Dysphotopsia after cataract surgery: comparison of four different intraocular lenses.

AIM: To assess the risk of dysphotopsia after phacoemulsification, with the use of four different intraocular lens (IOL) models. METHODS: In this prospective randomized study, 600 patients underwent phacoemulsification surgery. Four study groups were formed, according to the type of the IOL implanted: Meridian HP60M [Bausch & Lomb, hydrogel, 6 mm, three piece (3P), square edge, refraction index (RI): 1.470], Acrysof MA60BM (Alcon, acrylic, 6 mm, 3P, square edge, RI: 1.550), Acrysof MA30BA (Alcon, acrylic, 5.5 mm, 3P, square edge, RI: 1.550) and Clariflex (AMO, silicone, 6 mm, 3P, anterior round and posterior square edge, RI: 1.460). Patients were examined for dysphotopsia symptoms after 1 week, 1, 3 and 6 months. RESULTS: During the first follow-up visit, 117 patients (19.5%) reported dysphotopsia. During the next visits, the actual number of patients still reporting phenomena declined. Optic phenomena occurred less frequently in patients with AMO Clariflex lens, especially when compared to Acrysof (5.5 and 6 mm); IOL odds ratios ranged from 2.27 to 6.7, depending on follow-up time (p value < 0.05). IOL optic diameter was negatively but significantly associated with the risk of dysphotopsia. CONCLUSIONS: The design of the optic edge and the optic diameter of the IOL play an important role in the occurrence of dysphotopsia. AMO Clariflex, with round anterior and square posterior edge, overcomes the problem of dysphotopsia to a considerable extent.

Primary malignant melanoma of the conjunctiva of the upper eyelid. A case report.

BACKGROUND: Malignant melanoma of the conjunctiva is rare. The nomenclature and clinical and pathologic features of cutaneous and conjunctival melanomas are different. CASE: A 62-year-old male presented with a history of slight bleeding of the upper conjunctiva for the previous six months. On clinical examination the ophthalmologist observed a smooth, partly nodular, pigmented lesion on the conjunctiva under the left eyelid, 1.5 cm in diameter. Fine needle aspiration (FNA) biopsy of the mass showed tumor cells dispersed as single cells with eccentric, round nuclei; coarsely granular chromatin; prominent nucleoli; and dense cytoplasm with occasional brownish pigmentation as well as small aggregates of spindle-shaped neoplastic cells with hyperchromatic nuclei and no cytoplasmic pigment. CONCLUSION: FNA cytology is a simple and efficient method of making the diagnosis of malignant melanoma in conjunctival masses. Careful correlation with the clinical history and histologic findings is often necessary for confirmation of the diagnosis.