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1.
Klin Monbl Augenheilkd ; 240(9): 1107-1118, 2023 Sep.
Article in German | MEDLINE | ID: mdl-37586398

ABSTRACT

Malignant masses of the orbit include a large variety of neoplasms of epithelial or mesenchymal origin. The treatment of orbital malignancies is an essential interdisciplinary field of medicine that integrates ENT medicine, facial surgery, plastic surgery, neurosurgery, oncology and radiology.The main symptom of malignant orbital masses is the exophthalmos. A symptom that can help to differentiate a benign from a malignant orbital mass can be the pain. The main diagnostic tool is the MRI including new sequences like DWI and DCE.After presenting symptoms and diagnostic strategies of malignant orbital masses, this article starts with the description of malignant epithelial neoplasms of the lacrimal gland. Furthermore, it describes new insights in orbital lymphomas, followed by the discussion of semimalignant orbital masses. Last but not least the text deals with malignant neoplasms of the skin that can grow secondarily in the orbit. Finally, the manuscript discusses orbital metastases.


Subject(s)
Exophthalmos , Orbital Diseases , Orbital Neoplasms , Humans , Orbit/pathology , Orbital Neoplasms/diagnostic imaging , Orbital Neoplasms/surgery , Magnetic Resonance Imaging , Exophthalmos/diagnosis
3.
Eur J Ophthalmol ; 33(6): 2096-2105, 2023 Nov.
Article in English | MEDLINE | ID: mdl-36274639

ABSTRACT

PURPOSE: To analyse higher-order aberrations of an enhanced monofocal aspheric intraocular lens (IOL) in relation to the clinical outcome compared to a monofocal aspheric IOL. SETTING: Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Germany. DESIGN: Prospective, monocentric, controlled, non-randomized, two-armed study. METHODS: After phacoemulsification, a total of 30 patients (60 eyes) were bilaterally implanted with either TECNIS Eyhance IOL model ICB00 (Johnson & Johnson Surgical Vision, Inc.) or TECNIS Monofocal 1-Piece IOL model ZCB00 (Johnson & Johnson Surgical Vision, Inc.) in 30 eyes each. Assessments were performed 1 and 3 months after surgery including refraction, uncorrected and best-corrected distance, intermediate and near visual acuity, defocus curves, contrast sensitivities under photopic, mesopic and mesopic conditions with glare, higher-order aberrations (HOAs) at pupil sizes of 5, 4, 3 and 2 mm and patient satisfaction. RESULTS: At 3-month follow-up, measurements of HOAs revealed significant higher negative internal and ocular primary spherical aberrations in the ICB00 group at pupil sizes of 5, 4, 3 and 2 mm. The ICB00 showed significant better results in intermediate and near visual acuity, but no difference in distance visual acuity. No significant difference was found in contrast sensitivities at any condition or spatial frequency. Spectacle independence was significant better without significant higher rates of dysphotopsia in the ICB00 group. CONCLUSIONS: Higher negative spherical aberrations in the ICB00 group at all measured pupil sizes appear to lead to a superior clinical outcome in intermediate and near vision compared to the ZCB00 group without compromising contrast sensitivity or distance visual acuity.

