Comparison of short-term visual acuity and visual disturbance phenomena and spectacle independence after implantation of three different intraocular lenses / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the short-term postoperative visual acuity, visual disturbance phenomena, and spectacle independence rate in patients who underwent monocular implantation with trifocal, multifocal, or extended range of vision intraocular lens(IOL).METHODS: A retrospective analysis was conducted on 67 cataract patients(67 eyes)who underwent phacoemulsification cataract extraction combined with IOL implantation from March 2019 to December 2022. A total of 35 cases(35 eyes)received Symfony extended range of vision IOL implantation, 21 cases(21 eyes)received AcrySof IQ ReSTOR +3D multifocal IOL, and 11 cases(11 eyes)received AcrySof IQ PanOptix trifocal IOL. The preoperative uncorrected distance visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), and uncorrected near visual acuity(UNVA)and 3 mo postoperatively were documented. Moreover, defocus curves, visual disturbance phenomena, and spectacle independence rates were recorded at 3 mo postoperatively.RESULTS: At 3 mo postoperatively, no statistically significant differences were observed in UDVA among the three groups(P>0.05). A comparison of UIVA showed superior results in the Symfony and PanOptix groups compared to the ReSTOR group(all P<0.01). The UNVA of both the ReSTOR and PanOptix groups outperformed the Symfony group(all P<0.01). The defocus curves indicated that in the intermediate vision range(-1.00 to -1.50 D), the Symfony group exhibited better performance than the ReSTOR group(P<0.05); while in the near vision range(-2.50 to -3.50 D), the ReSTOR group was superior to the Symfony group(P<0.05). The PanOptix group demonstrated superior visual acuity in the near vision range(-2.00 to -3.50 D)compared to the Symfony group(P<0.05)and was also superior in the intermediate vision range(-1.00 to -2.00 D)compared to the ReSTOR group(P<0.05). No significant differences were observed in the incidence of glare or halo and binocular interference phenomena among the three groups(P>0.05). The PanOptix and ReSTOR groups exhibited a higher spectacle independence rate compared to the Symfony group(P<0.0167).CONCLUSION: Compared to Symfony extended range of vision IOL and ReSTOR multifocal IOL, PanOptix trifocal IOL offers a balanced approach to distance, intermediate, and near visual acuity, without a high incidence of glare and halo, and with a higher spectacle independence rate. Caution is still advised when considering monocular implantation with presbyopia-correcting IOLs.

Clinical observation of 25G vitrectomy and phacoemulsification combined with intrascleral fixated IOL implantation for treatment of complete lens luxation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate efficacy, safety and complications of 25G vitrectomy, phacoemulsification combined with intrascleral fixated intraocular lens(IOL)implantation for treatment of lens luxation.<p>METHODS: Totally 20 patients(20 eyes)with complete lens luxation and the hardness of lens nucleus was grade 3 or above who underwent 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation between May 2018 and December 2020 were analyzed retrospectively. The uncorrected visual acuity, best corrected visual acuity, intraocular pressure, the count of corneal endothelium cell, central corneal thickness and complications were observed. <p>RESULTS: The uncorrected visual acuity and best corrected visual acuity after operation were improved than those before treatment(<i>P</i><0.05). The number of corneal endothelial cells in the central part of cornea after operation was lower than that before operation(<i>P</i> >0.05). There was no significant difference in central corneal thickness 2wk after operation compared with that before operation(<i>P</i> >0.05). There were 3 cases of low intraocular pressure and 2 cases of high intraocular pressure, but they all returned to normal at the end of follow-up. The IOL were all centered and there were no obvious eccentricity and inclination. No other complications such as vitreous hemorrhage and retinal detachment occurred.<p>CONCLUSION: 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation is a fast, safe and simple method for the treatment of complete lens luxation.

