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Biomedical subjects

C Vass

Publications and source records attributed to C Vass.

At least 37 records · Page 2Linked to original sources

Assessment of optic disk blood flow in patients with open-angle glaucoma.

PURPOSE: To characterize optic disk blood flow in patients with open-angle glaucoma compared with age-matched healthy control subjects. METHODS: In this prospective cross-sectional study, 90 eyes of 90 patients with open-angle glaucoma and 61 eyes of 61 age-matched healthy control subjects were evaluated. Flow in the optic disk cup and the neuroretinal rim were assessed with scanning laser Doppler flowmetry. Fundus pulsation amplitude in the cup and the macula were assessed with laser interferometry. Visual field mean deviation was measured with the Humphrey 30 to 2 program. RESULTS: Flow in the neuroretinal rim (-18%, P =.002), and in the cup (-46%, P <.001) and fundus pulsation amplitude in the cup (-33%, P <.001) and in the macula (-24%, P <.001) were significantly lower in patients with open-angle glaucoma compared with healthy control subjects. A significant association between blood flow measurements in the cup and fundus pulsation amplitudes in the cup was observed in both study cohorts. A significant association was also observed between the mean defect from visual field testing and ocular hemodynamic parameters. CONCLUSIONS: Reduced optic disk perfusion in patients with open-angle glaucoma is evidenced from two independent methods in the present study. Moreover, our data indicate that reduced ocular blood flow in these patients is linked to visual field changes. It remains to be established whether compromised optic disk and choroidal blood flow contributes to optic disk damage in glaucomatous eyes or is a secondary functional phenomenon.

Aged↗

Astigmatism correction with a foldable toric intraocular lens in cataract patients.

PURPOSE: To determine the efficacy and rotational stability of a toric posterior chamber silicone intraocular lens (IOL) to correct preoperative astigmatism in cataract patients. SETTING: Department of Ophthalmology, University Hospital of Vienna, Vienna Austria. METHODS: Between 1993 and 1998, foldable toric single-piece plate-haptic silicone IOLs were implanted in 37 eyes (30 patients). The cylindrical IOL power was 2.00 diopters (D) (n = 29), 3.50 D (n = 7), or 4.00 D (n = 1). Phacoemulsification was performed through a scleral or a corneal sutureless self-sealing incision. Outcomes of Snellen visual acuity (without, with spherical, and with best correction), refractive and keratometric astigmatism, and IOL rotation after early postoperative (mean 15.9 days +/- 10.1 [SD]) and long-term (mean 20.3 +/- 16.6 months) follow-ups were evaluated. RESULTS: At last follow-up, 31 eyes (83.8%) had a spherically corrected and 34 (91.9%) a best corrected visual acuity of 0.5 (20/40) or better. Mean preoperative refractive and keratometric astigmatism was 2.68 and 2.70 D, respectively. At the last postoperative follow-up, mean refractive astigmatism was reduced to 0.84 D; keratometric astigmatism was 2.30 D. In 7 eyes (18.9%), the IOL axis was rotated a maximum of 25 degrees. In all 37 eyes, the axis of the toric IOL remained within 30 degrees of rotation. CONCLUSIONS: Early postoperative and long-term follow-ups showed effective and stable correction of astigmatism after implantation of a foldable toric posterior chamber silicone IOL.

Aged↗

The capsular tension ring: designs, applications, and techniques.

Originally, the open poly(methyl methacrylate) (PMMA) capsular tension ring (CTR) was designed to compensate for zonular defects or to stretch the posterior capsule in highly myopic eyes not receiving an intraocular lens (IOL). We address the variety of subsequent designs, applications, and techniques that have evolved. With pre-existing or intraoperative zonular defects, a standard CTR may be inserted before or at any time during cataract removal to maintain or re-establish an extended capsular diaphragm. For profound zonular dialysis or weakness, a CTR was designed for scleral fixation. Capsular tension rings with integrated tinted sector shields have been developed to compensate for sector iris colobomas or aniridia. The CTR has also been used as a measuring gauge for in vivo quantification of capsule dimensions and postoperative capsular shrinkage. The CTR has improved control during primary posterior capsulorhexis and prevented oval distortion along the lens axis postoperatively. During combined cataract and vitreous surgery, a CTR prevents capsule damage and provides undisturbed peripheral visualization before IOL implantation. Capsular tension rings may also influence capsule opacification formation. A special band-shaped CTR with sharp edges was developed to inhibit lens epithelial cell migration and avoid capsulorhexis-optic contact.

