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At least 955 records · Page 53Linked to original sources
PubMed2003

Stability of refraction, accommodation, and lens position after implantation of the 1CU accommodating posterior chamber intraocular lens.

PURPOSE: To investigate stability of refraction, anterior chamber depth (ACD), and accommodation up to 12 months after implantation of the 1CU accommodating posterior chamber intraocular lens (PC IOL). SETTING: Department of Ophthalmology, University Erlangen-Nürnberg, Erlangen, Germany. METHODS: In a prospective study, 15 eyes of 15 patients (mean age 62.2 years +/- 13.4 [SD] [range 44 to 86 years]) had phacoemulsification and PC IOL implantation. Distance refraction, accommodative range measured by the near point with an accommodometer, ACD measured with the IOLMaster (Carl Zeiss Meditec), and near visual acuity with best distance correction (Birkhäuser charts at 35 cm) were determined after 3, 6, and 12 months and analyzed for signs of systematic changes. RESULTS: After 3, 6, and 12 months, the mean distance refraction was -0.28 +/- 0.54 diopters (D), -0.29 +/- 0.52 D, and -0.21 +/- 0.54 D, respectively; the mean accommodative range, 1.93 +/- 0.47 D, 1.85 +/- 0.62 D, and 2.02 +/- 0.38 D, respectively; the mean ACD without pharmacological induction of ciliary muscle contraction, 4.40 +/- 0.44 mm, 4.35 +/- 0.50 mm, 4.25 +/- 0.53 mm, respectively; and the mean near visual acuity with best distance correction, 0.41 +/- 0.15, 0.37 +/- 0.12, and 0.39 +/- 0.11, respectively. There were no statistically significant changes in any measurement during the follow-up (P>.1). CONCLUSIONS: Refraction, ACD, and accommodative range remained stable without indication of a systemic trend toward myopia, hyperopia, PC IOL dislocation, or regression of accommodative properties. The 1CU accommodating PC IOL provided stable refraction, accommodation, and PC IOL position for up to 1 year.

Accommodation, Ocular↗
PubMed2003

Successful implementation of a protocol for photorefractive keratectomy in children requiring anesthesia.

PURPOSE: To describe a protocol for treating children with photorefractive keratectomy (PRK) under general anesthesia and to review intraoperative and postoperative complications. SETTING: Institutional academic practice. METHODS: Nine patients between 3 years and 9 years of age were treated with PRK under general anesthesia for anisometropia with unilateral high myopia or high hyperopia and amblyopia of the affected eye. Induction of anesthesia and the surgical procedure were carried out in separate rooms. The laser beam was centered on the entrance pupil, and eye position was monitored throughout the procedure. Specific precautions were taken before and during the procedure to prevent unwanted effects of inhalational anesthetic agents on laser performance. RESULTS: All children did well, with no anesthesia-related or treatment-related complications. CONCLUSIONS: Our protocol for PRK under general anesthesia was effective and efficient in children who were unable to cooperate for the procedure using local anesthesia. It can be adapted for laser in situ keratomileusis and other refractive surgical procedures in children and uncooperative adults.

Amblyopia↗
PubMed2004

Refractive outcomes after bilateral multifocal intraocular lens implantation.

PURPOSE: To evaluate the efficacy and safety of bilateral multifocal intraocular lens (IOL) implantation after cataract surgery. SETTING: Oftalmológico de Valencia-CEOVAL, Valencia, Venezuela. METHODS: This retrospective study evaluated patient charts for the patient selection method, preoperative evaluation, surgical technique, postoperative visual and refractive outcomes, and complications. It included 70 eyes of 35 patients who had lens extraction with bilateral implantation of an Array multifocal IOL. Fourteen eyes of 7 patients had hyperopia with presbyopia, and 56 eyes of 28 patients had cataract. RESULTS: All eyes achieved an uncorrected distance acuity of 20/40 or better and an uncorrected near acuity of J5 or better. Six patients (18%) reported moderate halos, and 22 patients (63%) occasionally wore glasses. CONCLUSION: Bilateral multifocal IOL implantation was effective and safe in cataract and hyperopic patients with presbyopia, providing good uncorrected distance and near acuities.

Aged↗
PubMed1989

Further development of experimental techniques for refilling the lens of animal eyes with a balloon.