Effect on postoperative visual quality with modified ABC design aspheric IOL implantation of cataract patients / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the visual quality of patients after modified design aspheric balance curve(ABC)with intraocular lens(IOL)implantation, and to analyze the influencing factors of clinical IOL selection and guide the patient's IOL selection plan. METHODS: A prospective case-control study was conducted in 67 patients(74 eyes)with simple cataract underwent phacoemulsification and foldable aspheric IOL implantation, and 23 eyes in the observation group were implanted with modified design IOL(HOYA Vivinex XY1 group), the control group was implanted with 51 eyes of traditional design IOL(Tecnis ZCB00 group with 27 eyes, IQ SN60WF group with 24 eyes). The uncorrected visual acuity, the best corrected visual acuity, total ocular spherical aberration(SA)and coma under different pupil diameters(3, 4, 5, 6mm), and different pupil diameters(3, 4, 5mm)were measured 1wk and 1mo after operation, the modulation transfer function(MTF)curve, objective scattering index(OSI), intraocular scattered light value Log(s)and contrast sensitivity were obtained. Statistical analysis was performed on the obtained data.RESULTS: The uncorrected visual acuity and best corrected visual acuity at 1wk and 1mo after operation in the three groups were significantly improved compared with those before operation, there was no significant difference among groups(P&#x003E;0.05). The difference of total ocular spherical aberration was statistically significant among the three groups with 5 and 6mm pupil diameter 1wk after operation(P=0.045, 0.037)and there were differences among three groups in pupil diameter of 6mm at 1mo after operation(P=0.042). Comparing the total ocular coma aberration, there were differences among the three groups at 1wk and 1mo after the operation at the pupil diameter of 5 and 6 mm(P&#x003C;0.05). With the increase of pupil diameter at 1wk and 1mo after operation, the total ocular spherical aberration in the HOYA Vivinex XY1 group was lower than that in the other two groups. The MTF values of the Vivinex XY1 group were higher than those that of the control group at each spatial frequency, there was no significant difference among groups(P&#x003E;0.05), and there were no statistical differences in objective scattering index, intraocular scattered light value Log(s)and contrast sensitivity among the three groups(P&#x003E;0.05).CONCLUSION:The improved design of the modified Vivinex IOL can reduce the total ocular spherical aberration and coma, improve the visual quality, and provide a new method for the selection of aspheric IOL.

Progress of IOL calculation formulas for cataract patients with high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

Cataract with high myopia is a kind of complicated cataract with highly blinding disease. Surgery has always been the only treatment, but there is always a difference between actual postoperative refraction and target refraction. The cataract patients with high myopia have increasing demands for postoperative refractive status and visual quality now. The intraocular lens(IOL)calculation formulas have been updating for higher predictive accuracy. A variety of alternative IOL calculation formulas can be applied to clinical practice. However, there is no consensus on the selection of a more suitable formula for cataract patients with high myopia. Based on the principles and clinical application of different formulas, this paper reviews the development of IOL calculation formulas and research progress of IOL calculation formulas for cataract patients with high myopia, in order to provide reference for clinical application.

Changes of biological parameters and the accuracy of IOL power calculation formulas after phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To measure the changes of ocular biological parameters before and after phacoemulsification, and compared the choice of intraocular lens(IOL)power calculation formulas based on the new optical biometric instrument IOL Master 700.METHODS: A prospective study. Clinical data were collected from 52 patients(57 eyes)with cataract at the First Affiliated Hospital of Soochow University from January to June 2021. The axial length(AL), anterior chamber depth(ACD)and corneal curvature(Km)were measured and analyzed before and 3mo after phacoemulsification by IOL Master 700. The target refractive value reserved in the calculation of different IOL formulas and the actual refractive value of the automatic refractor 3mo after phacoemulsification were compared and statistically analyzed.RESULTS: The average values of AL measured before and after phacoemulsification were 24.20±1.86, 24.09±1.86mm, the postoperative AL shortened by 0.11mm, and the ACD values were 3.08±0.44, 4.55±0.36mm(P&#x003C;0.001), ACD deepened by 1.49mm after phacoemulsification. The Km values were 44.14±1.86, 44.14±1.82D(P&#x003E;0.05). The refractive error of the results measured by the Barrett Universal Ⅱ formula was the smallest before operation, followed by Holladay Ⅱ and the SRK/T formula, the Holladay Ⅰ formula had the largest error and the difference was statistically significant(P&#x003C;0.05). CONCLUSION: The AL was shortened and the ACD was deepened after phacoemulsification. A correction factor of 0.1mm is suggested to add when calculating the degree. The Barrett Universal Ⅱ formula has the best predictability in the IOL power calculation formulas, follow by Holladay Ⅱ and SRK/T formula.

