Biomedical subjects

Rudolf Guthoff

Publications and source records attributed to Rudolf Guthoff.

16 recordsLinked to original sources

PubMed2007

In vivo confocal microscopic evaluation of langerhans cell density and distribution in the corneal epithelium of healthy volunteers and contact lens wearers.

PURPOSE: To examine and compare the density and distribution of Langerhans cells (LCs) in the corneal epithelium of healthy volunteers and contact lens wearers. METHODS: A total of 225 eyes of 130 healthy volunteers (age, 17-81 years) without history of ocular inflammation, trauma, or surgery and 98 eyes of 55 contact lens wearers (age, 13-76 years) were examined in vivo with the combination of the Heidelberg Retina Tomograph II and in-house-invented Rostock Cornea Module. RESULTS: In healthy volunteers, in vivo confocal microscopy revealed LCs in 31% of all volunteers, with 37 of these 43 volunteers presenting LCs both in the center and the periphery of the cornea with densities of 34 +/- 3 and 98 +/- 8 cells/mm, respectively. In the group of contact lens wearers, 55% of all corneas presented with LCs, and 11 of these 33 corneas revealed LCs at central and peripheral locations. Although LC densities were markedly higher in both the central (78 +/- 25 cells/mm) and the peripheral cornea (210 +/- 24 cells/mm) of contact lens wearers, the gradient of LC density from peripheral to central cornea was found almost identical in both groups. In the central cornea, LC density decreased with duration of contact lens wear. LCs were located at the depth of 35 to 60 microm (ie, the level of lower intermediate cells, basal cells, and subepithelial nervous plexus). LCs presented as either large cells bearing long processes or smaller cells lacking cell dendrites, most supposedly indicating mature and immature phenotype, respectively. CONCLUSIONS: In vivo confocal microscopy enables evaluation of LC density and distribution in corneal epithelium. LCs were found present both in the center and the periphery of the cornea without difference in distribution between healthy volunteers and contact lens wearers. However, contact lens wearers revealed almost twofold higher LC densities in both locations, implying chronic mechanical irritation of the cornea in response to the contact lens as foreign body. Taken together, analysis of LC using in vivo confocal microscopy provides helpful information for a better understanding of contact lens-disturbed ocular homeostasis.

Adolescent↗

PubMed2006

In vivo three-dimensional confocal laser scanning microscopy of the epithelial nerve structure in the human cornea.

PURPOSE: Evaluation of a new method for in vivo visualization of the distribution and morphology of human anterior corneal nerves. METHOD: The anterior cornea was examined to a depth of 100 microm in four human volunteers with a confocal laser scanning microscope (CLSM) using a Rostock Cornea Module (developed in house) attached to a Heidelberg Retina Tomograph II (Heidelberg Engineering, Germany). Optical sections were digitally reconstructed in 3D using AMIRA (TGS Inc., USA). The scanned volumes had a greatest size of 300 x 300 x 40 microm and voxel size of 0.78 x 0.78 x 0.95 microm. RESULTS: The spatial arrangement of the epithelium, nerves and keratocytes was visualized by in vivo 3D-CLSM. The 3D-reconstruction of the volunteers' corneas in combination with the oblique sections gave a picture of the nerves in the central human cornea. Thin nerves run in the subepithelial plexus aligned parallel to Bowman's layer and are partially interconnected. The diameter of these fibres varied between 1.0 and 5 microm. Thick fibres rose out of the deeper stroma. The diameter of the main nerve trunks was 12+/-2 microm. Branches penetrating the anterior epithelial cell layer could not be visualized. CONCLUSIONS: 3D-CLSM allows analysis of the spatial arrangement of the anterior corneal nerves and visualization of the epithelium and keratocytes in the living human cornea. The developed method provides a basis for further studies of alterations of the cellular arrangement and epithelial innervation in corneal disease. This may help to clarify alterations of nerve fibre patterns under various clinical and experimental conditions.

Adult↗

PubMed2006

In vivo confocal laser scanning microscopy of the cornea in dry eye.