4.
J Cataract Refract Surg ; 47(9): 1139-1146, 2021 Sep 01.
Article in English | MEDLINE | ID: mdl-34468451

ABSTRACT

PURPOSE: To evaluate visual performance and optical quality of an extended depth-of-focus intraocular lens (EDoF IOL) compared with a monofocal aspheric IOL. SETTING: Department of Ophthalmology, Charité-Medical University Berlin, Germany. DESIGN: Prospective case series. METHODS: After phacoemulsification, a total of 28 patients (56 eyes) underwent bilateral implantation of either the Mini Well (EDoF IOL) or the Mini 4 (monofocal IOL). Assessments including refraction, distance, intermediate and near visual acuity, defocus curves, contrast sensitivity, glare disability, higher-order aberrations (HOAs), and patient satisfaction were performed at 1 month and 3 months postoperatively. RESULTS: Both study groups comprised 14 patients (28 eyes) each. At 3-month follow-up, the EDoF IOL showed better results in monocular uncorrected intermediate visual acuity (-0.04 vs 0.10 logMAR, P = .000) and in uncorrected near visual acuity (0.13 vs 0.36 logMAR, P = .000), whereas no statistically significant difference was found between groups in monocular uncorrected distance visual acuity (0.04 vs 0.00 logMAR, P = .110). The monocular depth of focus was 0.8 D greater in the Mini Well IOL group. Measurements of internal HOAs revealed a greater negative primary spherical aberration in the EDoF group at pupil sizes of 2.0 to 5.0 mm. At 5.0 mm, total internal HOAs did not differ statistically significantly (0.376 vs 0.340 µm root mean square, P = .068). CONCLUSIONS: The Mini Well IOL provided greater depth of focus with superior outcomes at intermediate and near distances and comparable outcomes at far distance. Although inducing higher amounts of spherical aberration, it showed good results under low lighting conditions with little subjective dysphotopsia.


Subject(s)
Lenses, Intraocular , Phacoemulsification , Depth Perception , Humans , Lens Implantation, Intraocular , Prospective Studies , Prosthesis Design , Pseudophakia , Refraction, Ocular
5.
Eur J Ophthalmol ; 31(6): 2955-2961, 2021 Nov.
Article in English | MEDLINE | ID: mdl-33499651

ABSTRACT

PURPOSE: To compare and evaluate corneal higher-order aberrations (c-HOA) between conventional manual phacoemulsification (Phaco), femtosecond laser-assisted cataract surgery (FLACS), and femtosecond laser-assisted cataract surgery with astigmatic keratotomy (FSAK). METHODS: In this retrospective single center study, 53 healthy individuals with cataract (73 eyes) underwent phacoemulsification with implantation of an intraocular lens. Three groups were formed: group A, Phaco (n = 27 eyes of 21 patients); group B, FLACS (n = 25 eyes of 15 patients); group C, FSAK (n = 21 eyes of 17 patients). An iTrace aberrometer (Tracey Technologies, Houston, TX, USA) was used to perform aberrometry with a pupil scan size of 5.0 mm. We used ANOVA analysis and the paired sample t-test for statistical analysis. RESULTS: There was no difference in total c-HOA between the groups prior to surgery (F(2,66) = 2.2, p = 0.128), but some evidence for a difference between the groups after surgery (F(2,65) = 3.87, p = 0.025). After surgery, total c-HOA increased in all groups, but the greatest increase occurred FSAK. CONCLUSION: Manual phacoemulsification and femtosecond laser-assisted cataract surgery seem to have less impact on corneal higher-order aberrations than the combination of femtosecond laser-assisted cataract surgery with astigmatic keratotomy.


Subject(s)
Cataract Extraction , Cataract , Laser Therapy , Phacoemulsification , Humans , Lasers , Retrospective Studies , Visual Acuity
6.
Eur J Ophthalmol ; 31(2): 709-715, 2021 Mar.
Article in English | MEDLINE | ID: mdl-31973551

ABSTRACT

PURPOSE: To assess firework-inflicted ocular trauma in the German capital during the week around New Year's Eve with regards to patient characteristics and age, severity of injuries, and their management and outcome. METHODS: A retrospective chart review of all patients presenting to the department of ophthalmology of Charité-University Medicine Berlin during a 7-day period around New Year's Eve in the years 2014-2017 was performed. Patients with ocular complaints and injuries caused by fireworks were included. We recorded demographic data, active role, visual acuity at presentation and at last follow-up, the most pertinent clinical findings, management and outcome with regards to visual acuity, and integrity of the eye. RESULTS: A total of 146 patients with 165 injured eyes were included. Median age at presentation was 23 (4-58) years, and 71.2% were male. Fifty-one patients (34.9%) were less than 18 years old. Ninty-seven patients (66.4%) sustained minor, 34 (23.3%) sustained moderate, and 15 (10.3%) sustained severe injuries. Severe trauma was seen in younger patients (median age: 12, range: 4-58 years) than mild and moderate trauma (median age: 23, range: 4-45 years) and resulted in loss of light perception in two eyes and in a visual acuity of only light perception in three eyes. One eye was enucleated. CONCLUSION: Ocular trauma inflicted by fireworks can have serious consequences for ocular morbidity and visual acuity, especially in severe trauma which affected younger patients. To significantly reduce firework-inflicted trauma, a ban of private fireworks in densely populated areas and in the vicinity of children should be considered.


