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Contrast-enhanced color duplex sonography (CDS): an alternative for the evaluation of therapy-relevant tumor oxygenation?

PURPOSE: To evaluate the predictive value of radiotherapeutically relevant tumor hypoxia by contrast-enhanced color duplex sonography (CDS). The objectification was based on pO(2) histography. MATERIAL AND METHODS: 25 patients with metastatic neck lymph node from a primary squamous carcinoma of the head and neck were examined. To visualize as many vessels as possible, a contrast enhancer (Levovist), Schering Corp., Germany) was administered. Horizontal and longitudinal sonographic scans with a thickness of 5 mm were performed on the metastatic neck lymph node. Color pixel density (CPD) was defined as the ratio of colored to gray pixels in a region of interest. It represents the extent of vascularization in the investigated slice. To assess the biological and clinical relevance of oxygenation measurement, the relative frequency of pO(2) readings < or = 2.5, 5.0, and 10.0 mmHg, as well as mean and median pO(2), were documented. RESULTS: In order to investigate the degree of linear association, the Pearson correlation coefficient was calculated. Moderate (/r/ > 0.5) to high (/r/ > 0.7) correlation was found between the CPD and the parameters of hypoxic fraction (pO(2) readings with values < or = 5.0 and 10.0 mmHg, as well as mean and median). There was only a slight correlation between CPD and the fraction of pO(2) values < or = 2.5 mmHg (r = -0.479). CONCLUSION: CPD represents the mean degree of vascularization. As a noninvasive measurement, this method seems feasible for evaluating the state of global oxygenation in superficial tumors. Nevertheless, this method is limited through its deficiency in describing the vascular heterogeneity of tumors.

Adult↗

[The system of continuing professional education of medical doctors in Austria. Structure, guidelines and quality management].

This article describes the system of continuing medical education in Austria. Pursuant to section sign 49 para.1* of the Austrian Medical Law 1998/Amendment 2001, Austrian doctors are under the obligation to participate in continuing professional education according to the guidelines of the Austrian Medical Chamber. The Austrian doctors see themselves as members of an independent profession. The Austrian system of continuing (physician) professional education developed continuously, for one, based on the principle of self-responsibility of licensed doctors and for the other, on the responsibility for self-administration of the medical profession. The participation in CPD or CME events, which are quality assured by a given set of rules, is documented by a time-limited diploma issued by the Austrian Medical Chamber. The recognition system comprises CPD-CME events in Austria as well as abroad, literature study under specific rules including an assessment system and the use of electronic media. The CPD-CME guidelines are updated annually by the Austrian Medical Chamber. The permanent maintenance and administration of the CPD-CME Programme of the Austrian Medical Chamber (Diplom-Fortbildungs-Programm, DFP), was handed over to the Austrian Academy of Physicians, which is under the obligation to report to its founding body, the Austrian Medical Chamber.

Accreditation↗

[Surgical correction of penile deviation. Nesbit vs. Schroeder-Essed method].

60 patients with a marked penile deviation [40 because of a congenital penile deviation (CPD) and 20 as a result of the Peyronie's disease] were questioned about the result of the operation by means of a questionnaire in a retrospective study with an average follow-up of 45 month. The Nesbit procedure had been used with 49 of these 60 patients, the modified Schroeder-Essed technique had been used with 11 patients. There were 15 patients (25%) in all, who suffered a relapse. In spite of the continual use of non-absorbable suture material with the Schroeder-Essed technique, the number of relapses was in this group plainly higher than in the Nesbit group (55% and 18% respectively). In our opinion this is caused by the insufficient tensile strength of pure plications. Regardless of the operating method, patients suffering from IPP showed a higher number of relapses than patients having a CPD (35% and 20% respectively). The reason for this might be the fact that one can never rule out completely the possibility of a further progress of the disease. 71% of the patients in the Nesbit group were satisfied with the results of the operation, in the Schroeder-Essed group there were only 36%. Irrespective of the operating method, IPP patients complained moreoften about late complications and erection problems after the operation and were more rarely satisfied with the result than patients with a CPD (50% and 73% respectively). We put this down to the fact that patients with a CPD and patients suffering from IPP represent very different collectives as far as age structure and morbidity are concerned. IPP patients frequently have erection problems even before the operation. Especially with IPP patients, preoperative erectile disfunction must be excluded, in the case of their occurrence there are to prefer other programmes of therapy.

Adolescent↗

Activity of Crohn disease: value of Color-Power-Doppler and contrast-enhanced ultrasonography.