BACKGROUND: We carried out an investigation into the morphological and quantitative corneal properties in dry eye with various underlying pathologies. METHODS: Ten patients with aqueous tear deficiency, 8 with dysthyroid ophthalmopathy, 8 with chronic lagophthalmos and 10 normal participants were examined. Confocal microscope images were taken at the centre and at the lower and upper periphery of the cornea. Quantitative and morphological assessments of the epithelium, of the sub-basal nerves, of the stroma and the endothelium were made. The epithelial and corneal thicknesses were measured. RESULTS: The mean superficial and intermediate epithelial cell densities in the central cornea in the patient groups were significantly lower than in normal participants (p<0.01). The peripheral epithelial thickness was smaller (p<0.01); it was smallest in the lagophthalmos group. The cornea was thinner in the patient groups (p<0.01). For sub-basal nerves, the density had decreased (p<0.05), and in lagophthalmos the number of beadlike formations had increased (p<0.001); in some patients we found irregular branching patterns. CONCLUSIONS: Dry eye patients showed significant alterations in the cornea, presumably due to increased desquamation of the superficial cell layer. This was most pronounced at the lower periphery of the cornea in patients with exposure keratopathy.

Aged↗

PubMed2006

Medial canthal reconstruction by a modified glabellar flap.

AIMS: To present a modified technique for the preparation of glabellar skin flaps to reconstruct medial canthal defects. METHODS: Ten consecutively treated patients were included who had skin defects after resection of skin tumours like basal cell carcinomas in the medial canthal area of a medium vertical diameter of 2.5 cm. The defects were closed by preparation of a modified glabellar flap. The pedicle of the flap was guided through a skin tunnel prepared diagonally at the root of the nose. The pedicle was resected 4 weeks after the initial surgery. RESULTS: In all 10 cases, the procedure was adequate for reconstruction of the defect. There were no flap necroses and the cosmetic results were favourable in all cases. The resection of the pedicle could be performed easily in an out-patient procedure 4 weeks after the operation. CONCLUSION: Glabellar flaps are established procedures to reconstruct medium to large defects of the medial canthus. Skin distortion in the area of the flap pedicle leading to a skin bulge and visible scars at the root of the nose and medial transposition of the eye brows can be reduced by a modification of the surgical technique preparing a skin tunnel for the flap pedicle. In our hands, the cosmetic results are better with the modified technique in comparison to the original procedure.

Aged↗

PubMed2006

Pharmacological-induced haptic changes and the accommodative performance in patients with the AT-45 accommodative IOL.

PURPOSE: To investigate the accommodative performance of the AT-45 (eyeonics Inc, Aliso Viejo, Calif) using three-dimensional ultrasound biomicroscopy. METHODS: The AT-45 haptic region was visualized in vivo 1 month after surgery in four patients using an in-house developed three-dimensional ultrasound biomicroscope. Haptic changes, axial shift, and accommodation amplitude were determined under pharmacologically induced accommodation. RESULTS: The angulation, depending on the accommodation state, could be distinguished and analyzed. In vivo a mean change in haptic angulation of 3.3 +/- 3.3 degrees (range: 0 degrees to 7 degrees) and a mean forward shift of 0.13 +/- 0.08 mm (range: 0.05 to 0.2 mm) were observed for the AT-45 using pharmacologically induced accommodation. A mean accommodative amplitude of 0.44 +/- 0.24 diopters (D) (range: 0.25 to 0.75 D) was found using a Hartinger coincidence refractometer. CONCLUSIONS: Minimal angulation changes and axial movements of the AT-45 have been demonstrated using pharmacological stimulation and objective measurement methods. The mechanical performance of the AT-45 in these eyes does not appear to provide the range of accommodation necessary for close work.

Accommodation, Ocular↗

PubMed2005

In vivo confocal microscopic evaluation of Langerhans cell density and distribution in the normal human corneal epithelium.

