The 21st century gonioscopy: A technical paper / The Health Sciences Journal

OBJECTIVE@#The aim of this paper was to create a Portable Gonioscopy System (PGS) that is effcient and cost-effective in documenting iridocorneal angles.@*METHODS@#A 4-mirror gonioscopy prism lens was attached to a portable USB microscope with a built-in camera. The microscope was then connected to a laptop for viewing of the images. A lubricant was instilled and the portable gonioscope was placed parallel to the cornea for viewing and recording of iridocorneal angles. Images were fled and stored in a laptop.@*RESULTS@#The portable gonioscopy system allowed suffcient viewing and recording of the iridocorneal angles. The total cost of producing the portable gonioscopy system was PHP 25,000.00.@*CONCLUSION@#Iridocorneal angles can be visualized and recorded using the portable gonioscopy system. This device requires skill and expertise from professional prototypist to create. Like gonioscopy, this system also has a steep learning curve. The researchers are continuously improving the device adding more features and making it more affordable and easier to use.

Measurement of accommodative amplitude using wavefront aberrometer

@#<p style="font-size: 12.16px; text-align: justify;"><strong>OBJECTIVE:</strong> To measure and compare the accommodative amplitude of Filipino patients with different accommodative conditions using a wavefront aberrometer.</p> <p style="font-size: 12.16px; text-align: justify;"><strong>METHODS:</strong> A total of 120 eyes of 67 patients seen in a private eye center were included and divided into two groups (phakic and pseudophakic). After undergoing routine ophthalmologic examination that included manifest refraction and visual acuity testing, accomodative amplitude was measured using the iTraceTM wavefront aberrometer. Comparison of the measurements was made between the accommodative amplitude of phakic pre-presbyopes and presbyopes, and between eyes implanted with monofocal and accommodating intraocular lenses (IOLs).</p> <p style="font-size: 12.16px; text-align: justify;"><strong>RESULTS</strong>: The mean age of the pre-presbyopes was 27 years, presbyopes 50 years, monofocal IOL 69 years and accommodating IOL 67 years. The mean accommodative amplitude of the pre-presbyopes was 1.64 ± 1.06D, presbyopes 0.99 ± 0.42D, monofocal IOL 0.36 ± 1.16D, and accommodating IOL 0.94 ± 0.89D. The pre-presbyopes had a higher accommodative amplitude than the presbyopes (p=0.008), while the accommodating IOL subgroup had a higher amplitude than the monofocal IOL subgroup (p=0.02). Increasing age was correlated with decreasing amplitude in the phakic group (r2=0.926). There was no correlation between refractive error and amplitude of accommodation in the phakic and pseudophakic groups (r2=0.02 for both groups).</p> <p style="font-size: 12.16px; text-align: justify;"><strong>CONCLUSION:</strong> The wavefront aberrometer is a reliable tool in objectively measuring accommodative amplitude. Pre-presbyopes and accommodating IOLs were shown to have higher amplitudes of accommodation than presbyopes and monofocal IOLs.</p>

Comparison of the rotational stability of different toric intraocular lens implants

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To compare the rotational stability and cylinder reduction of different toric intraocular lenses (IOLs).<br /><strong>METHOD:</strong> This was a prospective, cross-sectional study of 68 eyes that had at least 0.75 diopters (D) of corneal astigmatism prior to cataract surgery and were at least 3 months post-toric IOL implantation (Envista, AcrySof, FineVision). Patients recruited underwent visual acuity testing, manifest refraction, pupil dilation, and toric IOL axis determination. Actual axis position was obtained and compared to the intended axis calculated from the tonic IOL calculator. Any difference between the two was considered an axis deviation. Main outcome measures were postoperative deviation of the IOL axis from the intended axis, uncorrected distance visual acuity (LIDVA), best corrected distance visual acuity (BCDVA), manifest refraction, and cylinder reduction.<br /><strong>RESULTS:</strong> There was no significant difference in the rotational stability of the three different types of toric IOLs (p=0.95). Mean axis deviation for .AcrySof, Envista, and FineVision were 2.43, 2.66, and 2.75 degrees, respectively. There was a significant decrease in the cylinder from preoperative to postoperative levels for all groups (p=0.00 for Envista, p=0.03 for AcrySof, and p=0.00 for Fine-Vision). There were significant improvements in the mean UCVA and BCDVA after cataract surgery and implantation of toric IOLs for all three groups.<br /><strong>CONCLUSION:</strong> The three IOL platforms (AcrySof, Envista, and FineVision) showed good rotational stability and significant cylinder reduction:Visual and refractive outcomes improved after surgery.<br /><br /></p>