Sorpresa refractiva tras la cirugía de catarata en paciente con lente fáquica / Refractive surprise after cataract surgery in a patient with a phakic lens implant

El implante de una lente intraocular fáquica puede resultar una opción lógica para los pacientes sumamente miopes que buscan liberarse de las gafas y de los lentes de contacto. Esta es una alternativa para corregir los grados de miopía extremos, y se diseñaron para permanecer dentro del ojo por muchos años. Con el cursar del tiempo, fisiológicamente comienza a opacarse el cristalino. Ante la necesidad de removerlo y de calcular una lente de potencia adecuada para el saco capsular y así conseguir la emetropía, surge un nuevo reto. El cálculo inexacto de la potencia dióptrica de la lente a implantar en la intervención quirúrgica es un problema y con él aparece la sorpresa refractiva; de ahí el objetivo de presentar con este caso la causa más frecuente de sorpresa refractiva tras la cirugía de catarata en un paciente miope con lente fáquica implantada. Se destaca la importancia de la longitud axil, sobre todo si esta se modifica después del implante de la lente fáquica para el correcto cálculo de la lente a implantar, así como el método ideal para su obtención: la interferometría óptica, sin olvidar la historia clínica previa al implante de la lente fáquica(AU)

Phakic intraocular lens implantation may be a logical option for extremely myopic patients who wish to get rid of their eyeglasses and contact lenses. This alternative was developed to correct extremely high degrees of myopia and remain inside the eye for many years. However, with the passing of time and due to physiological processes, the crystalline lens tends to become opaque. A new challenge is posed by the need to remove it and select a lens with an optical power appropriate to the capsular sac, thus achieving emmetropia. Inaccurate calculation of the dioptric power of the lens to be implanted in the surgical intervention is a problem leading to refractive surprise. Hence the interest in presenting a case illustrating the most common cause of refractive surprise after cataract surgery in a myopic patient with a phakic lens implant. The importance of axial length is highlighted, particularly whether it is modified after phakic lens implantation for accurate calculation of the lens to be implanted and the ideal method to obtain it: optical interferometry, without disregarding the medical record data preceding the phakic lens implantation(AU)

Cirugía de catarata bilateral en paciente con lente intraocular fáquica / Bilateral cataract surgery in a patient with a phakic intraocular lens

RESUMEN La cirugía refractiva corneal es una buena opción para corregir el defecto refractivo de los pacientes y lograr una buena visión sin el uso de espejuelos o lentes de contacto; pero cuando no es posible, las lentes fáquicas constituyen una elección viable, especialmente en pacientes jóvenes que mantienen la acomodación. Se presenta el caso de una paciente con antecedentes de implante de lente fáquica desde hacía 13 años, quien acudió al Instituto Cubano de Oftalmología "Ramón Pando Ferrer" por disminución de la visión en ambos ojos. Se destaca la importancia en la obtención de las medidas biométricas, especialmente la longitud axil, si esta se modifica después del implante de la lente fáquica para el correcto cálculo de la lente a implantar y la obtención del buen resultado refractivo. La interferometría óptica es el mejor modo de obtener estas medidas y la longitud axil no parece modificarse con la presencia de una lente fáquica(AU)

ABSTRACT Corneal refractive surgery is a good option to correct the refractive defect and achieve good vision without the use of eyeglasses or contact lenses. When it is not possible, phakic lenses are a viable choice, particularly in young patients who maintain accommodation. A case is presented of a female patient with an antecedent of phakic lens implantation 13 years before who presents at Ramón Pando Ferrer Cuban Institute of Ophthalmology with vision reduction in both eyes. Mention should be made of the importance of obtaining biometric measurements, especially of the axial length, if it changes after phakic lens implantation, for accurate calculation of the lens to be implanted and the achievement of a good refractive result. Optical interferometry is the best way to obtain those measurements, and axial length does not seem to change with the presence of a phakic lens(AU)

Comparing the postoperative refractive predictability of Pentacam HR and IOLMaster 500 after a multifocal intraocular lens implantation / Comparação da previsibilidade refrativa pós-operatória do Pentacam HR e IOLMaster 500 após implante de lentes intraoculares multifocais