Anterior Chamber↗

[Epidural analgesia in cases of placental dysfunction].

EDA has a favourable influence on uteroplacental perfusion. Data containing 262 deliveries with EDA followed pathological pregnancies were investigated by the authors. Their parameters were compared to 143 deliveries without pathological change and to the general obstetrical data of the Ward. In these groups the Apgar scores of the newborn babies, the duration of deliveries, the frequency of the delivery completing operations were studied and the complications of the intervention were surveyed.

Analgesia, Epidural↗

Corneal shape changes after temporal and superolateral 3.0 mm clear corneal incisions.

PURPOSE: To compare the corneal topographic changes after temporal and superolateral 3.0 mm clear corneal incisions (CCIs) and implantation of foldable silicone intraocular lenses (IOLs). SETTING: Department of Ophthalmology, University of Vienna, Austria, and a private clinic, Winterthur, Switzerland. METHODS: This prospective study comprised 54 eyes of 54 patients scheduled for cataract surgery. After a 0.3 mm deep precut, a temporal 3.0 mm CCI was made in 26 eyes and a superolateral (at 10:30) 3.0 mm CCI in 28 eyes. Corneal topography was recorded preoperatively and 1 week and 1 and 3 months postoperatively using the TMS-1 computer-assisted videokeratoscope (Computed Anatomy, Inc.). Surgically induced corneal shape changes were evaluated by batch-by-batch analyses of the paired differences between the records. The significance of topographic changes was calculated by the paired Wilcoxon test; group comparisons were made using the Wilcoxon group comparison test. RESULTS: Both groups had incision-related corneal flattening at 1 week and 1 and 3 months postoperatively. The extent of this flattening at 1 week and 1 and 3 months postoperatively was up to 1.0, 0.9, and 0.7 diopter (D), respectively, in the temporal group and up to 1.2 D at each observation time in the superolateral group. There was statistically significantly more incision-related corneal flattening in the superolateral incision group than in the temporal incision group; the difference was up to 0.3 D after 1 month and 0.5 D after 3 months. CONCLUSION: The superolateral incision induced statistically significantly more incision-related corneal flattening than the temporal incision.

Astigmatism↗

Prediction of pseudophakic capsular bag diameter based on biometric variables.

PURPOSE: To measure the capsular bag diameter (CBDm) in vivo and calculate a regression formula for future preoperative prediction of capsular bag diameter (CBDp). SETTING: Department of Ophthalmology, University of Vienna, Austria. METHODS: This prospective study comprised 70 eyes having cataract surgery with implantation of an open capsular tension ring (CTR) (Morcher Type 14). Within the first postoperative days, the distance between the ends of the CTR were measured through a gonioscopy lens by adjusting the slit height. This distance was added to the known length of the CTR to calculate the capsular bag circumference and from this, the CBDm. The CBDm was correlated with axial eye length (AL), corneal power (P), preoperative anterior chamber depth and lens thickness, corneal diameter, and age. A stepwise multiple regression analysis was computed with CBDm as the dependent variable. RESULTS: The mean CBDm was 10.37 mm +/- 0.25 (SD). A statistically significant negative correlation was found between CBDm and P (P < .0004; r2 = 0.16) and a positive correlation between CBDm and AL (P < .0226, r2 = 0.07). Stepwise multiple regression resulted in the following regression formula: CBDp = 3.44 to 0.056 x P + 0.713 x AL - 0.0135 x AL2 (P < .0001; r2 = 0.3145). Using this formula with the individual Ps and ALs, all 6 eyes with a large capsular bag diameter (CBDm > 10.7 mm) and 10 of 13 eyes with a small one (CBDm < 10.1 mm) were correctly classified. CONCLUSION: The capsular bag diameter in vivo correlated negatively with corneal power (P) and positively with AL. The regression formula used may serve as a tool for preoperative identification of eyes with a very large or very small CBDm.

Aged↗

Effect of dorzolamide and latanoprost on intraocular pressure after small incision cataract surgery.