PURPOSE: To examine the density and distribution of Langerhans cells (LCs) in the corneal epithelium of healthy volunteers. METHODS: Two hundred eyes of 112 healthy volunteers (age 21-81 years) without history of ocular inflammation or surgery were examined in vivo with the combination of the Heidelberg Retina Tomograph II and the Rostock Cornea Module. For statistical analysis data of one eye per volunteer were used, with random selection of one eye in those volunteers in whom both eyes were studied. RESULTS: As studied by in vivo confocal microscopy, 31.3% of all volunteers presented with LCs (24 volunteers with both eyes studied and 11 volunteers with only one eye studied). In 30 of these 35 volunteers, LCs were found in both the central and peripheral corneal epithelium. More than 50% of male volunteers with LCs were younger than 30 years; in contrast, almost two thirds of females with LCs were above 50 years in age. The density of LCs in the periphery of the cornea (98+/-8 cells/mm2; range 0-208 cells/mm2) was significantly (p<0.001) greater than in the central part (34+/-3 cells/mm2; range 0-64 cells/mm2). LCs were located at depths of 35-60 microm, with different frequency. While LCs were sparse at the level of deep intermedial cells (5.7% of the volunteers), 11.4% of the volunteers presented with LCs within the level of basal epithelial cells and most of the eyes (82.9%) had LCs at the level of basal epithelial cells and subbasal nerve plexus. Moreover, LCs presented as either large cells bearing long processes or smaller cells lacking cell dendrites, presumably indicating mature and immature phenotype, respectively. CONCLUSION: The Heidelberg Retina Tomograph II in combination with the Rostock Cornea Module enables in vivo assessment of density and distribution of LCs in the corneal epithelium, providing insight into human eye immunology. These data may now provide a suitable basis for further investigations in ocular pathology.

Adult↗

PubMed2005

Three-dimensional ultrasound biomicroscopy, environmental and conventional scanning electron microscopy investigations of the human zonula ciliaris for numerical modelling of accommodation.

PURPOSE: Biomechanical modelling of the accommodation process is a useful tool for studying the mechanism of accommodation and presbyopia and can aid in the development of accommodative lens-replacing materials. Existing biomechanical models, however, use a very simplified zonula structure. The aim of this study was to use three-dimensional ultrasonic imaging and scanning electron microscopy to provide a more detailed, three-dimensional description of the structure of the human zonula to improve the modelling of accommodation. METHODS: Five human eyes were examined without invasive manipulation using a custom-made three-dimensional ultrasonic imaging technique that allows scanning of features with a spatial resolution of 30 microm. Environmental and conventional scanning electron microscopy (SEM) provided information to complement the ultrasonic images for use in development of a more anatomically correct finite-element model of the zonula structures. These data along with the material properties of the ocular tissue structures were used to construct an advanced geometric model for finite-element simulation of the accommodation process. RESULTS: Images were obtained through three-dimensional ultrabiomicroscopy (3D-UBM) of anatomical features heretofore not directly imagable in their native state. Ciliary processes and zonula structures were clearly separated by both the 3D-UBM and the SEM methods. It was found that fibres inserting on the anterior and posterior lens capsule emerge anteriorly at the ciliary body. Fibres emerging near the pars plana insert on the lens and the ciliary body. No X-shaped crossing fibres were found. Modelling of the accommodation process with both the simple and the more complex geometric models produced refractive power changes comparable with in vivo findings. CONCLUSIONS: The 3D-UBM allowed examination of zonula structures in their native state with minimized preparation artefacts. While these data were incorporated into a complex and more anatomically correct finite-element simulation of intraocular features including lens, zonular system and ciliary body it was found that a simplified zonular model is sufficient for the numerical simulation of the accommodation process.

Accommodation, Ocular↗

PubMed2005

Changes of the accommodative amplitude and the anterior chamber depth after implantation of an accommodative intraocular lens.

