Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Aphakia”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1988

Prospects for contact lens wear in aphakia.

The success rate and complications for contact lens wear in 366 aphakic patients were evaluated retrospectively over a mean follow-up period of 36 months. Successful use of a daily wear contact lens (DWCL) was related to lens handling ability. In unilateral aphakia it was 86 per cent (161/187) for patients under 70 years old but only 27 per cent (19/70) for those over 70 years (p = less than 0.0001). This age related difference did not occur either for the use of a second lens, following successful use of a lens after the first cataract extraction, for which the overall success rate was 89 per cent (55/62) or for simultaneous bilateral lens fitting, which had a success rate of 81 per cent (38/47). Extended wear soft contact lenses (EWSCL) were fitted to patients unable to use DWCLs but only half were successful (21/40). There was no difference in the incidence of complications between daily wear soft and daily wear hard contact lenses or young (up to 44 years), middle aged (45-69 years) and elderly (over 70 years) patients, for the use of all DWCLs. However the risk of a serious complication was six times greater for patients using EWSCL (55 per cent) compared with those using DWCLs (8.8 per cent). DWCLs are a safe and successful method of aphakia correction for patients under 70 years of age. Once the ability to handle a DWCL has been learned, success is maintained when the second eye is fitted. EWSCLs have a high complication rate and a low success rate in patients unable to use DWCLs; other methods of aphakia correction should be considered first in this group.

Adult↗
PubMed1997

Isolation of a new homeobox gene belonging to the Pitx/Rieg family: expression during lens development and mapping to the aphakia region on mouse chromosome 19.

We recently reported the positional cloning of a homeobox gene involved in the pathogenesis of Rieger syndrome, RIEG1 , and its mouse homolog, Rieg1 . Rieg1 (also independently described as Pitx2) is highly homologous to the Ptx1/Potx gene product, suggesting that there may be additional members of this novel Pitx family. The Pitx genes play an important role in eye, tooth, pituitary and umbilical region development as evidenced by Rieger syndrome and iris hypoplasia phenotypes, resulting from mutations in the RIEG1 gene and by expression studies. In order to characterize further the Pitx gene family we searched mouse cDNA libraries to identify additional members. A new gene was isolated which encodes a homeoprotein with strong homology to the other Pitx proteins and 97-100% identity in the homeodomain itself, suggesting that this is a third member of the family, Pitx3 . In whole mount in situ hybridization on mouse embryos ranging from 8.5 to 11.5 days post-coitum (d.p.c.), Pitx3 mRNA was seen only in the developing lens starting at day 11. Hybridization on cross-sections revealed strong signals in the lens vesicle in 11 d.p.c. embryos and throughout the lens, particularly in the anterior epithelium and equator region in 15 d.p.c. embryos. Pitx3 was mapped close to aphakia on mouse chromosome 19. The aphakia homozygous mouse is characterized by small eyes lacking a lens, which fail to develop beyond 11 d.p.c. These data make Pitx3 a strong candidate gene for the aphakia phenotype in the mouse and suggest a role for the human homolog in congenital lens malformations.

Amino Acid Sequence↗
PubMed1991

Comparative study of clinical factors that predispose patients to proliferative vitreoretinopathy in aphakia.

To clarify the risk factors of proliferative vitreoretinopathy (PVR) in aphakia, the clinical features of 25 aphakic eyes with PVR were statistically analyzed and compared with a control group of 157 aphakic eyes with non-PVR rhegmatogenous retinal detachment. The statistically significant (P less than 0.05) factors that predisposed patients to PVR in aphakia were as follows: a history of vitreous loss on cataract surgery, retinal detachment developing within 3 months after cataract extraction, duration of retinal detachment longer than 3 months, break larger than three disc diameters, and choroidal detachment. Vitreous loss is believed to play the most important role in the development of PVR in aphakia.

Adolescent↗
PubMedDate not supplied

Traumatic aphakia treated with an iris prosthesis/intraocular lens or epikeratophakia.