PURPOSE: To evaluate the effect of dorzolamide 2% and latanoprost 0.005% on intraocular pressure (IOP) after small incision cataract surgery. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: This prospective study comprised 102 eyes of 102 consecutive patients scheduled for small incision cataract surgery. The patients were assigned preoperatively to 1 of 3 groups of 34 each: dorzolamide, latanoprost, and control (no treatment). One drop of the assigned medication was instilled immediately after surgery. Intraocular pressure was measured preoperatively and 6 and 20 to 24 hours postoperatively. RESULTS: Six hours after surgery, the mean increase in IOP was 1.9 mm Hg +/- 3.9 (SD) in the dorzolamide group (P = .004 versus control), 2.2 +/- 3.0 mm Hg in the latanoprost group (P = .005 versus control), and 4.8 +/- 5.2 mm Hg in the control group. Twenty to 24 hours postoperatively, IOP decreased a mean of -0.9 +/- 3.5 mm Hg in the dorzolamide group (P = .012 versus control) and increased a mean of 0.3 +/- 3.6 mm Hg in the latanoprost group (P = 0.24 versus control) and 1.3 +/- 4.2 mm Hg in the control group. One eye in the dorzolamide group, 1 eye in the latanoprost group, and 4 eyes in the control group had an IOP of 30 mm Hg or higher 6 hours postoperatively. CONCLUSION: Six hours postoperatively, dorzolamide and latanoprost were effective in reducing the IOP increase after small incision cataract surgery; however, at 20 to 24 hours, only dorzolamide was effective. Neither drug prevented IOP spikes of 30 mm Hg or higher.

Aged↗

Partial coherence interferometry: a novel approach to biometry in cataract surgery.

PURPOSE: To compare biometry performed by an enhanced version of dual beam partial coherence interferometry and applanation ultrasound in a prospective study of 85 cataract eyes to improve refractive outcome of cataract surgery due to a more accurate calculation of intraocular lens power. METHODS: The SRK II formula using ultrasound biometry data was employed. Three months after surgery, partial coherence interferometry biometry was repeated and refractive outcome was determined. Preoperative partial coherence interferometry biometry data were used to determine the refractive power of the intraocular lenses retrospectively and to calculate the possible refractive outcome. RESULTS: Precision of partial coherence interferometry biometry was more than 10 times better than that of ultrasound. Therefore, the possible mean absolute error for postoperative refraction achieved with partial coherence interferometry biometry was 0.49 diopters (compared with 0.67 diopters with ultrasound biometry), resulting in an improvement of 27%. Axial eye length measured with the two techniques differed by a mean of 460 microm. The difference in lens thickness measured with partial coherence interferometry and ultrasound significantly correlated with cataract grade. A mean shortening of 120 microm of axial eye length following cataract surgery was also detected by partial coherence interferometry. CONCLUSIONS: The enhanced version of partial coherence interferometry offers biometry with unprecedented precision (<10 microm) and resolution (approximately 12 microm), therefore improving the refractive outcome in cataract surgery. This noninvasive technique provides a high degree of comfort for the patient, with no need for local anesthesia or pupil dilation and minimized risk of corneal infection.

Adult↗

Accurate determination of effective lens position and lens-capsule distance with 4 intraocular lenses.

PURPOSE: To measure effective lens position (ELP) of 4 intraocular lenses (IOLs) using high precision and high resolution dual-beam partial coherence interferometry (PCI) and to assess the tendency of these IOLs to produce a lens-capsule distance (LCD), a possible risk factor for posterior capsule opacification. SETTING: Department of Ophthalmology, Vienna General Hospital; Institute of Medical Physics, University of Vienna, Austria. METHODS: In a retrospective study, PCI was used to measure ELP and LCD in 139 pseudophakic eyes of 110 patients with 4 IOLs: acrylic 3-piece IOL (AcrySof MA60BM); silicone 3-piece IOL without a capsular tension ring (PhacoFlex SI30) and with a capsular tension ring (PhacoFlex SI30 and Morcher Type 14); silicone plate-haptic IOL (Staar AA4203VF); and a hydrogel plate-haptic IOL (logel 1103). RESULTS: The ELP and LCD were determined with a precision of approximately 3 to 4 microns. An LCD was detected in 21% eyes with the AcrySof, 20% of eyes with the SI30 without a capsular tension ring, 10% of eyes with a capsular tension ring, 21% of eyes with the Staar, and 17% of eyes with the logel. The LCDs detected by PCI, but not by slitlamp examination, were significantly smaller than those detected by both. CONCLUSION: The amount of LCD detected by PCI was approximately the same with all IOL types (approximately 20%) except the PhacoFlex SI30 with a capsular tension ring (10%).

