We report the case of a high myopic patient who had been implanted with angle-supported phakic intraocular lenses (pIOL) in 1990 and who subsequently and gradually developed complications in both eyes including endoth...We report the case of a high myopic patient who had been implanted with angle-supported phakic intraocular lenses (pIOL) in 1990 and who subsequently and gradually developed complications in both eyes including endothelial cell loss, chronic glaucoma, cataract, pupil ovalization and severe iris atrophy. The patient was impaired by photophobia, glare, halo, loss in visual acuity and concerned about the cosmetically deforming aspect of her eyes. Cataract surgery was performed after explantation of the pIOL followed by combined implantation of a standard IOL in the capsular bag and a Dr Schmidt artificial iris in the sulcus. There were no intraoperative and postoperative complications except slight bilateral corneal oedema which resolved completely within 1 month after surgery. Uncorrected and corrected visual acuity improved progressively to reach 0.3 and 0.6 at the last follow-up visit (±1 year), respectively. The patient was very satisfied with the functional and aesthetical outcomes.展开更多
●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical tria...●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.展开更多
Background:To compare the outcomes of a toric phakic intraocular lens(PIOL)and a spherical PIOL combined with astigmatic keratotomy(AK)for the correction of high myopic astigmatism.Methods:This study enrolled patients...Background:To compare the outcomes of a toric phakic intraocular lens(PIOL)and a spherical PIOL combined with astigmatic keratotomy(AK)for the correction of high myopic astigmatism.Methods:This study enrolled patients with high myopic astigmatism,including 30 eyes(22 patients)that received a toric PIOL implantation(TICL group),and 32 eyes(24 patients)that received combined AK and a spherical PIOL implantation(AK+ICL group).The outcomes were compared between the two groups before surgery,and at the following time points after surgery:1 week,1,3,6 months,and 1,2 years.Results:Preoperatively,the mean manifest spherical equivalent(SE)was−14.14±2.12 D in the TICL group and−14.83±2.79 D in the AK+ICL group(P=0.28),and the mean manifest refractive cylinder,−2.87±1.09 D and−2.58±0.85 D,respectively(P=0.28).Two years postoperatively,the mean safety index was 1.53±0.55 in the TICL group and 1.60±0.70 in the AK+ICL group(P=1.00),and the mean efficacy index,1.18±0.45 and 1.38±0.52,respectively(P=0.86).The mean manifest refractive cylinder correction was 1.94±1.07 D in the TICL group and 1.39±0.71 D in the AK+ICL group(P=0.02).The mean changes in SE and refractive cylinder from 1 week to 2 years were less than 0.50 D in both groups.Conclusions:Both TICL implantation and AK+ICL implantation are a good alternative for correction of astigmatism in addition to high myopia.TICL implantation has better predictability in correction of high myopic astigmatism.展开更多
AIM: To compare Visian lens(model V4 c) and Artiflex lens regarding quality(contrast sensitivity) and quantity(efficacy, predictability, safety and stability) of vision in correcting high myopia with recording and ana...AIM: To compare Visian lens(model V4 c) and Artiflex lens regarding quality(contrast sensitivity) and quantity(efficacy, predictability, safety and stability) of vision in correcting high myopia with recording and analysis of complications. METHODS: The comparative prospective study included 39 eyes of 23 patients with high myopia, 19 eyes had Visian lens implantation(model V4 c) and 20 eyes had Artiflex lens implantation. The inclusion criteria were high myopia(higher than 6.0 D) and stable refraction(<0.5 D change over one year). Outcomes included assessment of safety and efficacy indices, predictability, stability, contrast sensitivity and analysis of complications at postoperative 1 d, 1 wk and 1, 3, 6 and 12 mo. Selection of the type of phakic intraocular lens for patients was based on surgeons' preferences, which was no specific selection criteria. RESULTS: After 12 mo of follow up, difference in uncorrected and corrected distant visual acuity(CDVA) between both groups was statistically insignificant(UDVA for VisianV4 c and Artiflex lens were 0.33±0.2 logMAR and 0.37±0.2 logMAR respectively, P=0.59, CDVA for VisianV4 c and Artiflex lens were 0.155±0.1 logMAR and 0.147± 0.1 logMAR respectively, P=0.87). The efficacy index was 1.25 for VisianV4 c lens and 0.8 for Artiflex lens, 78.9% of eyes were within one diopter spherical equivalent in Visian V4 c lens group compared to 70% in the Artiflex lens group. No eye lost lines of CVDA proving a good safety index for both lenses(safety index was 1.67 for VisianV4 c lens and 1.34 for Artiflex lens). Difference in contrast sensitivity between both groups was statistically insignificant(P=0.15, 0.88, 0.27, 0.32 and 0.82 at five spatial frequencies). CONCLUSION: Both Visian ICL V4 c and Artiflex lensesare safe and effective with stable and predictable refraction and they have comparable contrast sensitivity outcomes with no vision threatening complications.展开更多
AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectiv...AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectively analyzed 16 eyes of 16 patients who underwent transscleral fixation of C-loop PCIOLs using a flapless one-knot suture technique,which were followed up for longer than 17mo.In this technique,the capsulorless IOL was suspended using a single suture for transscleral fixation of four feet.Then we compared its surgical outcomes and complications with the four-haptics PC-IOLs using the Student's t test and Chi-square test.RESULTS:Sixteen patients of 16 eyes with a mean age of 58.3±10.1y(42-76y)who received transscleral C-loop IOL implantation due to trauma,vitrectomy,or cataract surgery with inadequate capsule support showed improved visual acuity.The difference was not significant between two IOLs except the surgery time(P>0.05).The mean operation times of C-loop IOL surgery was 24.1±1.83min and 31.3±4.47min of the four-haptics PC-IOL method(P<0.0001).In the C-loop IOLs group,there was statistical difference between the preoperative and the postoperative UCVA(log MAR,1.20±0.50 vs 0.57±0.32,P=0.0003).There was no statistical difference between the preoperative and the postoperative BCVA(log MAR,0.66±0.46 vs 0.40±0.23,P=0.056).However,there was no statistically significant difference in postoperative UCVA and BCVA between the two IOLs(P>0.05).We did not detect any optic capture,IOL decentration or dislocation,suture exposed,or cystoid macular edema in patients underwent C-loop IOLs surgery.CONCLUSION:The novel flapless one-knot suture technique for transscleral fixation of C-loop IOL is a simple,reliable,and stable technique.展开更多
