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1.
Rev. bras. oftalmol ; 81: e0004, 2022. tab, graf
Article in Portuguese | LILACS | ID: biblio-1357124

ABSTRACT

RESUMO A acurácia do cálculo da lente intraocular não é perfeita, podendo ser comuns erros refrativos pós-operatórios, especialmente em pacientes submetidos à cirurgia refrativa prévia ou na presença de córneas assimétricas. O poder corneano após cirurgia refrativa pode ser medido com maior acurácia utilizando o mapa de poder óptico total na zona central de 4mm, com Orbscan II ou pelo mapa equivalent keratometric reading disponível no pentacam, com medidas centrais de 1,0, 2,0, 3,0 e 4,5mm. O objetivo desta série de casos é demonstrar a abordagem de quatro olhos em condições especiais corneanas, por meio do equivalent keratometric reading do pentacam para mensuração do poder corneano e o utilizando na biometria, em comparação com possíveis resultados obtidos com outras estratégias. Os quatro olhos foram submetidos a procedimentos refrativos prévios, e a lente intraocular escolhida a partir do uso do poder corneano calculado pelo equivalent keratometric reading mostrou excelentes resultados pós-operatórios.


ABSTRACT The accuracy of the intraocular lens calculation is not perfect, and postoperative refractive errors are common, especially in patients who have undergone previous refractive surgery or in presence of asymmetric corneas. Corneal power after refractive surgery can be more accurately measured using the total optical power map in the 4-mm central zone, by means of Orbscan II or equivalent keratometric reading map available on pentacam, with central measurements of 1.0, 2.0, 3.0 and 4.5 mm. The purpose of this case series is to demonstrate four approaches performed in special corneal conditions, using pentacam equivalent keratometric reading to measure corneal power and biometrics, and comparing with possible results obtained with other strategies. The four eyes were submitted to previous refractive procedures, and the intraocular lens chosen from the use of the corneal power calculated by equivalent keratometric reading showed excellent postoperative results.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Biometry/methods , Lens Implantation, Intraocular , Refractive Surgical Procedures , Refraction, Ocular/physiology , Refractive Errors/diagnosis , Refractive Errors/physiopathology , Cataract/diagnosis , Visual Acuity , Corneal Topography , Slit Lamp Microscopy , Lenses, Intraocular
2.
Educ. med. super ; 35(2): e2205, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1286229

ABSTRACT

Introducción: La capsulotomía láser representa el único tratamiento efectivo para tratar la opacidad de cápsula posterior -causa más común de disminución de la visión después de una cirugía de catarata-. Este proceder es sencillo, pero no exento de complicaciones. Hasta ahora su aprendizaje se realiza directamente en los pacientes. El uso de simuladores permite el aprendizaje de la técnica sin dañar al paciente y sin la obligada presencia del profesor. Objetivo: Validar la confección de un modelo de ojo artificial como simulador para el entrenamiento de residentes de oftalmología en capsulotomía posterior con láser. Métodos: Estudio observacional, descriptivo y prospectivo en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", realizado desde febrero hasta marzo de 2019. Se confeccionó un modelo que simula el ojo pseudofáquico con opacidad de cápsula posterior. Se eligieron ocho residentes de oftalmología de primer año que nunca habían realizado una capsulotomía láser. Todos observaron la ejecución de la capsulotomía en pacientes reales y en el modelo docente, mientras recibían la explicación de la técnica. Posteriormente, cada estudiante efectuó el proceder sobre el simulador en tres ocasiones, y se evaluó en cuanto al completamiento de la capsulotomía y los impactos al lente. Resultados: Se obtuvo un modelo de simulación para el entrenamiento de la capsulotomía posterior láser con el uso de materiales reusables. El promedio de disparos para completar el proceder fue superior al necesario en pacientes reales. No obstante, el número de disparos e impactos de láser en el lente intraocular se redujo con las sucesivas sesiones de entrenamiento. Conclusiones: El simulador confeccionado es económico y de fácil factura. Su uso resulta funcional para el entrenamiento sistemático de la capsulotomía posterior con Nd. YAG láser, sin riesgo de daño para el paciente. Contribuye a perfeccionar el enfoque y a minimizar los impactos en la lente intraocular, por lo que se muestra como un medio didáctico útil para la formación y evaluación de habilidades de los residentes de oftalmología(AU)


Introduction: Laser capsulotomy is the only effective treatment for posterior capsule opacity, the commonest cause of decreased vision after cataract surgery. This procedure is simple, but not without complications. Until now, learning such procedure has been carried out directly on patients. Using simulators allows learning the technique without harming patients and without the professor's obligatory presence. Objective: To validate the creation of an artificial eye model to be used as a simulator for the training of Ophthalmology residents in posterior capsulotomy with laser. Methods: Observational, descriptive and prospective study carried out, from February to March 2019, at Ramón Pando Ferrer Cuban Institute of Ophthalmology. A model was made that simulates the pseudophakic eye with posterior capsule opacity. Eight first-year Ophthalmology residents who had never performed a laser capsulotomy were selected. All the participants observed the performance of capsulotomy in real patients, as well as in the teaching model, while receiving the explanation regarding the technique. Subsequently, each student performed the procedure with the simulator on three occasions, and received an evaluation based on the completion of the capsulotomy and the impacts to the lens. Results: A simulation model was obtained for training posterior laser capsulotomy with the use of reusable materials. The average number of shots to complete the procedure was higher than necessary in real patients. However, the number of shots and laser impacts on the intraocular lens decreased with successive training sessions. Conclusions: The simulator created is cheap and easy to make. Its use is functional for the systematic training of posterior capsulotomy with neodymium. Yttrium aluminium garnet (YAG) laser did not have any risks to the patient. It contributes to perfecting the focus and minimizing the impacts on the intraocular lens; therefore, it is shown as a useful didactic means for the training and evaluation of skills of Ophthalmology residents(AU)


Subject(s)
Humans , Laser Therapy/methods , Posterior Capsulotomy , Simulation Training/methods , Lenses, Intraocular/adverse effects , Epidemiology, Descriptive , Prospective Studies , Observational Studies as Topic
3.
Rev. cuba. oftalmol ; 34(2): e1070, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341463

ABSTRACT

La corrección quirúrgica de la afaquia se realiza mediante varias técnicas que permiten fijar los lentes intraoculares en la cámara posterior, suturados al sulcus ciliar o por fijación transescleral de las hápticas sin suturas. El cirujano determina cuándo, dónde y cómo, además del tipo de lente a implantar. Se presenta un paciente con una afaquia traumática del ojo izquierdo, con agudeza visual sin corrección de cuenta dedos a un metro y refracción dinámica de +8,00 dioptrías con agudeza visual mejor corregida de 0,8 por cartilla de Snellen. Tensión ocular de 16 mmHg. En el examen biomicroscópico con lámpara de hendidura del ojo izquierdo se observó midriasis traumática. Se le realizó examen con biomicroscopia indirecta y resultó sin alteraciones. Se implantó el lente intraocular de tres piezas (Tecnis ZA9003) de la cámara posterior y se fijaron las hápticas a la esclera sin utilizar suturas. Al mes de la cirugía la agudeza visual mejor corregida fue la unidad de visión(AU)