OBJECTIVE: We retrospectively analyzed the visual results and postoperative complications associated with severely traumatized eyes in which aphakia was corrected with epikeratophakia or a sutured iris prosthesis/intraocular lens (IOL). METHODS: Fourteen eyes (14 patients) with traumatic aphakia and severe anterior segment complications were corrected either with epikeratophakia or a sutured iris prosthesis/IOL. All eyes lacked lens capsule or iris support for an IOL. The surgical technique of implanting an iris prosthesis/IOL employed transcleral suturing in the ciliary sulcus combined with penetrating keratoplasty. RESULTS: In the eight eyes treated with epikeratophakia, four (50%) had spectacle-corrected visual acuity of 20/40 or better. Almost all of these eyes lost one or two Snellen lines of baseline spectacle-corrected visual acuity. Few complications occurred after epikeratophakia; none were severe. Of six eyes with penetrating keratoplasty and a sutured iris prosthesis/IOL or a sutured posterior chamber IOL, two (33%) achieved a visual acuity of 20/40 or better. In the IOL group, severe complications occurred, including posterior dislocation of the lens and secondary glaucoma. CONCLUSIONS: The surgical correction of aphakia in severely traumatized eyes requires specialized surgical techniques. Epikeratophakia is a low-risk operation that can be performed in eyes in which an IOL is contraindicated. The iris prosthesis/IOL technique results in good cosmetic results; however, due to complications, this technique should be used with caution.

Adult↗
PubMed1997

The preliminary report of epikeratophakia in the treatment of pediatric aphakia after traumatic cataract extraction.

PURPOSE: To study the role of epikeratophakia in treating pediatric unilateral aphakia after traumatic cataract extraction. METHODS: We performed epikeratophakia in 43 children to treat aphakia after traumatic cataract extraction, using the corneal lenses made by ourselves. The rehabilitation of the the postoperative vision and the prevention of amblyopia were observed with a mean follow-up period of 20 months. RESULTS: All the lenses remained transparent. Postoperatively, 31 cases (72.1%) achieved uncorrected visual acuities (V.A) over 0.2, 32 cases (74.4%) achieved corrected V.A over 0.4. Most of the cases achieved the best preoperative corrected V.A with spectacles of less than 3 diopters. No severe complication occurred. CONCLUSION: Epikeratophakia is predictable with quality lens and correct surgical technique. The result suggests that the epikeratophakia is one of the best treatment for the pediatric aphakia especially for those who are not optimal for IOL implantation.

Adolescent↗
PubMed2003

[The evolution of cataract surgery, extra- and intraocular correction of aphakia].

The evolution of cataract surgery during the recent 2 centuries, and especially in the last 50 years, witnessed essential changes--from reclination of the lens and a traditional extracapsular cataract extraction to cataract microsurgery including phacoemulsification. A lack of the lens in the eye, i.e. aphakia, is considered to be a serious complication. The optic extraocular correction of aphakia is implemented mainly by the use of spectacles and contact lenses, which are not deprived of essential shortcomings. H. Ridley was the first to implant, in 1949, a polymethylmethacrylate (PMMA) intraocular lens (IOL). After that, anterior-chamber and iris-clips lenses as well as extrapupillary lenses with fixation to Sulcus cyliaris, which had by some complications, were offered. Only in 1973, we offered, for the first time in the world practice, an intracapsular implantation and intercapsular fixation of IOLs of various models. The designed intraocular correction of aphakia was checked by time and it is used now in cataract microsurgery, including small-incisions as well as ultrasound and laser phacoemulsification. The use of the lens bag as a natural bed for the fixation and isolation of IOL from intraocular structures is a priority direction in the Russian research ophthalmology.

Aphakia↗
PubMed2006

[Aphakia in a German Holstein calf].

Aphakia and further malformations of both eyes were diagnosed in a female German Holstein calf. Besides aphakia of the left eye, the calf exhibited microphthalmia, glaucoma and a hypoplastic uveoscleral tissue. Additional findings in the right eye were buphthalmus and glaucoma. Instead of aphakia, pathohistological and investigations revealed a very small (microphakia) and luxated lens. Neither the clinical nor the pathological examination revealed further malformations of other organs. A BVD infection could be excluded as cause for the ocular malformations observed. A deficiency or excess of vitamine A was unlikely because this would have also applied to all other calves born at the same time on the farm. An inbreeding coefficient of 3.168% for the malformed calf and the exclusion of environmental causes for these malformations of the eyes let us suppose a hereditary problem.

Animals↗
PubMed1982

[Proposals for a new partial permanent incapacity rate for aphakia].