AIM:To assess the performance of a bespoke software for automated counting of intraocular lens(IOL)glistenings in slit-lamp images.METHODS:IOL glistenings from slit-lamp-derived digital images were counted manually an...AIM:To assess the performance of a bespoke software for automated counting of intraocular lens(IOL)glistenings in slit-lamp images.METHODS:IOL glistenings from slit-lamp-derived digital images were counted manually and automatically by the bespoke software.The images of one randomly selected eye from each of 34 participants were used as a training set to determine the threshold setting that gave the best agreement between manual and automatic grading.A second set of 63 images,selected using randomised stratified sampling from 290 images,were used for software validation.The images were obtained using a previously described protocol.Software-derived automated glistenings counts were compared to manual counts produced by three ophthalmologists.RESULTS:A threshold value of 140 was determined that minimised the total deviation in the number of glistenings for the 34 images in the training set.Using this threshold value,only slight agreement was found between automated software counts and manual expert counts for the validating set of 63 images(κ=0.104,95%CI,0.040-0.168).Ten images(15.9%)had glistenings counts that agreed between the software and manual counting.There were 49 images(77.8%)where the software overestimated the number of glistenings.CONCLUSION:The low levels of agreement show between an initial release of software used to automatically count glistenings in in vivo slit-lamp images and manual counting indicates that this is a non-trivial application.Iterative improvement involving a dialogue between software developers and experienced ophthalmologists is required to optimise agreement.The results suggest that validation of software is necessary for studies involving semi-automatic evaluation of glistenings.展开更多
AIM:To evaluate the postoperative intraocular lens(IOL)rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL...AIM:To evaluate the postoperative intraocular lens(IOL)rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL.METHODS:In this retrospective case series,32 eyes of 32 patients underwent a combined 25-gauge vitrectomy and phacoemulsification for vitreoretinal diseases and cataract with regular corneal astigmatism of at least 1 diopter(D).A plate haptic toric IOL(AT Torbi 709M,Carl Zeiss Meditec AG)was implanted in all eyes.The outcome measures were rotational stability and refractive astigmatism up to 6mo postoperatively as well as the best corrected visual acuity(BCVA).RESULTS:Preoperative refractive astigmatism was 2.14±1.17 D,which was significantly reduced to 0.77±0.37 D six to eight weeks postoperatively and remained stable throughout the observation period(0.67±0.44 D at three months and 0.75±0.25 D at six months;for all groups:P<0.0001 compared to baseline).BCVA improved significantly from 0.36±0.33 logMAR preoperatively to 0.10±0.15 logMAR following surgery(P=0.02).Mean IOL axis deviation from the target axis was 3.4°±2.9°after six to eight weeks and significantly decreased over time(2.4°±2.6°six months after surgery;P=0.04).In one patient IOL,re-alignment was performed.CONCLUSION:Corneal astigmatism is significantly reduced following combined 25-gauge vitrectomy and cataract surgery.The plate haptic toric IOL position and axis remain stable during the observation period of six months.展开更多
AIM:To report the long-term vision-threatening complications in patients who underwent phakic intraocular lens(pIOLs)implantation for high myopia.METHODS:Thisstudywasdesignedfromaconsecutive series of phakic intraocul...AIM:To report the long-term vision-threatening complications in patients who underwent phakic intraocular lens(pIOLs)implantation for high myopia.METHODS:Thisstudywasdesignedfromaconsecutive series of phakic intraocular lens complication and corrective surgeries.Sixteen eyes of 13 patients had implantation of phakic intraocular lens for correction high myopia and developed serious complications have been included in this study.The mean age of patients was 38.6±6.35y(range 32-50y)and the mean time of history of pIOL implantation for high myopia was 6±2y(range 2-10y).Before corrective surgery,best spectaclecorrective visual acuity(BSCVA)ranged from perception to 20/200 in the eyes in which severe complications occurred.RESULTS:Corneal decompensation occurred in 12eyes of 9 high myopic patients after anterior chamber pIOL implantation.Rhegmatogenous retinal detachment(RRD)occurred in 4 eyes of 4 high myopic patients following anterior chamber and posterior chamber pIOL implantation.Patients with corneal decompensation,had combined procedures consisting of pIOL removal and penetrating keratoplasty(PKP).Removals of pIOL,phacoemulsification and pars plana vitrectomy(PPV)with silicone oil tamponade were performed in patients with RRD.After corrective surgeries,all patients but one(P+,patient 2,right eye)achieved moderate BSCVA ranged from 20/200 to 20/50 at the last visit.CONCLUSION:Phakic IOLs may be effective for thecorrection of high myopia.Although these IOLs may have severe complications and it affects safety and efficacy of this surgery.As seen here,corneal decompensation and rhegmatogenous retinal detachment are possible postoperative vision-threatening complications of phakic IOLs.Patients must be carefully examined before and after surgery for possible endothelial cell loss and vitreoretinal problems.展开更多
AIM:To evaluate the efficacy,safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia.METHODS:Retrospective case review of 82 eyes(43patients)undergoing implanta...AIM:To evaluate the efficacy,safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia.METHODS:Retrospective case review of 82 eyes(43patients)undergoing implantable Coliamer lens(ICL)placement by a single surgeon(Xiao-Wei Gao)to correct preoperative mean spherical equivalents between-9.00diopter(D)and-23.00D.Main outcome measures included uncorrected visual acuity(UCVA),refraction,best spectacle-corrected visual acuity(BSCVA),endothelial cell density(ECD),intraocular pressure(IOP),lens transparency,postoperative uveitis.Visante anterior segment optical coherence tomography(AS-OCT)was used to measure anterior chamber depth(ACD)and the position of ICL.RESULTS:Mean follow-up was 6.54±3.26 months(range 3-12 months).Predictability of the manifest spherical equivalent(SE)refraction to within±1.OOD was achieved in 88%of eyes and±0.50D in 72.5%of eyes.The mean postoperative manifest SE refraction was-1.85±0.72D,with 96.34%of eyes maintaining or gaining≥1 line(s)of BSCVA.The mean 3-month postoperative ECD decreased but had no statistically difference compared with the preoperative ECD.Of the 7 eyes(8.54%)with a mild transient increase in intraocular pressure(up to 30mmHg),none required a second surgical procedure or prolonged topical medication.There was no loss of lens transparency.Pigmented precipitates were observed in 5 eyes(6.09%).The mean preoperative ACD measured with AS-OCT was 3.28±0.14mm,three months after surgery,the mean ACD was2.45±0.22mm.Anterior chamber depth showed astatistically significant reduction.One eye(1.22%)had ICL spontaneous rotation,81 eyes(98.78%)of the lens remained correctly centered.CONCLUSION:The implantation of ICL is an effective surgical option for the management of high myopia.But its long time effect and safety still need more time to prove.展开更多