Diagnosis and follow-up of Crohn disease (CD) often require invasive instrumental examinations, with a high risk of iatrogenic damage. Ultrasound (US) examination of bowel walls could be the first choice in managing patients with CD. We evaluated the role of tissue color power Doppler (CPD) and B-mode US with intravenous injection of contrast medium in the detection of disease activity. In our series, 52 patients with CD underwent US examination. Each study was completed with tissue CPD and US with intravenous injection of contrast medium (Sono Vue) to evaluate intestinal wall vascularization as an index of disease activity. We then compared our results with those from clinical and laboratory tests and follow-up. Data from US examination with intravenous injection of Sono Vue partly agreed with clinical and laboratory tests and CPD in disease activity evaluation but were most useful in the follow-up. Bowel US examination associated with CPD and in particular US contrast medium injection can be used to detect CD activity and modulate therapy and follow-up.

Adult↗

Topographic change in the central macula coupled with contrast sensitivity loss in diabetic pregnancy.

PURPOSE: To study macular topography and contrast sensitivity (CS) in diabetic and nondiabetic women during pregnancy and post partum. METHODS: A prospective study of 46 pregnant women with insulin-dependent diabetes and 11 nondiabetic pregnant controls. Macular surface topography was analyzed by Heidelberg Retinal Tomograph. Volume above the reference plane (VARP) was measured with 1.0-, 1.5-, 2.0-, and 3.0-mm-diameter circles. CS was measured with the Vistech 6500 Contrast Test System. RESULTS: The diabetic women had greater VARP than the controls measured with the 1.5-mm diameter circle. In diabetic women, the mean VARP was 0.084+/-0.064 mm(3) (mean +/- SD) in the first trimester, 0.080 +/- 0.056 mm(3) in the third trimester, and 0.087 +/- 0.067 mm(3) 3 months post partum compared with the values of 0.069+/-0.043, 0.054+/-0.024, and 0.036+/-0.020 mm(3) in the controls ( P=0.036 between groups). In diabetic women requiring laser treatment, the difference from controls was more significant ( P<0.001). CS at 3 cpd and 6.0 cpd was lower in diabetic women than in controls throughout pregnancy and post partum ( P=0.012 and P=0.043). A statistically significant negative correlation appeared between macular topography and CS during the third trimester; between cpd 6 and VARP 1.5 mm ( r=-0.471, P=0.001), and between cpd 6 and VARP 2.0 mm ( r=-0.446, P=0.002). CONCLUSIONS: In the diabetic women, especially in those with clear progression of retinopathy during pregnancy and post-partum, the macula seemed to be slightly more elevated than in the controls, and CS was lower at mid-range spatial frequencies. CS loss in the diabetic women correlated with macular elevation during the third trimester.

Case-Control Studies↗

A gene for a Class II DNA photolyase from Oryza sativa: cloning of the cDNA by dilution-amplification.

Ultraviolet radiation induces the formation of two classes of photoproducts in DNA-the cyclobutane pyrimidine dimer (CPD) and the pyrimidine [6-4] pyrimidone photoproduct (6-4 product). Many organisms produce enzymes, termed photolyases, which specifically bind to these lesions and split them via a UV-A/blue light-dependent mechanism, thereby reversing the damage. These photolyases are specific for either CPDs or 6-4 products. Two classes of photolyases (class I and class II) repair CPDs. A gene that encodes a protein with class II CPD photolyase activity in vitro has been cloned from several plants including Arabidopsis thaliana, Cucumis sativus and Chlamydomonas reinhardtii. We report here the isolation of a homolog of this gene from rice (Oryza sativa), which was cloned on the basis of sequence similarity and PCR-based dilution-amplification. The cDNA comprises a very GC-rich (75%) 5; region, while the 3; portion has a GC content of 50%. This gene encodes a protein with CPD photolyase activity when expressed in E. coli. The CPD photolyase gene encodes at least two types of mRNA, formed by alternative splicing of exon 5. One of the mRNAs encodes an ORF for 506 amino acid residues, while the other is predicted to code for 364 amino acid residues. The two RNAs occur in about equal amounts in O. sativa cells.

Amino Acid Sequence↗

Continuous peritoneal dialysis in children: a single-centre experience in a developing country.