Thanks to modern methods of correction in aphakia, (precornea lenses, and intra-ocular implants), the patient is less and less concerned by the major inconveniences linked to aphakia. It is, therefore, desirable to fix, in common law, the rate of partial permanent incapacity, according to whether the aphakic patient is well or poorly compensated by a prothesis. The residual global incapacity rate, would be the sum of the two following figures: 1 - A basic disability figure, of five to eight per cent taking into account the discomfort brought by the accessory consequences of the aphakic condition (photophobia, dyschromatopsy, post-operative astigmatism, exophory). 2 - A figure varying from the simple to double, based not upon the degree of visual acuity obtained after correction, but on the loss of visual acuity in comparison with the previous condition. This figure would be one per cent of incapacity, if aphakia is functional corrected, and two per cent in the contrary case.

Accidents, Occupational↗
PubMedDate not supplied

[Contact lens correction in aphakia in children].

The paper presents our experience in correcting with contact lens the children's aphakia. Since February 1990, soft contact lenses daily ported have been used in children's aphakia. The study included 17 children with ages, between 2 and 9 year old, from which 9 cases were of congenital cataract, 6 of traumatic cataract and 2 of Marfan syndrome. The survey was done for evaluating the experience regarding the use of soft contact lenses daily--worn in children's aphakia, as an optimal method for functional recovering, at this age. The following measures have been followed: tolerance, patients' and parents' cooperation, the incidence of complication. The method's evaluation was done on the bases of functional obtained and the average yearly number of contact lenses.

Aphakia, Postcataract↗
PubMedDate not supplied

[Effects of the duration of cataract extraction and eyeglass wear in patients with aphakia on the development of changes in the macular area].

Forty-eight patients with aphakia were examined to elucidate the effect of cataract extraction duration on subsequent development of Irwin-Hass syndrome. A total of 229 patients were examined 6 months and more after cataract extraction to find out whether sun light could induce development of dystrophic changes in the central retina in aphakia. The results indicate that operation duration of more than an hour increased the risk of subsequent development of Irwin-Hass syndrome. Aphakia patients wearing no eyeglasses or contact lenses or intraocular lenses may develop maculodystrophies, probably due to the injurious effect of sun rays on the retina.

Aged↗
PubMedDate not supplied

Combined epikeratoplasty and homoplastic keratophakia for correction of aphakia: double curve effect.

BACKGROUND: Having used the nonfreeze Barraquer-Krumeich-Swinger set for refractive lamellar keratoplasty since January 1987, the authors found the results of this procedure to be disappointing for correction of aphakia. Insufficient refractive gains for epikeratoplasty (+39% of initial refraction at 12-month follow up) persuaded the authors to look for a more effective refractive corneal surgery technique for correcting aphakia. METHODS: We describe a new technique consisting of the insertion of a plano-convex homoplastic donor cornea meniscus between the patient's cornea and a hypermetropic epikeratoplasty. A nonfreeze Barraquer-Krumeich-Swinger set was used to fashion the two donor lenticules. This double surgery, called the "double curve effect," because it uses two convex surfaces to increase the converging power of the cornea, has been performed in 15 eyes. RESULTS: We report the results of 10 eyes with a 6-month follow up. The average refractive gain was +11.75 D, 90% of the needed correction. But there was a loss of approximately 46% of best spectacle-corrected visual acuity. CONCLUSION: Three problems should be emphasized: the existence of two interfaces, the difficulty of perfectly centering the two lenticules, and the induced irregular astigmatism. Despite these problems which can reduce the level of best spectacle-corrected visual acuity, the double curve effect may offer an effective solution for treating certain cases of unilateral aphakia.

Adult↗
PubMed1990

Contact lenses for infant aphakia.

We prospectively studied for three years the optical correction by contact lenses of 83 aphakic infants (141 eyes) who generally also had systemic and other ocular anomalies: 85% of the patients tolerated the lens wear for the whole study period. Complications occurred in 46 eyes and led to cessation of lens wear in two cases. Ten patients abandoned the lenses for other reasons. Thirty-four eyes needed subsequent intraocular surgery, mostly minor, and nine patients had strabismus surgery. Contact lenses are a versatile, safe, successful, and cost effective treatment for aphakia in infancy against which, before their widespread introduction for primary optical correction of infant aphakia, other methods of aphakic treatment need to be compared.

