Visual Performance at Different Distances After Implantation of an Isofocal Optic Design Intraocular Lens.

PURPOSE: To evaluate refractive and visual outcomes at different distances after implantation of an isofocal optic design intraocular lens (IOL) following cataract surgery. METHODS: This multicentric, retrospective/prospective, open-label, observational study considered 183 eyes of 109 patients who were implanted with the ISOPURE 123 (PhysIOL) IOL. The main outcome measures were refractive error and monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and distance-corrected intermediate visual acuity (DCIVA) at 66 and 80 cm, uncorrected near visual acuity (UNVA), and distance-corrected near visual acuity (DCNVA) at 40 cm. Binocular visual acuity at different vergences (defocus curve) was also measured. Patients were evaluated at least 120 days postoperatively. RESULTS: A total of 95.7% of the eyes were within ±1.00 diopter (D) and 73.2% of the eyes were within ±0.50 D; the mean postoperative spherical equivalent was -0.12 ± 0.42 D. There were 90.54% and 98.57% of patients presenting a cumulative binocular UDVA and CDVA value of 20/25 or better, respectively; 80.65% and 50.0% of patients presented a binocular DCIVA value of 20/25 or better at 80 and 66 cm, respectively; and 41.94% of patients presented a binocular DCNVA value of 20/40 or better. The through-focus curve showed good visual acuity at far and intermediate distances with a depth of focus value of 1.50 D. No adverse events were reported. CONCLUSIONS: The current study shows that this isofocal optic design IOL provides excellent visual performance for far vision and functional intermediate vision with an extended range of vision. This lens is an effective option for providing functional intermediate vision and correcting aphakia. [J Refract Surg. 2023;39(3):150-157.].

Análise morfológica da base do crânio, maxila e mandíbula em maloclusões classe I, II, III esqueléticas. Estudo em CBCT. / Morphologica analysis of the base of the skull Jaw and mandibula in maloclusions class I, II, III skeletals. Study in CBCT

Introdução: O objetivo desse estudo foi avaliar quantitativamente a anatomia 3D da Base do Crânio em pacientes com padrão esquelético Classe I, II e III. Material e Método: Um estudo retrospetivo, foi realizado com as imagens de TCFC de 75 pacientes. A amostra foi dividida em três grupos de acordo com o padrão esquelético de cada individuo: Classe I, II e III. As Imagens de TCFC foram reorientadas e foi realizada a segmentação dos arquivos. Foram posicionados pontos de referência em Base do Crânio, Maxila e Mandíbula. Posteriormente, foram construídos modelos volumétricos 3D da Base do Crânio, Maxila e Mandibula. Foram realizadas medidas angulares e lineares utilizando os pontos de referência. As medidas foram utilizadas para avaliar a morfologia da base do crânio e as suas correlações em diferentes padrões esqueléticos. Analise Estatística: As diferenças entre os grupos foram testadas usando o teste de ANOVA, e as correlações foram medidas utilizando o teste de correlação de Pearson. Resultados: Ainda sem muitas diferenças estatisticamente significativas entre os grupos, foram observadas algumas diferenças menores, onde a Classe II e III se comportam como extremos e a Classe I se comporta como intermediário. Foram observadas diferenças estatisticamente significativas para a posição 3D da Fossa Mandibular (p <0.05) e o Comprimento Mandibular (p <0.05). Foram verificadas correlações entre comprimento Mandibular, comprimento Maxilar e o posicionamento mandibular com uma serie de estruturas na Base do Crânio. Conclusões: Nossos resultados sugerem que o comprimento mandibular e o posicionamento da fossa mandibular podem estar relacionados com o padrão esquelético do individuo. (AU)

Introduction: The aim of this study was to quantitatively assess 3D anatomy of CB in patients with Class I, II and II skeletal patterns. Material and Methods: This retrospective study sample was composed by CBCT scans of 75 patients. The sample was divided into three groups according to the skeletal pattern: Class I, II and III. The CBCT scans were re-oriented and segmentation was performed. Landmarks were positioned in CB, Mx and Md. 3D models of CB, Mx, and Md were constructed, and linear and angular measurements was performed. Measurements were used to evaluate the CB morphology and correlations on different skeletal patterns. Statistical Analysis: The differences among groups were tested by ANOVA test and correlation was performed by Pearson correlation test. Results: Even without many significant differences between groups, were observed some differences between groups in most of the measure, where Class II and III have a greater distance between them and Class I behaves as an intermediary. Statistically significant differences were observed for 3D position of MF (p 0.05) and mandibular length (p 0.05). Correlation between MD length, Mx and Md positioning with some structures was verified. Conclusions: Our results suggested that de Md length and MF positioning can be related with de patient skeletal pattern. (AU)

Reorganization of laryngeal motoneurons after crush injury in the recurrent laryngeal nerve of the rat.

Motoneurons innervating laryngeal muscles are located in the nucleus ambiguus (Amb), but there is no general agreement on the somatotopic representation and even less is known on how an injury in the recurrent laryngeal nerve (RLN) affects this pattern. This study analyzes the normal somatotopy of those motoneurons and describes its changes over time after a crush injury to the RLN. In the control group (control group 1, n = 9 rats), the posterior cricoarytenoid (PCA) and thyroarytenoid (TA) muscles were injected with cholera toxin-B. In the experimental groups the left RLN of each animal was crushed with a fine tip forceps and, after several survival periods (1, 2, 4, 8, 12 weeks; minimum six rats per time), the PCA and TA muscles were injected as described above. After each surgery, the motility of the vocal folds was evaluated. Additional control experiments were performed; the second control experiment (control group 2, n = 6 rats) was performed labeling the TA and PCA immediately prior to the section of the superior laryngeal nerve (SLN), in order to eliminate the possibility of accidental labeling of the cricothyroid (CT) muscle by spread from the injection site. The third control group (control group 3, n = 5 rats) was included to determine if there is some sprouting from the SLN into the territories of the RLN after a crush of this last nerve. One week after the crush injury of the RLN, the PCA and TA muscles were injected immediately before the section of the SLN. The results show that a single population of neurons represents each muscle with the PCA in the most rostral position followed caudalwards by the TA. One week post-RLN injury, both the somatotopy and the number of labeled motoneurons changed, where the labeled neurons were distributed randomly; in addition, an area of topographical overlap of the two populations was observed and vocal fold mobility was lost. In the rest of the survival periods, the overlapping area is larger, but the movement of the vocal folds tends to recover. After 12 weeks of survival, the disorganization within the Amb is the largest, but the number of motoneurons is similar to control, and all animals recovered the movement of the left vocal fold. Our additional controls indicate that no tracer spread to the CT muscle occurred, and that many of the labeled motoneurons from the PCA after 1 week post-RLN injury correspond to motoneurons whose axons travel in the SLN. Therefore, it seems that after RLN injury there is a collateral sprouting and collateral innervation. Although the somatotopic organization of the Amb is lost after a crush injury of the RLN and does not recover in the times studied here, the movement of the vocal folds as well as the number of neurons that supply the TA and the PCA muscles recovered within 8 weeks, indicating that the central nervous system of the rat has a great capacity of plasticity.