Various techniques for experimental refilling of the lens of animal eyes are possible. We describe two new methods: Balloon insertion after endocapsular phacoemulsification and after phacoemulsification with circular capsulorhexis. The feasibility of these techniques was tested in both rabbit eyes and pig cadaver eyes. With organo-silicone gel as the balloon filling material, post-operative refractive changes of up to 4 diopters of residual hyperopia were achieved; accommodation changes were up to -1 diopter. The technique of refilling the lens with a balloon to avoid leakage of filling material warrants further study.

Animals↗
PubMed1996

Comparison of the UniversalKeratome and the Automated Corneal Shaper.

PURPOSE: To compare the morphologic appearance and measurements of in situ keratomileusis performed with the UniversalKeratome (UK) with those done with the Automated Corneal Shaper (ACS). SETTING: Surgical suite within private practice. METHODS: Procedures were performed the same day on mate eye-bank eyes. In situ keratomileusis was done using existing nomograms for each instrument to resect a cap thickness of 160 microns and a myopic resection of 100 microns. Intraocular pressures were increased by inflating the globes with balanced salt solution and were measured with the suction fixation rings in place. The excised caps and stromal resections were measured twice independently after surgery, again after tissue fixation, and then evaluated with light and scanning electron microscopy. RESULTS: No complications were encountered. Compared with the ACS, the UK was easy to set up, use, clean, and take down. Its excised tissue dimensions were greater and more predictable, it resected a concave shaped lenticule (edges imperceptibly blending with the host stroma), and it created a smoother power resection surface and primary resection base. CONCLUSIONS: Smoother, predictable tissue resection, and simple assembly/disassembly and use give the UK an apparent advantage over the ACS. The UK corrects astigmatism and hyperopia by changing the shape of the poly(methyl methacrylate) optical insert.

Aged↗
PubMed1997

Photodynamic biologic tissue glue to enhance corneal wound healing after radial keratotomy.

PURPOSE: To evaluate the effect of photodynamic biologic tissue glue (PBTG) on corneal wound healing after radial keratotomy (RK). SETTING: Cornea Research Laboratory, The University of Chicago, Chicago, Illinois, USA. METHODS: Bidirectional, eight-incision RK was done in one eye of eight Dutch pigmented rabbits. Then, PBTG was inserted into the RK incisions and activated with an argon blue-green laser in four treatment eyes. The rabbits were divided into three groups: early, in which corneal wound healing was assessed at 1 and 3 weeks; late, in which corneal wound healing was assessed at 8 weeks; enhancement. RESULTS: The PBTG-treated keratotomy wounds had a more prominent epithelial healing response immediately after RK and a decreased propensity for wound dehiscence. Collagen fiber arrangement in the PBTG-treated incisions was sagittal to the keratotomy wound 1 to 3 weeks after RK and then changed to a transverse orientation across the keratotomy wound by 8 weeks. The control keratotomy wounds had a less prominent epithelial healing response and developed late disorganization of the posterior keratotomy wound at 8 weeks. Keratometry measurements 2 months after RK showed corneal flattening of 1.0 diopter (D) in the PBTG-treated eye and 6.5 D in the control eye, which is consistent with histologic studies showing more advanced wound healing in the PBTG-treated eyes. After RK enhancement, the PBTG-treated eye resisted further corneal flattening and had 4.5 D of corneal steepening; the control eye had 2.0 D of additional corneal flattening. CONCLUSION: The nontoxic, laser-activated adhesive PBTG accelerated corneal wound healing after RK and simulated the placement of sutures into the RK wound. Thus, PBTG may be an alternative to sutures to correct hyperopia after RK in humans.

Animals↗
PubMed1998

Complications of photorefractive keratectomy for myopia: two year follow-up of 3000 cases.

PURPOSE: To evaluate the results and complications of photorefractive keratectomy (PRK) for myopia. SETTING: Alicante Institute of Ophthalmology, University of Alicante, Spain. METHODS: This prospective study evaluated the results and complications of the first 3000 cases of PRK performed with a VISX Twenty-Twenty excimer laser. Myopia ranged from -1.0 to -14.0 diopters (D) and astigmatism, from -1.0 to -5.0 D. Follow-up was 2 years. RESULTS: Ten eyes (0.7%) lost two or more lines of best corrected visual acuity 1 year after surgery. Retreatment for undercorrection or regression was done in 7.41% in the low myopia group and 38.69% in the high myopia group. Central islands, which could be detected only on videokeratoscopy, occurred frequently but influenced the refractive and visual outcomes in few cases. Severe haze was present in 17 eyes only after 1 year follow-up. There were no cases of progressive hyperopia. Other complications such as eccentric ablation producing astigmatism (n = 15), delayed re-epithelialization, or recurrent corneal erosion were rare. CONCLUSION: There were few complications after PRK in 3000 eyes. With proper patient selection, PRK can be considered relatively safe compared with other refractive procedures.