Surgical aphakia correction is based on several techniques allowing to fix intraocular lenses in the posterior chamber, sutured to the ciliary sulcus or by sutureless transcleral fixation of the haptics. The surgeon will decide when, where and how, as well as the lens type to implant. A case is presented of a male patient with traumatic aphakia of his left eye, finger counting uncorrected visual acuity at one meter and dynamic refraction of +8.00 diopters with best corrected visual acuity of 0.8 by the Snellen chart. Ocular tension was 16 mmHg. Biomicroscopic slit lamp examination of the left eye found traumatic mydriasis. Indirect biomicroscopy did not find any alteration. A three-piece intraocular lens (Tecnis ZA9003) was implanted in the posterior chamber, fixing the haptics to the sclera without the use of sutures. One month after surgery, best corrected visual acuity was the vision unit(AU)


Subject(s)
Humans , Male , Aphakia/etiology , Mydriasis/diagnosis , Slit Lamp Microscopy/methods , Lenses, Intraocular
4.
Arq. bras. oftalmol ; 84(1): 11-16, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153094

ABSTRACT

ABSTRACT Purpose: To determine the effect of upper blepharoplasty on corneal topography and intraocular lens power calculation using Galilei and IOLMaster. Methods: Thirty patients submitted to upper blepharoplasty from May 2014 to March 2017 at the Hospital Oftalmológico de Sorocaba (São Paulo, Brazil) were included in this observational case series. All patients underwent imaging sessions with Galilei and IOLMaster preoperatively (baseline) and at 1 and 6 months postoperatively. Primary outcome measures using both devices included flattest, average, and steepest corneal curvature, corneal astigmatism, and blepharoplasty-induced corneal astigmatism. Determination of axial length and lens power calculation were performed using only IOLMaster (Holladay formula). Paired t-test and vectorial analysis were used for statistical analysis. Results: Sixty eyes from 30 patients were prospectively included. Vectorial analysis showed that 6 months after surgery, blepharoplasty induced on average 0.39 D and 0.31 D of corneal astigmatism, as measured with Galilei and IOLMaster, respectively. IOLMaster measurements showed that average corneal curvature (44.56 vs 44.64 D, p=0.01), steepest corneal curvature (45.17 vs 45.31, p=0.01) and corneal astigmatism (1.22 vs 1.34, p=0.03) were higher 6 months after surgery. IOLMaster measurements also showed that intraocular lens power was significantly smaller 6 months after surgery (22.07 vs 21.93, p=0.004). All other parameters showed no change for comparisons between baseline and 6 months (p>0.05 for all comparisons). Conclusion: Upper eyelid blepharoplasty influenced intraocular lens calculation using the IOLMaster. However, the influence was not clinically significant. No topographic changes were found using Galilei.


RESUMO Objetivo: Determinar o efeito da blefaroplastia superior na topografia corneana e no cálculo do poder das lentes intraoculares usando Galilei e IOLMaster. Métodos: Trinta pacientes submetidos a blefaroplastia superior de maio de 2014 a março de 2017 no Hospital Oftalmológico de Sorocaba, São Paulo, Brasil foram incluídos neste estudo de série de casos observacional. Todos os pacientes foram submetidos a sessões de imagem com Galilei e IOLMaster antes da cirurgia (exame de base) e no 1º e 6º mês pós-operatório. Os resultados primários utilizando os dois aparelhos incluíram ceratometria, astigmatismo corenano e astigmatismo corneano induzido pela blefaroplastia. O comprimento axial e o cálculo do poder da lente intraocular foram realizados unicamente com o IOLMaster (fórmula de Holladay). Teste-t pareado e análise vetorial foram usados na análise estatística. Resultados: Sessenta olhos de 30 pacientes foram incluídos prospectivamente. A análise vec­torial mostrou que após 6 meses da cirurgia, a blefaroplastia superior induziu na média 0,39 D de astigmatismo corneano medido com o Galilei e 0,31 D com IOLMaster. As medidas com o IOLMaster mostraram que a ceratometria média (44,56 vs 44,64 D, p=0,01), ceratometria máxima (45,17 vs 45,31, p=0,01) e o astigmatismo corneano (1,22 vs 1,34, p=0,03) foram maiores após 6 meses da blefaroplastia. As medidas com IOLMaster mostraram que o poder da lente intraocular foi significativamente menor 6 meses após a blefaroplastia (22,07 vs 21,93, p=0,004). Todos os outros parâmetros não mostraram mudanças entre o pré-operatório e o 6º mês da cirurgia (p>0,05 para todas as comparações). Conclusões: A blefaroplastia superior influenciou o cálculo da lente intrao­cular utilizando o IOLMaster. Contudo, a influência não foi cli­­nicamente significativa. Não foram encontradas mudanças topográficas com o Galilei.


Subject(s)
Humans , Astigmatism , Astigmatism/etiology , Biometry , Blepharoplasty , Lenses, Intraocular , Refraction, Ocular , Brazil , Cornea/surgery , Cornea/diagnostic imaging , Corneal Topography , Blepharoplasty/adverse effects , Lens Implantation, Intraocular , Eyelids
5.
Rev. bras. oftalmol ; 80(5): e0034, 2021. tab, graf
Article in English | LILACS | ID: biblio-1341156

ABSTRACT

ABSTRACT Objective To compare the performance of Sanders-Retzlaff-Kraft/Theoretical, Hoffer Q, Barrett Universal II, Kane, and Hill-radial basis function formulas to calculate intraocular lens power in eyes with normal axial length, in terms of predicting target refraction by using partial coherence interferometry technology. Methods Phacoemulsification and intraocular lens implantation were performed in 135 eyes of 135 patients with an axial length between 22 and 24.5 mm. Axial length, keratometry, and anterior chamber depth were measured by intraocular lens Master 500. Sanders-Retzlaff-Kraft/Theoretical, Hoffer Q, Barrett Universal II, Kane, and Hill-radial basis function formulas were used for intraocular lens power calculations. The difference between the expected postoperative refraction and the mean absolute prediction error was calculated for each eye. Statistical significance was evaluated at the level of p<0.05. Results The study included 135 subjects. The mean axial length, anterior chamber depth, keratometry, and intraocular lens power were 23.2±1.2 (22 to 24.5) mm, 3.2±0.4 (2.4 to 4.4) mm, 43.5±1.5 (40.8 to 46.2) diopter, 21.5±1.8 (18.5 to 25.5) diopter, respectively. The mean absolute prediction error for Sanders-Retzlaff-Kraft/Theoretical, Hoffer Q, Barrett Universal II, Kane, and Hill-radial basis function was 0.306±0.291, 0.312±0.257, 0.314±0.268, 0.299±0.206 and 0.308±0.280, respectively (p>0.05). Conclusion The study showed the third-generation (Sanders-Retzlaff-Kraft/Theoretical and Hoffer Q), fourth-generation (Barrett Universal II) and new-generation (Kane and Hill-radial basis function) intraocular lens power calculation formulas had similar performances regarding calculation of intraocular lens power to predict target refraction after phacoemulsification in eyes with normal axial length.