Subject(s)
Blast Injuries/epidemiology , Eye Injuries/epidemiology , Urban Population , Visual Acuity , Adolescent , Adult , Child , Child, Preschool , Female , Germany/epidemiology , Humans , Male , Middle Aged , Morbidity/trends , Retrospective Studies , Young Adult
7.
BMJ Open Ophthalmol ; 5(1): e000337, 2020.
Article in English | MEDLINE | ID: mdl-32154368

ABSTRACT

BACKGROUND: Conjunctival defects can be repaired with several mucosal tissues. The simplicity of harvesting oral mucosa and its wide availability makes it the preferred graft tissue for all indications requiring mucosal grafting. Through analysing the postsurgical outcomes and rate of revisions, this study explores the suitability of oral mucosa grafts, depending on the initial diagnosis. METHODS: We reviewed all the files of patients with a history of oral mucosal graft surgery, performed at our clinic between 2012 and 2018, focusing on complications and revision rates. RESULTS: In total, we analysed 173 oral mucosa grafts in 131 patients. The most common initial diagnosis was tumour resection, followed by surgical complications, postenucleation socket syndrome, trauma and ocular surface disorders. Complication and revision rates depended highly on the initial diagnosis. Revision rates were highest if the initial diagnosis included ocular surface disorders or chemical trauma. CONCLUSIONS: Oral mucosa grafting (OMG) is the most effective treatment for a wide range of ocular conditions involving conjunctival defects. Conjunctival defects that result from trauma or cicatricial surface diseases seem less suitable for OMG and may benefit from alternative graft tissue or treatment options.

8.
Klin Monbl Augenheilkd ; 236(7): 929-947, 2019 Jul.
Article in German | MEDLINE | ID: mdl-30999361

ABSTRACT

Benign orbital neoplasms comprise a wide spectrum of different entities. The origin of the tumours can be epithelial or mesenchymal. Epithelial neoplasms of the orbit originate from the lacrimal gland. The most important tumour is the pleomorphic adenoma, which should not be biopsied but resected in toto. The most common intraconal neoplasm in adults is the cavernous hemangioma. Symptomatic cavernous hemangiomas should be treated. The treatment of choice for most symptomatic benign neoplasms of the orbit is surgical resection. Suitable surgical approaches are anterior transconjunctival and lateral orbitotomy. Cryoextraction is a minimally invasive technique that is particularly suitable for cavernous hemangiomas.


Subject(s)
Hemangioma, Cavernous , Orbital Neoplasms , Biopsy , Humans , Ophthalmologic Surgical Procedures , Orbit
9.
Eur J Ophthalmol ; 28(4): 425-432, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29623732