Subjective visual quality, reading fluency and patient satisfaction with the extended depth of focus IOL / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the subjective visual quality, reading fluency and patient satisfaction after a unilateral or bilateral implantation of the Tecnis Symfony extended depth of focus intraocular lens(IOL)with cataract.<p>METHODS: The retrospective analysis on the 48 patients(71 eyes)with cataract phacomulsification surgery in our hospital, which were randomly divided into two groups. The bilateral group with 23 patients(46 eyes)bilateral implanted the Symfony extended depth of focus IOL, the unilateral group with 25 patients(25 eyes)implanted the Symfony IOL in one eye and an aspherical monofocal IOL in the other eye. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and best corrected distance visual acuity(BCVA)were measured 3, 6mo after surgery. The contrast sensitivity, reading fluency, reading speed, patient satisfaction and the occurrence of complications were also observed.<p>RESULTS: In the unilateral group, there were no significant differences in the UDVA and BCVA between an eye with the Symfony IOL and an eye with monofocal IOL 3mo after surgery(P>0.05). After 6mo of surgery, UDVA were significantly better than pre-operation in two groups, average visual acuity of LogMAR was under 0.1. There were no significant differences in UDVA, BCVA, UIVA and UNVA between two groups(P>0.05). The patients'far, intermediate, and near distances satisfaction were higher after 3mo of surgery. There were no statistically significant differences in spatial frequency contrast sensitivity between the two groups under photopic/mesopic conditions and mesopic with glare 6mo after surgery. The scores of satisfactions for reading fluency were better in the bilateral group than in the unilateral group(P>0.05). After 6mo, the reading speed of binocular group was slightly higher than the unilateral group(P<0.05), but there was no significant difference between two groups(P >0.05).<p>CONCLUSION:The Symfony extended depth of focus IOL provides good far, intermediate, and near visual acuity in the bilateral group and the unilateral group, while maintaining the same level of visual quality. In both groups over 90% patients were spectacle independent. Symfony IOL has widely adaptability and highly predictability, patients can obtain better satisfactions for reading fluency and reading speed. It is more suitable for intermediate vision.

Effects of different viscoelastic agents on corneal endothelium of patients after phacoemulsification and foldable IOL implantation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the effects of dual viscoelastic agents DisCoVisc and sodium hyaluronate on corneal endothelium of patients after phacoemulsification and foldable intraocular lens(IOL)implantation.METHODS: A total of 247 patients(285 eyes)with cataract treated in Jingmen Aier Eye Hospital between June 2017 and December 2019 were selected, and they were divided into DisCoVisc group(123 cases, 141 eyes)and sodium hyaluronate group(124 cases, 144 eyes)by random number table method. Both groups were treated with phacoemulsification and foldable IOL implantation. DisCoVisc and 1.7% sodium hyaluronate were used as viscoelastic agents in DisCoVisc group and sodium hyaluronate group, respectively. The two groups were compared in terms of intraoperative ultrasound time(UST), cumulative dissipated energy(CDE), time for aspiration of viscoelastic agents after IOL implantation, corneal edema at 1d, 1wk, 1 and 3mo after operation, corneal endothelial cell density(ECD)and ECD loss rates before operation and at 3mo after operation, coefficient variation of corneal endothelial cell size(CV), percentage of corneal hexagonal endothelial cells(6A), intraocular pressure, the proportions of patients with uncorrected visual acuity ≥0.5 and central corneal thickness(CCT)values before and after operation at 1d, 1wk and 1mo.RESULTS:There was no statistically significant difference between the two groups in UST, CDE, aspiration time of viscoelastic agents(P &#x003E;0.05)or corneal edema both rate on day 1 after operation(P&#x003E;0.05). Corneal edema disappeared at 1 wk after operation. The ECD loss rate in DisCoVisc group was significantly lower than that in sodium hyaluronate group at 3mo after operation(P&#x003C;0.05). Intraocular pressure, the proportion of patients with uncorrected visual acuity ≥0.5 and CCT values showed no statistically significant differences between the two groups before and after operation at 1d, 1wk and 1mo(P &#x003E;0.05).CONCLUSION: DisCoVisc, as the viscoelastic agent in phacoemulsification and foldable IOL implantation for patients with Emery-Little grade Ⅱ-Ⅲ lens nucleus hardness, can better protect the patients' corneal endothelium.