RESUMO Objetivo Comparar o desempenho das fórmulas Sanders-Retzlaff-Kraft/Teórica, Hoffer Q, Barrett Universal II, Kane, e Hill-radial basis function (RBF) para cálculo de poder dióptrico das lentes intraoculares, em olhos com comprimento axial normal, em termos de predição da refração alvo, utilizando a tecnologia de interferometria de coerência parcial. Métodos Facoemulsificação e implante de lentes intraoculares foram realizados em 135 olhos de 135 pacientes com comprimento axial entre 22 e 24.5 mm. Comprimento axial, ceratometria, e profundidade da câmara anterior foram medidos por lente intraocular Master 500. As fórmulas Sanders-Retzlaff-Kraft/Teórica, Hoffer Q, Barrett Universal II, Kane, e Hill-radial basis function foram empregadas para cálculo de poder dióptrico das lentes intraoculares. A diferença entre a refração esperada no pós-operatório e a média dos erros absolutos preditivos foi calculada para cada olho. Os valores de p<0,05 foram considerados estatisticamente significativos. Resultados O estudo incluiu 135 sujeitos. As médias de comprimento axial, profundidade da câmara anterior, ceratometria, e poder dióptrico das lentes intraoculares foram 23,2±1,2 (22 a 24,5) mm, 3,2±0,4 (2,4 a 4,4) mm, 43,5±1,5 (40,8 a 46,2) dioptria, 21,5±1,8 (18,5 a 25,5) dioptria, respectivamente. A média de erro absoluto preditivo para as fórmulas Sanders-Retzlaff-Kraft/Teórica, Hoffer Q, Barrett Universal II, Kane, e Hill-radial basis function foi 0,306±0,291, 0,312±0,257, 0,314±0,268, 0,299±0,206 e 0,308±0,280, respectivamente (p>0,05). Conclusão O estudo mostrou que as fórmulas de terceira geração (Sanders-Retzlaff-Kraft/Teórica e Hoffer Q), de quarta geração (Barrett Universal II) e as da nova geração (Kane e Hill-radial basis function) para cálculo de poder dióptrico das lentes intraoculares, têm desempenhos semelhantes para cálculo do poder dióptrico das lentes intraoculares, para predizer a refração alvo após facoemulsificação em olhos com comprimento axial normal.


Subject(s)
Humans , Biometry/methods , Phacoemulsification , Lens Implantation, Intraocular , Lenses, Intraocular , Refraction, Ocular/physiology , Cross-Sectional Studies , Axial Length, Eye , Observational Study
6.
Article in Spanish | LILACS | ID: biblio-1281080

ABSTRACT

Introducción: La cirugía de cataratas tiene como objetivo restablecer la función visual comprometida por la opacificación del cristalino; con el implante del Lente Intraocular se pretende obtener la mejor agudeza visual posible sin corrección adicional. Objetivos: Comparar la exactitud de 8 fórmulas de cálculo de Lentes Intraoculares en la predicción de la refracción postoperatoria con un único dispositivo de biometría óptica en pacientes operados de cirugía de catarata con técnica de facoemulsificación. Materiales y métodos: Serie de casos consecutivos retrospectivos. 100 pacientes fueron sometidos a cirugía de catarata no complicada con de Lente Intraoculares por un único cirujano; del 1 mayo del 2017 al 1 de mayo del 2018; donde la cirugía fue realizada por córnea clara facoemulsificación. En el período preoperatorio todos los pacientes fueron medidos con biometría óptica. La refracción manifiesta se obtuvo al mes de realizada la cirugía. Resultados: La fórmula más precisa y con mejor desempeño general fue PANACEA con un DRA de 0,18 D; cuando consideramos ojos cortos y largos la fórmula Barrett Universal 2 obtuvo menor error de predicción. HAIGIS y LADAS obtuvieron el mejor desempeño en ojos con cámaras estrechas y profundas respectivamente. Conclusión: No se encontraron diferencias en el defecto refractivo absoluto entre las fórmulas tradicionales de tercera generación y las de reciente desarrollo. Algunas fórmulas tuvieron mejor desempeño al considerar ciertas características anatómicas particulares. Es importante personalizar la elección de la fórmula para cada caso específico.


Introduction: Cataract surgery aims to reestablish visual function compromised by lens opacification; Intraocular Lens implantation the aim is to achieve the best visual acuity without additional correction. In recent years, new Intraocular Lens calculation formulas have appeared that could be more accurate than traditional formulas. Objectives: To compare the accuracy of 8 intraocular lens calculation formulas in the prediction of postoperative refraction with a single optical biometry device in patients undergoing cataract surgery with phacoemulsification technique. Materials and methods: Consecutive retrospective case series. Between May 1 2017 and May 1 2018; 100 patients undergo uncomplicated cataract surgery with Intraocular Lens implantation using the phacoemulsification technique. One surgeon did the cases. Optical Biometry was performed using the IOL Master 500 device. Manifest refraction was obtained one month after the surgery. Results: PANACEA was the most accurate formula; with an Absolute Refractive Defect of 0,18 D. When Considering only short and long eyes Barrett Universal 2 got the smallest defect. HAIGIS and LADAS performed better in eyes with narrow and deep anterior chamber respectively. Conclusion: No differences in Absolute Refractive Defect were found between traditional third-generation formulas and those of recent development. Some formulas performed better when considering certain particular anatomical features. It is important to customize the choice of the formula for each specific case.


Subject(s)
Cataract , Cornea , Lens, Crystalline , Biometry , Lenses, Intraocular
7.
Arq. bras. oftalmol ; 83(6): 547-551, Nov.-Dec. 2020. graf
Article in English | LILACS | ID: biblio-1153077

ABSTRACT

ABSTRACT This article reports a combined technique of sutureless intrascleral fixated intraocular lens implantation and Descemet membrane endothelial keratoplasty in a patient with anterior pseudophakic bullous keratopathy. Two scleral tunnels were created, corneal incisions were made, and a foldable intraocular lens was cut and removed from the anterior chamber. After performing anterior vitrectomy, a 3-piece foldable intraocular lens was implanted into the anterior chamber. One of the intraocular lens haptics was grasped with a forceps and pulled out from the scleral tunnel. Then, the end of the haptic was cauterized. Similar maneuvers were applied for the other haptic. Next, an 8-mm-diameter donor tissue was prepared, and the recipient endothelial tissue was peeled and removed from the center of the recipient cornea. The prepared donor tissue was injected into the anterior chamber. After proper opening and placement of the donor tissue, an air bubble was injected below the tissue. There were no postoperative complications during the 1-month follow-up.