BACKGROUND: Modern cataract surgery is interested in recovery of the accommodative power. This investigation aimed at determining pseudophakic accommodation in subjects implanted with the accommodative Human Optics 1 CU intraocular lens after drug-induced ciliary muscle stimulation by measuring the objective refraction and the changes in anterior chamber depth in comparison with a PMMA intraocular lens with rigid haptics. METHODS: The studied sample involved 30 eyes of 30 patients undergoing cataract surgery due to age-related cataract. Patients were between 50 and 77 years of age (67.71 +/- 8.0). No randomization was performed. The 1 CU accommodative intraocular lens and the PMMA intraocular lens were implanted in 15 eyes of patients with an expected visual acuity of at least 0.7. Objective refraction under pilocarpine-stimulated ciliary muscle contraction was determined with a Hartinger coincidence refractometer. The anterior chamber depth was measured with Jäger's Haag-Streit slit-lamp attachment. The accommodative amplitude and the anterior chamber flattening were calculated from the measured values. RESULTS: Twelve weeks after surgery the average accommodative amplitude in eyes with a 1 CU intraocular lens calculated from the refractive change under drug-induced stimulation was 0.48 +/- 0.36 D (with a maximum of 1.25 D). The measured change of anterior chamber depth under drug-induced stimulation was 0.3 +/- 0.32 mm (at a maximum of 0.9 mm). In the reference group with PMMA lenses, the mean accommodative amplitude derived from the refractive changes under drug-induced stimulation was 0.34 +/- 0.27 D (at a maximum of 0.85 D). The measured change in anterior chamber depth under drug-induced stimulation was 0.18 +/- 0.09 mm (at a maximum of 0.31 mm). No statistically significant differences were found between the two groups of lenses concerning change in anterior chamber depth and accommodative amplitude. CONCLUSIONS: This investigations indicate a mean anterior 1 CU shift of only 0.32 mm and a maximum of 0.9 mm. The accommodative amplitudes measured with the Hartinger coincidence refractometer (mean value 0.47 D) correspond to these values. Similar conclusions may be drawn from existing investigative results of the reference group, which are on the same order of magnitude as those of the 1 CU group. Objective accommodation measurements are needed to evaluate commercially available accommodative intraocular lenses in a scientifically satisfactory manner. Objectively measurable parameters include changes of the anterior chamber depth as well as refraction, as determined for instance by coincidence refractometry and streak retinoscopy. Future studies should also consider the IOL properties, astigmatism, and pupillary diameter. This is the only way to identify pseudoaccommodation and a decisive factor for further development of accommodative artificial lenses.

Accommodation, Ocular↗

PubMed2005

In vivo observation of papillae of the human tongue using confocal laser scanning microscopy.

The aim of this investigation was to visualize the epithelial structures of the tongue using confocal laser scanning microscopy (LSM). The human tongue epithelium of 28 healthy subjects, aged 21-67 years, mean age 38 years, 14 women and 14 men, was examined in vivo by LSM. Using LSM, a combination of the Heidelberg Retina Tomograph HRT II and the Rostock Cornea Module, up to 800-fold magnifications were obtained. On the tongue surface both filiform and fungiform papillae and their taste pores were easily identified. The epithelium of the tongue with its subcellular structures could be observed up to a depth of 50 microm, cellular structures up to 150 microm and subepithelial vessels up to 300 microm. Additionally the papillary crests and blood flow were visible. Confocal LSM seems suitable for noninvasive in vivo examination of the tongue. The hydraulic z scan, the manual start setting and the measurement of the depth allow a clear classification of the observed structures.

Adult↗

PubMed2005

Comparison of the accommodation theories of Coleman and of Helmholtz by finite element simulations.

PURPOSE: The accommodation process of the human eye is still a controversial subject. Coleman assumes that the lens, together with the zonula fibers, forms a diaphragm which is held in a catenary shape due to the pressure difference between the aqueous and vitreous body of the lens. The aim of the paper is to compare the results of two simulations (according to the Helmholtz and to the Coleman theories) with ultrasonographic data. METHODS: An axisymmetric static finite element model of the lens was generated using the literature data for geometry, material properties and loads. The refractive power of the lens was calculated for two different ages (29 and 45 years). RESULTS: The application of a pressure to the posterior lens surface did not yield an increase in refractive power change during accommodation. Rather a decrease in accommodation related refractive power was found. CONCLUSIONS: Physiologically relevant refractive power changes are obtained by a simulation in accordance with the Helmholtz theory. A simulation in accordance with the Coleman theory does not yield physiological values of refractive power change.

Accommodation, Ocular↗

PubMed2002

Monitoring accommodative ciliary muscle function using three-dimensional ultrasound.

BACKGROUND: Our objective was to develop a three-dimensional high-resolution ultrasonic imaging technique to be utilized for in-vivo characterization of the ciliary body and the posterior iris. The benefit of this imaging in enhancing the quantification of the configurational changes in the ciliary body during accommodation is demonstrated. METHODS: Sequential ultrasound biomicroscopic images of the ciliary body region were obtained with a computer-controlled scanning device designed for use with a standard ultrasound biomicroscope for 3D imaging. Custom-made software allows online data collection, data analysis and 3D reconstruction in conjunction with commercially available VoxelView software. RESULTS: The three-dimensional presentation allows a close approximation of the ciliary muscle inside the ciliary body in vivo. We are able to distinguish and to analyze the changes in the muscle contour in different accommodation states. During accommodation a shift in the ciliary muscle center of gravity in a range of 0.04-0.26 mm (mean 0.13+/-0.06 mm) in the direction of the lens equator, with an interindividual variation and a small decrease with age, was observed. CONCLUSIONS: High-resolution ultrasound is a well established technique for in-vivo investigation of the anterior segment. Three-dimensional ultrasound biomicroscopy allows an assessment of the individual ciliary muscle activity in consideration of the ciliary processes. In combination with a contour analysis tool we improved the muscle contour determination during different accommodation states. The investigation showed an activity of the ciliary muscle in young volunteers as well as those of presbyopic age.