ABSTRACT

PURPOSE: The purpose of this study was to assess the clinical outcome after a bilateral implantation of an extended depth of focus intraocular lens in comparison to a monofocal intraocular lens. SETTING: Department of Ophthalmology, Charité-Medical University Berlin, Germany. PATIENTS AND METHODS: A total of 60 eyes of 30 patients were enrolled in this prospective, single-center study. The cataract patients underwent phacoemulsification with bilateral implantation of a TECNIS® Symfony (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients) or a TECNIS Monofocal ZCB00 (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients). Postoperative evaluations were performed after 1 and 3 months, including visual acuities at far, intermediate, and near distance. Mesopic, scotopic vision, and contrast sensitivity were investigated. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm. RESULTS: After 3 months, the TECNIS Symfony group reached an uncorrected visual acuity at far distance of -0.02 logMAR compared to -0.06 logMAR in the TECNIS Monofocal group ( p = 0.03). Regarding the uncorrected vision at intermediate and near distance the following values were obtained: intermediate visual acuity -0.13 versus 0.0 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001) and near visual acuity 0.11 versus 0.26 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001). Low-contrast visual acuities were 0.27 versus 0.20 logMar (TECNIS Symfony vs TECNIS Monofocal, p = 0.023). CONCLUSION: The TECNIS Symfony intraocular lens can be considered an appropriate alternative to multifocal intraocular lenses because of good visual results at far, intermediate, and near distance as well as in low-contrast vision.


Subject(s)
Aberrometry/methods , Contrast Sensitivity/physiology , Multifocal Intraocular Lenses , Myopia/rehabilitation , Phacoemulsification , Visual Acuity , Aged , Aged, 80 and over , Female , Germany , Humans , Male , Middle Aged , Myopia/physiopathology , Postoperative Period , Prospective Studies
10.
BMJ Open Ophthalmol ; 3(1): e000148, 2018.
Article in English | MEDLINE | ID: mdl-30687781

ABSTRACT

OBJECTIVE: Descemet membrane endothelial keratoplasty (DMEK) remains a challenging technique. We compare the precision of femtosecond laser-assisted DMEK to manual DMEK. METHODS AND ANALYSIS: A manual descemetorhexis (DR) of 8 mm diameter was compared with a femtosecond laser-assisted DR of the same diameter (femto-DR) in 22 pseudophakic patients requiring DMEK. We used OCT images with a centred xy-diagram to measure the postoperative precision of the DR and the amount of endothelial denuded area. Endothelial cell loss (ECL) and best corrected visual acuity were measured 3 months after surgery. RESULTS: In the manual group, the median error of the DR was 7% (range 3%-16%) in the x-diameter and 8% (range 2%-17%) in the y-diameter. In the femto group, the median error in the respective x and y-diameters was 1% (range 0.4%-3%) and 1% (range 0.006%-2.5%), smaller than in the manual group (p=0.001). Endothelial denuded areas were larger in the manual group (11.6 mm2, range 7.6-18 mm2) than in the femto group (2.5 mm2, range 1.2-5.9 mm2) (p<0.001). The ECL was 21% (range 5%-78%) in the manual DR and 17% (range 6%-38%) in the femto-DR group (p=0.351). The median visual acuity increased from 0.4 logMAR (range 0.6-0.4 logMAR) in both groups to 0.1 logMAR (range 0.4-0 logMAR) in the manual group and to 0.1 logMAR (range 0.3-0 logMAR) in the femto group (p=0.461). Three rebubblings were required in the manual group, whereas the femto group required only one. CONCLUSION: The higher precision of the femto-DR bears the potential to improve DMEK surgery.