This study aims to evaluate the clinical results of posterior chamber implantable collamer lens(ICL) implantation in adults with high myopic anisometropic amblyopia. Thirteen patients aged 27.04±7.24 y(range 19.2...This study aims to evaluate the clinical results of posterior chamber implantable collamer lens(ICL) implantation in adults with high myopic anisometropic amblyopia. Thirteen patients aged 27.04±7.24 y(range 19.2 to 42.5) were studied. ICL implantation was performed in 13 amblyopic eyes. The mean myopic anisometropia was significantly dropped from-10.70±3.02 D preoperatively to +0.09±1.67 D at 1 mo postoperatively. The logMAR CDVA at 3 d, 1, 3 and mean 9 mo postoperatively improved by a mean of 1.69, 2.50, 3.01 and 3.00 lines and gained more than 2 lines accounted for 23.08%(3 eyes), 41.67%(5 eyes), 63.63%(7 eyes) and 55.56%(5 eyes), respectively. The contrast sensitivity of amblyopic eyes was significantly increased after surgery. Four patients partially recovered near stereopsis(400" to 100"). There was no severe complications were observed. ICL implantation alone can improve vision, contrast sensitivity, and partial restoration of binocular vision in adult patients with high myopic anisometropia.展开更多
AIM: To compare higher order aberrations in two aspherical intraocular lenses(IOLs): Akreos advanced optics(AO) and Dr. Schmidt Microcrystalline 6125 aspheric anterior surface(MC6125AS) with each other. METHODS: Forty...AIM: To compare higher order aberrations in two aspherical intraocular lenses(IOLs): Akreos advanced optics(AO) and Dr. Schmidt Microcrystalline 6125 aspheric anterior surface(MC6125AS) with each other. METHODS: Forty eyes of 39 patients underwent phacoemulsification and Akreos AO and MC6125 AS were implanted in their eyes in a random manner. Three months post-operatively, higher order aberrations including spherical aberration, coma aberration, and total aberrations were measured and compared.RESULTS: The total aberration was 0.24±0.17 in eyes with Dr. Schmidt and 0.20 ±0.01 in eyes with Akreos AO(P =0.361). The mean of coma aberration was 0.17 ±0.21 and 0.09 ±0.86 in Dr. Schmidt and Akreos lenses,respectively(P =0.825). Total spherical aberration was almost the same in both groups(mean: 0.05, P =0.933).Best corrected visual acuity in Akreos AO(0.10±0.68) and Dr. Schmidt(0.09±0.67) did not differ significantly(P =0.700). CONCLUSION: There is no statistically significant difference in the higher order aberrations between these two aspherical lenses.展开更多
·AIM:To evaluate the distance vision of Chinese patients with cataracts and corneal astigmatism after implantation of bilateral AcrySof toric intraocular lens (IOL) versus bilateral AcrySof spherical IOL.·ME...·AIM:To evaluate the distance vision of Chinese patients with cataracts and corneal astigmatism after implantation of bilateral AcrySof toric intraocular lens (IOL) versus bilateral AcrySof spherical IOL.·METHODS:This study randomized 60 patients into equal groups to receive toric IOL or spherical IOL.IOL powers targeting emmetropia were selected for 93% of toric IOL patients and for 90% of spherical IOL patients.Assessments included monocular and binocular distance vision,with and without best correction.Patients also completed surveys about their distance vision.·RESULTS:Preoperatively,the two study groups were similar in age,in distance visual acuity,and in the magnitude of corneal astigmatism.At 6 months postoperative,binocular uncorrected distance vision was 0.06?à0.14 logMAR in the AcrySof toric IOL group,significantly better than the 0.14?à0.11 logMAR in the spherical IOL group (P<0.05).For eyes with emmetropia as a target,the equivalent of 20/20 uncorrected vision was more likely (P<0.001) in the toric IOL group (36% of eyes) than in the spherical IOL group (4% of eyes).No patients in the emmetropia/toric IOL group used distance glasses,as compared to 52% of patients in the emmetropia/spherical IOL group.All patients were satisfied or highly satisfied.Quality of distance vision was rated higher by toric IOL patients than by spherical IOL patients (P<0.05).·CONCLUSION:Bilateral AcrySof toric IOL is superior to bilateral spherical IOL in providing uncorrected distance vision to cataract patients with corneal astigmatism.·展开更多
AIM:To assess the visual outcomes of aspheric multifocal intraocular lenses(IOLs) compared with spherical multifocal IOL after cataract surgery.METHODS:Potential prospective controlled trials that comparing aspheric m...AIM:To assess the visual outcomes of aspheric multifocal intraocular lenses(IOLs) compared with spherical multifocal IOL after cataract surgery.METHODS:Potential prospective controlled trials that comparing aspheric multifocal IOL implantation with spherical multifocal IOL group were extracted from the computer database.The statistical analysis was carried out using Stata 10 software.Standardized mean differences with 95% confidence intervals(CIs) were calculated for continuous variables.The pooled estimates were computed in the use of a random-effects model. RESULTS:A systematic review identified five prospective nonrandomized controlled trials,including 178 aspheric multifocal IOL and 164 spherical multifocal IOL.There was no significant difference in uncorrected distance visual acuity(95%CI,-0.248 to 0.152;P=0.641) and uncorrected near visual acuity(95% CI,-0.210 to 0.428;P=0.504) between aspheric multifocal IOL and spherical multifocal IOL.Statistically significant differences were detected less spherical aberration in aspheric multifocal IOL(95% CI,-1.111 to-0.472;P<0.001) when compared to spherical multifocal IOL.Spherical multifocal IOL showed a greater higher order aberration compared to the aspheric multifocal IOL(95% CI,-1.024 to-0.293;P<0.001).Sensitivity analysis suggested that the results were relatively reliable. CONCLUSION:The overall findings indicated that aspheric multifocal IOL and spherical multifocal IOL provided similar visual acuity at near and distance.Patients implanted with aspheric multifocal IOL had less spherical aberration and higher order aberration than patients with spherical multifocal IOL.Further well organized,prospective controlled trials involving larger patient numbers are needed.展开更多
AIM:To compare the efficacy and complications of Artisan iris-claw intraocular lens(IOL)implantation and posterior chamber IOL sulcus fixation for the treatment of aphakic eyes without capsular support after vitrectom...AIM:To compare the efficacy and complications of Artisan iris-claw intraocular lens(IOL)implantation and posterior chamber IOL sulcus fixation for the treatment of aphakic eyes without capsular support after vitrectomy.METHODS:A prospective study of 45 cases was conducted.Forty-five eyes without sufficient lens capsule support following pars plana vitrectomy(PPV)combined lens extraction were divided into two groups.Group A:25 eyes received Artisan iris-claw IOL implantation.Group B:20 eyes received posterior chamber IOL sulcus fixation.The corrected distance visual acuity(CDVA)and intraocular pressure(IOP),corneal endothelial cell loss rate,surgical time and complications were compared between the two groups.Pigment changes of trabecular meshwork and anterior chamber depths were measured at each time point in Artisan group.RESULTS:The mean surgical time of Artisan group was significantly shorter(P<0.05).No statistically significant difference in endothelial cell loss rate was noted between two groups at any time point(P>0.05).CDVA of Artian group was better than that of the sulcus fixation group 1d after surgery(P<0.05)and there was no statistically significant difference 1 and 3mo after surgery(P>0.05).Mean IOP showed no significant differences between groups before and after surgery.The postoperative complications of Artisan group were anterior uveitis,iris depigmentation,pupillary distortion and spontaneous lens dislocation.The complications of sulcus fixation group include choroidal detachment,intraocular haemorrhage,tilt of IOL optic part and retinal detachment.CONCLUSION:Secondary Artisan IOL implantation canbe performed less invasively and in a shorter surgical time period with earlier visual recovery after surgery compared to transscleral suturing fixation of an IOL.This technique is an effective and safe procedure.It is a promising option for the treatment of aphakic eyes without capsular support after vitrectomy.展开更多