Aphakia↗
PubMed1999

Management of pediatric aphakia with silsoft contact lenses.

PURPOSE: To evaluate the performance of silicone elastomer lenses in pediatric eyes with aphakia. METHODS: We retrospectively studied pediatric aphakic eyes fit with Silsoft lenses (elastofilcon A, Bausch & Lomb) at the L.V. Prasad Eye Institute, India. RESULTS: Seventy-four children (106 eyes) with a median age of 9.0 months (range: 1 month to 12 years) were included in the study. Congenital cataract was the pre-existing pathology in 84 eyes. Lenses were fit between 1 week and 5 years following surgical intervention (median: 25 days). The most frequently used base curves were 7.5 mm (n=46 eyes) and 7.7 mm (n=39 eyes); lens diameter was 11.3 mm (n=103 eyes). Satisfactory fit was achieved in 86 eyes (81.1%). One-week extended wear was the most commonly recommended mode of wear (n=95 eyes). Lenses (n=118) were replaced for change of power, lens loss, and deposits or damage. Lenses were worn for > or =6 months in 68 eyes (64.2%). Twenty-three contact lens related adverse events occurred, all of which resolved uneventfully. On survival analysis, the probability of not having a lens related complication was 75.5% (95% CI; 61.5-89.5) at 24 months. CONCLUSIONS: In the management of pediatric aphakia, Silsoft lenses are safe, provide satisfactory optical correction, and are easy to handle. Limited availability and the financial costs associated with frequent lens replacement are limitations in our socioeconomic circumstances.

Aphakia↗
PubMed1986

Epikeratophakia with commercially prepared tissue for the correction of aphakia in adults.

The records of all adult patients at Louisiana State University Eye Center, New Orleans, who underwent epikeratophakia for aphakia with commercially prepared tissue since February 1984 were reviewed. The epikeratophakia lenticule was maintained in 37 (92.5%) of 40 patients; complications required the removal of three tissue lenses. The average refractive error three months after surgery was +0.67 +/- 1.97 diopters; 25 (90%) of 28 patients were within 3 D of emmetropia. At six months, the average refractive error was -0.18 +/- 2.27 D. Fourteen (58%) of 24 patients whose visual acuity was 20/40 or better with spectacles before surgery achieved 20/40 spectacle visual acuity three months after surgery, as did ten (59%) of 17 patients at six months and five (83%) of six patients at 12 months. The results in these recent cases are better than in previously reported series and reaffirm the usefulness of epikeratophakia in the treatment of aphakia.

Adult↗
PubMed1993

The effectiveness of daily wear contact lenses for the correction of infantile aphakia.

OBJECTIVE: To evaluate the effectiveness and safety of daily wear contact lenses in the treatment of infantile aphakia. DESIGN: A study of prognosis using a cohort followed up for a mean of 58 months. SETTING: All operations, contact lens care, and follow-up were conducted at a university referral center. PATIENTS: Of 111 children undergoing surgery for cataract between 1980 and 1990, 51 (68 eyes) met the criteria of age younger than 2 years at the time of surgery and of cataract of nontraumatic origin. Patients were evaluated for visual acuity, complications, number of contact lenses worn per year, and changes in contact lens refractive power per month. A subgroup of 28 eyes of patients undergoing surgery before age 7 months and followed up for at least 24 months was studied. INTERVENTION: Following cataract surgery, all patients were fitted with daily wear contact lenses. MAIN OUTCOME MEASURE: Final visual acuity and complications were studied. The distribution of mean contact lens power for each month of age was determined. RESULTS: During the follow-up period, no serious complications were encountered. The visual acuity outcome was better following bilateral cataract surgery than unilateral surgery (P < .001 using chi 2 analysis) and was comparable with that achieved with extended wear contact lenses. CONCLUSION: Daily wear contact lenses were found to be safe and effective in the treatment of infantile surgical aphakia. The daily care was easily learned by the parents.

Aphakia, Postcataract↗
PubMed2005

Artificial iris-lens diaphragm in reconstructive surgery for aniridia and aphakia.