11.
Eur J Ophthalmol ; 27(4): 402-406, 2017 Jun 26.
Article in English | MEDLINE | ID: mdl-27791246

ABSTRACT

PURPOSE: To analyze the impact of different incision sizes for phacoemulsification on corneal higher-order aberrations (HOA). METHODS: Patients seeking cataract surgery were randomly assigned to one of the following groups: 1.4 mm with biaxial microincision phacoemulsification (25 eyes), 1.8 mm with coaxial phacoemulsification (27 eyes), and 2.2 mm with coaxial phacoemulsification (62 eyes). Inclusion criteria were a minimum age of 18 years and uncomplicated cataract. Exclusion criteria were history of ocular trauma or intraocular surgery, any sign of inflammation or infection, pseudoexfoliation syndrome, glaucoma, optic atrophy, diabetic retinopathy, lens dislocation, cataracta intumescens, cataracta matura, and corneal diseases. Patients underwent phacoemulsification with implantation of an intraocular lens. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm preoperatively and at postoperative follow-up visits after 1 month. The paired sample t test and analysis of covariance were used for statistical analysis. RESULTS: Ninety patients (114 eyes) were enrolled (mean age 73.7 ± 8.9 years). In all groups, an increase of total HOAs could be measured. The strongest increase was seen in the 2.2 mm group (mean difference 0.031 [95% confidence interval (CI) 0.006-0.056], p = 0.014) and in the 1.4 mm group (mean difference 0.035 [95% CI -0.007 to 0078], p = 0.097). No important difference was found in the 1.8 mm group. CONCLUSIONS: The 2.2 mm and the 1.4 mm incisions seem to have a higher impact on corneal HOAs in comparison to the 1.8 mm incision.


Subject(s)
Cornea/surgery , Corneal Wavefront Aberration/prevention & control , Lens Implantation, Intraocular , Minimally Invasive Surgical Procedures/methods , Phacoemulsification/methods , Aberrometry , Aged , Aged, 80 and over , Analysis of Variance , Astigmatism/prevention & control , Cataract/complications , Cornea/physiopathology , Female , Humans , Male , Middle Aged , Phacoemulsification/adverse effects , Prospective Studies , Visual Acuity/physiology
12.
Cornea ; 35(10): 1274-8, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27538189

ABSTRACT

PURPOSE: To explore the feasibility of femtosecond laser-assisted descemetorhexis (DR) to facilitate Descemet membrane endothelial keratoplasty (DMEK) surgery. METHODS: Six pseudophakic patients suffering from Fuchs' endothelial dystrophy underwent femtosecond laser-assisted DMEK surgery. DR was performed using the LenSx femtosecond laser, followed by manual removal of the Descemet membrane. Optical coherence tomography images were used to measure DR parameters. Patients were followed up for 1 month to examine best corrected visual acuity, endothelial cell loss, flap detachment, and structure of the anterior chamber of the eye. RESULTS: The diameter of the DR approximated the intended diameter closely [mean error of 34 µm (0.45%) and 54 µm (0.67%) in the x- and y-diameter, respectively] and did not require manual correction. The median visual acuity increased from 0.4 logMAR (range 0.6-0.4 logMAR) preoperative to 0.2 logMAR (range 0-0.4 logMAR) postoperative. The median endothelial cell loss was 22% (range 7%-34%). No clinically significant flap detachments were noted. All patients had clear corneas after surgery, and no side effects or damage to structures of the anterior chamber were noted. CONCLUSIONS: Femtosecond laser-assisted DR is a safe and precise method for facilitating DMEK surgery.


Subject(s)
Descemet Membrane/surgery , Descemet Stripping Endothelial Keratoplasty/methods , Fuchs' Endothelial Dystrophy/surgery , Laser Therapy/methods , Aged , Aged, 80 and over , Anterior Chamber/pathology , Cell Count , Corneal Endothelial Cell Loss/diagnosis , Endothelium, Corneal/pathology , Female , Follow-Up Studies , Fuchs' Endothelial Dystrophy/physiopathology , Humans , Male , Middle Aged , Tomography, Optical Coherence , Visual Acuity/physiology
13.
Doc Ophthalmol ; 130(3): 211-9, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25637045