AIM: To assess the outcomes of posterior chamber implantable collamer lens(ICL) implantation in Chinese pediatric patients with unilateral high myopic amblyopia.·METHODS: Eleven eyes of 11 amblyopic patients aged...AIM: To assess the outcomes of posterior chamber implantable collamer lens(ICL) implantation in Chinese pediatric patients with unilateral high myopic amblyopia.·METHODS: Eleven eyes of 11 amblyopic patients aged11.02±3.34 y underwent ICL(model V4, Staar Surgical Inc.)implantation to treat unilateral anisometropia were studied. Visual acuity, cycloplegic refraction, contrast sensitivity, stereopsis, intraocular pressure(IOP),vaulting, corneal endothelial cell count and complications were evaluated. Patients completed follow-up at 3d, 1,3mo and the last follow-up time(mean 8.18 ±2.82mo)after surgery.· RESULTS: The mean myopic anisometropia was-13.70 ±3.25 D preoperatively and +0.69 ±2.63 D at 8mo postoperatively. The log MAR corrected distance visual acuity(CDVA) of the amblyopic eye was 1.51 ±0.72 preoperatively and 0.75±0.40 at 8mo postoperatively. The log MAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by a mean of 0.64, 1.55, 1.82 and 2.64 lines and gained more than 2 lines accounted for 18%, 45%, 45%,64%, respectively. The contrast sensitivity of 0.5, 1 and 2cpd in amblyopic eyes was significantly increased after surgery. No patient had near stereopsis recovery. The vaulting at 3 and 8mo was significantly lower than that at1 mo postoperatively. No other intraoperative or postoperative complications were observed, except an acute pupillary block glaucoma happened in a patient at two weeks postoperatively.·CONCLUSION: This short-term results indicate that ICL implantation can be a promising alternative therapy for high myopic anisometropic amblyopia in pediatric patients who have failed with conventional treatments and not suitable to corneal refraction surgery.展开更多
AIM:To prepare a new-type soft intraocular lens (IOL) that silicone intraocular lenses (IOLs) were modified by surface modification technique to assess IOLs biocompatibility.· METHODS:With the technique of ion be...AIM:To prepare a new-type soft intraocular lens (IOL) that silicone intraocular lenses (IOLs) were modified by surface modification technique to assess IOLs biocompatibility.· METHODS:With the technique of ion beam combined with low temperature and low pressure plasma,the surface characteristics of the IOLs including physical and optical properties were determined by the instruments of IOLs resolution,UV/VIS scanning spectrophotometer,contact angle measurement system,electron spectroscopy for chemical analysis (ESCA) and scanning electron microscope (SEM).· RESULTS:The color of titanium (Ti) modified IOLs was light yellow and that of titanium nitride (TiN) modified IOLs was light brown.The absorptive degree of ultraviolet rays and the hydrophilicity of the surfaces of modified IOLs were increased,and appeared suitable chemical compositions.The resolution of unmodified and modified IOLs reached normal standard.The surfaces of unmodified and Ti-modified IOLs appeared uniform.The surfaces of TiN-modified IOLs presented fine porcelain structure.CONCLUSION:The optical properties of all IOLs and the surface morphology of the modified IOLs were not affected by modification processes.The surface properties of the modified IOLs were improved.展开更多
This cohort study included 36 eyes of 21 patients with high myopia treated with angle supported phakic intraocular lens(p IOL).Endothelial cell density(ECD) at baseline,6 mo and 3 y were 3017±296,2775±265 an...This cohort study included 36 eyes of 21 patients with high myopia treated with angle supported phakic intraocular lens(p IOL).Endothelial cell density(ECD) at baseline,6 mo and 3 y were 3017±296,2775±265 and 2558±299 cells/mm^2 respectively.ECD loss at 6 mo was 7.2% and annual ECD loss was 3% over 36 mo.Corrected distance visual acuity at 36 mo was 0.4 log MAR or better in 32(88.9%) eyes.Intraocular pressure did not change(P=0.9).No eyes developed cataract,retinal detachment or pupillary distortion.Angle supported p IOL gives good visual outcome.Endothelial cell loss should be monitored.展开更多
AIM:To assess the safety,efficacy and predictability of the AcrySof phakic angle-supported intraocular lens(IOL)(Alcon Inc.,U.S.A.) for correction of high-to-extremely high myopia in adults.· METHODS:In this pros...AIM:To assess the safety,efficacy and predictability of the AcrySof phakic angle-supported intraocular lens(IOL)(Alcon Inc.,U.S.A.) for correction of high-to-extremely high myopia in adults.· METHODS:In this prospective study performed in Tianjin Medical University Eye Center & College of Optometry,Tianjin,China,25 eyes of 13 patients were implanted with AcrySof phakic angle-supported IOLs and followed for 1 year postoperatively.Preoperative manifest refractive sphere was(-12.08±2.44) diopters(D) and cylinder was(-1.35±0.62)D.Visual acuity,predictability and stability of manifest refraction spherical equivalent(MRSE),adverse events,and endothelial cell density were analyzed during 1-year of follow-up.· RESULTS:After 1 year of follow-up,no eyes lost ≥1 line(best spectacle-corrected visual acuity)BSCVA;an uncorrected visual acuity(UCVA) of 20/20 or better was achieved in 60% of eyes;100% had an UCVA of 20/40 or better;a BSCVA of 20/30 or better was achieved by 100% of eyes;84% had a BSCVA of 20/20 or better.The overall mean percentage change in endothelial cell density 1 year after surgery was(-0.27±3.60)%.Two eyes(8%) had increased intraocular pressure(IOP) on the day of surgery.No pupil ovalization,pupillary block,or retinal detachment events were observed.· CONCLUSION:After 1 year of follow-up,the implantation of AcrySof phakic angle-supported IOL is proved to be safe,effective and predictable with minimal complications in patients with high-to-extremely high myopia.Due to the limitation of visiting time,long-term of clinical investigation is necessary to verify the safety and efficacy of this IOL.展开更多
AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·MET...AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best - corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. ·RESULTS:Threemonthspostoperatively,themonocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. ·CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractivepower than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo.展开更多