Continuous peritoneal dialysis (CPD) is the most commonly used modality of dialysis in children. Continuous ambulatory peritoneal dialysis (CAPD) has been an established form of therapy in adult patients with end-stage renal failure in India for more than a decade. There is a paucity of published experience of CPD in children from developing countries. We retrospectively studied children with end-stage renal failure (ESRD) that had been on CAPD over the past 10 years. Thirty patients with ESRD, mean age 13+/-8 years (range 5-21 years), male 18, were started on CAPD from 1994 to October 2004. The mean break-in period was 12+/-3 days. Of these 30 patients, 15 had a total of 21 episodes of peritonitis. The peritonitis rate was 0.58 episodes per patient year. E. coli was the commonest organism causing peritonitis. On outcome analysis, 7/30 (23.3%) patients received a renal transplant, while 11/30 (36.6%) continued on CAPD, awaiting a kidney transplant. Of the rest, eight (26.6%) patients died, two (6.7%) suffered technique failure and were changed to haemodialysis, and two (6.7%) were lost to follow-up after 2 months. The mean cumulative survival time of patient on CPD was 42 months. We conclude that CPD is a viable option for dialysis in ESRD children in a developing country and is a successful bridge between ESRD and renal transplantation.

Adolescent↗

Selective enrichment and biochemical characterization of seven human skin fibroblasts cell types in vitro.

The mitotic and postmitotic populations of the human skin fibroblast cell line HH-8 are heterogeneous when studied in vitro. There are reproducible changes in the frequencies of the mitotic fibroblasts (MF), MF I, MF II, MF III, and the postmitotic fibroblasts (PMF), PMF IV, PMF V, PMF VI, and PMF VII. For biochemical characterization, methods for selective enrichment of homogeneous populations of these seven fibroblast cell types have been established. Clonal populations with 95% purity for the mitotic fibroblasts MF I, MF II, and MF III can be raised in uniform clone types of fibroblasts (CTF) CTF I, CTF II, and CTF III. Pure clonal subpopulations of MF I type cells are present in mass populations in the range of 1-20 cumulative population doublings (CPD). Populations of mitotic fibroblasts represent nearly homogeneous populations of MF II (75-85% purity) in the range of 28-34 CPD and MF III (73-86% purity) in the range of 48-53 CPD. These populations can be easily expanded to up to 10(7)-10(8) cells. The spontaneous transition of MF III to PMF VI takes 140-180 days. In order to shorten this period and increase the proportion of distinct postmitotic types, mitotic fibroblast mass populations (CPD 30-32, MF II: 75-85% purity) have been induced by uv-irradiation to differentiate to nearly homogeneous populations of PMF IV, PMF V, PMF VI, and PMF VII within 4 to 36 days of culture. Using this method, 10(7) cells of one differentiation stage can be obtained. Spontaneously arising and experimentally selected or induced homogeneous clonal and mass populations of MF I, MF II, MF III, PMF IV, PMF V, PMF VI, and PMF VII express an identical differentiation-dependent and cell-type-specific [35S]methionine-labeled polypeptide pattern.

Cell Differentiation↗

Interocular differences in contrast and spatial frequency: effects on stereopsis and fusion.

Anisometropia produces interocular differences in contrast and spatial frequency. The influence of these two parameters on Panum's fusional limit (PFL) and stereoscopic depth thresholds was investigated with sinusoidal gratings and one-dimensional band-pass-limited targets. Vertical fusion limits were unaffected by large interocular differences in contrast (40-10%) at two spatial frequencies (0.8 and 1.6 cpd). However, when tested with a low spatial frequency (0.8 cpd), stereothresholds increased 150% with an interocular difference in contrast as small as 50-25%. Stereoacuity was reduced less by differential contrast when tested with higher spatial frequencies (3.2 cpd). When tested with low spatial frequencies the stereothreshold was elevated more by reducing the contrast of one image than by equal contrast reductions of both ocular images. Stereothresholds appear to be elevated by binocular suppression evoked by interocular differences in contrast. Vertical as well as horizontal fusion limits decreased with increasing interocular size difference. Horizontal fusion limits fell off more gradually with increasing size difference than did vertical fusion limits, particularly at higher spatial frequencies (2.4 cpd). Similarly, stereothresholds increased with increasing interocular size differences. Changes in the fusion limit and stereothreshold that occur with interocular size differences are predicted from positional disparities between edge features rather than from differences in spatial frequency.

Contrast Sensitivity↗

Studies on blood coagulation activity during storage of red cell products intended for transfusion.