Adult↗
PubMed1999

Evaluation of relationships among refractive and topographic parameters.

PURPOSE: To examine the relationships among several refractive and topographic parameters. SETTING: Cullen Eye Institute Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA. METHODS: Using computerized videokeratography (EyeSys Corneal Analysis System), 287 corneas of 150 patients were retrospectively analyzed. The Holladay Diagnostic Summary (HDS) refractive maps were used to evaluate relationships among variables of the HDS and refractive error. RESULTS: Myopic spherical equivalent refraction (P = .0003) and more negative asphericity (Q-values) (P = .0119) were correlated with steeper corneas. The Q-values were less negative in eyes with moderate myopia (2.0 to 6.0 diopters [D]) than in those with hyperopia (1.0 D or greater). The Q-values below -0.3 were correlated with less favorable values for predicted corneal acuity and corneal uniformity index values. Mean corneal curvature measurements obtained by computerized videokeratography and standard keratometry showed a strong degree of correlation (P = .0001). CONCLUSION: As the degree of myopia and negative asphericity increased, the corneal radius of curvature decreased. Corneal Q-values less than -0.3 were associated with reduced optical performance of the cornea.

Adolescent↗
PubMed1999

Refractive lensectomy to correct ametropia.

PURPOSE: To assess the postoperative outcome of refractive lensectomy for ametropia. SETTING: Pacific Eye Center, Brisbane, Australia. METHODS: One hundred thirty-eight cases of refractive lensectomy performed from September 1994 to September 1997 by 1 surgeon were analyzed retrospectively. Preoperative refractive spherical equivalent (SE) ranged from -0.25 to -23.75 diopters (D) in the myopic group and from +0.25 to +11.62 D in the hyperopic group. In all cases with a low SE, the astigmatism was greater than -2.00 D. Eyes were divided into 6 groups by the preoperative SE. RESULTS: Overall, 90.0% of eyes achieved an uncorrected visual acuity of 20/40 or better; 81.2% achieved 20/30 or better. Postoperative SE was within +/- 2.0 D of emmetropia in 93.5% of eyes and within +/- 1.0 D in 78.3%. The postoperative incidence of retinal detachment was 0.7%; intraocular lens (IOL) exchange, 2.8%; late uveitis, 0.7%; piggyback IOL, 2.1%; and neodymium: YAG capsulotomy, 8.0%. No cystoid macular edema, capsule tear, or endophthalmitis was seen. CONCLUSION: Refractive lensectomy can achieve excellent visual acuity and refractive outcomes with few complications. The surgery can be considered in selected patients with myopia, hyperopia, and astigmatism and to correct residual ametropia after refractive surgery.

Adult↗
PubMed1999

Phototherapeutic keratectomy for treatment of recurrent corneal erosion.

PURPOSE: To study the role of phototherapeutic keratectomy (PTK) in the management of recurrent corneal erosion (RCE) refractory to other forms of treatment. SETTING: The Eye Department of Leicester Royal Infirmary, a tertiary referral center, Leicester, England. METHOD: A retrospective analysis of all patients who had PTK for refractory RCE between July 1994 and October 1998 was performed. The patients were recalled to determine whether they had further symptoms and whether there had been a change in their refractive error or their best corrected visual acuity. RESULTS: Seventy-seven eyes of 68 patients were treated and divided into 3 etiologic groups: trauma, 40 eyes; corneal dystrophy, 24 eyes; and no established cause (idiopathic), 13 eyes. Phototherapeutic keratectomy was combined with photorefractive keratectomy (PRK) in 6 eyes with a good result. A single treatment was performed in 71 eyes (92.2%). No significant refractive change occurred in 67.5% of eyes; 22.1% developed hyperopia (range 0 to +2.0 diopters [D]), and 10.3% developed myopia (range 0 to -1.5 D). Best corrected visual acuity was unchanged in 72.7% of eyes; 11.7% lost 1 Snellen line and 15.5% gained 1 line. There were no symptoms in 68.8% of eyes; in 31.2%, minor symptoms were noted in the morning, and these patients continued to use ocular lubricants at night. CONCLUSION: Phototherapeutic keratectomy is a safe and effective treatment for refractory RCE and, where appropriate, can be combined with PRK.