AIM:In order to improve the biocompatibility of intraocular lenses(IOL),the polymethylmethacrylate(PMMA)IOL was modified with F-heparin. METHODS:The PMMA IOL was modified with F ions and heparin by the technique of io...AIM:In order to improve the biocompatibility of intraocular lenses(IOL),the polymethylmethacrylate(PMMA)IOL was modified with F-heparin. METHODS:The PMMA IOL was modified with F ions and heparin by the technique of ion beam combined with low temperature and low pressure plasma.The monkeys(20 eyes)with cataract partly were randomly classified into 2 groups and implanted with PMMA IOL and modified IOL respectively for 180 days.All of the eyes were examined by slit-lamp microscope at postoperative 15,30,60,90,180 days.The extracted IOL was analyzed with computer image analysis,light microscope(LM)and scanning electron microscope(SEM)at postoperative 180 days. RESULTS:The early inflammatory reactions postoperatively include anterior chamber exudation and aqueous cell count. The modified IOL group showed less than the non-modified IOL group.The late foreign body cell reaction that adhered to the surface of non-modified IOL was more predominant.The morphologic and pathological changes of posterior capsule opacification(PCO)in monkeys’ eyes included fibrosis-type, pearl-type and soemmerring’s ring.There was a significant difference between the two groups. CONCLUSION:F-heparin modified IOL has good uveal and capsular biocompatibility.展开更多
文摘We report the case of a high myopic patient who had been implanted with angle-supported phakic intraocular lenses (pIOL) in 1990 and who subsequently and gradually developed complications in both eyes including endothelial cell loss, chronic glaucoma, cataract, pupil ovalization and severe iris atrophy. The patient was impaired by photophobia, glare, halo, loss in visual acuity and concerned about the cosmetically deforming aspect of her eyes. Cataract surgery was performed after explantation of the pIOL followed by combined implantation of a standard IOL in the capsular bag and a Dr Schmidt artificial iris in the sulcus. There were no intraoperative and postoperative complications except slight bilateral corneal oedema which resolved completely within 1 month after surgery. Uncorrected and corrected visual acuity improved progressively to reach 0.3 and 0.6 at the last follow-up visit (±1 year), respectively. The patient was very satisfied with the functional and aesthetical outcomes.
文摘●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.
基金funded by the Nature and Science Foundation of China(Grant No.81570869)Nature and Science Foundation of Zhejiang Province,China(Grant No.Y2110784)+2 种基金Zhejiang Provincial Foundation of China for Distinguished Young Talents in Medicine and Health(Grant No.2010QNA018)Foundation of Wenzhou City Science&Technology Bureau(Grant No.Y20140705)Engineering Development Project of Ophthalmology and Optometry(Grant No.GCKF201601).
文摘Background:To compare the outcomes of a toric phakic intraocular lens(PIOL)and a spherical PIOL combined with astigmatic keratotomy(AK)for the correction of high myopic astigmatism.Methods:This study enrolled patients with high myopic astigmatism,including 30 eyes(22 patients)that received a toric PIOL implantation(TICL group),and 32 eyes(24 patients)that received combined AK and a spherical PIOL implantation(AK+ICL group).The outcomes were compared between the two groups before surgery,and at the following time points after surgery:1 week,1,3,6 months,and 1,2 years.Results:Preoperatively,the mean manifest spherical equivalent(SE)was−14.14±2.12 D in the TICL group and−14.83±2.79 D in the AK+ICL group(P=0.28),and the mean manifest refractive cylinder,−2.87±1.09 D and−2.58±0.85 D,respectively(P=0.28).Two years postoperatively,the mean safety index was 1.53±0.55 in the TICL group and 1.60±0.70 in the AK+ICL group(P=1.00),and the mean efficacy index,1.18±0.45 and 1.38±0.52,respectively(P=0.86).The mean manifest refractive cylinder correction was 1.94±1.07 D in the TICL group and 1.39±0.71 D in the AK+ICL group(P=0.02).The mean changes in SE and refractive cylinder from 1 week to 2 years were less than 0.50 D in both groups.Conclusions:Both TICL implantation and AK+ICL implantation are a good alternative for correction of astigmatism in addition to high myopia.TICL implantation has better predictability in correction of high myopic astigmatism.
文摘AIM: To compare Visian lens(model V4 c) and Artiflex lens regarding quality(contrast sensitivity) and quantity(efficacy, predictability, safety and stability) of vision in correcting high myopia with recording and analysis of complications. METHODS: The comparative prospective study included 39 eyes of 23 patients with high myopia, 19 eyes had Visian lens implantation(model V4 c) and 20 eyes had Artiflex lens implantation. The inclusion criteria were high myopia(higher than 6.0 D) and stable refraction(<0.5 D change over one year). Outcomes included assessment of safety and efficacy indices, predictability, stability, contrast sensitivity and analysis of complications at postoperative 1 d, 1 wk and 1, 3, 6 and 12 mo. Selection of the type of phakic intraocular lens for patients was based on surgeons' preferences, which was no specific selection criteria. RESULTS: After 12 mo of follow up, difference in uncorrected and corrected distant visual acuity(CDVA) between both groups was statistically insignificant(UDVA for VisianV4 c and Artiflex lens were 0.33±0.2 logMAR and 0.37±0.2 logMAR respectively, P=0.59, CDVA for VisianV4 c and Artiflex lens were 0.155±0.1 logMAR and 0.147± 0.1 logMAR respectively, P=0.87). The efficacy index was 1.25 for VisianV4 c lens and 0.8 for Artiflex lens, 78.9% of eyes were within one diopter spherical equivalent in Visian V4 c lens group compared to 70% in the Artiflex lens group. No eye lost lines of CVDA proving a good safety index for both lenses(safety index was 1.67 for VisianV4 c lens and 1.34 for Artiflex lens). Difference in contrast sensitivity between both groups was statistically insignificant(P=0.15, 0.88, 0.27, 0.32 and 0.82 at five spatial frequencies). CONCLUSION: Both Visian ICL V4 c and Artiflex lensesare safe and effective with stable and predictable refraction and they have comparable contrast sensitivity outcomes with no vision threatening complications.
基金Supported by the Gongli Hospital of Pudong New Area,Shanghai(No.2017YQNJJ-13)。
文摘AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectively analyzed 16 eyes of 16 patients who underwent transscleral fixation of C-loop PCIOLs using a flapless one-knot suture technique,which were followed up for longer than 17mo.In this technique,the capsulorless IOL was suspended using a single suture for transscleral fixation of four feet.Then we compared its surgical outcomes and complications with the four-haptics PC-IOLs using the Student's t test and Chi-square test.RESULTS:Sixteen patients of 16 eyes with a mean age of 58.3±10.1y(42-76y)who received transscleral C-loop IOL implantation due to trauma,vitrectomy,or cataract surgery with inadequate capsule support showed improved visual acuity.The difference was not significant between two IOLs except the surgery time(P>0.05).The mean operation times of C-loop IOL surgery was 24.1±1.83min and 31.3±4.47min of the four-haptics PC-IOL method(P<0.0001).In the C-loop IOLs group,there was statistical difference between the preoperative and the postoperative UCVA(log MAR,1.20±0.50 vs 0.57±0.32,P=0.0003).There was no statistical difference between the preoperative and the postoperative BCVA(log MAR,0.66±0.46 vs 0.40±0.23,P=0.056).However,there was no statistically significant difference in postoperative UCVA and BCVA between the two IOLs(P>0.05).We did not detect any optic capture,IOL decentration or dislocation,suture exposed,or cystoid macular edema in patients underwent C-loop IOLs surgery.CONCLUSION:The novel flapless one-knot suture technique for transscleral fixation of C-loop IOL is a simple,reliable,and stable technique.