ABSTRACT

PURPOSE: To evaluate the effect of long-term chloroquine intake on the multifocal electroretinogram (mfERG) in female patients with and without maculopathy. METHODS: Retrospective analysis of the mfERGs recorded in three different groups: (1) patients with bilateral maculopathy having taken chloroquine, (2) patients without maculopathy having taken chloroquine, and (3) healthy control subjects (age-matched to group 2) who never took chloroquine. MfERGs of each group were averaged, and the data of each patient group were compared to the control group. The main outcome measures were N1 and P1 characteristics and the ring ratio analysis. RESULTS: In group 1, 11 female subjects (22 eyes) were included, group 2 consisted of nine patients (18 eyes) and group 3 of seven healthy female subjects (14 eyes). Compared with healthy controls, patients in group 1 showed significantly reduced response densities of both N1 and P1 across all ring eccentricities except ring 5. Implicit times were significantly delayed only concerning N1 (ring 4 and the sum response of the left eye of group 1). P1 implicit times showed no significant alterations in either group. Ring ratios of the response densities were significantly higher mainly concerning group 1 (N1: ring 5/ring 2 and ring 5/ring 4 of the right eye; P1: all ring ratios of the right eye and all ratios except ring 5/ring 1 and ring 5/ring 4 of the left eye). The only ring ratio being significantly higher in group 2 was P1 ring 5/ring 1 ratio of the right eye. CONCLUSIONS: In the absence of clinically apparent maculopathy, chloroquine intake was not associated with major alterations of the mfERG.


Subject(s)
Antirheumatic Agents/administration & dosage , Chloroquine/administration & dosage , Electroretinography/drug effects , Retina/physiopathology , Retinal Diseases/complications , Arthritis, Rheumatoid/drug therapy , Female , Humans , Middle Aged , Retinal Diseases/physiopathology , Retrospective Studies , Visual Fields/physiology
14.
Ophthalmic Res ; 53(1): 8-14, 2015.
Article in English | MEDLINE | ID: mdl-25471052

ABSTRACT

PURPOSE: The purpose of this study was to analyze the clinical outcome and higher-order aberrations (HOAs) after 1.4-mm biaxial microincision cataract surgery (B-MICS) and implantation of a new aspheric intraocular lens (IOL). MATERIAL AND METHODS: A total of 157 eyes of 106 patients were enrolled in this prospective, single-center study. The B-MICS (1.4 mm, 26 eyes) was followed by an implantation of a microincision aspheric Incise® IOL MJ14T (Bausch & Lomb, Rochester, N.Y., USA). The control groups consisted of patients operated with 1.8-mm (coaxial MICS, Akreos MI60, 41 eyes), 2.2-mm (small incision cataract surgery, Tecnis ZCB00, 44 eyes) and 2.2-mm (small incision cataract surgery, CT Asphina, 46 eyes) coaxial phacoemulsification with implantation of an aspheric IOL. Intraoperative and postoperative complications, best-corrected visual acuity, HOAs for a 5.0-mm pupil using the iTrace aberrometer (Tracey Technologies, Houston, Tex., USA) and endothelial cell loss were evaluated. The difference among the groups was evaluated by analysis of variance. RESULTS: In the Incise group, the mean best-corrected visual acuity improved significantly from 0.4 ± 0.27 logMAR preoperatively to 0.05 ± 0.07 postoperatively. The root mean square of total ocular HOAs was measured at 0.419 ± 0.191 µm, spherical aberration was measured at 0.168 ± 0.072 µm and coma was measured at 0.213 ± 0.200 µm. The best-corrected visual acuity (p = 0.097), total ocular HOA (p = 0.630) and coma (p = 0.193) showed no statistically significant difference between the 4 groups. CONCLUSION: The aspheric microincision IOL was safely implanted through a 1.4-mm incision and showed similarly good postoperative outcome in comparison to 1.8- and 2.2-mm coaxial phacoemulsification.


Subject(s)
Corneal Wavefront Aberration/physiopathology , Lens Implantation, Intraocular , Lenses, Intraocular , Phacoemulsification/methods , Aged , Aged, 80 and over , Contrast Sensitivity/physiology , Female , Humans , Intraoperative Complications , Male , Microsurgery/methods , Postoperative Complications , Prospective Studies , Prosthesis Design , Pseudophakia/physiopathology , Visual Acuity/physiology
15.
Ophthalmic Res ; 51(1): 9-14, 2014.
Article in English | MEDLINE | ID: mdl-24157951