ABSTRACT Purpose: To compare the postoperative refractive predictability of IOLMaster 500 and Pentacam HR on the basis of keratometry and anterior chamber depth values in eyes with an indication for multifocal intraocular lens (IOL) implantation. Methods: This was a retrospective study conducted on 118 eyes treated with phacoemulsification and multifocal intraocular lens implantation. Only the eyes that achieved emmetropia in the dynamic refraction performed on postoperative day 30 were included. Haigis' formula was used in each case to calculate the intraocular lens power, and the intraocular lens with the target refraction closest to emmetropia was implanted. Four lens calculation scenarios were tested by combining keratometry and anterior chamber depth measurements obtained using the two devices. Results: IOLMaster 500 and Pentacam HR differed with regard to mean keratometry (D 0.07 ± 0.03 D; p=0.0065) and anterior chamber depth (D 0.08 ± 0.01 mm; p<0.001). In the analysis of covariance, the following differences were obtained using the Haigis' formula when confronted with the biometric values obtained by inserting keratometry and anterior chamber depth values, respectively: Penta/IOL x IOL/Penta (0.13 ± 0.03; p<0.0001); Penta/Penta × IOL/Penta (0.13 ± 0.03; p<0.0001); Penta/IOL × IOL/IOL (0.11 ± 0.03; p=0.001); Penta/Penta × IOL/IOL (0.11 ± 0.03; p=0.002); IOL/IOL × IOL/Penta (0.02 ± 0.03; p=0.865); and Penta/IOL × Penta/Penta (0.002 ± 0.03; p=0.99). The difference was smaller when measuring the anterior chamber depth using the IOLMaster 500, regardless of which device was used to measure keratometry. Conclusions: Pentacam HR significantly differed from IOLMaster 500 when calculating keratometry. As regards the anterior chamber depth, the two devices were equally accurate.

RESUMO Objetivo: Comparar a previsibilidade refrativa pós-operatória do IOLMaster 500 e Pentacam HR com base nos valores de ceratometria e profundidade de câmara anterior nos olhos com indicação de implante de lentes intraoculares multifocais. Métodos: Estudo retrospectivo realizado em 118 olhos tratados com facoemulsificação e implante de lentes intraoculares multifocal. Apenas os olhos que atingiram a emetropia na refração dinâmica no 30º dia pós-operatório foram incluídos. A fórmula de Haigis foi usada em cada caso para calcular o poder das lentes intraoculares, e a lente intraocular com a refração alvo mais próxima da emetropia foi implantada. Cenários de cálculo de quatro lentes foram testados pela combinação de medidas de ceratometria e profundidade de câmara anterior obtidas usando os dois dispositivos. Resultados: IOLMaster 500 e Pentacam HR diferiram quanto à média de ceratometria (D 0,07 ± 0,03 D; p=0,0065) e profundidade de câmara anterior (D 0,08 ± 0,01 mm; p<0,001). Na análise da covariância, as seguintes diferenças foram obtidas usando a fórmula de Haigis quando confrontadas com os valores biométricos obtidos pela inserção dos valores de ceratometria e profundidade de câmara anterior, respectivamente: Penta/IOL x IOL/Penta (0,13 ± 0,03; p<0,0001); Penta/Penta x IOL/Penta (0,13 ± 0,03; p<0,0001); Penta/IOL x IOL/IOL (0,11 ± 0,03; p=0,001); Penta/Penta x IOL/IOL (0,11 ± 0,03; p=0,002); IOL/IOL x IOL/Penta (0,02 ± 0,03; p=0,865); Penta/IOL x Penta/Penta (0,002 ± 0,03; p=0,99). A diferença foi menor ao medir a profundidade da câmara anterior usando o IOLMaster 500, independentemente de qual dispositivo foi usado para medir a ceratometria. Conclusões: O Pentacam HR diferiu significativamente do IOLMaster 500 no cálculo de ceratometria. Quanto à profundidade da câmara anterior, os dois dispositivos foram igualmente precisos.