RESUMO Relato de uma técnica que combina o implante de uma lente intraocular com fixação intraescleral sem sutura e uma ceratoplastia endotelial da membrana de Descemet em paciente com ceratopatia bolhosa pseudofácica anterior. Foram criados dois túneis esclerais. Foram feitas incisões na córnea e a lente intraocular dobrável foi cortada e removida da câmara anterior. Foi então efetuada uma vitrectomia anterior e uma lente intraocular dobrável de 3 peças foi implantada na câmara anterior. Um dos hápticos da lente intraocular foi pinçado com um fórceps e puxado para fora do túnel escleral. A extremidade do háptico foi cauterizada. Manobras semelhantes foram feitas no outro háptico. Foi preparado um tecido de doador com 8 mm de diâmetro e o tecido endotelial da área receptora foi removido do centro da córnea. O tecido preparado do doador foi injetado na câmara anterior. Após abertura e posicionamento adequados do tecido do doador, foi injetada uma bolha de ar abaixo do tecido. Não foi observada nenhuma complicação pós-operatória durante um mês de acompanhamento.


Subject(s)
Humans , Female , Aged , Corneal Transplantation , Lenses, Intraocular , Sclera/surgery , Surgical Instruments , Lens Implantation, Intraocular , Descemet Membrane
8.
Rev. bras. oftalmol ; 79(6): 386-390, nov.-dez. 2020. tab
Article in English | LILACS | ID: biblio-1156162

ABSTRACT

Abstract Purpose: To evaluate six different premium IOLs retrospectively in respect to both subjective and objective refraction after cataract operation. Methods: Five hundreds and seventy eyes of 285 patients with bilateral cataract who had undergone phacoemulsification and IOL implantation operation between February 2017 and September 2018 were enrolled in this study. The mean age of the patients was 57.78 ± 7.49 (41-71) years. Out of 285 patients 137 were male (48.07%) and 148 were female (51.93%). TheIOLsusedare: RayOne Trifocal (Rayner, Worthing, UK), Lucidis (Swiss Advanced Vision, Neuchâtel, Switzerland), PanOptix (Alcon, Fort Worth, USA), LentisMplus (Oculentis, Berlin, Germany), TecnisSymfony (Abbott, Illinois, USA) and Acriva Trinova (VSY Biotechnology, Istanbul, Turkey). Results: There were no significant differences among the groups regarding age, sex, axial length, the mean preoperative and postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), the mean preoperative spherical equivalent (SE) and the mean postoperative SE (subjective measurement) (P> .05). The postoperative refractions measured with autorefractometer were more myopic than subjective refractions in all patients except the patients who had PanOptix IOL. In postoperative twelfth month, the mean UCVA arrived 0.00 logMAR in 405 eyes (78.48%) , however, the mean autorefractometric measurement was -1.28 ± 1.02 (0.00_-2.75) D. Conclusion: The autorefractometer measurements of all patients who had premium IOLs except PanOptix IOL were not coherent with their visual acuities postoperatively. The ophthalmologists and/or optometrists should be careful while examining these types of patients.


Resumo Objetivo: Avaliar retrospectivamente seis diferentes LIOs premium em relação à refração subjetiva e objetiva após operação de catarata. Métodos: Quinhentos e setenta (570) olhos de 285 pacientes com catarata bilateral submetidos a facoemulsificação e operação de implantação de LIO entre fevereiro de 2017 e setembro de 2018 foram incluídos neste estudo. A média de idade dos pacientes foi de 57,78 ± 7,49 (41-71) anos. Dos 285 pacientes, 137 eram do sexo masculino (48,07%) e 148, do sexo feminino (51,93%). As seguintes IOLs foram utilizadas: RayOne Trifocal (Rayner, Worthing, Reino Unido), Lucidis (Swiss Advanced Vision, Neuchâtel, Suíça), PanOptix (Alcon, Fort Worth, EUA), LentisMplus (Oculentis, Berlim, Alemanha), TecnisSymfony (Abbott, Illinois, EUA) e Acriva Trinova (VSY Biotechnology, Istambul, Turquia). Resultados: Não houve diferenças significativas entre os grupos em relação à idade, sexo, comprimento axial, média da acuidade visual não corrigida pré e pós-operatória (AVNC), melhor acuidade visual corrigida (MAVC), equivalente esférico pré-operatório médio (EE) e EE pós-operatório médio (medição subjetiva) (P > 0,05). As refrações pós-operatórias medidas com autorefratômetro foram mais míopes do que as refrações subjetivas em todos os pacientes, exceto naqueles que usavam LIO PanOptix. No décimo segundo mês pós-operatório, a AVNC média chegou a 0,00 logMAR em 405 olhos (78,48%); no entanto, a medição autorefractométrica média foi de -1,28 ± 1,02 (0,00_-2,75) D. Conclusão: As medições autorefractométricas de todos os pacientes que usavam LIOs premium, exceto LIO PanOptix, não foram coerentes com suas acuidades visuais no pós-operatório. Oftalmologistas e/ou optometristas devem ter cuidado ao examinar pacientes com esses perfis.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Refraction, Ocular , Visual Acuity , Phacoemulsification/methods , Lenses, Intraocular , Retrospective Studies
9.
Rev. bras. oftalmol ; 79(5): 341-343, set.-out. 2020. graf
Article in Portuguese | LILACS | ID: biblio-1137983

ABSTRACT

Resumo Descrição de relato de caso de paciente com ceratocone (KC), Distrofia Endotelial de Fuchs (DEF) e catarata concomitantes com descompensação corneana submetido a Ceratoplastia Lamelar Posterior pela técnica Descemet's Membrane Endothelial Keratoplasty (DMEK) associado a facoemulsificação com implante de lente intraocular (LIO). Observou-se aplanamento corneano significativo no pós-operatório e acuidade visual final sem correção de 20/25 . Destaca-se a possibilidade do DMEK como alternativa à Ceratoplastia Penetrante (Penetrating Keratoplasty - PK) em casos de DEF e KC associados. Aplanamento corneano pode ocorrer neste grupo de pacientes, o que pode resultar em imprevisibilidade refracional no cálculo do poder da LIO ao se optar por facectomia combinada. Neste relato, apesar da modificação da curvatura corneana após cirurgia combinada de DMEK com facectomia, a acuidade visual final sem correção foi satisfatória, demonstrando a possibilidade de sucesso desta abordagem na coexistência de DEF, KC e Catarata. Entretanto, a possibilidade de mudança significativa na curvatura corneana deve ser considerada em pacientes com KC, edema de córnea secundário a DEF e catarata, na decisão de cirurgia simultânea ou em dois tempos.