Acrylates↗

Comparative study of corneal topographic changes after 3.0 mm beveled and hinged clear corneal incisions.

PURPOSE: To compare the corneal topographic changes after cataract surgery using 2 types of clear corneal incisions (CCIs). SETTING: Department of Ophthalmology, University of Vienna, Austria. METHODS: This prospective, unmasked, nonrandomized study comprised 64 eyes scheduled for cataract surgery; 29 eyes received a temporal sutureless 3.0 mm corneal beveled CCI and 35 eyes, a temporal sutureless 3.0 mm hinged CCI. Preoperatively and 1 week, 1 and 3 months, and 1 year postoperatively, corneal topography was recorded by computer-assisted videokeratoscopy (TMS-1, Computed Anatomy, Inc.). Data were evaluated by batch-by-batch analyses of the paired differences between these records. The significance of topographic changes was calculated by paired Wilcoxon tests, and group comparisons were made using Wilcoxon tests. RESULTS: In both groups, there was statistically significant horizontal flattening and lower corneal steepening (P < .01). The horizontal flattening decreased between 1 week and 1 year, from -0.6 to -0.3 diopter (D) in the beveled-incision group and -0.7 to -0.4 D in the hinged-incision group. Vertical steepening was significant in the lower corneal region and decreased between 1 week and 1 year, from 0.3 to 0.2 D. Group comparisons revealed significant differences in an oblique lower temporal semimeridian, with 0.1 to 0.3 D more steepening after the hinged incision than after the beveled incision (P < .05). CONCLUSION: There were only minimal differences between beveled and hinged CCIs in surgically induced corneal shape changes.

Cornea↗

Long-term course of surgically induced astigmatism after a 5.0 mm sclerocorneal valve incision.

PURPOSE: To study surgically induced astigmatism (SIA) after a sutureless 5.0 mm sclerocorneal valve incision. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: This study evaluated SIA in 34 cases of sutureless cataract surgery with a 5.0 mm superior sclerocorneal valve incision and implantation of a poly(methyl methacrylate) intraocular lens. Keratometry was measured with a Zeiss keratometer in all cases preoperatively, and 1 day, 1 week, 1 and 3 months, and 1 and 5 years postoperatively. RESULTS: Surgically induced astigmatism, calculated by Cravy's vector analysis, showed an initial mean with-the-rule shift of 0.35 diopter (D), followed by an against-the-rule shift to a mean of -0.30 D after 1 month. One year postoperatively, mean SIA was -0.46 D. Between 1 and 5 years postoperatively, there was a statistically significant increase in mean SIA calculated by Cravy's vector analysis; SIA increased from -0.46 D after 1 year to -0.76 D after 5 years postoperatively. CONCLUSIONS: A small, although statistically significant, amount of postoperatively induced astigmatism occurred 5 years after a sutureless 5.0 mm sclerocorneal valve incision.

Aged↗

Phacotrabeculectomy with a small-optic PMMA implant: two-year functional and morphological results.

PURPOSE: Previous studies have documented good pressure control with combined cataract and filtering surgery. However, relatively high incidences of iridocapsular synechiae (ICS) and cell precipitates on the optic (CPO) were found. Corneal valve incisions preclude intraoperative chamber flattening and iris injury or prolapse. Rigid one-piece PMMA lenses with a small optic maintain a pronounced optic-iris clearance. In a prospective series, the effect of this approach was studied with special regard to the morphological results. METHODS: A temporary corneal lip was created in the clear cornea beneath the scleral flap to serve as a temporary valve during cataract extraction. The lip was then widened and a rigid one-piece 5-mm PMMA lens implanted. Lip and trabeculum were finally excised en bloc at a width of 3 mm. Two years' functional and morphological results were evaluated. RESULTS: Fifty-four eyes were available for evaluation. After the mean follow-up of 21 months, mean IOP had dropped from 21.6+/-3 mm Hg preoperatively to 13.9+/-2.4 mm Hg, with a mean pressure reduction of 7.7+/-3.4 mm Hg. IOP was 18 mm Hg or less in all cases. The mean medication index dropped from 2.7 to 1.0. Eyes with a preoperative IOP of 21 mm Hg or more showed a significantly greater IOP reduction than eyes with an IOP of 20 mm Hg or less (-9.2+/-3.0 vs. -6.1+/-2.9 mm Hg, p = 0.0003). Intraoperatively, the temporary valve effectively prevented chamber flattening and iris injury or prolapse. Postoperatively, 9 eyes or 6% showed hyphemas, 1 undergoing lavage. Two eyes developed a capsular hematoma, 1 requiring YAG capsulotomy. Ten eyes or 19% developed mild and 2 eyes severe but transient fibrin exudation following hypotony or iridoplasty. One eye showed grade I anterior chamber flattening, 1 developed a ciliolenticular block requiring surgery. Postoperative pressure spikes of 30-35 mm Hg were noted in 4 eyes. Three eyes showed prolonged hypotony associated with transient choroidal effusion. A pronounced optic-iris clearance was found in 87% of the eyes. Iris-optic touch developed in 1 eye with prolonged postoperative anterior chamber flattening and in 3 of the 4 eyes that had undergone intraoperative iridoplasty. Three of the latter developed extensive ICS followed by CPO. The mean optic-iris distance was 1.2 mm and the anterior chamber depth 4.2 mm. CONCLUSION: Apart from effectively lowering IOP, the surgical approach used significantly reduced the incidence of ICS and CPO.