Evolución de la biometría de coherencia óptica y las nuevas plataformas / Evolution of optical coherence biometry and the new platforms

RESUMEN La interferometría de coherencia óptica es un procedimiento esencial para calcular la potencia óptica de la lente intraocular. La presente revisión describe la evolución de la biometría óptica por interferometría, las nuevas plataformas, las características técnicas, los parámetros de calibración, la interpretación de los resultados y las situaciones especiales con indicación de cirugía de catarata. Para efectuar el trabajo fueron consultadas las bases de datos de la plataforma Infomed, específicamente en la Biblioteca Virtual de Salud, PubMed, Cochrane Database-Wiley Online Library, LILACS y Scielo. El IOL Máster favorece la medición de los parámetros biométricos oculares, ya que realiza mediciones sólidas y repetibles que incluye fórmulas de cuarta generación para el cálculo de potencia de lentes intraoculares. Actualmente se dispone en el mercado de varias plataformas para la biometría ocular usando los métodos interferométricos de alta resolución que tienen el potencial de mejorar significativamente los resultados refractivos. Estos estudios son de alta predictibilidad, lo cual permite obtener una buena agudeza visual y evita la sorpresa refractiva((AU)

ABSTRACT Optical coherence interferometry is an essential procedure for calculating the optical power of the intraocular lens. The present review describes the evolution of optical biometry by interferometry, the new platforms, technical features, calibration parameters, interpretation of results, and special situations in which cataract surgery is indicated. Information was collected from the databases on the Infomed platform, specifically the Virtual Health Library, PubMed, Cochrane Database-Wiley Online Library, LILACS and Scielo. IOL Master facilitates the measurement of ocular biometric parameters, since it performs solid, repeatable measurements that include fourth-generation formulas for the calculation of intraocular lens power. Several ocular biometry platforms are currently available in the market which use high resolution interferometric methods with the potential to significantly improve refractive results. These studies are characterized by their high predictability, making it possible to obtain good visual acuity and avoid refractive surprise(AU)

Long-term microwaving of denture base materials: effects on dimensional, color and translucency stability

Abstract While the combined effect of microwave irradiation with cleansing solutions on denture base materials has been investigated, the effects of only using microwave irradiation and, more importantly, in a long-term basis, was not studied yet. Objective The purpose of this study was to evaluate the effect of a long-term repeated microwaving on the dimensional, color and translucency stability of acrylic and polyamide denture base materials. Material and Methods Thirty two specimens (32 mm x 10 mm x 2.5 mm) from polyamide (Valplast) and PMMA (Vertex Rapid Simplified) denture base materials were made. Eight specimens from each material were immersed in distilled water (control) and 8 were subjected to microwave exposure at 450 W for 3 minutes for a period simulating 224 days of daily disinfection. Linear dimension, color change (ΔE*) and translucency parameter (TP) were measured at baseline and after certain intervals up to 224 cycles of immersion, using a digital calliper and a portable colorimeter. The results were analysed using two-way repeated measures ANOVA to estimate possible differences among predetermined cycles and material type. Regression analysis was also performed to estimate the trend of changes with time. Statistical evaluations performed at a significance level of 5%. Results Data analysis showed significant changes in length at baseline with an increasing number of cycles (p<0.05) and a significant interaction of cycle-material (p<0.001). The ΔΕ* parameter was significantly higher with a higher number of cycles (p<0.001), but it did not vary between materials (p>0.05). TP decreased similarly in both materials following microwave action but in a significantly higher level for Valplast (p<0.001). Conclusions The results indicated that long-term repeated microwaving affects linear dimensional, color and translucency changes of both materials. Differences between PMMA and polyamide material were noted only in dimension and translucency changes.

Is partial coherence interferometry more accurate than a scan ultrasonography in the estimation of anterior chamber depth?

Purpose: To assess the degree of agreement of anterior chamber depth [ACD] measurements by optical device [NIDEK AL-scan biometer] and contact ultrasound A-scan [Mentor [[R]] - Advent [[TM]] A/B system US biometry]

Setting: Department of Ophthalmology at ALAZHAR University, Cairo, Egypt

Methods: This prospective observational cross sectional comparative study of 50 normal healthy eyes were included in this study, ACD estimation was done by 2 methods partial coherence interferometry[PCI], and contact ultrasound A-scan. The measurements was performed by the same observer. The difference in measurements between the two methods was assessed using the t-test

Results: The mean ACD [ +/- SD] by the two methods were [2.8 mm] and [3.5 mm], respectively. There was a statistically significant difference between measurements recorded by the 2 methods [P<0.01]

Conclusion: there was a statistically different between the two methods the PCI values were significantly higher [by 0.7 mm] than the U/S values with no correlation between the two sets of values. So PCI is more accurate but we still need U/S measurements in some situations [e.g., tear film abnormalities, corneal pathologies]

Noncontact three-dimensional evaluation of surface alterations and wear in NiTi endodontic instruments