Abstract This is a case report of a patient with concomitant Keratoconus (KC), Fuchs Endothelial Dystrophy (FED) and cataract with corneal decompensation submitted to Posterior Lamellar Corneal surgery (Descemet's Membrane Endothelial Keratoplasty - DMEK) associated with phacoemulsification with intraocular lens (IOL) implantation. Corneal flattening and uncorrected visual acuity of 20/25 was observed in the postoperative period. We reasure the viability of DMEK as an alternative to Penetrating Keratoplasty (PK) in cases of associated DEF and KC associated. Changes in corneal curvature may occur in this group of patients and lead to the possibility of refractive unpredictability in IOL calculation when performing a combined cataract surgery. Despite unexpected corneal flattening, satisfactory final visual acuity was achieved, demonstrating the possibility of success of this approach in the coexistence of the three conditions. Nonetheless, the possibility of corneal curvature changes should be considered in patients with KC and corneal decompensation due to FED in decision making, regarding simultaneous or sequential surgical approach.


Subject(s)
Humans , Female , Middle Aged , Tomography/methods , Fuchs' Endothelial Dystrophy/surgery , Phacoemulsification/methods , Descemet Stripping Endothelial Keratoplasty/methods , Keratoconus/surgery , Lenses, Intraocular
10.
Rev. cuba. oftalmol ; 33(3): e875,
Article in Spanish | LILACS, CUMED | ID: biblio-1139094

ABSTRACT

RESUMEN La catarata es la primera causa de ceguera curable en el mundo y se produce por la opacidad del cristalino, con una disminución gradual, lenta y progresiva de la agudeza visual. La cirugía para extraer el cristalino es la única forma de curar esta discapacidad visual. La facoemulsificación ha evolucionado con el fin de lograr su perfección y el objetivo de restablecer la visión de los pacientes con la mayor calidad y cantidad en el menor tiempo posible. El desarrollo científico ha estado encaminado a controlar o eliminar el astigmatismo preoperatorio o inducido por la cirugía, y para esto se ha incluido en la actualidad el empleo de los lentes intraoculares trifocales flexibles tóricos y las incisiones menores a dos milímetros en la córnea clara, así como las incisiones relajantes limbares, las incisiones opuestas en la córnea clara, la cirugía refractiva fotoablativa y el láser de femtosegundo. Para lograr un resultado refractivo en la cirugía de catarata es imprescindible minimizar al máximo el astigmatismo inducido por el procedimiento. Este éxito se logra con un estudio personalizado preoperatorio exhaustivo, que permita satisfacer las necesidades visuales del paciente y su reincorporación temprana a sus tareas. De ahí la motivación para realizar una búsqueda de los últimos diez años de diversos artículos publicados, con el objetivo de describir los principios para evaluar el astigmatismo medio inducido posterior a la cirugía del cristalino, y su repercusión en la calidad visual y de vida de los pacientes. Se utilizó la plataforma google, específicamente la Biblioteca Virtual de Salud, con todos sus buscadores(AU)


ABSTRACT Cataract is the leading cause of curable blindness worldwide. It results from opacity of the crystalline lens with gradual, slow and progressive visual acuity reduction. Surgery for removal of the crystalline lens is the only cure for this visual impairment. Phacoemulsification technique has evolved to achieve perfection and the aim of restoring patients' vision with the greatest quality and quantity in the shortest possible time. Scientific development has been aimed at either controlling or eliminating preoperative or surgically induced astigmatism. To achieve this aim, recent inclusion has been made of the use of flexible toric trifocal intraocular lenses and minor incisions at two millimeters in the clear cornea, as well as limbal relaxing incisions, opposite incisions in the clear cornea, photoablative refractive surgery and femtosecond laser. To obtain a good refractive result in cataract surgery it is indispensable to minimize the astigmatism induced by the procedure. Such success is accomplished through an exhaustive personalized preoperative study allowing to meet the visual needs of patients and their early reincorporation to daily activities. Hence the motivation to conduct a search of a variety of papers published in the last ten years with the purpose of describing the principles applied to evaluate mean induced astigmatism after crystalline lens surgery and its effect on the patients' visual acuity and quality of life. Use was made of the Google platform, particularly the Virtual Health Library with all its search engines(AU)


Subject(s)
Humans , Astigmatism , Cataract Extraction/methods , Phacoemulsification/methods , Lenses, Intraocular/adverse effects , Review Literature as Topic , Databases, Bibliographic
11.
Rev. cuba. oftalmol ; 33(3): e888, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139092

ABSTRACT

RESUMEN La cirugía de catarata es uno de los procedimientos quirúrgicos más frecuentes de toda la medicina. El objetivo de la técnica es eliminar el cristalino opacificado y sustituirlo con lentes intraoculares para lograr una rehabilitación de la función visual. El cálculo preciso de la posición efectiva del lente es crítico para lograr un buen resultado refractivo. Esta es la única variable que no puede medirse en el preoperatorio y que debe predecirse, por lo que representa uno de los retos más grande para el cirujano de catarata, ya que puede influir ampliamente en el resultado visual del paciente. Investigaciones recientes proponen nuevos parámetros para la estimación de la posición efectiva del lente, que están relacionados con la geometría del cristalino. Se realizó una búsqueda con el objetivo de describir la importancia de una adecuada estimación de la posición efectiva del lente y para conocer las últimas fórmulas propuestas para el cálculo del lente. Se encontraron estudios de investigación recientes en varias partes del mundo que proponen nuevas fórmulas basadas en parámetros anatómicos del cristalino. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud, con todos sus buscadores(AU)


ABSTRACT Cataract surgery is one the most common surgeries within medicine. The technique's objective is the removal of the natural lens of the eye that has developed an opacification, and its replacement with an intraocular lens to provide optimal visual acuity. An accurate assessment of the effective lens position is critical to achieve a good postoperative refractive outcome. This is the only variable that cannot be measured in the preoperative period and most be predicted, therefore it represents one of the greatest challenge for the cataract surgeon, since it can greatly influence the visual outcome of the patient. Recent research proposes new parameters of the estimation of the effective lens position that are related to the geometry of the lens. Research has been made in order describe the importance of an adequate estimation of the effective lens position and to learn more about the lastest formulas proposed for its calcutation. Many studies proposed new formulas based on lens geometry parameters. The Infomed platform, specifically the Virtual Health Library, was used with all its search engines(AU)