Preservation of red blood cells in special media, such as saline-adenine-glucose-mannitol (SAGM) solution involves storage at a citrate and plasma protein concentration much lower than found in normal CPD or CPD-adenine plasma. In the present study, the effects on the coagulation and other connected enzymatic systems in SAGM medium have been investigated. Significantly higher levels of fibrinopeptide A (FPA) and plasma kallikrein activity were observed in the SAGM medium compared to CPD plasma, indicating an increased enzymatic activation in the SAGM medium. For this reason storage of red cells in SAGM solution, supplemented with citrate, was tested and compared with storage in SAGM and CPD plasma. The results demonstrate a positive effect of citrate as an added ingredient in the SAGM solution. Significantly lower levels of primarily FPA but also decreased activities of plasma kallikrein and general proteolysis were noticed. The decreased citrate concentration in Red Blood Cells stored in SAGM protein poor medium must be considered to have a destabilizing influence on the coagulation and on other connected enzymatic systems.

Blood Coagulation↗

Direct effect of bombesin on pancreatic and gastric growth in suckling rats.

Bombesin stimulates growth of the stomach and pancreas in adult rats. Part of this effect is thought to be through the release of CCK following bombesin treatment. We studied the effect of long term administration of bombesin on the pancreas and stomach in suckling rats and examined the action of bombesin using specific CCK antagonist (CR-1409) and bombesin antagonists (GRP19-26, D-Phe19, Leu26CH2NHCOCH3 = cpd 17; L-686,095-001C002 = cpd 23). Rat pups (7-days-old) were given bombesin (20 micrograms/kg body wt. twice a day) or vehicle (1% gelatin) for 9 days. Bombesin stimulated pancreatic and gastric growth (tissue weight, total protein and DNA content all increased). Pancreatic trypsinogen concentration and content showed a 2-3-fold increase. CR-1409 at 6 mg/kg body wt., a dose that blocked the trophic action of CCK-33 when given to pups at similar ages, did not affect the bombesin-stimulated growth of the pancreas or the increase in trypsinogen level. At 2.4 mg/kg body wt., cpd 17 partially blocked and cpd 23 completely blocked the trophic effect of bombesin on the pancreas and stomach and the increase in trypsinogen level in the pancreas. RU-486, a type II glucocorticoid receptor antagonist, given at a dose sufficient to block the physiological action of glucocorticoid, had no effect on bombesin-stimulated growth of the pancreas. Thus, in vivo, bombesin acts directly on the neonatal pancreas and stomach.

Animals↗

The reduction of disulphides by rat liver mitochondria.

The capacity of rat liver mitochondria to reduce 23 non-protein disulphides to their thiols has been examined. The best reduced include the three intermolecular disulphides, bis(2-aminoethyl)disulphide (cystamine, basic), bis(2-hydroxyethyl)disulphide (HED, neutral and bis(3-carboxypropyl)disulphide (CPD, acidic). Their behaviour has been compared. In each case the thiol formed is found in highest concentration in the mitochondrial matrix. The three disulphides require an NAD-reducing substrate and respond similarly to changes in the initial disulphide concentration, pH of the medium and inhibitors. The most effective of these are N-ethylmaleimide, phenylarsenoxide (shown to be a potent swelling agent), triethyltin and 1-chloro-2,4-dinitrobenzene (CDNB). The fall in GSH induced by the latter correlates with the extent of inhibition. An uncoupler (carbonylcyanide-m-chlorophenylhydrazone, CCCP) inhibits reduction of HED and CPD but not that of cystamine. After lysis of mitochondria there is no significant reduction even in the presence of NADH or NADPH. Reduction is observed in sonicates if lipoamide is added with NADH but this reaction is insensitive to CDNB and CPD is not reduced. Also neither cystamine nor HED supports pyruvate dehydrogenation. There is also reduction if GSH and glutathione reductase are added with NADPH. All three disulphides are reduced to some extent but the rates for HED and especially CPD are inadequate to account for the rates in intact mitochondria.

Animals↗

Diphenylamine-2-carboxylate analogues block Cl- conductances in A7r5 cells by affecting cellular Ca2+ homeostasis.