Abstract The aim of this study was to undertake a qualitative and quantitative assessment of nanoscale alterations and wear on the surfaces of nickel-titanium (NiTi) endodontic instruments, before and after use, through a high-resolution, noncontact, three-dimensional optical profiler, and to verify the accuracy of the evaluation method. Cutting blade surfaces of two different brands of NiTi endodontic instruments, Reciproc R25 (n = 5) and WaveOne Primary (n = 5), were examined and compared before and after two uses in simulated root canals made in clear resin blocks. The analyses were performed on three-dimensional images which were obtained from surface areas measuring 211 × 211 µm, located 3 mm from their tips. The quantitative evaluation of the samples was conducted before and after the first and second usage, by the recordings of three amplitude parameters. The data were subjected to statistical analysis at a 5% level of significance. The results revealed statistically significant increases in the surface wear of both instruments groups after the second use. The presence of irregularities was found on the surface topography of all the instruments, before and after use. Regardless of the evaluation stage, most of the defects were observed in the WaveOne instruments. The three-dimensional technique was suitable and effective for the accurate investigation of the same surfaces of the instruments in different periods of time.

Optical Coherence Tomography; A Modern Technique to Detect Oral Mucosal Lesion: A Review.

Early detection and management of potentially malignant oral lesions can significantly reduce progression of these lesions into invasive cancer, and would thus reduce morbidity and fatality rate. Cancerous and potentially malignant lesions show dysplastic feature which is mostly detected by biopsy. However, biopsy has a certain constraints like (i) biopsy can cause delay in the result, (ii) experienced pathologist must expound the biopsy sample (iii) sometimes can cause spread of cancer cells, (iv) cannot be done repeatedly. Therefore, in potentially malignant lesions and cancer optical coherence tomography (OCT) is utilized to detect early dysplastic changes. Therefore, we are presenting a review on the applications of OCT in oral mucosal lesions.

Lentes progressivas: análise dos campos intermediário e de perto por deflexometria / Progressive addition lenses: analysis of intermediate and near vision zones by deflectometry

OBJETIVO: Avaliar por deflexometria as diferentes regiões das lentes progressivas e determinar as áreas dos campos de visão intermediário e de perto. MÉTODOS: Foram incluídas vinte e duas lentes progressivas com poder +1,00 DE para longe e duas adições diferentes (adição 1,00 e 2,00, 11 de cada). Mediram-se as áreas dos campos intermediário e de perto entre as isoastigmáticas de 0,5 DC. RESULTADOS: Encontraram-se diferenças significativas entre as áreas dos campos intermediário e de perto das lentes estudadas. Entre a área do campo intermediário e a adição observou-se correlação inversa; entre a área do campo intermediário e a extensão vertical do corredor encontrou-se correlação direta. CONCLUSÃO: Com esses dados permitem-se recomendar as lentes de acordo com o campo de maior necessidade visual de cada usuário.

PURPOSE: To determine near and intermediate vision areas of progressive addition lenses by means of a deflectometer. METHODS: Twenty-two progressive addition lenses with +1.00 SD far power and two different additions (add 1.00 and 2.00; eleven subjects in each addition) were studied. Near and intermediate vision areas within 0.50 CD isoastigmatic lines were determined. RESULTS: There are significant differences between near and intermediate vision areas of the studied lenses. There is also an inverse correlation between the addition and intermediate areas as well as direct relation between the vertical length of the corridor and its area. CONCLUSION: Based on those findings, progressive addition lenses can be selected to suit the wearer's visual requirements.

Personalización de las constantes en las fórmulas de cálculo de la lente intraocular / Personalization of constants in the intraocular lens calculation formulas

Objetivo: personalizar las constantes A, factor cirujano y profundidad de la cámara anterior para las fórmulas de cálculo de la lente intraocular en la cirugía de catarata en el Instituto Cubano de Oftalmología Ramón Pando Ferrer de mayo de 2007 a enero de 2011...

Objective: to personalize the A, surgeon factor and anterior chamber depth constants for intraocular lens calculation formulas in the cataract surgery at the Ramón Pando Ferrer Cuban Ophthalmological Institute from May 2007 to January 2011...