Subject(s)
Humans , Surgical Procedures, Operative/rehabilitation , Cataract/etiology , Forecasting , Lenses, Intraocular/adverse effects , Search Engine/methods
12.
Rev. cuba. oftalmol ; 33(3): e891, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1139085

ABSTRACT

RESUMEN Objetivo: Determinar los resultados refractivos en pacientes operados de catarata, según el cálculo del poder dióptrico de la lente intraocular con la fórmula Holladay 2. Métodos: Se realizó un estudio descriptivo prospectivo y longitudinal en 222 ojos de 173 pacientes operados de catarata mediante la técnica de facoemulsificación. Se empleó para el cálculo de la lente el IOL Master 700 y la fórmula Holladay 2. Resultados: Predominó el sexo femenino y el grupo etario mayor de 60 años. En el posoperatorio se observó una mejoría en la agudeza visual sin corrección y corregida de más de 4 líneas en la cartilla de Snellen, independiente de la longitud axial, sin cambios significativos en el cilindro queratométrico. En 69,0 por ciento de los casos el resultado refractivo final estuvo en el rango de la emetropía. Los ojos mayores de 26 mm presentaron una disminución del equivalente esférico superior a 6 dioptrías en el posoperatorio; los menores de 22 mm mostraron la mayor diferencia entre el poder dióptrico de la lente intraocular que se implantó y el que sugiere la fórmula convencional. Conclusiones: La fórmula Holladay 2 resulta útil para el cálculo de la lente intraocular en todos los rangos de longitud axial(AU)


ABSTRACT Objective: Determine refractive results in patients undergoing cataract surgery based on intraocular lens dioptric power calculation with the Holladay 2 formula. Methods: A prospective longitudinal descriptive study was conducted of 222 eyes of 173 patients undergoing cataract surgery by phacoemulsification technique. IOL Master 700 and the Holladay 2 formula were used for lens calculation. Results: There was a predominance of the female sex and the over-60 years age group. The postoperative period was characterized by improvement in visual acuity without correction and corrected of more than 4 lines on the Snellen chart, regardless of axial length, with no significant changes in the keratometric cylinder. In 69.0 percent of the cases, the final refractive result was within the range of emmetropia. Eyes larger than 26 mm displayed a spherical equivalent reduction above 6 diopters postoperative, whereas eyes smaller than 22 mm showed the greatest difference between the dioptric power of the intraocular lens implanted and the one suggested by the conventional formula. Conclusion: The Holladay 2 formula is useful for intraocular lens calculation in all axial length ranges(AU)


Subject(s)
Humans , Female , Middle Aged , Cataract/diagnosis , Visual Acuity , Phacoemulsification/methods , Lenses, Intraocular/adverse effects , Epidemiology, Descriptive , Prospective Studies , Longitudinal Studies , Observational Studies as Topic , Emmetropia/physiology
14.
Arq. bras. oftalmol ; 83(4): 289-293, July-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131608

ABSTRACT

ABSTRACT Purpose: Pharmacological pupillary dilation is performed in comprehensive ophthalmological examinations and before biometric measurements. So far, there is no consensus regarding its impact on biometric measurements. This study's aim was to investigate the effects of pharmacological pupillary dilation on ocular biometric measurements in healthy children. Methods: This was a prospective, observational, non-randomized study of children (4-18 years of age) who were admitted for routine ophthalmological examination. Biometric measurements were performed, using a non-contact optical biometry device, both before and after pharmacological pupillary dilation with cyclopentolate hydrochloride. Intraocular lens power calculations were performed using Hill-RBF, Barrett, Olsen, Sanders-Retzlaff-Kraff/Theoretical, Holladay, and Hoffer Q formulas. Descriptive statistical analyses were also performed. The Wilcoxon signed-rank test was used to compare measurements before and after pharmacological pupillary dilation. Relationships between variables were analyzed using the Spearman-Brown rank correlation coefficient. Results: The study included 116 eyes of 58 children (mean age, 8.4 ± 0.32 years; 34 girls). Significant changes were observed after pupillary dilation, compared with before pupillary dilation, in terms of anterior chamber depth, aqueous depth, and central corneal and lens thicknesses. No significant change was observed in axial length. Intraocular lens power calculations revealed no significant changes after pupillary dilation in most formulas except for the Olsen formula. The intraocular lens power was significantly inversely correlated with axial length and anterior chamber depth. Conclusions: Pharmacological pupillary dilation in children appeared to have no impact on axial length and intraocular lens power, but caused a significant increase in anterior chamber depth. The difference in anterior chamber depth measurements before and after pupillary dilation could be related to the optical biometry device model used. These outcomes should be considered in intraocular lens power calculations performed using anterior chamber depth parameters.


RESUMO Objetivo: A dilatação pupilar farmacológica é realizada em exames oftalmológicos abrangentes e antes das medições biométricas. Até o momento, não há consenso sobre seu impacto nas medições biométricas. O objetivo deste estudo foi investigar os efeitos da dilatação pupilar nas medidas biométricas oculares em crianças saudáveis. Métodos: Estudo prospectivo, observacional e não randomizado de crianças (4-18 anos) que foram admitidas para exame oftalmológico de rotina. As medidas biométricas foram realizadas usando um dispositivo de biometria óptica sem contato, antes e após a dilatação pupilar farmacológica com cloridrato de ciclopentolato. Os cálculos de potência das lentes intraoculares foram realizados utilizando as fórmulas de Hill-RBF, Barrett, Olsen, Sanders-Retzlaff-Kraff/ Teórica, Holladay e Hoffer Q. Análises estatísticas descritivas também foram realizadas. O teste dos postos sinalizados de Wilcoxon foi usado para comparar as medidas antes e após a dilatação pupilar farmacológica. As relações entre as variáveis foram analisadas pelo coeficiente de correlação de Spearman-Brown. Resultados: O estudo incluiu 116 olhos de 58 crianças (idade média de 8,4 ± 0,32 anos; 34 meninas). Alterações significativas foram observadas após a dilatação pupilar, em termos de profundidade da câmara anterior, profundidade do humor aquoso e espessura central da córnea e do cristalino. Nenhuma mudança significativa ocorreu no comprimento axial. Os cálculos de potência da lente intraocular não revelaram alterações significativas após a dilatação pupilar na maioria das fórmulas, com exceção da fórmula Olsen. O poder da lente intraocular foi significativamente inversa correlacionada com o comprimento axial e a profundidade da câmara anterior. Conclusões: A dilatação pupilar farmacológica em crianças parece não ter impacto no comprimento axial e no poder da lente intraocular, mas causou um aumento significativo na profundidade da câmara anterior. A diferença nas medidas da profundidade da câmara anterior antes e após a dilatação pupilar pode estar relacionada ao modelo do dispositivo de biometria óptica utilizado. Tais resultados devem ser considerados nos cálculos de potência da lente intraocular realizados usando parâmetros de profundidade da câmara anterior.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Biometry , Dilatation , Axial Length, Eye/diagnostic imaging , Anterior Chamber/anatomy & histology , Anterior Chamber/diagnostic imaging , Refraction, Ocular , Prospective Studies , Optics and Photonics , Lenses, Intraocular
15.
Arq. bras. oftalmol ; 83(4): 329-331, July-Aug. 2020. graf
Article in English | LILACS | ID: biblio-1131599

ABSTRACT

ABSTRACT Despite the recent developments in modern cataract surgery and the application of a vast array of new devices and machines, late in-the-bag intraocular lens dislocation remains a devastating, albeit rare, complication. Various nonsurgical and surgical techniques have been used to manage this complication. We report a case of spontaneous repositioning in the left eye of an anteriorly subluxated in-the-bag intraocular lens. The spontaneous repositioning may have been caused by antagonistic effects related to the topical administration of brimonidine and prednisolone. The dislocation was treated without aggressive manipulation or surgical intervention.


