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Long-term results of a diffractive trifocal intraocular lens: Visual, aberrometric and patient satisfaction results
摘要： Purpose: To evaluate the long-term objective and subjective results of a trifocal intraocular lens. Methods: Prospective observational study enrolling 24 eyes that underwent uneventful microincisional cataract surgery with bilateral implantation of a diffractive trifocal intraocular lens (FineVision Micro F, PhysIOL, Belgium). After a mean follow-up period of 60 ± 2 months, patients answered the 10-item Near Activity Vision Questionnaire (NAVQ-10) and were assessed for uncorrected and corrected distance, intermediate and near visual acuity, defocus curve, light-distortion analysis, and total ocular aberrometry with a pyramidal wavefront sensor (Osiris, CSO, Italy). Results: There was significant improvement of uncorrected visual acuity at all distances in all eyes (p < 0.01). The distorsion index and best-fit circle radius were significantly lower in binocular conditions (p = 0.02). Mean Rasch score at NAVQ-10 was 16.29 ± 11.57. Patients reported to be completely, very, and moderately satisfied with their uncorrected near vision in 67%, 25%, and 8% of cases, respectively. We found no significant correlation between patient satisfaction scores at near vision satisfaction questionnaire and other variables such as light-distortion analysis or wavefront aberrometry parameters. Conclusion: The studied diffractive trifocal intraocular lens provides good and stable long-term results for distance, intermediate, and near vision, with high levels of patient satisfaction at long-term follow-up. The intraocular lens’ light-distortion effect is less disturbing in binocular conditions and may have its perception down-modulated by neuroadaptation over time.
关键词： diffractive trifocal intraocular lens,patient satisfaction,Cataract surgery
更新于2025-09-04 15:30:14
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Pseudoexfoliation material on posterior chamber intraocular lenses
摘要： The presence of pseudoexfoliation material on the surface of an intraocular lens (IOL) is a rare finding. We report a series of seven cases with different patterns of pseudoexfoliation material deposition on the posterior chamber IOLs, recognized 2–20 years after cataract surgery. Six patients had an IOL implanted in the capsular bag and one in the ciliary sulcus. Two patients had undergone posterior capsulotomy. Although the pathophysiological mechanisms and clinical significance of this finding remain unknown, the careful follow-up of pseudophakic patients with known or suspected pseudoexfoliation syndrome is essential to monitor the development or progression of glaucoma, since deposition of pseudoexfoliation material continues even after cataract surgery.
关键词： cataract,intraocular lens,exfoliation syndrome,glaucoma
更新于2025-09-04 15:30:14
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Comparison between Toric and Non-Toric Intraocular Lenses in Patients with Corneal Astigmatism: A One-Year Multicenter Study
摘要： Objective: To compare the clinical results obtained with a toric intraocular lens (IOL) and non-toric IOL in eyes with corneal astigmatism. Methods: This multicenter retrospective study included eyes with corneal astigmatism ranging from 0.75 diopter (D) to 3.00 D that were implanted with a toric IOL and a non-toric IOL. Non-toric IOLs were implanted before toric IOLs were approved, and the eyes were divided into three groups (T3, T4, or T5) depending on the preoperative degree of corneal astigmatism. Residual refractive cylinder, uncorrected distance visual acuity (UDVA), and contrast sensitivity were compared more than 1 year after implantation. Results: The toric group included 149 eyes (mean patient age, 73.7 ± 7.9 years standard deviation, SD) and the non-toric group included 121 eyes (mean patient age, 76.2 ± 5.9 years). One year postoperatively, the respective residual refractive cylinder values and ± SD of the toric/non-toric groups were -0.61 ± 0.43/-1.45 ± 0.98 D (all eyes), -0.58 ± 0.42/-1.14 ± 0.70 D (T3), -0.59 ± 0.42/-1.63 ± 0.99 D (T4), and -0.67 ± 0.47/-2.18 ± 1.27 D (T5). The respective logarithm of the minimum angle of resolution UDVA values was 0.00 ± 0.12/0.16 ± 0.20 (all eyes), 0.00 ± 0.11/0.13 ± 0.18 (T3), 0.00 ± 0.13/0.25 ± 0.23 (T4), and 0.00 ± 0.11/0.17 ± 0.16 (T5). The toric group had better cylinder and UDVA outcome values; the difference between the groups reached significance (p<0.0001). In the toric group, the IOL rotation after implantation was 4.3 ± 4.0 degrees. Conclusion: Toric IOLs reduced the residual refractive cylinder in cases with corneal astigmatism between 0.75 and 3.00 D, and this effect was similar among different toric models. Toric IOLs are useful to improve the UDVA after cataract surgery.