Adult↗
PubMed2000

Phototherapeutic keratectomy of a corneal scar due to presumed infection after photorefractive keratectomy.

This case involves a 25-year-old patient who suffered from corneal ulceration several days after photorefractive keratectomy (PRK). A central scar developed, resulting in discomfort and reduction in visual acuity. Four months later, the scar was treated by phototherapeutic keratectomy (PTK) (25 microns depth, 5 mm ablation zone). Some scar tissue was left, but it cleared slowly and steadily over the next few years. The induced hyperopia decreased from 5.00 to 1.37 diopters spherical equivalent within 28 months postoperatively. Best corrected visual acuity increased from 20/60 preoperatively to 20/20 at 28 months postoperatively. Surgeons can encourage patients with postinfectious scars after PRK to try at least 1 PTK treatment.

Adult↗
PubMed2003

Disposable and frequent replacement contact lenses.

Disposable and frequent replacement contact lenses dominate the marketplace. They are available in a wide variety of parameters for use in refractive errors, including myopia, hyperopia, astigmatism, and presbyopia. They are convenient and affordable and lend themselves to most wearing modalities, including daily wear, flexible wear, and extended wear for up to 30 days. In addition, they have been shown to be the most trouble-free contact lens wear modality for daily wear or extended wear. They are an appropriate choice for patients who desire occasional contact lens wear and have gained wide acceptance as therapeutic bandage contact lenses. Disposable and frequent replacement lenses will remain important modalities for some time to come as the variety of contact lenses and contact lens parameters that are offered continue to expand. New contact lens varieties, such as the high-Dk silicone hydrogel lenses, will further expand the role of these contact lenses in vision correction.

Contact Lenses↗
PubMed2001

Accommodative esotropia.

Accommodative esotropia is the most common type of strabismus with a very favorable prognosis if the appropriate treatment is initiated promptly. Spectacles remain the preferred treatment, but both contact lenses and refractive surgery may be helpful in some situations to correct the associated hyperopia. Strabismus surgery should only be used if optical correction or refractive surgery are ineffective in restoring normal ocular alignment.

Accommodation, Ocular↗
PubMed2003

Risk factors for abnormal binocular vision after successful alignment of accommodative esotropia.

PURPOSE: The purpose of this study was to identify clinical factors associated with abnormal binocular vision outcomes among children with accommodative esotropia (ET) whose eyes were successfully realigned with spectacles only or with spectacles and surgery. METHODS: The participants were 69 children with accommodative ET who were followed up prospectively from the time of diagnosis. Clinical factors examined in this study included high accommodative convergence-to-accommodation (AC/A) relationship, high hyperopia, anisometropia, age of onset, and duration of eye misalignment. Binocular vision was assessed using measures of stereopsis, fusional vergence, sensory foveal fusion, and motion visual-evoked potential (mVEP). RESULTS: Children with a high AC/A relationship are 2.2 times more likely to have an absence of fusional vergence than are children with a normal AC/A relationship. Children having a duration of constant eye misalignment >/= 4 months before being successfully treated are 4.6 times more likely to have abnormal stereopsis, 33 times more likely to have no stereopsis, 37 times more likely to have an absence of fusional vergence, 31 times more likely to have an absence of sensory foveal fusion, and 17 times more likely to have an asymmetric mVEP response than children with a duration of constant ET diagnosed at 0 to 3 months. CONCLUSIONS: Following successful eye alignment, as many as 75% of patients with accommodative ET had anomalous binocular vision. A high AC/A relationship poses a significant risk for abnormal fusional vergence only. A constant eye misalignment lasting >/= 4 months poses a significant risk for anomalous binocular vision on all measures studied.

Accommodation, Ocular↗
PubMed2001

Accommodative esotropia: an unrecognized cause of hemifacial spasm in children.