Comparison of Toric IOL alignment marking using Verion image guided system and conventional manual marker / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To compare the accuracy of Toric intraocular lens(IOL)alignment using the Verion image guided system and conventional manual marker. <p>METHODS:Prospective randomized controlled study. A total of 56 eyes of 47 age-related cataract patients who underwent phacoemulsification combined with Toric IOL implantation in our hospital from June 2016 to December 2019 were randomly divided into two groups:In the image-guided group, Verion navigation system collected anterior segmental images before surgery, and Toric target was set to 27 eyes in axial direction. In the marker group, Toric target was marked at 0° and 180° levels before surgery, and Toric target was marked in 29 eyes in axial direction according to the labeling ring. At 1h, 1wk, 1 and 3mo postoperatively, the anterior segment of patients with dilated pupil was photographed. Photoshop software was used to analyze the deviation between the actual axial direction and the target axial direction of the two groups, and the patients' naked eye visual acuity(UCDVA), best corrected visual acuity(BCDVA)and residual astigmatism were recorded. <p>RESULTS: At 1h and 3mo postoperatively, the deviation between the actual axis and the target axis of IOL in the navigation group was less than that in the marker group(1.5°±1.8° <i>vs</i> 3.1°±2.1°; 1.9°±1.6° <i>vs</i> 3.3°±2.4°, all <i>P</i><0.05). There was no difference in UCDVA(LogMAR)between the navigation group and the marker group(0.04±0.08 <i>vs</i> 0.06±0.07, <i>P</i>=0.338)and there was no difference in residual divergence(-0.39±0.32 <i>vs</i> -0.45±0.31D, <i>P</i>=0.491)between two groups at 3mo after operation.<p>CONCLUSION:Verion digital marking and manual marking showed high accuracy in marking Toric IOL axial direction. Although the navigation group showed no advantage in UCDVA and residual astigmatism, the IOL misalignment in navigation group was significantly smaller than the marker group, and Toric IOL axial direction was implanted more accurately under Verion digital marking.

Clinical application of OPD-Scan Ⅲ aberration analyzer in evaluating the implantation of trifocal intraocular lens in patients with high myopia complicated with cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the visual quality of patients with high myopia complicated with cataract after implantation of trifocal intraocular lens by OPD-Scan Ⅲ aberration analyzer.METHODS: Totally 32 patients(38 eyes)with high myopia complicated with cataract who underwent femtosecond laser assisted cataract phacoemulsification combined with trifocal intraocular lens implantation in Foshan Aier Eye Hospital from June 2018 to December 2020 were selected. Uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA)and uncorrected near visual acuity(UCNVA)were compared before, and 1wk, 3mo after surgery; OPD-Scan Ⅲ aberration analyzer measured objective visual quality before, and 1wk and 3mo after surgery. RESULTS: There were significant differences in UCDVA, UCIVA and UCNVA before, and 1wk, 3mo after operation(<i>P</i><0.05). The average orientation and centration distance was 0.12(0.08-0.15)mm and the average axial was(212.68±90.45)°in 3mo postoperative. There were significant differences in spherical aberration(<i>P</i><0.05), Strehl ratio(SR)and area ratio(AR)before, and 1wk, 3mo after operation(<i>P</i><0.001). In comparison, SR at 1wk and 3mo postoperative was higher than that before operation, whereas AR in 1wk and 3mo postoperative were both higher than that before operation(all <i>P</i><0.001). There was a negative correlation between SR and spherical aberration at 3mo postoperative(<i>rs</i>=-0.420, <i>P</i><0.01); There was a negative correlation between SR and trefoil at 3mo postoperative(<i>rs</i>= -0.418, <i>P</i><0.01); There was a negative correlation between AR and trefoil at 3mo postoperative(<i>rs</i>=-0.400, <i>P</i><0.05).CONCLUSION: Femtosecond laser assisted cataract surgery combined with trifocal intraocular lens implantation can provide a comfortable and natural full-range vision. The orientation and centricity of trifocal intraocular lens using OPD-Scan Ⅲ has shown that there was a good reliability and consistency. The vision quality using OPD-Scan Ⅲ is satisfactory.

Long-term Changes in the Spherical Equivalent and Axial Length in Bilateral High-hyperopia Children

PURPOSE: To explore changes in the spherical equivalent refractive error and axial length of both eyes of children with high hyperopia over time. METHODS: Children with bilateral hyperopia ≥ 4.0 diopters (D) underwent visual acuity testing and comprehensive ophthalmic examinations. The mean age at the first visit was 6.5 years and spherical equivalent refractive error and axial length were measured at least three times over the following year. Axial length was measured using an intraocular lens Master instrument (Carl Zeiss Meditec, Jena, Germany). RESULTS: The mean annual increase in axial length was +0.21 mm and the mean annual reduction in spherical equivalent refractive error was −0.39 D. Between the ages of 3 and 5 years, the mean annual increase in axial length was +0.36 ± 0.26 mm. In patients aged ≥ 9 years old, the mean annual increase was +0.12 ± 0.09 mm (p = 0.00). The mean annual reduction in spherical equivalent refractive error was −0.53 ± 1.00 D between the ages of 3 and 5 years, but became −.32 ± 0.54 D at age ≥ 9 years old. This difference was not significant (p = 0.11). CONCLUSIONS: In children with bilateral hyperopia, the spherical equivalent refractive error decreased and the axial length increased with age. The rate of axial length growth was higher in younger children.