RESUMO Apesar dos recentes avanços na cirurgia moderna de catarata e da aplicação de uma ampla gama de novos dispositivos, o deslocamento tardio de uma lente intraocular dentro do saco capsular continua a ser uma complicação devastadora, ainda que rara. Várias técnicas cirúrgicas e não cirúrgicas têm sido usadas para tratar esta complicação. Este é o relato de um caso de reposicionamento espontâneo de uma lente intraocular sub-luxada anteriormente dentro do saco capsular do olho esquerdo. Este reposicionamento pode ter sido causado pelos efeitos opostos da aplicação tópica simultânea de brimonidina e prednisolona. O deslocamento foi tratado sem manipulação agressiva ou intervenção cirúrgica.


Subject(s)
Humans , Drug Repositioning , Lenses, Intraocular , Postoperative Complications , Visual Acuity , Lens Subluxation , Retrospective Studies
16.
Rev. bras. oftalmol ; 79(1): 42-45, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1092659

ABSTRACT

Abstract Purpose: To determine the impact of neodymium:YAG (Nd:YAG) laser posterior capsulotomy on quality of life and visual acuity in adults. Methods: A prospective study that included patients over 65 years old with clinical indications for Nd: YAG laser capsulotomy. On the day of the procedure, corrected distance visual acuity tests, slit-lamp examination and posterior capsule opacification (PCO) photo documentation were performed, followed by application of the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). The PCO rate was evaluated with Evaluation of Posterior Capsule opacification (EPCO 2000) software. Four weeks after the posterior capsulotomy, corrected distance visual acuity was measured, and the NEI-VFQ-25 was applied again. Complications were also reported. Results : Sixty eyes from 45 patients were enrolled in the study. The mean age was 71.51 ± 6.38 years (65 to 93). Comparing the results before and after the Nd:YAG laser capsulotomy, there was a statistically significant improvement in quality of life according to the NEI-VFQ-25 (p<0.001) and in visual acuity (p=0.0). The mean score in NEI-VFQ-25 Questionnaire before capsulotomy was 62.07 ± 20.90 (16.81-95.90) and after was 83.95±19.49 (20.68 - 100.0). The mean CDVA before the procedure was 0.75 ± 0.35 LogMAR (0.1-1.3) and after was 0.21 ± 0.20 LogMAR (0.0-1.3). The mean PCO rate measured by the EPCO software was 0.688 ± 0.449. There was a positive correlation between the EPCO score and the total score of quality of life after Nd: YAG laser capsulotomy (r=0.845, p=0.00). Damage to intraocular lens was the only complication observed in six eyes (10%). Conclusion: Nd: YAG laser capsulotomy, in addition to improving visual acuity, is able to improve quality of life.


Resumo Objetivo: Determinar o impacto da capsulotomia posterior com laser de neodímio: YAG (Nd: YAG) na qualidade de vida e na acuidade visual em adultos. Métodos: Estudo prospectivo que incluiu pacientes acima de 65 anos com indicação clínica para capsulotomia com laser de Nd: YAG. No dia do procedimento, foram realizados testes de acuidade visual corrigida, exame com lâmpada de fenda e fotodocumentação da opacificação da cápsula posterior (OCP), seguido da aplicação do National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). A taxa de OCP foi avaliada utilizando o software de avaliação de opacificação de cápsula posterior (EPCO 2000). Quatro semanas após a capsulotomia posterior, a acuidade visual corrigida foi medida, e o NEI-VFQ-25 foi aplicado novamente. Complicações também foram relatadas. Resultados: Sessenta olhos de 45 pacientes foram incluídos no estudo. A idade média foi de 71,51±6,38 anos (65 to 93). Comparando os resultados antes e após a capsulotomia com laser Nd: YAG, houve melhora estatisticamente significante na qualidade de vida de acordo com o NEI-VFQ-25 (p <0,001) e na acuidade visual (p = 0,0). A média do escore total do questionário NEI-VFQ-25 pré capsulotomia foi de 62.07 ± 20.90 (16.81-95.90) e pós foi de 83.95 ±19.49 (20.68 - 100.0). A AVCC antes do procedimento foi 0.75 ± 0.35 LogMAR (0.1-1.3) e após foi 0.21 ± 0.20 LogMAR (0.0-1.3). A taxa média de OCP medida pelo software EPCO foi de 0,688 ± 0,449. Houve correlação positiva entre o escore EPCO e o escore total de qualidade de vida após a capsulotomia com laser de Nd: YAG (r = 0,845, p = 0,00). O dano à lente intraocular foi a única complicação observada em seis olhos (10%). Conclusão: A capsulotomia com laser Nd: YAG, além de melhorar a acuidade visual, é capaz de melhorar a qualidade de vida.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Quality of Life , Capsule Opacification/surgery , Posterior Capsulotomy/psychology , Cataract Extraction , Visual Acuity , Prospective Studies , Surveys and Questionnaires , Lens Implantation, Intraocular , Laser Therapy/methods , Lasers, Solid-State , Posterior Capsule of the Lens/surgery , Posterior Capsule of the Lens/pathology , Posterior Capsulotomy/methods , Lenses, Intraocular , Neodymium
17.
Rev. bras. oftalmol ; 79(1): 6-11, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1092657

ABSTRACT

Abstract Purpose: To assess long, intermediate and near uncorrected visual acuity after a tetrafocal diffractive intraocular lens implantation, presence of dystopic phenomenon and patient satisfaction after surgery. Methods: Retrospective, observational study performed in Puerta de Hierro Specialties Hospital, in Jalisco, México. That included 100 eyes after phacoemulsification surgery by femtosecond assistance, followed by tetrafocal diffractive intraocular lens implantation due to cataract. Long, intermediate and near visual acuity without correction was measured, and presence or absence of dystopic phenomenon, plus patient satisfaction after surgery. Results: A total of 100 eyes in 50 patients who underwent cataract surgery with phacoemulsification by femtosecond assistance were evaluated. 100% underwent bilateral phacoemulsification. Long, intermediate, and near visual acuity after three months was in the most patients 20/20 (46%), 20/15 (44%) and Jaeger 1 (48%) respectively. The percentage or patients who refers halos was 7%; and other associated symptoms in 18%, being astenopia the most prevalent. The removal of the lens was not required in any case. Conclusion: Tetrafocal diffractive intraocular lenses provides excellent intermediate vision (at 60 centimeters) and satisfactory near (30 centimeters) and long (6 meters) visual acuity.