ABSTRACT

PURPOSE: To analyze the dependence between corneal endothelial cell loss by Aqualase® cataract surgery and the nuclear opalescence grade of the lens. PATIENTS AND METHODS: A total of 100 eyes of 92 patients were enrolled in this prospective, single-center study. Patients were randomly assigned to the Aqualase (50 eyes) or the phacoemulsification group (50 eyes). The nuclear density was classified with the Lens Opacities Classification System III. All procedures were performed by the same surgeon. Preoperatively and 1 week postoperatively, endothelial cell counts were obtained using a noncontact specular microscope (Konan, Japan). RESULTS: (1) Aqualase group: the group of patients with a nuclear density of 1-2 (17 patients) showed no significant endothelial cell loss (4.1%, p = 0.163). The endothelial cell loss in grade 3 cataracts (28 eyes) was 13.9% (p = 0.004) and in grade 4 cataracts (5 eyes) 69.1% (p = 0.043), being statistically significant in both groups. (2) Phacoemulsification group: in nuclear density groups 1 and 2, endothelial cell loss was 6.3% (p = 0.41), in group 3 it was 17.6% (p = 0.001) and in group 4 it was 14.9% (p = 0.08). Only in nuclear opalescence grade 4 there was a significant difference between the Aqualase and the phacoemulsification procedure (p = 0.008). CONCLUSION: Endothelial cell loss by Aqualase technology depends strongly on the nuclear opalescence grade. In low- and medium-density cataracts, Aqualase does not seem to provoke significant endothelial cell loss. Due to very high endothelial loss in hard nuclei, Aqualase is unsuitable for these cataracts.


Subject(s)
Capsule Opacification/pathology , Cataract Extraction/methods , Corneal Endothelial Cell Loss/pathology , Endothelium, Corneal/cytology , Aged , Cataract Extraction/instrumentation , Cell Count , Female , Humans , Lasers, Solid-State , Male , Middle Aged , Prospective Studies
16.
Eur J Ophthalmol ; 24(3): 352-7, 2014.
Article in English | MEDLINE | ID: mdl-24057936

ABSTRACT

PURPOSE: To evaluate the indications, visual outcomes, and complication rate after posterior implantation of an iris-claw aphakic intraocular lens (IOL) in subluxated lenses due to Marfan syndrome. METHODS: Eyes without adequate capsular support had posterior chamber iris-claw aphakic IOL implantation between 2006 and 2012. RESULTS: This retrospective cohort study comprised 13 eyes of 10 patients (7 female, 3 male; mean age ± standard deviation, 34.7 ± 19.6; range 9-61 years). The mean follow-up was 37 months (range 6-74 months). The mean final postoperative best-corrected visual acuity was significantly (0.24 ± 0.36 logMAR) better at the last follow-up than 1 day preoperatively (0.72 ± 0.46 logMAR) (p<0.05). There was no significant change in intraocular pressure before and after surgery. The mean endothelial cell density decreased from 2793 ± 478 cells/mm2 preoperatively to 2637 ± 612 cells/mm2 at last follow-up, representing a mean endothelial cell loss of 5.6%. Complications included early transient postoperative hypotony in 2 eyes (15.4%), slight persistent pupil ovalization in 1 eye (7.7%), and retinal detachment in 1 eye (7.7%). CONCLUSIONS: The posterior implantation technique of aphakic iris-claw IOL provided good visual outcomes with a favorable complication rate and can be used as a reasonable alternative in subluxated lenses due to Marfan syndrome without adequate capsular support.