Risk Factors of Secondary Glaucoma after Congenital Cataract Surgery in Korean Patients

PURPOSE: To assess the risk of development of secondary glaucoma after congenital cataract surgery using a long-term follow-up study. METHODS: In total, 148 eyes of 91 patients who underwent congenital cataract surgery at our hospital or other hospitals were included in a retrospective chart review. A diagnosis of secondary glaucoma was made if the intraocular pressure (IOP) exceeded 21 mmHg and the corneal diameter, axial length, or the cup-to-disc ratio increased, or surgery was performed to control the IOP. To analyze the clinical features and risk factors of secondary glaucoma, we evaluated the mean age at cataract surgery, binocularity, presence of a nuclear cataract, methods of cataract surgery, presence of an intraocular lens (IOL), duration of diagnosis of secondary glaucoma after cataract surgery, duration of follow-up, recent best-corrected visual acuity, and refractive errors. RESULTS: Thirty-five eyes (23.6%) were diagnosed with secondary glaucoma as a complication of congenital cataract surgery. Of these, 11 eyes (31.4%) were treated with glaucoma surgery a mean of 3.4 times. The mean duration from congenital cataract surgery to diagnosis of glaucoma was 112.2 ± 113.1 months. Patients with aphakia had a higher risk of developing secondary glaucoma compared with patients undergoing primary IOL implantation (p = 0.001). Younger age (<3 months at surgery), a nuclear cataract, and aphakia were risk factors for the development of secondary glaucoma (p = 0.03, p = 0.006, and p < 0.001, respectively), and the risk of developing secondary glaucoma increased with secondary IOL implantation (p = 0.052). CONCLUSIONS: Secondary glaucoma after congenital cataract surgery was more common in patients with secondary IOL implantation, aphakia, a younger age (<3 months), and a nuclear cataract. Patients who underwent congenital cataract surgery had an increased risk for developing secondary glaucoma. Long-term monitoring of the IOP and optic nerve is therefore required for these patients.

Intraindividual Comparison of Visual Outcomes between Blue Light-filtering and Ultraviolet Light-filtering Intraocular Lens

PURPOSE: To compare the clinical results of short-term visual acuity and quality of vision after implantation of a yellow-tinted blue light-filtering intraocular lens (IOL) (Acrysof IQ® SN60WF) and an clear ultraviolet (UV) light filtering IOL (enVista™ MX60) in the same patient. METHODS: 44 patients with bilateral cataract received an SN60WF in one eye and an MX60 in the other eye. All eyes were evaluated for refraction power and uncorrected visual acuity (UCVA) at preoperative and 1, 3 months postoperatively. At postoperative 3 months, corrected visual acuity, quality of vision (OQAS II®), contrast sensitivity (CGT 2000®) and visual field (Humphrey Field Analyzer®), and subjective patients' response to the degree of brightness were evaluated. Furthermore, glistening degree, intraocular stability, and posterior capsular opacification were examined. RESULTS: There were no significant differences in average refractive power or UCVA at 1 and 3 months (p > 0.05) between the two groups. At 3 months after cataract surgery, the quality of vision according to OQAS II®, the contrast sensitivity according to CGT 2000® with the glare either on or off, and visual field; showed no difference between the two groups (p > 0.05). Both IOLs had no glistening and posterior capsular opacity. The patients' response to the degree of brightness shows that MX60 (48.3%) has a higher degree of satisfaction. CONCLUSIONS: Yellow-tinted blue light-filtering IOL and clear UV light-filtering IOL had no difference in short-term visual acuity and quality of vision. Subjective brightness perception, however, was better with clear UV light-filtering IOL.