关键词： Uncorrected visual acuity,Cataract surgery,Contrast sensitivity,Toric intraocular lens,Corneal astigmatism
更新于2025-09-04 15:30:14
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Expression of the <i>HSF4 DNA Binding Domain-EGFP</i> Hybrid Gene Recreates Early Childhood Lamellar Cataract in Transgenic Mice
摘要： The clinical management of cataracts in infancy involves surgical removal of the lens to ensure transmission of light to the retina, which is essential for normal neural development of the infant. This surgery, however, entails a lifelong follow-up and impaired vision. To our knowledge, no animal models recapitulate human lamellar opacities, the most prevalent form of early childhood cataracts. We present data on the recreation of the human lamellar cataract phenotype in transgenic mice.
关键词： transgenic mice,BACs,HSF4,cataract,lens
更新于2025-09-04 15:30:14
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[IEEE 2018 International Conference on Current Trends towards Converging Technologies (ICCTCT) - Coimbatore, India (2018.3.1-2018.3.3)] 2018 International Conference on Current Trends towards Converging Technologies (ICCTCT) - Processing Retinal Images to Discover Diseases
摘要： The retina of a human eye consists of billion of photosensitive cells (rods and cones) and alternative nerve cells that acquire and arrange visual information. The retina of a human eye is a thin tissue layer on the inside back wall of your eye. Three of the are Diabetic retinal diseases most Retinopathy, Glaucoma, and Cataract. The world is presently experiencing an epidemic of Diabetic Retinopathy (DR). Current predictions draw an estimation of doubling of the number affected from the current 170 million to an estimated 367 million by 2030. We propose a system wherein we extract blood vessels of the retina to detect eye diseases. Manually extracting the blood vessels of the human retina is a time-consuming task, and thus an automation of this process results in easy implementation of the work. This paper aims to design and consequently implement deep convolutional neural networks to identify the presence of an exudate, and thereby classify it into Diabetic Retinopathy, Glaucoma, and/or Cataract.
关键词： Computer vision,Glaucoma,Diabetic Retinopathy,Cataract,Convolutional Neural Networks,Retinal disease detection,CNN
更新于2025-09-04 15:30:14
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Off-Label Use of Phakic Intraocular Lens with a “Piggyback” Technique
摘要： Purpose: We report a case of a highly myopic pseudophakic patient who received off-label placement of a phakic intraocular lens (pIOL) via a “piggyback” technique, allowing the placement of an intraocular lens (IOL) in his fellow eye, resulting in improved visual acuity and emmetropia. Case Report: A 66-year-old, highly myopic, pseudophakic male with an IOL implant in his left eye was referred for second opinion for surgical options for his phakic right eye. Given the severe myopic status of both eyes, he received off-label placement of a posterior chamber pIOL with a piggyback technique for the pseudophakic left eye followed by standard cataract surgery and intraocular lens implantation in the right eye. For the left eye, uncorrected best visual acuity improved from 20/70 to 20/25. Conclusion: This case demonstrates the successful off-label use of a phakic IOL in a pseudophakic, highly myopic patient with a piggyback technique, resulting in improved visual acuity and ultimately allowing IOL placement in the fellow eye for emmetropia. This off-label use of pIOL can offer ophthalmologists an alternative option for pseudophakic patents with severe refractive error.