Subject(s)
Lens Implantation, Intraocular/methods , Lens Subluxation/surgery , Marfan Syndrome/surgery , Phacoemulsification/methods , Adolescent , Adult , Cell Count , Child , Corneal Endothelial Cell Loss/physiopathology , Female , Follow-Up Studies , Humans , Intraocular Pressure/physiology , Iris/surgery , Lens Subluxation/physiopathology , Lenses, Intraocular , Male , Marfan Syndrome/physiopathology , Middle Aged , Postoperative Complications , Prosthesis Design , Retrospective Studies , Tonometry, Ocular , Treatment Outcome , Visual Acuity/physiology , Young Adult
18.
Am J Ophthalmol ; 156(2): 382-386.e1, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23721944

ABSTRACT

PURPOSE: To evaluate the indications, visual outcomes, and complication rate after posterior implantation of an iris-claw aphakic intraocular lens (IOL) in children. DESIGN: Noncomparative retrospective cohort study. METHODS: setting: Institutional practice. patients/intervention procedures: Seven eyes of 4 children without adequate capsular support had posterior chamber iris-claw aphakic IOL implantation between 2007 and 2012. main outcome measures: Visual acuity, endothelial cell changes, intraoperative and postoperative complications. RESULTS: The mean age of the 3 boys and 1 girl was 12.0 ± 3.4 (SD) years (range 8-16 years). In all eyes, the mean postoperative best spectacle-corrected visual acuity (0.13 ± 0.17 logMAR) was statistically significantly better at the last follow-up than at 1 day preoperatively (0.60 ± 0.39 logMAR) (P < .05). The mean follow-up was 31 months (range 10-64 months). The mean endothelial cell density decreased from 3013 ± 155 cells/mm(2) preoperatively to 2831 ± 236 cells/mm(2) at last follow-up, representing a mean endothelial cell loss of 6.4%. No corneal decompensation, iritis, secondary glaucoma, or pupillary block occurred after surgery in any eye. Postoperative complications included transient postoperative hypotony in 1 eye and a traumatic dislocation of a posterior aphakic iris-claw IOL in 1 eye. CONCLUSION: The posterior implantation technique of aphakic iris-claw IOL provided good visual outcomes with a favorable complication rate and can be used as a reasonable alternative for a wide range of indications in pediatric eyes without adequate capsular support.


Subject(s)
Aphakia, Postcataract/surgery , Lens Implantation, Intraocular , Lenses, Intraocular , Adolescent , Aphakia, Postcataract/physiopathology , Cell Count , Child , Endothelium, Corneal/pathology , Female , Follow-Up Studies , Humans , Intraocular Pressure/physiology , Intraoperative Complications , Iris/surgery , Male , Postoperative Complications , Prosthesis Design , Retrospective Studies , Tonometry, Ocular , Visual Acuity/physiology
19.
Eur J Ophthalmol ; 23(6): 836-40, 2013.
Article in English | MEDLINE | ID: mdl-23709335

ABSTRACT

PURPOSE: The aim of the study was to determine the influence of axial length (AL) and anterior chamber depth (ACD) on the rotational stability of a toric intraocular lens (IOL).
 METHODS: In this retrospective study, 40 eyes of 40 patients were included. All patients underwent phacoemulsification and had AcrySof toric IOL implantations. The AL and the ACD (epithelium to lens) were measured using optical coherence biometry. Cornea astigmatism was determined by topography. Rotational stability was measured 1 day, 1 week, 4 weeks, and 3 months postoperatively. 
 RESULTS: The mean AL and ACD were 23.91 ± 1.51 and 2.91 ± 0.37 mm. The medial rotation was 2.47 ± 22.7, 2.92 ± 2.93, 2.56 ± 2.07, and 2.37 ± 2.29 degrees from baseline at 1 day, 1 week, 4 weeks, and 3 months, respectively. No correlation occurred between AL and ACD and IOL rotation at any time. 
 CONCLUSION: Biometric parameters may not influence the rotational stability of this type of acrylic posterior chamber toric IOL in the short term.


Subject(s)
Anterior Chamber/anatomy & histology , Axial Length, Eye/anatomy & histology , Lenses, Intraocular , Rotation , Aged , Astigmatism/diagnosis , Astigmatism/surgery , Biometry , Corneal Topography , Female , Humans , Lens Implantation, Intraocular , Male , Middle Aged , Phacoemulsification , Prosthesis Failure , Retrospective Studies
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