Resumo Objetivo: Avaliar a acuidade visual de longe, intermediária e de perto após o implante de lente intra-ocular difrativa tetrafocal, presença de fenômenos distópicos e satisfação do paciente após a cirurgia. Métodos: Estudo retrospectivo, observacional, realizado em Puerta de Hierro Hospital de Especialidades, em Jalisco, México. Isso incluiu 100 olhos após a cirurgia de facoemulsificação pela presença de laser de femtosegundo, seguida por implante de lente intra-ocular difrativa tetrafocal devido à catarata ou cirurgia facorrefractiva. Foi medida a acuidade visual de longe, intermediária e de perto, e a presença ou ausência de fenômenos distópicos, além da satisfação do paciente após a cirurgia. Resultados: Um total de 100 olhos em 50 pacientes submetidos à cirurgia de catarata com facoemulsificação por femtosegundo foram avaliados. 100% foram submetidos a facoemulsificação bilateral. A acuidade visual para longe, intermediária e de perto após três meses foi na maioria dos pacientes 20/20 (46%), 20/15 (44%) e Jaeger 1 (48%) respectivamente. A porcentagem ou pacientes que se referem a halos foi de 7%; e outros sintomas associados em 18%, sendo a astenopia a mais prevalente. A remoção da lente não foi necessária em nenhum caso. Conclusão: A lente intra-ocular difrativa tetrafocal fornece excelente visão intermediária (a 60 centímetros) e acuidade visual satisfatória de perto a (30 centímetros) e de longe (6 metros).


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Phacoemulsification/methods , Lens Implantation, Intraocular/methods , Lenses, Intraocular , Presbyopia/surgery , Presbyopia/diagnosis , Refraction, Ocular/physiology , Cataract/diagnosis , Visual Acuity/physiology , Retrospective Studies , Treatment Outcome , Patient Satisfaction , Observational Study
18.
Article in Korean | WPRIM | ID: wpr-811328

ABSTRACT

PURPOSE: To determine the through-focus optical bench test performance of monofocal, bifocal, and extended depth-of-focus intraocular lenses (IOLs), and to measure their defocus curves.METHODS: A model eye was placed on an optical bench to test three different IOLs (TECNIS ZXR00, ZMB00, and ZCB00; Abbott Medical Optics, Santa Ana, CA, USA). The focus was changed by inserting trial lenses from +1.00 diopters to −4.00 diopters, in increments of +0.25 diopters. The 1951 United States Air Force Resolution chart was used to determine the quality of the images. The degree of similarity with reference images was given by the cross-correlation coefficient, and defocus curves were drawn and compared.RESULTS: Bifocal IOLs showed lower image quality with the addition of minus diopter trial lenses, but showed good image quality at near distance. Bifocal IOLs also showed a ‘double peak’ in their defocus curve. Monofocal IOLs showed a lower image quality and cross-correlation coefficient with addition of lower-diopter trial lenses. The extended depth of focus IOLs showed a single peak in their defocus curve, but had a wider range of diopters and better image quality than monofocal IOLs.CONCLUSIONS: Bifocal IOLs showed a double peak defocus curve, and extended depth of focus IOLs showed a wider diopter range and better image quality than monofocal IOLs.


Subject(s)
Lenses, Intraocular , United States
19.
Article in Korean | WPRIM | ID: wpr-811320

ABSTRACT

PURPOSE: To report a patient with a pseudophakic bullous keratopathy (PBK) who underwent Descemet's membrane stripping endothelial keratoplasty (DSEK) with manual preparation of the donor corneal graft.CASE SUMMARY: A 61-year-old female presented with visual disturbance in her right eye. Five months prior, she was treated with phacoemulsification and intraocular lens exchange surgery of the right eye, and a very severe corneal edema was revealed by slit-lamp examination. We diagnosed PBK and planned DSEK with manual preparation of a donor corneal graft because of the non-availability of a microkeratome or a femtosecond laser. After making the corneal graft using an artificial anterior chamber, crescent knife and cornea dissector, the keratoplasty proceeded using the graft. Three months after surgery, her graft was well-maintained on the right eye. The patient's visual acuity was 0.3, and the corneal endothelial cell count was 1,844/mm².CONCLUSIONS: Manual preparation of the donor corneal graft for DSEK is suitable as a second choice treatment method when the availability of surgical devices is limited.


Subject(s)
Anterior Chamber , Cornea , Corneal Edema , Corneal Transplantation , Descemet Membrane , Endothelial Cells , Female , Humans , Lenses, Intraocular , Methods , Middle Aged , Phacoemulsification , Tissue Donors , Transplants , Visual Acuity
20.
Article in Korean | WPRIM | ID: wpr-811315

ABSTRACT

PURPOSE: In this study, we evaluated changes in the anterior chamber structure and lens position before and after phacoemulsification in eyes grouped by axial length (AL).METHODS: This study included 65 eyes (16 short eyes [AL < 22.5 mm], 33 normal eyes [22.5 mm < AL < 25.0 mm], and 16 long eyes [AL > 25.5 mm]) that underwent cataract surgery. Pre- and postoperative anterior chamber depth (ACD) was measured using Pentacam® and IOL Master®,. In addition, we evaluated the anterior chamber angle (ACA), anterior chamber volume (ACV), epithelium-iris distance, and iris-lens (intraocular lens [IOL]) distance.RESULTS: The change in ACD was significantly smaller in long eyes (Pentacam®,, p = 0.000; IOL Master®,, p = 0.001). The change in ACA was significantly larger in short eyes (p = 0.000), and the change in ACV was significantly smaller in long eyes (p = 0.000). The change in the epithelium–iris distance was significantly smaller in long eyes (p = 0.000), and the change in the iris-lens (IOL) distance was significantly smaller in short eyes (p = 0.000).CONCLUSIONS: In short eyes, changes in ACD, ACA, and ACV were found to be larger than those of other groups as the iris moved backward. In long eyes, greater backward movement of the IOL was observed. Therefore, the appropriate IOL power should be chosen, considering the postoperative position of the IOL during cataract surgery of short and long eyes.


Subject(s)
Anterior Chamber , Cataract , Iris , Lenses, Intraocular , Phacoemulsification
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