关键词： Cataract surgery,Piggyback technique,Refractive error,High myopia,Phakic intraocular lens
更新于2025-09-04 15:30:14
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Deformable Surface Accommodating Intraocular Lens: Second Generation Prototype Design Methodology and Testing
摘要： Purpose: Present an analysis methodology for developing and evaluating accommodating intraocular lenses incorporating a deformable interface. Methods: The next generation design of extruded gel interface intraocular lens is presented. A prototype based upon similar previously in vivo proven design was tested with measurements of actuation force, lens power, interface contour, optical transfer function, and visual Strehl ratio. Prototype verified mathematical models were used to optimize optical and mechanical design parameters to maximize the image quality and minimize the required force to accommodate. Results: The prototype lens produced adequate image quality with the available physiologic accommodating force. The iterative mathematical modeling based upon the prototype yielded maximized optical and mechanical performance through maximum allowable gel thickness to extrusion diameter ratio, maximum feasible refractive index change at the interface, and minimum gel material properties in Poisson’s ratio and Young’s modulus. Conclusions: The design prototype performed well. It operated within the physiologic constraints of the human eye including the force available for full accommodative amplitude using the eye’s natural focusing feedback, while maintaining image quality in the space available. The parameters that optimized optical and mechanical performance were delineated as those, which minimize both asphericity and actuation pressure. The design parameters outlined herein can be used as a template to maximize the performance of a deformable interface intraocular lens.
关键词： physiological optics,accommodation,lens,cataract surgery,optics
更新于2025-09-04 15:30:14
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Epidemiology of Persistent Postsurgical Pain Manifesting as Dry Eye-like Symptoms After Cataract Surgery
摘要： To evaluate the epidemiology of persistent postsurgical pain (PPP) manifesting as dry eye (DE)-like symptoms 6 months after surgery. Methods: This single-center study included 119 individuals whose cataract surgeries were performed by a single surgeon at the Bascom Palmer Eye Institute and who agreed to participate in a phone survey 6 months after surgery. Patients were divided into 2 groups: the PPP group was defined as those with a Dry Eye Questionnaire-5 score $6 and without PPP as those with a Dry Eye Questionnaire-5 score ,6 at 6 months after cataract surgery. Results: Mean age of the study population was 73 6 8.0 years; 55% (n = 66) were female. PPP was present in 34% (n = 41) of individuals 6 months after surgery. Factors associated with an increased risk of PPP were female sex [odds ratio (OR) = 2.68, 95% confidence interval (CI) = 1.20–6.00, P = 0.01], autoimmune disorder (OR = 13.2, CI = 1.53–114, P = 0.007), nonocular chronic pain disorder (OR = 4.29, CI = 1.01–18.1, P = 0.06), antihistamine use (OR = 6.22, CI = 2.17–17.8, P = 0.0003), antireflux medication use (OR = 2.42, CI = 1.04–5.66, P = 0.04), antidepressant use (OR = 3.17, CI = 1.31–7.68, P = 0.01), anxiolytic use (OR = 3.38, CI = 1.11–10.3, P = 0.03), and antiinsomnia medication use (OR = 5.28, CI = 0.98–28.5, P = 0.047). PPP patients also reported more frequent use of artificial tears (P , 0.0001), higher ocular pain levels (P , 0.0001), and greater neuropathic ocular pain symptoms, including burning (P = 0.001), wind sensitivity (P = 0.001), and light sensitivity (P , 0.0001). Conclusions: PPP in the form of persistent DE-like symptoms is present in approximately 34% of individuals 6 months after cataract surgery. The frequency of PPP after cataract surgery is comparable to that of other surgeries including laser refractive surgery, dental implants, and genitourinary procedures.