文摘AIM:To assess the performance of a bespoke software for automated counting of intraocular lens(IOL)glistenings in slit-lamp images.METHODS:IOL glistenings from slit-lamp-derived digital images were counted manually and automatically by the bespoke software.The images of one randomly selected eye from each of 34 participants were used as a training set to determine the threshold setting that gave the best agreement between manual and automatic grading.A second set of 63 images,selected using randomised stratified sampling from 290 images,were used for software validation.The images were obtained using a previously described protocol.Software-derived automated glistenings counts were compared to manual counts produced by three ophthalmologists.RESULTS:A threshold value of 140 was determined that minimised the total deviation in the number of glistenings for the 34 images in the training set.Using this threshold value,only slight agreement was found between automated software counts and manual expert counts for the validating set of 63 images(κ=0.104,95%CI,0.040-0.168).Ten images(15.9%)had glistenings counts that agreed between the software and manual counting.There were 49 images(77.8%)where the software overestimated the number of glistenings.CONCLUSION:The low levels of agreement show between an initial release of software used to automatically count glistenings in in vivo slit-lamp images and manual counting indicates that this is a non-trivial application.Iterative improvement involving a dialogue between software developers and experienced ophthalmologists is required to optimise agreement.The results suggest that validation of software is necessary for studies involving semi-automatic evaluation of glistenings.
文摘AIM:To evaluate the postoperative intraocular lens(IOL)rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL.METHODS:In this retrospective case series,32 eyes of 32 patients underwent a combined 25-gauge vitrectomy and phacoemulsification for vitreoretinal diseases and cataract with regular corneal astigmatism of at least 1 diopter(D).A plate haptic toric IOL(AT Torbi 709M,Carl Zeiss Meditec AG)was implanted in all eyes.The outcome measures were rotational stability and refractive astigmatism up to 6mo postoperatively as well as the best corrected visual acuity(BCVA).RESULTS:Preoperative refractive astigmatism was 2.14±1.17 D,which was significantly reduced to 0.77±0.37 D six to eight weeks postoperatively and remained stable throughout the observation period(0.67±0.44 D at three months and 0.75±0.25 D at six months;for all groups:P<0.0001 compared to baseline).BCVA improved significantly from 0.36±0.33 logMAR preoperatively to 0.10±0.15 logMAR following surgery(P=0.02).Mean IOL axis deviation from the target axis was 3.4°±2.9°after six to eight weeks and significantly decreased over time(2.4°±2.6°six months after surgery;P=0.04).In one patient IOL,re-alignment was performed.CONCLUSION:Corneal astigmatism is significantly reduced following combined 25-gauge vitrectomy and cataract surgery.The plate haptic toric IOL position and axis remain stable during the observation period of six months.
文摘AIM:To report the long-term vision-threatening complications in patients who underwent phakic intraocular lens(pIOLs)implantation for high myopia.METHODS:Thisstudywasdesignedfromaconsecutive series of phakic intraocular lens complication and corrective surgeries.Sixteen eyes of 13 patients had implantation of phakic intraocular lens for correction high myopia and developed serious complications have been included in this study.The mean age of patients was 38.6±6.35y(range 32-50y)and the mean time of history of pIOL implantation for high myopia was 6±2y(range 2-10y).Before corrective surgery,best spectaclecorrective visual acuity(BSCVA)ranged from perception to 20/200 in the eyes in which severe complications occurred.RESULTS:Corneal decompensation occurred in 12eyes of 9 high myopic patients after anterior chamber pIOL implantation.Rhegmatogenous retinal detachment(RRD)occurred in 4 eyes of 4 high myopic patients following anterior chamber and posterior chamber pIOL implantation.Patients with corneal decompensation,had combined procedures consisting of pIOL removal and penetrating keratoplasty(PKP).Removals of pIOL,phacoemulsification and pars plana vitrectomy(PPV)with silicone oil tamponade were performed in patients with RRD.After corrective surgeries,all patients but one(P+,patient 2,right eye)achieved moderate BSCVA ranged from 20/200 to 20/50 at the last visit.CONCLUSION:Phakic IOLs may be effective for thecorrection of high myopia.Although these IOLs may have severe complications and it affects safety and efficacy of this surgery.As seen here,corneal decompensation and rhegmatogenous retinal detachment are possible postoperative vision-threatening complications of phakic IOLs.Patients must be carefully examined before and after surgery for possible endothelial cell loss and vitreoretinal problems.
文摘AIM:To evaluate the efficacy,safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia.METHODS:Retrospective case review of 82 eyes(43patients)undergoing implantable Coliamer lens(ICL)placement by a single surgeon(Xiao-Wei Gao)to correct preoperative mean spherical equivalents between-9.00diopter(D)and-23.00D.Main outcome measures included uncorrected visual acuity(UCVA),refraction,best spectacle-corrected visual acuity(BSCVA),endothelial cell density(ECD),intraocular pressure(IOP),lens transparency,postoperative uveitis.Visante anterior segment optical coherence tomography(AS-OCT)was used to measure anterior chamber depth(ACD)and the position of ICL.RESULTS:Mean follow-up was 6.54±3.26 months(range 3-12 months).Predictability of the manifest spherical equivalent(SE)refraction to within±1.OOD was achieved in 88%of eyes and±0.50D in 72.5%of eyes.The mean postoperative manifest SE refraction was-1.85±0.72D,with 96.34%of eyes maintaining or gaining≥1 line(s)of BSCVA.The mean 3-month postoperative ECD decreased but had no statistically difference compared with the preoperative ECD.Of the 7 eyes(8.54%)with a mild transient increase in intraocular pressure(up to 30mmHg),none required a second surgical procedure or prolonged topical medication.There was no loss of lens transparency.Pigmented precipitates were observed in 5 eyes(6.09%).The mean preoperative ACD measured with AS-OCT was 3.28±0.14mm,three months after surgery,the mean ACD was2.45±0.22mm.Anterior chamber depth showed astatistically significant reduction.One eye(1.22%)had ICL spontaneous rotation,81 eyes(98.78%)of the lens remained correctly centered.CONCLUSION:The implantation of ICL is an effective surgical option for the management of high myopia.But its long time effect and safety still need more time to prove.
