Clinical Outcome of in-the-Bag Single-Piece Aspheric Intraocular Lens Implantation after Microincision Cataract Surgery

PURPOSE: To evaluate the stability and optical performance of the newly developed single-piece aspheric intraocular lens (IOL) by comparing the clinical outcome of the aspheric IOL with the new optic profile design (HOYA iSert, HOYA iMics) and the aspheric IOL (Akreos MI60), which has been proven effective and safe. METHODS: iSert, iMics, and MI60 were inserted into 55 eyes, 60 eyes, and 50 eyes, respectively, after microincision phacoemulsification cataract surgery. Best corrected visual acuity (BCVA), refraction in spherical equivalent, anterior chamber depth (ACD), total higher order aberration (HOA), contrast sensitivity, and surgically induced astigmatism (SIA) were measured and each IOL was evaluated on the functional stability, anterior-posterior stability, centration in the capsular bag, and quality of vision. RESULTS: No statistical differences in preoperative and postoperative BCVA among the 3 IOL groups were observed, however, MI60 showed significant myopic shift postoperatively. Anterior-posterior stability assessed with postoperative change in refractive error and ACD was slightly lower in the MI60 group. In terms of vision quality, while total aberration, total HOA, coma aberration, and contrast sensitivity for the 3 IOLs were not different significantly, spherical aberration of the MI60 group was higher than the other groups at 6 months postoperative. SIA was significantly increased in eyes implanted with iSert than in eyes with iMics or MI60 at 1 month postoperatively, however, the differences were no longer evident after 3 months postoperatively. CONCLUSIONS: The new aspheric IOLs, iSert and iMics, showed good stability and visual outcome equal to MI60 at the 6-month postoperative follow-up.

Posterior Laxity after Conservative Treatment of the Acute Injured Posterior Cruciate Ligament

PURPOSE: This study analyzed the contributing factors on posterior stability after conservative treatment for the posterior cruciate ligament(PCL) injury. MATERIALS AND METHODS: During the period from June 1996 to February 2002, 16 cases had been followed for more than 12 months after conservative treatment for acute PCL injury. We analyzed associated injury, continuity and location of PCL injury by magnetic resonance imaging(MRI) also subjective scores and serial stress radiogram. RESULTS: The average posterior displacement after conservative treatment was 4.0 mm. At last follow up, posterior drawer radiogram showed average 3.3 mm in isolated PCL injury, 4.6 mm in associated injuries. In serial posterior drawer radiogram, side to side difference was average 9.1 mm at injured time, 6.0 mm at 3 months after injury, 4.5 mm at 9 months after injury, 4.0 mm at 12 months after injury. In MRI findings, twelve cases showed interstitial tear of PCL, four cases complete disrupted, respectively and their posterior displacement was at last follow op 3.7 mm, 5.0 mm. The PCL tear location was in the proximal third in 3 cases, the middle third in 8 cases, and the distal third in 5 cases. Lysholm knee score improved from 73.3 points at 6 months after injury to 86.1 points at final follow up. Lysholm knee score was 84.6 points in patients > 5 mm posterior tibial translation, 86.1 points in patients < 5 mm posterior tibial translation. CONCLUSION: The isolated PCL injury usually heals with some residual knee laxity which increase with associated injury. we recommend to protect the injured PCL for healing period, because significant improvement was found in serial stress radiogram until 6 months after injury. We also recommend aggressive treatment of associated injury.