Anterior Eye Segment↗

Episcleral versus combined episcleral and intrascleral application of mitomycin-C in trabeculectomy.

BACKGROUND AND OBJECTIVE: To determine whether intrascleral exposure to mitomycin-C (MMC) improves the control of intraocular pressure (IOP), increases the incidence of complications, or both. PATIENTS AND METHODS: The authors retrospectively evaluated 38 eyes of 29 patients following the intraoperative application of MMC (0.2 mg/ml; 5 minutes). In 21 eyes the MMC-soaked sponge was applied to the intact episclera (episcleral group). In 17 eyes, two sponges, one episcleral and the other intrascleral (sandwich group), were applied. The median follow-up times were 19.0 (episcleral group) and 24.0 (sandwich group) months. Outcome measures were the IOP, the number of medications, success rates, and the incidence of complications. RESULTS: The only statistically significant difference between the two groups was the 2-week postoperative IOP, which was significantly lower in the episcleral group (P = .0314). CONCLUSION: Because there is no additional benefit, the authors recommend that the intrascleral application of MMC be avoided. However, they did not observe increased complication rates when MMC was applied in this way.

Adult↗

[A case of ovarian struma causing symptoms of hyperthyroidism].

The authors report the case of a 46-year old woman, who went with diffuse complaints to the endocrinology department. The laboratory date showed hyperthyroidism. She had hypogastric complaints, therefore a gynecological consultation was carried out. An infant--head sized elastic formation was found on the left hand side next to a female fist sized myomatous uterus. On sonographic examination the growth proved to have a size of 12 x 14 cm. Besides the myomatous uterus the histology of the operative specimen confirmed a left sided ovarious teratoma, which was composed solely of usual thyroid tissue. After the operation it the patient's endocrine disorders became spontaneously regulated. Our attention to called the fact that especially in case of therapy resistant hyperthyroidism we should think of this infrequent clinical picture.

Female↗

Capsular bag shrinkage after implantation of an open-loop silicone lens and a poly(methyl methacrylate) capsule tension ring.

PURPOSE: To quantify the dynamics of capsular bag shrinkage after cataract surgery. SETTING: University Eye Hospital, Vienna, Austria. METHODS: Nineteen eyes in 13 patients had clear corneal cataract surgery with implantation of a foldable, open-loop, silicone posterior chamber intraocular lens (IOL) (AMO SI-30). At the same time, an open, poly(methyl methacrylate) capsule tension ring (Morcher type 14 or 14A) was inserted to allow measurement of capsular bag circumference and diameter. After surgery, capsular bag shrinkage was quantified by measuring anterior chamber depth (ACD), iris-lens distance (ILD), and distance between the eyelets of the capsule tension ring using optical methods. Capsular bag circumference (CBC) was deduced from these measurements, which were taken 1 day (baseline), 1 week, and 1 and 3 months postoperatively. RESULTS: Between 1 day and 3 months, all three parameters decreased significantly. During the first postoperative week, ACD and ILD did not change, while both parameters decreased between 1 week and 1 month. After 1 month, ACD did not decrease further; ILD continued to decrease. The CBC decreased during the entire postoperative period. CONCLUSION: Besides ACD and ILD, CBC significantly decreased during the first 3 months after cataract surgery with in-the-bag posterior chamber IOL implantation. The CBC can be calculated from the distance between the ends of the capsule tension ring, which can be measured gonioscopically. From this, the diameter of the capsular bag can be calculated in the living eye. The influence of the capsule tension ring itself on capsular bag shrinkage remains to be established.