We have investigated the cellular signalling pathway by which vasopressin stimulates a Ca2(+)-dependent Cl- conductance and the effects of two known Cl- channel blockers in cultured rat A7r5 aortic smooth muscle cells using anion efflux and fluorescent Ca2+ imaging studies. Addition of vasopressin (100 nM) to A7r5 cells enhanced 125I (Cl- substitute) efflux from the cells through a V1 receptor-mediated pathway. Maximal increases in the rate of efflux were observed 1 min following addition of vasopressin (4-fold above basal levels). Activation of the V1 pathway was demonstrated by an increase in inositol trisphosphate (IP3) formation and lack of cAMP accumulation by the cells following the addition of vasopressin. Fluorescent ratio imaging with fura-2 revealed that addition of vasopressin to the cells results in an increase of [Ca2+]i which peaks within 20 s and does not return to resting levels during the 100 s observation period. The addition of a Ca2+ ionophore mimicked the vasopressin-induced efflux from the cells. 5-Nitro-2-(3-phenylpropylamino)-benzoic acid (NPPB) and a chloro-substituted compound (cpd 149) inhibited the vasopressin-stimulated 125I efflux from the cells. The concentrations of NPPB and cpd 149 required to inhibit 125I efflux from the cells were similar to those which also attenuated vasopressin-induced Ca2+ transients in the cells. NPPB and cpd 149 had no effects on the ionomycin stimulated efflux. The mechanism(s) by which cpd 149 exerts its effect on stimulated efflux was examined by measuring its action on vasopressin-induced changes in IP3. Compound 149 inhibited IP3 generation in response to vasopressin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Concordance of different measures of nicotine dependence: two pilot studies.

Two samples of adult daily smokers completed a structured interview to determine nicotine dependence according to generic (DSM-IV/ICD-10), Fagerström [Fagerström Tolerance Questionnaire (FTQ), Fagerström Test for Nicotine Dependence (FTND), Heavy Smoking Index (HSI), and time to first cigarette after awakening (TFC)], consumption [e.g., cigarettes/day (CPD)], and self-rating (e.g., "how addicted are you") measures. One sample was a population-based sample of 43 smokers from the Vermont site of the DSM-IV field trial for substance use disorders. The other sample consisted of 50 smokers evenly distributed across a wide range of CPD to study biochemical markers of smokers. In the first study, DSM/ICD criteria were only slightly correlated with Fagerström (r =.24-.35) and consumption (r =.06-0.33) criteria. Self-rating criteria were correlated moderately with most other criteria (r =.24-.60). In the second study, generic, Fagerström, and self-rating criteria increased with increasing CPD up to 30 CPD but not thereafter. One interpretation of these results is that generic, Fagerström, consumption, and self-rating criteria each tap different aspects of nicotine dependence.

Adult↗

Evaluating the effects of spatial frequency on migraines by using pattern-reversal visual evoked potentials.

OBJECTIVE: To clarify the effects of contrast and spatial frequency in patients with migraine by means of pattern-reversal visual evoked potentials (PVEPs). METHODS: PVEPs were obtained from 14 patients who had migraine without aura (MO), 11 patients who had migraine with aura (MA), and 25 age-matched, healthy controls (CO). PVEPs were binocularly recorded with a reversal rate of 1Hz (2 reversal/s) at 3 spatial frequencies (0.5, 1.0 and 4.0 cpd) at high (98%), medium (83%) and low (29%) contrast. N75, P100 and N135 latency and the amplitudes of P50-N75, N75-P100 and P100-N135 were analyzed. RESULTS: Increased amplitude of PVEPs in patients with migraines were revealed at 3 different spatial frequencies in all components. The MO and the MA showed increased amplitudes mostly in high contrasts (98%). These findings were detected more at a high spatial frequency (4.0 cpd) than at a low spatial frequency (0.5 cpd). Increased amplitude with prolonged latency of N135 were found both in MO and MA at 4.0 cpd. CONCLUSIONS: We conclude that pattern stimuli of high contrasts may be particularly effective in uncovering abnormal cortical reactivity which may be modified in the primary and secondary visual cortex in the interictal state of migraine. SIGNIFICANCE: These findings indicate that there is abnormal visual cortex processing in patients with migraine.

Adult↗

Binding of MutS mismatch repair protein to DNA containing UV photoproducts, "mismatched" opposite Watson--Crick and novel nucleotides, in different DNA sequence contexts.