Accommodation, Ocular↗

PubMed2002

Transscleral diode laser contact cyclophotocoagulation in the treatment of different glaucomas, also as primary surgery.

PURPOSE: To evaluate the clinical outcome of transscleral cyclophotocoagulation (TSCPC) with the diode laser for different glaucomas, especially as primary surgery. METHODS: A retrospective analysis of 250 TSCPC (193 eyes of 145 patients) with different glaucomas and an average age of 62.6+/-17.1 years. Postoperative follow-up ranged from 6 to 48 months (mean 13.9 months). Most of the patients had primary open-angle glaucoma (POAG) or secondary glaucoma. All eyes were treated with 24-30 spots and 1.4-1.8 W at an exposure time of 2 s using a diode laser with a focussing tip. RESULTS: The mean intraocular pressure (IOP) decreased from 24.6+/-6.7 mmHg before to 19.3+/-5.7 mmHg after operation ( P<0.001). The IOP was successfully controlled (final IOP 10-22 mmHg) in 76.4% of cases after a single or multiple TSCPC treatments. The reductions in maximal IOP and in the number and frequency of administration of antiglaucomatous drugs were also significant ( P<0.001). The best results were obtained among the patients with POAG, in the oldest age group and in those patients without any previous or subsequent glaucoma operations. The proportion of eyes requiring multiple treatments was 21.2%, with an average of 1.3 treatments per eye. There was a complication rate of 14.4%, mostly mild uveitis. Phthisis bulbi occurred in three eyes (1.6%). CONCLUSIONS: TSCPC with the diode laser is a safe, effective procedure to reduce the IOP in the treatment of different glaucomas with few severe complications. It is also suitable for primary surgical treatment.

Adolescent↗

PubMed2002

[Nasolacrimal duct obstruction caused by a cylindroma. Report of an atypical tumor manifestation and review of the literature].

BACKGROUND: The purpose of this report is to describe the clinical characteristics, management and histological findings in a patient with obstruction of the nasolacrimal duct caused by a cylindroma. About 618 lacrimal sac tumours have been reported previously in reviews and case reports, which were reviewed after searching in medline database. CASE REPORT: A 79-year old man suffered from multiple cylindromas (Spiegler tumour) on his head for about 40 years. He presented with a 6 months' history of left-sided epiphora and a painless medial canthal mass of various size. A tumour which caused nasolacrimal duct obstruction was found during dacryocystorhinostomy. After complete excision histological examination revealed a cylindroma, which had shown expansive growth from dermis to the lacrimal sac area. The patient felt well; there was no longer any epiphora or dacryocystitis after the operation. CONCLUSION: Although very rare, lacrimal sac tumours must be considered in the differential diagnosis of nasolacrimal duct obstruction. To our knowledge this case represents the first report on an atypical manifestation on a Spiegler tumour in the lacrimal sac region.

Aged↗

PubMed2002

[Glabellar transposition flap for medial canthal reconstruction after tumour excision].

BACKGROUND: We focussed on the suitability of a glabellar transposition flap for repairing medial canthal defects after tumour excision and also on a satisfactory cosmetic result. PATIENTS AND METHOD: Between July 1994 and November 1999 we supplied 11 patients with a glabellar transposition flap to repair a soft tissue defect in the medial canthal area. 4 patients with a histologically proven basalioma. 5 patients had a recurrence of basalioma, who had first been operated on elsewhere. One patient was suffering from a squamous cell carcinoma and one patient showed a scar epicanthus. In the following we describe the glabellar transposition flap. This method is available for the reconstruction of the medial canthus. We also mention other methods and combinations. RESULTS: No patient required a further operation. Good postoperative cosmetic and functional results were seen in all patients. CONCLUSIONS: The glabellar transposition flap is suitable for reconstructing the medial canthus. Our results suggested that this flap can be applied for the repair of defects measuring up to 30 x 25 mm. This method is also appropriate for deeper defects in this area. The flap is suitable if a patient has a recurrence of tumour.