Clinical Outcomes of Combined Descemet-stripping Endothelial Keratoplasty and Intraocular Lens Exchange

PURPOSE: To evaluate clinical outcomes after combined descemet-stripping endothelial keratoplasty (DSEK) and intraocular lens (IOL) exchange in a Korean population. METHODS: The medical records of 15 patients (15 eyes) with pseudophakic bullous keratopathy who underwent combined DSEK and IOL exchange from January 2011 to January 2015 and who were followed up for more than 12 months were reviewed retrospectively. RESULTS: In 14 eyes with successful results after surgery, the best corrective visual acuity (BCVA) was significantly improved from 2.01 ± 0.96 (log MAR, mean) to 0.68 ± 0.26 at 3 months (p = 0.001) except for one eye that received reoperation on the endothelial disc detachment. The BCVA at postoperative 6 and 12 months gradually increased (0.51 ± 0.26 and 0.40 ± 0.22 log MAR, mean). Central corneal thickness was significantly improved from 777 ± 139 µm to 605 ± 28 µm at 6 months (p = 0.003) and was maintained at 12 months. The mean endothelial cell count was 2,973 ± 281/mm2 in the donor lenticules and 1,790 ± 265/mm2 at 12 months. Endothelial cell loss was 40%. The target refraction was -0.81 ± 0.16 D and the 12 months postoperative spherical equivalent was -0.28 ± 0.36 D. Complications included intraocular pressure elevation in one eye and pupillary capture in one eye. CONCLUSIONS: Combined DSEK and IOL exchange may be a very efficient and safe option for surgically managing pseudophakic bullous keratopathy.

Resultados refractivos y selección del poder del lente intraocular en cirugía de catarata por facoemulsificación / Refractive outcomes and intraocular lens power selection in cataract surgery with phacoemulsification

Introducción: La catarata es una de las principales causas de ceguera reversible a nivel mundial. La cirugía de catarata con implante de lente intraocular (LIO) además de ser la cirugía oftalmológica más frecuentemente realizada a nivel mundial, le permite a la mayoría de los pacientes recuperar su visión. Para obtener un óptimo resultado refractivo y la mejor visión posible en el paciente, es fundamental realizar una adecuada selección del lente, basada en un examen confiable de biometría. Objetivo: Describir el resultado refractivo postoperatorio de los pacientes operados de cirugía de catarata por facoemulsificación en el Hospital de San José. Además, determinar la precisión de la biometría. Estos resultados se evaluaron de acuerdo a la longitud axial. Diseño: Estudio descriptivo, de corte transversal. Métodos: Se revisaron y analizaron las historias clínicas de los pacientes operados de cirugía de catarata por facoemulsificación con implante de LIO entre julio de 2011 y junio de 2013. Para las variables cuantitativas se utilizaron medidas de tendencia central y de dispersión y para las variables cualitativas, se utilizaron frecuencias absolutas y relativas. La precisión de la biometría se calculó con base en la diferencia entre el target de la biometría escogido por el cirujano y el resultado refractivo postoperatorio dado en equivalente esférico. Resultados: Se analizaron 612 ojos. Se obtuvo un resultado refractivo en el rango de ±1.00D en el 77% (471) de los ojos y en el rango de ±0.50D en el 50.7% (310) de los ojos. La precisión de la biometría fue del 81% (495) para el rango ±1.00D y del 58% (355) para el rango ±0.50 D. Conclusiones: La precisión de la biometría fue satisfactoria y al igual que el resultado refractivo, también favorable y es comparable con otros estudios publicados en la literatura. Consideramos que los resultados refractivos hubieran podido ser aún mejores si el cirujano hubiera escogido el target sugerido por la biometría.

Introduction: Cataract is one of the main causes of reversible blindness worldwide. Cataract surgery is the most frequent ophthalmological surgery performed in the world and allows the majority of patients to recover their vision. To obtain an optimal refractive result and the best possible visual acuity, it is essential to adequately select IOL, based on a reliable biometric test. Objective: To describe the postoperatory refractive results of patients operated with phacoemulsification at Hospital San José. Additionally, to determine the accuracy of biometry based on the difference between the biometric target (objective refraction) chosen by the surgeon and the postoperatory refractive result. Design: Descriptive study Methods: The medical records of patients who underwent cataract surgery by phacoemulsification technique with IOL implant between July 2011 and June 2013 were reviewed and analyzed. For quantitative variable, central and dispersion tendencies were measured, and for qualitative variables, absolute and relative frequencies were used. The biometry precision was obtained from the difference between the target and postoperative refractive result. Results: 612 eyes were analyzed. 77% of eyes obtained a postoperatory refractive result between ±1.00 D and 50.7% (310) were in the optimal refractive result group, between±0.50D. Conclusions: The biometry accuracy was satisfactory and as the postoperative refractive result, also favorable, is similar to other studies published, as well as postoperative refractive result. We consider that the refractive results could have been better if the surgeon would have chosen the target suggested by biometry.