Avaliação in vitro do colar de implantes cone Morse de diferentes diâmetros sob cargas cêntrica e excêntrica: estudo por meio da Interferometria Eletrônica por Padrões de Speckle / In vitro evaluation of the collar of Morse taper dental implants with different diameters under centric and eccentric loads: an electronic speckle pattern interferometry study

Cargas oclusais excessivas podem promover tensões exageradas às estruturas de implantes/pilares/próteses, resultando em deformação, desadaptação ou mesmo fratura dos componentes e do próprio implante. Além disso, tais sobrecargas podem gerar necrose por compressão e perda óssea peri-implantar e, ainda, a ocorrência de microdeslocamentos na interface de conexão implante-pilar (I-P) ocasionando a formação de fendas propícias à colonização bacteriana, o que pode levar ao desenvolvimento de peri-implantite, contribuindo para o insucesso do conjunto. O presente estudo objetivou avaliar, por meio de uma técnica já amplamente utilizada na Engenharia e na Física a Interferometria Eletrônica por Padrões de Speckle (ESPI) as deformações a nível do colar de implantes com conexão cônica interna (cone Morse) de diferentes diâmetros (Kopp 4,3/5,5 mm e Neodent 3,5/5,0 mm), sob dois tipos (cêntrica e excêntrica) e intensidades (50 N e 100 N) de cargas, similares as quais os implantes ficam expostos durante a função mastigatória. Testou-se a hipótese de que a deformação do colar do implante seria inversamente proporcional ao diâmetro do implante. Além disso, discutiu-se vantagens e limitações da técnica ESPI frente a outros métodos comumente utilizados na avaliação de tensões. As maiores deformações foram sempre associadas às cargas excêntricas, com exceção do G1-Kopp. A maior deformação ocorreu no G1-Neodent sob carga excêntrica de 100 N e a menor, no G2-Neodent sob carga cêntrica de 50 N. A técnica ESPI mostrou-se altamente sensível e reprodutível para avaliar deformações a nivel do colar de implantes sendo possível confirmar a hipótese inicial, visto que a maior deformação esteve sempre associada aos implantes de menor diâmetro, em ambos os sistemas de implante pesquisados.

Occlusal overloading may promote excessive stresses to the implants/abutments/prosthesis, resulting in deformation, misfit or fracture of the components, until the implants. Futhermore, strains of the implant-abutment connection can cause the formation of microgaps propitious to bacterial colonization, which leads to the development of peri-implant sites, leading to the failure of the rehabilitation. This study aimed to evaluate, by a technique widely used in the engineering and physics Electronic Speckle Pattern Interferometry (ESPI) the strains related to the implant collar with internal tappered connection (Morse taper) with different diameters (Kopp 4.3/5.5 mm and Neodent 3,5/5,0 mm), under two types (centric and eccentric) and intensities (50 N and 100 N) of loads, similar which implants are exposed during masticatory function. We tested the hypothesis that the strains of the implants collar would be inversely proportional to the diameter of the implant. In addition, the survey discussed the advantages and limitations of the ESPI technique over other methods commonly used to assess strains. The largest strain was always associated with eccentric loads, except for G1-Kopp. The largest strain occurred in the G1-Neodent under the eccentric loads of 100 N and the lowest in the G2-Neodent under the centric loads of 50 N. The ESPI technique was a highly sensitive and reproducible to evaluate the strains at the level of the collar of implants being possible to confirm the initial hypothesis, since most strains was always associated with narrower-diameter implants in both implant systems studied.

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

Effect of hydrogen peroxide topical application on the enamel and composite resin surfaces and interface.

OBJECTIVES: The objective of the present study was to analyze the superficial roughness and the interface between enamel and composite resin restorations after dental bleaching procedure. MATERIALS AND METHODS: Black's class V cavities were made and restored with composite resin, and the whole set, enamel-restorative material, was treated with 35% hydrogen peroxide. Seven procedures of 30 min each were performed. A profilometric assessment was carried out before and after the treatment of each sample, and roughness scores were obtained. Treated and untreated samples were analyzed under scanning electronic microscope and images of their surface were obtained. RESULTS AND CONCLUSION: The treatment with 35% hydrogen peroxide caused no alteration in the interface between enamel and composite resin, Tetric Ceram, fillings and the topical application of 35% hydrogen peroxide on enamel and composite resin, Tetric Ceram, caused an alteration of their surface topography, featuring a predominance of depressions after the bleaching treatment.