Adult↗

PubMedDate not supplied

[Prof. Carl Wilhelm von Zehender (1819-1916)--first professor of ophthalmology and co-founder of the ophthalmological clinic at the University of Rostock--commemorative lecture at the 100th DOG meeting in Berlin from 26.9 to 29.9.2002].

The Grand-ducal University Eye Department in Rostock was solemnly inaugurated 16 May 1892. According to many years of studies in Europe and on efforts to build this clinic, construction was outlined by Professor Carl Wilhelm v. Zehender, but the drafts were executed by the "Grossherzoglich-Mecklenburgisch-Schwerinschen Medicinalcommission" and Landbaumeister Schlosser in winter 1888/89. Professor v. Zehender, who originated from a very ancient Swiss family, was born in Bremen, 21 May 1819. He studied medicine in Goettingen, Jena, Prague, Paris and Vienna. During this time he developed a lifelong friendship with Albrecht v. Graefe. 1856 he took over the medical care for the hereditary duke Georg von Mecklenburg-Strelitz and published the "Correspondenzblatt für Aerzte im Grossherzoglichen Mecklenburg-Strelitz". 1857, during a conference in Heidelberg, his initiative led in the long run to the establishment of the "Heidelberger Ophthalmologische Gesellschaft", the forerunner of the "Deutsche Ophthalmologische Gesellschaft", which was founded in 1920. In 1863 the first edition of "Klinische Monatsblaetter für Augenheilkunde" was published as a periodical; the cover page bore its name as the founder of the magazine. In 1866, after the death of the hereditary duke and a professorship in his hometown Berne, he became honorary professor of the Rostock University, and from 1869 onwards he chaired the clinic as a regular professor. After all his efforts to build his own hospital had failed, he demonstratively and finally resigned from his professorship in 1889. He went to Munich and became editor of the " Klinische Monatsblaetter für Augenheilkunde". In 1907 he moved with his wife via Eutin to Warnemuende. There the nestor of world ophthalmologists died at the age of 98. His burial place without gravestone is situated in today's landscape park "Stephan Jantzen". So far all efforts of the author and of the Rostock University Eye Department taken after 1980 to create a worthy note to this exceptional ophthalmologist in the Baltic Sea resort Warnemuende were unsuccessful, also for financial reasons. But on 2.9.2002 with the help of the Lighthouse Club of Warnemuende a memorial plaque to Prof. C. W. v. Zehender was mounted on the guest house "Margarete". This plaque commemorates Professor Zehender's merits in establishing the DOG, planning and building the eye clinic of the university of Rostock.

Germany↗

PubMedDate not supplied

Potentially accommodating intraocular lenses--an in vitro and in vivo study using three-dimensional high-frequency ultrasound.

PURPOSE: To investigate the accommodative performance of new intraocular lenses (IOL) using the advantages of three-dimensional ultrasound biomicroscopy. METHODS: An in vitro simulation device was designed to study IOL performance using an artificial capsular bag and a stretching device. The haptic region of the Akkommodative 1CU (HumanOptics AG) and CrystaLens AT-45 (Eyeonics Inc) was visualized in vitro in three dimensions, using an in-house developed three-dimensional ultrasound biomicroscope. The in vitro results were used to describe the in vivo situation in four patients with accommodative implants. RESULTS: The haptic position and angulation in consideration of the accommodation state was distinguished and analyzed. In the simulation model, a maximal angulation change of 4.5 degrees and 4.3 degrees and a maximal forward shift of 0.33 mm and 0.28 mm was observed for the AT-45 and 1CU, respectively. In vivo, a change in haptic angulation <100 and a maximal forward shift of 0.50 mm was observed for the 1CU. These changes correspond to a theoretical approximate value of 0.50 diopters. CONCLUSIONS: The in vitro simulation device examined with three-dimensional ultrasound biomicroscopy provided information on the accommodative performance of these potentially accommodative IOL designs. Using three-dimensional ultrasound biomicroscopy, corresponding changes in haptic angulation during pharmacological-induced accommodation were observed.

Accommodation, Ocular↗