Evaluación del equipo de interferometia óptica de coherencia parcial Lenstar en la biometría ocular / Evaluation of Lenstar partial coherente optical interferometry device in the ocular biometry

OBJETIVOS: Comparar y evaluar la biometría ocular con el nuevo equipo de interferometría óptica de coherencia parcial (Lenstar) con el equipo de interferometría óptica de baja coherencia IOL Master y también con los sistemas topográficos Galilei y Pentacam. MÉTODOS: Se realizó un estudio descriptivo, transversal, en 120 ojos de 60 pacientes. Para el cálculo del lente intraocular se tomaron mediciones con un nuevo biómetro Lenstar LS 900 (Haag Streit AG) y con el IOL Master V.5 (Carl Zeiss Meditec AG). Se compararon mediante el análisis de regresión lineal y correlación de Pearson. También se compararon las medidas con las obtenidas por los equipos topógrafos Galilei y Pentacam. RESULTADOS: Existe una alta correspondencia en los valores biómetricos de longitud axial, queratometría y profundidad de la cámara anterior entre los equipos Lenstar e IOL Master. También se encontró una buena correspondencia entre las medidas de profundidad de cámara posterior y queratometría entre Lenstar y los topógrafos Galilei y Pentacam. CONCLUSIONES: El nuevo biómetro Lenstar, provee resultados que se correlacionan muy bien con aquellos obtenidos con los equipos IOL Master, Pentacam y Galilei. El equipo Lenstar es un equipo preciso que brinda información adicional por lo que es útil en la cirugía de catarata y la cirugía refractiva

OBJECTIVES: To compare and to evaluate the ocular biometry taken by a new optical partial coherence interferometry device (Lenstar),the low coherence optical interferometry equipment (ILO Master) and the topographic systems Pentacam y Galilei. METHODS: A descriptive cross-sectional study was conducted in 120 eyes from 60 patients. For the IOL calculation, the necessary measurements were taken with the new optical biometer Lenstar LS 900 (Haig Streit AG) and with the IOL Master V5 (Carl Zeiss Meditec AG). The results were evaluated using the linear regression analysis and Pearson´s correlation. The measures were then compared to those taken by topographic devices Galilei and Pentacam. RESULTS: There existed high correlation in biometric measurements of axial length, keratometry and anterior chamber depth between the Lenstar and the IOL Master. Good correlation was also found for the Keratometry and anterior chamber depth between the Lenstar and the topographs Pentacam and Galilei. CONCLUSION: The new biometer LENSTAR provided results that correlated very well with those of the IOL Master, Pentacam and Galilei systems. Lenstar is a precise device offering additional features that will be helpful for any cataract or refractive surgery

Visual acuity after secondary intraocular lens implantation in 102 patients / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To evaluate and analyze the visual acuity after secondary anterior and posterior chamber intraocular lens (IOL) implantation in aphakic patients.The most common reasons for performing secondary implantation were dissatisfied with aphakic glasses and intolerance or reluctance to use contact lenses,·METHODS:In this prospective,non randomized compara-tive trial study was done at Ophthalmology Department of Sadoughi Hospital,Yazd,Iran from 1995 to 2005.Posterior chamber lens was inserted in 62 eyes (60.78%) and anterior chamber lens in 40 eyes (39.21%) depending upon the type of previous cataract surgery.Demographic and clinical data was analyzed from the patient's medical records during follow up.·RESULTS:102 patients [42 females (41.18%) and 60 males (58.82%)] underwent secondary lens implantation from 1995 to 2005.Their age range was between 48 and 72 years ( mean = 62.6 years),and mean follow up time was 20.2 months (range of 6 -72 months).There were minor intra operative and post operative complications.The state of visual acuity three months after procedure and final suture removal was as follows:visual acuity of 20/20 in 48 cases (47.05%),visual acuity of 20/40 or better in 51 patients (50%),and decrease in visual acuity (3 lines of snellens chart) in 3 cases (2.95%).·CONCLUSION:The short term complications were not more than that of primary cataract surgery with lens insertion and the visual acuity outcome was as good as the preoperative best correction, so secondary lens implantation appears to be safe and effective for aphakic correction.