关键词： dry eye symptoms,persistent postsurgical pain,cataract surgery,epidemiology
更新于2025-09-04 15:30:14
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Verus Ring as a New Device to Perform a Safe and Efficient Capsulorhexis in Patients with Corneal Opacities Undergoing Cataract Surgery
摘要： Background and Introduction One of the most difficult and critical step in cataract surgery is making a perfectly circular and properly sized capsulorhexis, allowing the capsular bag to completely envelop uniformly the IOL optic, reducing the incidence of posterior capsular opacification and providing a more predictable effective lens position [1]. And to prevent anterior capusle extension which complicates cataract surgery and might prevent completion of cataract surgery especially in cases that visibility is not optimal like in corneal scars. Some techniques or devices has been developed in order to make this step easier as the Verus ring (Verus capsulorhexis device, Mile High Ophthalmics), a silicone ring-shaped first suggested as an easy-to-use device option for guiding surgeons under training to perform anterior circular curvilinear capsulorhexis, allowing an efficient opening in the anterior capsule, sizing and safe centering a continuous curvilinear capsulorhexis with minimal cost compared to a femtosecond laser [2] which can do the same job but with more cost. Many studies support the theory of the importance of perfect sizing and centering the capsulorhexis on effect lens position. Capsulorhexis is a delicate step during phacoemulsification requiring experience of the surgeon and can be even more challenging in corneal opacities. We are proposing a new use for the Verus ring to perform capsulorhexis in patients with corneal opacity. Verus ring has been pioneered by Dr. Malik Y. Kahook who is the Glaucoma service chief, University of Colorado, Aurora, Colorado. Methods Eyes with mild to moderate corneal scars undergoing cataract surgery (n=20) were subjected to implantation of the Verus ring during capsulorhexis by an expert single surgeon. Outcome measures included complications during the capsulorhexis procedure and time taken to complete the capsulorhexis and surgeon feedback. Historical and surgeon controls (n=20) for capsulorhexis in patients with clear cornea were used as a comparative group. Results There were no complications related to the insertion and removal of the device. Anterior capsular extensions were not observed in any of the cases with corneal scarring (Zero%). The capsulorhexis was well centered in all the eyes with 5.5 mm. The average time for capsulorhexis using the Verus ring was 25.59 s. Average historical and surgeon control time to perform capsulorhexis was 28.21 s. This difference was 2.62 s. Surgeon feedback indicated that the insertion of the device did not require steep learning curve other than careful following the instructions as noted in the instructional video and was safe, easier, less stressful and better centration and curvilineal even with the presence of corneal scar (Figure 2). Conclusion The Verus ring appears to be a useful device in performing safe and efficient capsulorhexis in patients with corneal scars undergoing cataract surgery. It is also a useful device for physicians under training and residents as it adds safety and centration and perfect sizing. We suggest using Verus ring in cases of mild to moderate corneal scars.
关键词： corneal opacities,Verus ring,capsulorhexis,cataract surgery
更新于2025-09-04 15:30:14
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Intraocular Lens Power Calculations Using Dual Scheimpflug Analyzer
摘要： Purpose: To investigate the accuracy of intraocular lens power calculations using simulated keratometry (simK) of dual Scheimpflug analyzer and 5 types of formulas in cataract patients. Methods: The keratometry (K), axial length (AXL) and anterior chamber depth (ACD) were measured using ultrasound biometry (USB) combined with auto-keratometry (Auto-K), parital coherence interferometry (PCI; IOL master?) and dual Scheimpflug analyzer (DSA; Galilei?) in 39 eyes of 39 patients. Predicted refraction was calculated using Auto-K, mean K of PCI, and simK and total corneal power (TCP) of DSA in the Sanders-Retzlaff-Kraff (SRK-T) formula. The SRK-II, SRK-T, Holladay II, Haigis, and Hoffer-Q formula were used to calculate predicted refraction with the simK of DSA and AXL of USB. Manifest refraction, mean numerical error (MNE) and mean absolute error were evaluated 1, 3 and 6 months after cataract surgery. Results: TCP of DSA was lower compared with other keratometric values (p < 0.05). The MNE was not different among Auto-K, mean K and simK. The MNE using TCP was larger compared with Auto-K, mean K and simK at 1 month after surgery (p < 0.05). There was a difference in MNE between simK and TCP of DSA at 6 months after surgery (p < 0.05). The MNE of SRK-T formula was the smallest in the intraocular lens (IOL) power calculation using the simK of DSA. Conclusions: We suggest using IOL power calculations with simK of DSA and SRK-T formula rather than TCP of DSA in cataract patients with normal corneas.
关键词： Dual Scheimpflug analyger,Intraocular lens power calculation,Cataract surgery
更新于2025-09-04 15:30:14