PURPOSE: To assess the safety and efficacy of a second generation, anterior chamber phakic intraocular lens (Baikoff Model ZB5M) in patients with high myopia. METHODS: One hundred and twenty-one patients (134 eyes) with myopia of -7.00 to -18.80 D were implanted with the ZB5M lens and followed for 18 to 52 months; the number of eyes evaluated was: 6 months (104 eyes), 1 year (91 eyes), 18 months (78 eyes), 2 years (68 eyes), and 3 years (35 eyes). RESULTS: Postoperative spherical equivalent refraction averaged -1.00 D and the error in refractive correction (achieved minus intended) averaged -0.40 D during the first 2 years, increasing -to -1.30 D refraction and -0.60 D error in refractive correction at 3 years. At 2 years, approximately 40% of eyes had a spherical equivalent refraction within +/-0.50 D, and 65% within +/-1.00 D. The uncorrected distance visual acuity was 0.048 at baseline and 0.5 at 3 years; near visual acuity was 0.21 at baseline and approximately 0.7 over the 3 years of follow-up. Spectacle-corrected distance visual acuity at baseline was 0.54; it improved to 0.7. Near visual acuity was 0.65 at baseline and it improved to approximately 0.75. Endothelial cell counts in the central and peripheral cornea were reduced by an average 3.3% at 6 months, declining an additional 1% to 2% over the remaining follow-up period. Regression analyses indicated that most of the endothelial cell loss was due to surgery. Additional complications included halos/glare in 37 of 133 eyes (27.8%) and iris retraction with pupillary ovalization in 30 of 133 eyes (22.6%). The intraocular lens was exchanged in four of 133 eyes (3.0%) and removed in three of 133 eyes (2.3%), the latter because of halos (one eye) and a flat anterior chamber with severe inflammation (two eyes). CONCLUSIONS: Implantation of the Baikoff ZB5M lens in the anterior chamber of phakic eyes significantly reduced high myopia and produced a stable refractive outcome over the 3 years, accompanied by marked improvement in uncorrected distance visual acuity and minimal, non-progressive damage to the corneal endothelium. Frequent complications included pupillary ovalization and halos/glare. Improvements in accuracy of IOL power calculations are needed.

Adult↗

PubMedDate not supplied

[Spontaneous resolution of a case of congenital glaucoma].

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Adult↗

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[Ultrastructural study of the oculomotor muscle in 2 familial cases of Steinert's disease].

A biopsy specimen of an extra-ocular muscle from a brother and sister affected by typical familial Steinert's disease was examined by electron microscopy. Considerable disorganisation of the contractile element was observed with a gross accumulation of abnormal mitochondria. This was a very different appearance to the findings observed in skeletal muscle in Steinert's disease and much closer to the findings in skeletal muscle in certain 'ocular' myopathies. One cannot fail to be impressed by the discordance between the appearance of the muscular disorganisation and the rarity of clinical oculomotor disturbances in this disease.

Female↗

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[Viral infections of the anterior segment (author's transl)].

A focus on the pathogenesis, clinical manifestations and therapy. Contemporary ideas on viral infections of the anterior segment are examined.--The pathogenesis of lesions (viral activity, delayed hypersensitivity reaction), the clinical aspects of herpes infections of the anterior segment are the result of the relative importance of these two factors. Schematically--dendritic keratitis infiltrates and stromal necrosis and hypopion represent active viral infection. Disciform keratitis, oedematous keratitis, serous iridocyclitis represent delayed hypersensitivity reaction. Corticosteroids are contrindicated in the former cases and recommended in the latter.--Special features concerning zoster inflammations of the anterior segment are considered.--An important number of adenoviral anterior segment infections are also reported and their benign nature stressed.

Adenovirus Infections, Human↗

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