Anterior Chamber↗

Surgically induced astigmatism following a 4.0 mm sclerocorneal valve incision.

PURPOSE: To determine whether sutureless small incision cataract surgery reduces induced astigmatism over the long term. SETTING: University Eye Hospital, Vienna, Austria. METHODS: In a prospective study, we investigated surgically induced astigmatism in 63 cases of no-stitch, small incision cataract surgery with a 4.0 mm square sclerocorneal tunnel and implantation of a flexible intraocular lens. Follow-up was 4 to 5 years. Keratometry was measured with a Zeiss keratometer preoperatively and after 1 day, 1 week, 1, 3, and 9 months, and a median of 4.4 years. In 21 nonoperated eyes, we investigated the natural course of astigmatism over 5 years. RESULTS: The mean keratometric cylinder stabilized at 0.8 diopter (D) after 1 week and slightly decreased to 1.0 D after 4 to 5 years. Cravy's vector analysis showed an immediate against-the-rule (ATR) shift of -0.2 D that remained relatively stable until 9 months. Between 9 months and 4.4 years postoperatively, there was a statistically significant increase in ATR induced astigmatism from -0.2 to -0.5 D. The natural course of astigmatism in the nonoperated eyes showed an ATR shift of -0.1 D for the same period. CONCLUSION: The result show a small, though statistically significant amount of postoperatively induced astigmatism 4 to 5 years after no-stitch, small incision cataract surgery.

Aged↗

Effects of changes in intraocular pressure on human ocular haemodynamics.

PURPOSE: Myogenic autoregulation is the ability of a vascular bed to maintain blood flow despite changes in perfusion pressure. Ocular perfusion pressure is defined as the difference between ocular arterial pressure and ocular venous pressure, the latter dependent on intraocular pressure (IOP). The aim of the present study was to investigate the effect of moderate increases in IOP on ocular haemodynamics. METHODS: Changes in IOP (+ 10 mmHg, +20 mmHg) were induced by a suction cup in 10 healthy subjects. Ocular fundus pulsations in the macula and the optic disc were measured by laser interferometry; blood flow velocities in the central retinal artery (CRA) and in the ophthalmic artery (OA) were measured by Doppler sonography. RESULTS: Changes in IOP caused a significant reduction in fundus pulsations, which was more pronounced in the macula (at +10 mmHg: -9 +/- 2%, p < 0.01; at +20 mmHg: -19 +/- 3%, p < 0.001) than in the optic disc (at +10 mmHg: -5 +/- 2% (ns); at +20 mmHg: -9 +/- 3%, p < 0.01). Mean flow velocity in the CRA was reduced by -5 +/- 3% at +10 mmHg (ns) and by -14 +/- 5% at +20 mmHg (p < 0.005), resistive index was increased by +4 +/- 1% at +10 mmHg (p < 0.05) and by +6 +/- 2% at +20 mmHg (p < 0.01). In contrast, a rise in IOP did not affect blood flow parameters in the OA. CONCLUSIONS: Our results from fundus pulsation measurements indicate that choroidal blood flow decreases when IOP is increased. The Doppler sonographic findings in the CRA indicate reduced blood flow velocity in this artery during raised IOP.

Adult↗

Straight-entrance, sclerocorneal valve incision with horizontal sutures for poly(methyl methacrylate) intraocular lenses.

Self-sealing sclerocorneal tunnel incisions with an external frown entry are widely used for implantation of poly(methyl methacrylate) intraocular lenses. Although safe and effective, these incisions have certain drawbacks. We developed a wound construction in which a straight external incision is used in conjunction with a tension-free, infinity-type suture. Out of 100 consecutive cases, only two did not seal satisfactorily at the conclusion of surgery but were tight upon placement of re-enforcing sutures. Postoperatively, the valve remained tight in all cases; there were no cases of hypotony, filtering bleb, flat chamber, or pupil capture or endophthalmitis indicating transient leakage. Flattening in the vertical and steepening in the horizontal meridian were minor and nonprogressive.

Cornea↗