Refractive Predictability of Partial Coherence Interferometry and Factors that can Affect It

PURPOSE: To evaluate the refractive predictability of a partial coherence interferometry (PCI) biometry device (IOL Master(R)) for cataract surgery and to investigate factors that may affect it. METHODS: Retrospective review of 209 eyes from 151 patients that had undergone preoperative PCI biometry and an uneventful phacoemulsification cataract surgery with posterior chamber intraocular lens (IOL) implantation was conducted. Prediction error defined as the intended refraction minus the postoperative refraction in spherical equivalent (SE) and the absolute error were analyzed according to IOL calculation formulas, patient characteristics, preoperative visual acuity (VA) and refraction, posterior subcapsular cataract (PSC), signal-to-noise ratio (SNR), and axial length (AL). RESULTS: The overall refractive predictability of the PCI device was good. Generally, the SRK/T formula performed better than the SRK-II formula. Refractive predictability was slightly worse in eyes with > or =+2.0 diopters (D) of preoperative SE (with both SRK-II and SRK/T) and in eyes with an AL or =+2.0D was related to a significantly greater hyperopic shift in postoperative refraction. With proper verification of measured data and a suitable IOL calculation formula, good refractive predictability is expected from PCI biometry regardless of patient characteristics, preoperative VA, SNR, PSC, and AL.

Biometrias óptica e ultra-sônica: comparação dos métodos usados para o cálculo da lente intra-ocular acomodativa / Optical and ultrasound biometry: comparision between the two methods used for the calculation of accommodative intraocular lens

OBJETIVO: Comparar a precisão e reprodutibilidade de dois biômetros ultra-sônicos convencionais e um biômetro óptico para o cálculo da lente intra-ocular (LIO) acomodativa. MÉTODOS: Pacientes com catarata foram submetidos aos exames em 3 biômetros distintos (IOLMaster®, Axis II® e Humphrey Mod. 820®), antes da cirurgia para implantação da lente intra-ocular acomodativa de silicone (C&C Vision AT-45). No biômetro Humphrey Mod. 820 utilizou-se a técnica de contato e o Axis II foi usado para as técnicas de contato e imersão. O método de interferometria óptica foi realizado pelo IOLMaster. O comprimento axial (AL), profundidade da câmara anterior (ACD) e a ceratometria corneana (K) foram os parâmetros oculares analisados. RESULTADOS: Foram submetidos aos exames 34 pacientes com média de idade de 70,6 anos e idade variando entre 53 e 90 anos. A menor média do comprimento axial (23,12 mm), foi obtida no Axis II (contato) e maior (23,21 mm) no Humphrey Mod. 820 (contato). A maior média da profundidade da câmara anterior (3,10 mm) no IOLMaster e a menor (2,97 mm) no Humphrey Mod. 820 (contato). A reprodutibilidade para os dados de comprimento axial foi significativamente grande para todos os biômetros [3,02 por cento, 3,07 por cento e 3,19 por cento respectivamente para Humphrey Mod. 820 e Axis II (imersão), Axis II (contato) e IOLMaster]. Os biômetros foram extremamente concordantes nas medidas dos parâmetros analisados (99,01 por cento e 94,77 por cento respectivamente para o comprimento axial e ceratometria corneana). Os coeficientes de Pearson (r) demonstraram alta correlação entre os aparelhos nas medidas do comprimento axial e profundidade da câmara anterior. CONCLUSAO: Os métodos do estudo para o cálculo da lente intra-ocular acomodativa, demonstraram que houve precisão e reprodutibilidade dos resultados, podendo evitar insatisfação visual do paciente no pós-operatório da cirurgia de catarata decorrente de erros no cálculo da lente intra-ocular.

Retinal visual acuity tested by laser interferometer

Rodenstock Retinometer was used to test retinal visual acuity [RVA] in three subject groups, normal, cataractous and those with fundus lesions. Snellen visual acuity [SVA] was similarly measured and compared with RVA. The quality of stimuli was changed by imitating conditions of ametropia, media opacity or stimulus eccentricity. Such maneuvers caused more reduction of SVA than RVA. Stimulus eccentricity had the most marked effect. This test could not provide definite clues to presence or absence of fundus lesions behind cataractous lenses and it could not be used for prediction of post- operative SVA. This failure was attributed to nonstandardization of retinal stimulation as regard quality of the stimulus and the area tested, both being altered by the non constant variable of site and density of lens opacity