PURPOSE: To determine the efficacy and safety of surgical implantation of artificial iris-lens diaphragm in patients with anatomic or functional iris deficiencies, aphakia or cataract. SETTING: Svyatoslav Fyodorov MNTK Eye Microsurgery, Cheboksary, Russia. METHODS: Twenty eyes of 19 consecutive patients with combined iris and lens pathology of traumatic or congenital etiology were identified for an interventional noncomparative case series. The newly proposed model of an elastic iris-lens diaphragm with a colored haptic and additional support elements was implanted using various fixation approaches. RESULTS: Fifteen eyes (75%) experienced improvement in corrected visual acuities. The best spectacle-corrected visual acuity (BSCVA) in 2 eyes did not change, while the uncorrected visual acuity (UCVA) in these eyes increased. There were 3 eyes in which BSCVA deteriorated with no change or even slight improvement in UCVA. All patients were satisfied with the cosmetic results of the surgery and reported a decrease in glare and photophobia. There was 1 intraoperative complication of vitreous hemorrhage. Postoperatively, 2 cases of hyphema, 1 case of ciliochoroidal detachment, 4 eyes with exaggerated immediate postoperative reaction, and 1 eye with persistent low-grade cyclitis were observed. In 1 eye, there was persistent intraocular pressure rise. One eye showed signs of cystoid macular edema. No iris-lens diaphragm decentrations and no new or extensions of old retinal detachments were seen during the follow-up period. CONCLUSIONS: Artificial iris-lens diaphragm implantation effectively improved postoperative outcomes by correcting aphakia, reducing glare disability, and addressing cosmetic issues faced by iris-deficient, and aphakic or cataract patients. Although the iris-lens diaphragm appears to be safe, long-term results must be clarified in studies with longer follow-up and a larger patient population.

Adolescent↗
PubMed2003

The association between myopic shift and visual acuity outcome in pediatric aphakia.

PURPOSE: The advent of intraocular lens implantation after pediatric cataract surgery necessitates an increased understanding of refractive development. The significant variation in rate and amount of refractive change among eyes, both aphakic and pseudophakic, is well recognized, although the causes of such variation remain unclear. The purpose of this study was to determine if a correlation exists between the rate of refractive growth (RRG) and visual acuity outcome in pediatric aphakia. METHODS: Multicenter, retrospective observational case series. One hundred and twenty-five eyes of 85 patients with cataract surgery before 1 year of age and a minimum of 3 years of follow-up were analyzed. RRG was calculated for each eye using the logarithmic model of ocular growth and compared with final logMAR acuity using linear regression. RESULTS: The correlation of RRG with final logMAR acuity was statistically significant (r(2) = 0.10; P <.01), ie, 10% of variance in RRG is related to acuity outcome. The correlation was higher in unilaterally aphakic patients (n = 44; r(2) = 0.19; P <.01) than in bilaterally aphakic patients (n = 81; r(2) = 0.08; P <.01). Eyes with visual acuity of 20/60 or better had a significantly lower RRG than those with poorer acuity (4.1 v 5.4 diopters (D); P <.01). CONCLUSIONS: RRG in aphakia is correlated with visual acuity outcome. Eyes with poorer acuity have a greater RRG.

Aphakia, Postcataract↗
PubMed1995

Pars plana Baerveldt tube insertion with vitrectomy in glaucomas associated with pseudophakia and aphakia.

PURPOSE: We reviewed the course of intraocular pressure, visual acuity, and complications in patients with shallow anterior chambers or vitreous prolapse who underwent insertion of glaucoma drainage tubes through the pars plana (after a complete posterior vitrectomy). METHODS: Thirteen patients (13 eyes) with uncontrolled glaucoma associated with shallow anterior chamber or vitreous prolapse and aphakia or pseudophakia underwent pars plana Baerveldt tube insertion after vitrectomy. RESULTS: In 11 eyes the intraocular pressure was less than or equal to 15 mm Hg at a minimum follow-up of one year; the other two eyes underwent additional glaucoma surgery. Two of the 11 eyes with controlled intraocular pressure had limitation of ocular motility postoperatively. No retinal complications had occurred in any of the 13 eyes. CONCLUSION: This technique of combined pars plana vitrectomy and pars plana insertion of a Baerveldt tube provides intraocular pressure control in eyes with shallow anterior chamber or vitreous prolapse and glaucoma associated with pseudophakia or aphakia.

Adolescent↗