Pediatric hemifacial spasm can be a sign of an intracranial tumor. We examined two females, ages 2 and 6 years, who presented with hemifacial spasm as an early sign of accommodative esotropia. Initial ophthalmologic examination disclosed high hyperopia without detectable esotropia. Both children developed an intermittent esotropia over the following month. In the first child, the hemifacial spasm resolved concurrent with the onset of amblyopia. In the second child, spectacle correction produced immediate cessation of the spasms. In both children, squinting to avoid diplopia produced an overflow facial movement that manifested as hemifacial spasm. Accommodative esotropia should be considered in the differential diagnosis of pediatric hemifacial spasm.

Amblyopia↗
PubMed1991

Refractive state, contrast sensitivity, and resolution in the freshwater turtle, Pseudemys scripta elegans, determined by tectal visual-evoked potentials.

Visual-evoked potentials (VEPs) were recorded from the surface of the optic tectum of the freshwater turtle, Pseudemys scripta elegans, in response to phase reversal of square-wave gratings of different spatial frequency and contrast. The refractive state of a group of 12 turtles in air was assessed from VEPs by placing trial lenses in front of the eye. The group mean refraction did not differ significantly from emmetropia, as compared to 4.8 diopters of hyperopia when refracted retinoscopically. The difference was explained by the retinoscopic reflex originating from the interface between vitreous humor and retina. Peak VEP amplitude was approximately linear with log grating contrast; extrapolation to zero VEP amplitude yielded contrast thresholds as low as 1%. High spatial-frequency cutoffs ranged from 4.4-9.9 cycle/deg in different animals, the highest values corresponding to the intercone spacing in the area centralis and to behavioral measures of acuity in a related species.

Adaptation, Ocular↗
PubMedDate not supplied

Clinical heterogeneity between two Japanese siblings with congenital achromatopsia.

Congenital achromatopsia is a stationary retinal disorder with autosomal recessive inheritance. It is characterized by significant attenuation of cone-photoreceptor function. Symptoms include photophobia, nystagmus, and poor visual acuity from birth. Unlike in cone or cone-rod dystrophies, the retinal fundus usually appears normal. Here we describe two siblings with congenital achromatopsia, who exhibit different ophthalmic phenotypes. History was taken, and ophthalmic examinations were performed in a 7-year-old girl and her 5-year-old brother, who were referred to our department because of poor visual acuity. Two of their grandparents were brother and sister, suggesting an autosomal recessive transmission in inheritance. They have been followed for more than 13 years since the initial evaluation. Symptoms, visual acuity, and kinetic visual field were very similar to each other, consistent with findings of typical congenital achromatopsia. However, color-vision tests suggested that the brother had residual color discrimination, but the sister did not. The siblings had different full-field electroretinographic and spectral-sensitivity findings: residual cone functions were detected in only the brother, in agreement with his residual color vision. They also had different findings of retinal fundi and ocular refractions: the sister had bilaterally atrophic-appearing macular lesions and myopic errors. In contrast, the brother remains hyperopia and has exhibited no specific retinal findings until age 18 years. The causes why both complete and incomplete achromats occur in the siblings are uncertain but might be caused by modifying effects of sex-related genes or by environmental factors influencing certain gene regulations in cone photoreceptors.

Child↗
PubMed1998

Autosomal recessive cornea plana. A clinical and genetic study of 78 cases in Finland.

PURPOSE: To review the literature of autosomal recessive cornea plana (RCP) and to perform a clinical and genetic study on this disorder in Finland. The 78 Finnish RCP patients represent the majority of RCP cases worldwide; outside Finland only 35 cases have been reported. METHODS: Families with RCP, particularly in northern Finland, have been followed up by the senior author since the 1950s and extensive genealogical studies have been made. RESULTS: The most typical symptoms are greatly reduced corneal refraction, 25-35 dioptres, causing strong hyperopia, slight microcornea, an extended limbus zone, a central, deep corneal opacity and a marked arcus senilis, seen even before the age of 20. We present a pedigree comprising 33 affected persons with cornea plana. We have mapped the two genes for the dominantly and the recessively inherited type of cornea plana to the same region on the long arm of chromosome 12, (12q21). CONCLUSIONS: In northern Finland RCP has a higher frequency than elsewhere, probably as a result of a strong founder effect in the population that arrived in these regions approx. 400 years ago. The strong accumulation of this rare disease in these isolated areas and the strong genealogical connections between different families with RCP, suggest that probably all the Finnish RCP cases are caused by the same mutation.

Adolescent↗