基金Supported by Natural Science Foundation of China (No.81670848 No.81470626)
文摘This study aims to evaluate the clinical results of posterior chamber implantable collamer lens(ICL) implantation in adults with high myopic anisometropic amblyopia. Thirteen patients aged 27.04±7.24 y(range 19.2 to 42.5) were studied. ICL implantation was performed in 13 amblyopic eyes. The mean myopic anisometropia was significantly dropped from-10.70±3.02 D preoperatively to +0.09±1.67 D at 1 mo postoperatively. The logMAR CDVA at 3 d, 1, 3 and mean 9 mo postoperatively improved by a mean of 1.69, 2.50, 3.01 and 3.00 lines and gained more than 2 lines accounted for 23.08%(3 eyes), 41.67%(5 eyes), 63.63%(7 eyes) and 55.56%(5 eyes), respectively. The contrast sensitivity of amblyopic eyes was significantly increased after surgery. Four patients partially recovered near stereopsis(400" to 100"). There was no severe complications were observed. ICL implantation alone can improve vision, contrast sensitivity, and partial restoration of binocular vision in adult patients with high myopic anisometropia.
文摘AIM: To compare higher order aberrations in two aspherical intraocular lenses(IOLs): Akreos advanced optics(AO) and Dr. Schmidt Microcrystalline 6125 aspheric anterior surface(MC6125AS) with each other. METHODS: Forty eyes of 39 patients underwent phacoemulsification and Akreos AO and MC6125 AS were implanted in their eyes in a random manner. Three months post-operatively, higher order aberrations including spherical aberration, coma aberration, and total aberrations were measured and compared.RESULTS: The total aberration was 0.24±0.17 in eyes with Dr. Schmidt and 0.20 ±0.01 in eyes with Akreos AO(P =0.361). The mean of coma aberration was 0.17 ±0.21 and 0.09 ±0.86 in Dr. Schmidt and Akreos lenses,respectively(P =0.825). Total spherical aberration was almost the same in both groups(mean: 0.05, P =0.933).Best corrected visual acuity in Akreos AO(0.10±0.68) and Dr. Schmidt(0.09±0.67) did not differ significantly(P =0.700). CONCLUSION: There is no statistically significant difference in the higher order aberrations between these two aspherical lenses.
文摘·AIM:To evaluate the distance vision of Chinese patients with cataracts and corneal astigmatism after implantation of bilateral AcrySof toric intraocular lens (IOL) versus bilateral AcrySof spherical IOL.·METHODS:This study randomized 60 patients into equal groups to receive toric IOL or spherical IOL.IOL powers targeting emmetropia were selected for 93% of toric IOL patients and for 90% of spherical IOL patients.Assessments included monocular and binocular distance vision,with and without best correction.Patients also completed surveys about their distance vision.·RESULTS:Preoperatively,the two study groups were similar in age,in distance visual acuity,and in the magnitude of corneal astigmatism.At 6 months postoperative,binocular uncorrected distance vision was 0.06?à0.14 logMAR in the AcrySof toric IOL group,significantly better than the 0.14?à0.11 logMAR in the spherical IOL group (P<0.05).For eyes with emmetropia as a target,the equivalent of 20/20 uncorrected vision was more likely (P<0.001) in the toric IOL group (36% of eyes) than in the spherical IOL group (4% of eyes).No patients in the emmetropia/toric IOL group used distance glasses,as compared to 52% of patients in the emmetropia/spherical IOL group.All patients were satisfied or highly satisfied.Quality of distance vision was rated higher by toric IOL patients than by spherical IOL patients (P<0.05).·CONCLUSION:Bilateral AcrySof toric IOL is superior to bilateral spherical IOL in providing uncorrected distance vision to cataract patients with corneal astigmatism.·
文摘AIM:To assess the visual outcomes of aspheric multifocal intraocular lenses(IOLs) compared with spherical multifocal IOL after cataract surgery.METHODS:Potential prospective controlled trials that comparing aspheric multifocal IOL implantation with spherical multifocal IOL group were extracted from the computer database.The statistical analysis was carried out using Stata 10 software.Standardized mean differences with 95% confidence intervals(CIs) were calculated for continuous variables.The pooled estimates were computed in the use of a random-effects model. RESULTS:A systematic review identified five prospective nonrandomized controlled trials,including 178 aspheric multifocal IOL and 164 spherical multifocal IOL.There was no significant difference in uncorrected distance visual acuity(95%CI,-0.248 to 0.152;P=0.641) and uncorrected near visual acuity(95% CI,-0.210 to 0.428;P=0.504) between aspheric multifocal IOL and spherical multifocal IOL.Statistically significant differences were detected less spherical aberration in aspheric multifocal IOL(95% CI,-1.111 to-0.472;P<0.001) when compared to spherical multifocal IOL.Spherical multifocal IOL showed a greater higher order aberration compared to the aspheric multifocal IOL(95% CI,-1.024 to-0.293;P<0.001).Sensitivity analysis suggested that the results were relatively reliable. CONCLUSION:The overall findings indicated that aspheric multifocal IOL and spherical multifocal IOL provided similar visual acuity at near and distance.Patients implanted with aspheric multifocal IOL had less spherical aberration and higher order aberration than patients with spherical multifocal IOL.Further well organized,prospective controlled trials involving larger patient numbers are needed.
文摘AIM:To compare the efficacy and complications of Artisan iris-claw intraocular lens(IOL)implantation and posterior chamber IOL sulcus fixation for the treatment of aphakic eyes without capsular support after vitrectomy.METHODS:A prospective study of 45 cases was conducted.Forty-five eyes without sufficient lens capsule support following pars plana vitrectomy(PPV)combined lens extraction were divided into two groups.Group A:25 eyes received Artisan iris-claw IOL implantation.Group B:20 eyes received posterior chamber IOL sulcus fixation.The corrected distance visual acuity(CDVA)and intraocular pressure(IOP),corneal endothelial cell loss rate,surgical time and complications were compared between the two groups.Pigment changes of trabecular meshwork and anterior chamber depths were measured at each time point in Artisan group.RESULTS:The mean surgical time of Artisan group was significantly shorter(P<0.05).No statistically significant difference in endothelial cell loss rate was noted between two groups at any time point(P>0.05).CDVA of Artian group was better than that of the sulcus fixation group 1d after surgery(P<0.05)and there was no statistically significant difference 1 and 3mo after surgery(P>0.05).Mean IOP showed no significant differences between groups before and after surgery.The postoperative complications of Artisan group were anterior uveitis,iris depigmentation,pupillary distortion and spontaneous lens dislocation.The complications of sulcus fixation group include choroidal detachment,intraocular haemorrhage,tilt of IOL optic part and retinal detachment.CONCLUSION:Secondary Artisan IOL implantation canbe performed less invasively and in a shorter surgical time period with earlier visual recovery after surgery compared to transscleral suturing fixation of an IOL.This technique is an effective and safe procedure.It is a promising option for the treatment of aphakic eyes without capsular support after vitrectomy.
