Corneal radii and anterior chamber depth measurements using the IOLmaster versus the Pentacam.

PURPOSE: Corneal radii (R1, R2) and anterior chamber depth are important parameters for biometry and refractive surgery. This study aimed to investigate whether the IOLMaster, a biometric device, and the Pentacam, a rotating Scheimpflug camera, provide comparable results. METHODS: In this prospective study, corneal radii and anterior chamber depth were analyzed in 82 eyes of 41 phakic patients (median age 72 years) using the IOLMaster and Pentacam. Normal distribution was confirmed using the Kolmogorov-Smirnov test. A paired t test was used for statistical analysis. RESULTS: No statistically significant difference was noted for R2 using the Pentacam versus the IOLMaster (P = .40). There was a small statistical difference of 0.03 mm (P < .01) for R1 (corresponding to 0.08 diopters [D]). The IOLMaster measured a mean R1 of 7.87 mm and R2 of 7.67 mm. The Pentacam measured mean R1 of 7.90 mm and R2 of 7.69 mm. For anterior chamber depth values, a small statistically significant difference of 0.05 mm (P < .001) was found (corresponding to 0.01 D). Mean anterior chamber depth measured from the epithelium was 3.20 mm for the IOLMaster and 3.25 mm for the Pentacam. The Bland-Altman plot showed no distorting trends for either variable. CONCLUSIONS: Keratometry and anterior chamber depth were comparable for the two devices. If the axial length is known, the Pentacam can be used as a biometric device.

Influence of 360-degree enhanced optic edge design of a hydrophilic acrylic intraocular lens on posterior capsule opacification.

PURPOSE: To compare the rate of posterior capsule opacification (PCO) with the single-piece hydrophilic acrylic foldable Rayner Centerflex 570H intraocular lens (IOL), which has a sharp optic edge design excluding the optic-haptic junction, and the Rayner C-flex 570C IOL, which has an improved 360-degree sharp edge. SETTING: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. METHODS: As part of a multicenter U.S. Food and Drug Administration (FDA) study, 42 patients who had implantation of a C-flex IOL in 1 eye after uneventful phacoemulsification were enrolled. Six and 12 months postoperatively, PCO was evaluated by retroillumination photographs using Evaluation of Posterior Capsule Opacification (EPCO) 2000 image-analysis software. The data were then compared with those in a matched group of patients with a Centerflex IOL who participated in a previous FDA study. RESULTS: The mean age of the patients with the C-flex IOL was 71.5 years +/- 8.2 (SD) There was a statistically significant difference in EPCO scores between the C-flex group and Centerflex group. Six months after surgery, the mean EPCO value (total IOL optic) was 0.07 +/- 0.17 in the C-flex group (n = 37) and 0.20 +/- 0.20 in the Centerflex group (n = 36) (P<.01, Wilcoxon test). By 12 months, the mean had increased to 0.16 +/- 0.20 in the C-flex group (n = 37) and 0.35 +/- 0.22 in the Centerflex group (n = 31) (P<.01, Wilcoxon test). CONCLUSIONS: The C-flex IOLs showed good functional results and significantly lower PCO formation than the earlier model Centerflex IOL. The enhanced edge of the C-flex IOL seemed to improve PCO prevention clinically.

Long-term results of sealed capsule irrigation using distilled water to prevent posterior capsule opacification: a prospective clinical randomised trial.

BACKGROUND: We investigated long-term safety and efficacy of sealed capsule irrigation (SCI) during cataract surgery to prevent posterior capsule opacification (PCO). METHODS: One eye of each of 17 patients (mean age: 70.1+/-9.7 years) who presented with bilateral cataracts was randomly chosen for SCI treatment. After phacoemulsification, the capsular bag was vacuum sealed with the PerfectCapsule device (Milvella) followed by SCI using distilled water for two minutes. No vacuum loss occurred during irrigation. Each patient's fellow eye served as a control. One hydrophilic acrylic intraocular lens model was implanted in all eyes. Five patients had to be excluded due to deep anterior chamber, small pupil or unilateral surgery. Follow-up examinations took place one day and one, three, six, 12 and 24 months after surgery. We evaluated safety parameters, anterior capsule (AC) overlapping and PCO. RESULTS: Postoperatively, mean best corrected visual acuity, pachymetry, endothelial cell count, intraocular pressure, AC overlapping and PCO showed no statistically significant difference between SCI and the control group (p>0.05, Wilcoxon test). CONCLUSION: SCI is a safe procedure and enables the specific pharmacological targeting of lens epithelial cells inside the capsular bag. Using distilled water, however, it is not possible to reduce PCO development significantly. Thus, alternative substances should be evaluated.

Cataract surgery in eyes with iridoschisis using the Perfect Pupil iris extension system.

PURPOSE: To evaluate the use of the Perfect Pupil system (Milvella Pty. Ltd.) in 3 eyes in cataract surgery with iridoschisis. SETTING: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. METHODS: Patient 1 was an 83-year-old man with a nuclear cataract, pseudoexfoliation syndrome, and iridoschisis. He was also having systemic anticoagulation therapy. Preoperative best corrected visual acuity (BCVA) was 0.05 in the right eye and 0.08 in the left eye. Patient 2 was a 73-year-old mentally retarded man with a brunescent cataract in the right eye. Preoperative BCVA was 0.1. RESULTS: In the first patient, cataract surgery was performed under topical anesthesia in both eyes through a clear corneal incision. Intraoperative pupil size was 3.0 mm. The Perfect Pupil device was inserted manually and fixated at the iris rim, leading to pupil dilation of 6.0 mm. Uneventful cataract surgery was performed without damage to the iris. Hydrophobic acrylic foldable intraocular lenses (IOLs) were implanted with forceps. Postoperative BCVA was 0.5 in the right eye and 0.4 in the left eye. The second patient was operated on under general anesthesia. Pupil dilation was successfully achieved. The brunescent cataract was removed and a hydrophobic acrylic IOL was implanted with an injector, resulting in postoperative uncorrected visual acuity of 0.3. CONCLUSION: In iridoschisis patients, there is risk of aspiration of iris fibers during cataract surgery. In these 2 patients, this was prevented using the Perfect Pupil system.