The Clinical Characteristics of Stress Line and the Corrleation with Diabetes Mellitus

PURPOSE: To find the incidence of the stress line, its mechanism, the clinical features and the relationship with diabetes mellitus, and to compare with the results of the other studies. METHODS: A prospective study with 60 consecutive eyes of the 51 patients who had phacoemulsification with IOL (Alcon AcrySof Model MA60BM in 20 eyes and Allergan Sensar Model AR40 in 40 eyes) implantation from October 2002 to March 2003. The presence of stress lines was noted at the end of the operation and at the first and second months after the operation. The linear posterior capsular opacifications(PCOs) were noted during the average 6-month follow-up period. RESULTS: Stress lines were observed 40 eyes (66.6%) among the total 60 eyes. Among the 19 diabetic eyes, 15 (78.9%) had the stress lines. The stress lines were significantly related with the hardness (P = 0.109) and PCO (P = 0.002). CONCLUSIONS: The stress lines didn't influence vision but could be channels to the PCO having an effect on vision. Especially, among the diabetic eyes, stress lines had a significant relationship with the PCOs.

Comparison of Optical Aberrations and Contrast Sensitivity between Monofocal and Multifocal Intraocular Lens

PURPOSE: The purpose of this study was to compare the postoperative contrast sensitivity and optical aberration between monofocal and multifocal IOL implanted patients. METHODS: Postoperative contrast sensitivity and optical aberration were measured for 7 cataract patients, 12 eyes that underwent monofocal IOL implantation and for 8 cataract patients, 9 eyes that underwent multifocal IOL implantation. Phacoemulsification was conducted on all patients prior to either multifocal or monofocal IOL implantation, and Multivison Contrast Tester (MCT 8000, Vistech, Dayton, U.S.A.) and WaveScan WavefrontT M system (VISX, Santa Clara, U.S.A.) were used to measure contrast sensitivity and optical aberration. RESULTS: Under the nighttime contrast sensitivity mode, the multifocal-group displayed a statistically significant decrease in contrast sensitivity compared to the monofocal-group (P< 0.01), while there was no statistical difference in the optical aberration index of the two groups. (the multi-group; 0.36, the monogroup; 0.31, p=0.64) CONCLUSIONS: After cataract extraction, there was no difference in the optical aberration between the multifocal IOL implantated patients and the monofocal IOL implanted patients. The decrease in postoperative contrast sensitivity was subjectively greater for multifocal IOL implantated patients than the monofocal IOL implanted patients.

Bacterial Adherence to Intraocular Lenses

Bacterial adherence to intraocular lenses (IOLs)could be the cause of the endophthalmitis following cataract surgery and IOL implantation. In this study we investigated bacterial adherences to the four different IOLs. Clinical strains of Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa were used.Polymethylmethacrylate (PMMA), silicone, hydrophilic acrylate (Acrysof)and hydrogel IOLs were used in this study.Four types of lenses were suspended for 60 minutes in suspensions of each strain of bacteria and then these lenses were washed with sterile broth to remove the nonadherent bacteria.The adherent bacteria were removed from the lenses, diluted with sterile broth and inoculated onto the blood and chocolate agar plates.The plates were incubated for 24 hours, and the numbers of colony forming units were counted. The lenses with the adherence of S.aureus in order of decreasing magnitude were: Acrysof>silicone>hydrogel>PMMA; the adherence of S.epider-midis, silicone>Acrysof>PMMA>hydrogel;the adherence of P.aeruginosa, Acrysof>silicone>PMMA>hydrogel. The bacterial adherence was significantly lower in the hydrophilic IOL.This result suggests that the risk of postoperative endophthalmitis after cataract extraction and IOL implantation may be reduced with the use of hydrophilic IOL.

Clinical Study of Domestic-made Intraocular Lens(UNI-IOL(R))

I studied twenty cases who underwent domestic-made intraocular lens(IOL; UNI-IOL(R)) implantation from 12th April, 1988 to July 29, 1988. All patients most of them were females, were over 60 years old and followed up over 1 year. The results were as follows: 1. The postoperative final corrected visual acuity of 20/40 or better was noted in 18 eyes(90.0%) and visual acuity below 20/50 was in 2 eyes(10.0%). The reason's of this poor vision were optic atrophy and age related macular degeneration. 2. The final refractive state within +/-1.0D with spherical equivalent was fifty-five percent and only one over -2.0D. 3. The corneal thickness increased mostly(9.8%) at postoperative 3 days and graually returned to the normal level by postoperative fifteen days. 4. Anterior chamber reaction, cells, pigments on the IOL decreased gradually at postoperative period. 5. The percentage loss of corneal endothelium was 13.4% at postoperative 2 months and 14.1% at postoperative 1 year. 6. Partial posterior capsule rupture was developed in one eye during the opera tion and fibrinous membrane and after cataract were developed in one eye.