文摘AIM: To assess the outcomes of posterior chamber implantable collamer lens(ICL) implantation in Chinese pediatric patients with unilateral high myopic amblyopia.·METHODS: Eleven eyes of 11 amblyopic patients aged11.02±3.34 y underwent ICL(model V4, Staar Surgical Inc.)implantation to treat unilateral anisometropia were studied. Visual acuity, cycloplegic refraction, contrast sensitivity, stereopsis, intraocular pressure(IOP),vaulting, corneal endothelial cell count and complications were evaluated. Patients completed follow-up at 3d, 1,3mo and the last follow-up time(mean 8.18 ±2.82mo)after surgery.· RESULTS: The mean myopic anisometropia was-13.70 ±3.25 D preoperatively and +0.69 ±2.63 D at 8mo postoperatively. The log MAR corrected distance visual acuity(CDVA) of the amblyopic eye was 1.51 ±0.72 preoperatively and 0.75±0.40 at 8mo postoperatively. The log MAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by a mean of 0.64, 1.55, 1.82 and 2.64 lines and gained more than 2 lines accounted for 18%, 45%, 45%,64%, respectively. The contrast sensitivity of 0.5, 1 and 2cpd in amblyopic eyes was significantly increased after surgery. No patient had near stereopsis recovery. The vaulting at 3 and 8mo was significantly lower than that at1 mo postoperatively. No other intraoperative or postoperative complications were observed, except an acute pupillary block glaucoma happened in a patient at two weeks postoperatively.·CONCLUSION: This short-term results indicate that ICL implantation can be a promising alternative therapy for high myopic anisometropic amblyopia in pediatric patients who have failed with conventional treatments and not suitable to corneal refraction surgery.
基金A Foundation for the Author of National Excellent Doctoral Dissertation of PR China(No.10021201)
文摘AIM:To prepare a new-type soft intraocular lens (IOL) that silicone intraocular lenses (IOLs) were modified by surface modification technique to assess IOLs biocompatibility.· METHODS:With the technique of ion beam combined with low temperature and low pressure plasma,the surface characteristics of the IOLs including physical and optical properties were determined by the instruments of IOLs resolution,UV/VIS scanning spectrophotometer,contact angle measurement system,electron spectroscopy for chemical analysis (ESCA) and scanning electron microscope (SEM).· RESULTS:The color of titanium (Ti) modified IOLs was light yellow and that of titanium nitride (TiN) modified IOLs was light brown.The absorptive degree of ultraviolet rays and the hydrophilicity of the surfaces of modified IOLs were increased,and appeared suitable chemical compositions.The resolution of unmodified and modified IOLs reached normal standard.The surfaces of unmodified and Ti-modified IOLs appeared uniform.The surfaces of TiN-modified IOLs presented fine porcelain structure.CONCLUSION:The optical properties of all IOLs and the surface morphology of the modified IOLs were not affected by modification processes.The surface properties of the modified IOLs were improved.
文摘This cohort study included 36 eyes of 21 patients with high myopia treated with angle supported phakic intraocular lens(p IOL).Endothelial cell density(ECD) at baseline,6 mo and 3 y were 3017±296,2775±265 and 2558±299 cells/mm^2 respectively.ECD loss at 6 mo was 7.2% and annual ECD loss was 3% over 36 mo.Corrected distance visual acuity at 36 mo was 0.4 log MAR or better in 32(88.9%) eyes.Intraocular pressure did not change(P=0.9).No eyes developed cataract,retinal detachment or pupillary distortion.Angle supported p IOL gives good visual outcome.Endothelial cell loss should be monitored.
文摘AIM:To assess the safety,efficacy and predictability of the AcrySof phakic angle-supported intraocular lens(IOL)(Alcon Inc.,U.S.A.) for correction of high-to-extremely high myopia in adults.· METHODS:In this prospective study performed in Tianjin Medical University Eye Center & College of Optometry,Tianjin,China,25 eyes of 13 patients were implanted with AcrySof phakic angle-supported IOLs and followed for 1 year postoperatively.Preoperative manifest refractive sphere was(-12.08±2.44) diopters(D) and cylinder was(-1.35±0.62)D.Visual acuity,predictability and stability of manifest refraction spherical equivalent(MRSE),adverse events,and endothelial cell density were analyzed during 1-year of follow-up.· RESULTS:After 1 year of follow-up,no eyes lost ≥1 line(best spectacle-corrected visual acuity)BSCVA;an uncorrected visual acuity(UCVA) of 20/20 or better was achieved in 60% of eyes;100% had an UCVA of 20/40 or better;a BSCVA of 20/30 or better was achieved by 100% of eyes;84% had a BSCVA of 20/20 or better.The overall mean percentage change in endothelial cell density 1 year after surgery was(-0.27±3.60)%.Two eyes(8%) had increased intraocular pressure(IOP) on the day of surgery.No pupil ovalization,pupillary block,or retinal detachment events were observed.· CONCLUSION:After 1 year of follow-up,the implantation of AcrySof phakic angle-supported IOL is proved to be safe,effective and predictable with minimal complications in patients with high-to-extremely high myopia.Due to the limitation of visiting time,long-term of clinical investigation is necessary to verify the safety and efficacy of this IOL.
基金Zhejiang Key Innovation Team Project(No. 2009R50039)Doctoral Fund of Ministry of Education of China (No: 20100101120135)Key Lab Fund of Zhejiang Province, China (No. 2011E10006)
文摘AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best - corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. ·RESULTS:Threemonthspostoperatively,themonocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. ·CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractivepower than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo.
文摘AIM:In order to improve the biocompatibility of intraocular lenses(IOL),the polymethylmethacrylate(PMMA)IOL was modified with F-heparin. METHODS:The PMMA IOL was modified with F ions and heparin by the technique of ion beam combined with low temperature and low pressure plasma.The monkeys(20 eyes)with cataract partly were randomly classified into 2 groups and implanted with PMMA IOL and modified IOL respectively for 180 days.All of the eyes were examined by slit-lamp microscope at postoperative 15,30,60,90,180 days.The extracted IOL was analyzed with computer image analysis,light microscope(LM)and scanning electron microscope(SEM)at postoperative 180 days. RESULTS:The early inflammatory reactions postoperatively include anterior chamber exudation and aqueous cell count. The modified IOL group showed less than the non-modified IOL group.The late foreign body cell reaction that adhered to the surface of non-modified IOL was more predominant.The morphologic and pathological changes of posterior capsule opacification(PCO)in monkeys’ eyes included fibrosis-type, pearl-type and soemmerring’s ring.There was a significant difference between the two groups. CONCLUSION:F-heparin modified IOL has good uveal and capsular biocompatibility.
