p < 0.001). The OSI value of the OQAS was significantly correlated with nuclear and posterior opacity (p = 0.049, p = 0.039, respectively) except cortical opacity (p = 0.781). MTF and nuclear opacity showed statistically significant correlation and the lens opacity of Pentacam was correlated with nuclear and posterior opacities. In cortical cataract with severe peripheral opacity, the cortical opacity showed significant correlation with Maximum. Conclusions: The OQAS and Pentacam results showed high correlation with the nuclear and posterior opacities which can be useful for cataract surgery.
关键词： OQAS,MTF,Cataract,Pentacam,OSI
更新于2025-09-04 15:30:14