Mismatch-repair (MMR) systems suppress mutation via correction of DNA replication errors (base-mispairs) and responses to mutagenic DNA lesions. Selective binding of mismatched or damaged DNA by MutS-homolog proteins-bacterial MutS, eukaryotic MSH2.MSH6 (MutSalpha) and MSH2.MSH3-initiates mismatch-correction pathways and responses to lesions, and may cumulatively increase discrimination at downstream steps. MutS-homolog binding selectivity and the well-known but poorly understood effects of DNA-sequence contexts on recognition may thus be primary determinants of MMR specificity and efficiency. MMR processes that modulate UV mutagenesis might begin with selective binding by MutS homologs of "mismatched" T[CPD]T/AG and T[6--4]T/AG photoproducts, reported previously for hMutSalpha and described here for E. coli MutS protein. If MMR suppresses UV mutagenesis by acting directly on pre-mutagenic products of replicative bypass, mismatched photoproducts should be recognized in most DNA-sequence contexts. In three of four contexts tested here (three substantially different), T[CPD]T/AG was bound only slightly better by MutS than was T[CPD]T/AA or homoduplex DNA; only one of two contexts tested promoted selective binding of T[6--4]T/AG. Although the T:G pairs in T[CPD]T/AG and T/G both adopt wobble conformations, MutS bound T/G well in all contexts (K(1/2) 2.1--2.9 nM). Thus, MutS appears to select the two mismatches by different mechanisms. NMR analyses elsewhere suggest that in the (highly distorted) T[6--4]T/AG a forked H-bond between O2 of the 3' thymine and the ring 1-imino and exocyclic 2-amino guanine protons stabilizes a novel planar structure not possible in T[6--4]T/AA. Replacement of G by purines lacking one (inosine, 2-aminopurine) or both (nebularine) protons markedly reduced or eliminated selective MutS binding, as predicted. Previous studies and the work here, taken together, suggest that in only about half of DNA sequence contexts could MutS (and presumably MutSalpha) selectively bind mismatched UV photoproducts and directly suppress UV mutagenesis.

Adenosine Triphosphatases↗

Improved functional vision with a modified prolate intraocular lens.

PURPOSE: To evaluate whether the Tecnis Z9000 intraocular lens (IOL) (Pfizer) with a modified prolate anterior surface provides better quality of vision than a conventional spherical IOL. SETTING: Oregon Eye Institute, Eugene, Oregon, USA. METHODS: Patients presenting for cataract surgery who were randomly assigned to receive a Tecnis Z9000 IOL (Pfizer) or a Sensar OptiEdge AR40e IOL (AMO) in 1 eye were followed for 3 months postoperatively. The patient could elect to have the same type of IOL implanted in the fellow eye. The results of sine-wave grating contrast sensitivity testing under mesopic and photopic conditions were compared interindividually. RESULTS: Monocular comparison was made between the 2 IOL groups, which comprised 15 patients each. The Tecnis IOL provided significantly better contrast sensitivity at 6 cycles per degree (cpd) under photopic conditions and at 1.5 and 3 cpd under mesopic conditions. Seven patients with a Tecnis IOL and 9 patients with an AR40e IOL had subsequent implantation in the fellow eye. In all eyes, including fellow eyes, having IOL implantation, the Tecnis provided significantly better contrast sensitivity at 3 and 6 cpd under photopic conditions and at 1.5, 3, and 6 cpd under mesopic conditions. The mean contrast sensitivity in fellow eyes showed that the Tecnis IOL produced significantly better results at some spatial frequencies. CONCLUSIONS: Results show the Tecnis IOL with a modified prolate anterior surface may produce better contrast sensitivity than a standard spherical IOL under mesopic and photopic conditions. Because contrast sensitivity testing correlates well with functional vision, a goal of future research should be to evaluate patient performance using functional tests such as driving simulation.

Aged↗

Contrast sensitivity after implantation of toric iris-claw lenses in phakic eyes.

PURPOSE: To evaluate the change in contrast sensitivity after implantation of the Verisyse toric phakic intraocular lens (IOL) (AMO) for the correction of myopia with astigmatism. SETTING: Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. METHODS: Eighteen eyes had implantation of an iris-supported toric phakic IOL to correct myopia with astigmatism. The mean preoperative spherical equivalent was -12.65 diopters +/- 3.6 (SD). The contrast sensitivity with best spectacle correction was determined before surgery and 3 months after surgery using the CSV-1000 HGT instrument (Vector Vision Inc.). RESULTS: Three months after IOL implantation, the mean contrast sensitivity had significantly increased from preoperatively at midrange spatial frequencies from 3.2 to 4.4 (6 cycles per degree [cpd]; P = .033) and from 2.4 to 3.7 (12 cpd; P = .032). The differences at spatial frequencies of 3 cpd and 18 cpd were not statistically significant (P = .59 and P = .086, respectively). CONCLUSIONS: Implantation of the Verisyse toric iris-claw lens in phakic eyes to correct high or moderate myopia with astigmatism has the potential to improve contrast vision. The mean contrast sensitivity increased considerably at all spatial frequencies compared with preoperative levels.

Adult↗