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At least 127 records · Page 7Linked to original sources
PubMed1999

Black iris-diaphragm intraocular lens for aniridia and aphakia.

We present the first reported use in the United States of a black iris-diaphragm intraocular lens (IOL) for the treatment of traumatic aniridia and aphakic bullous keratopathy. The patient presented to a university-based practice with contact-lens-intolerant aniridia and aphakia with painful bullous keratopathy from a failed corneal graft. He was treated with combined penetrating keratoplasty and transscleral fixation of an aniridia IOL. The patient's preoperative symptoms of debilitating glare and photophobia resolved substantially after surgery, despite mild postoperative inflammation that resolved. The symptoms associated with aniridia can be successfully treated with a black iris-diaphragm IOL; however, chronic low-grade inflammation has been reported with its use in some cases.

Adult↗
PubMed1998

Visual outcomes after surgery for unilateral cataract in children more than two years old: posterior chamber intraocular lens implantation versus contact lens correction of aphakia.

PURPOSE: We sought to determine whether posterior chamber intraocular lens implantation yields better visual acuity and binocular vision than does conventional contact lens correction of aphakia in similar groups of pediatric cataract patients. METHODS: We reviewed the medical records of children aged 2 to 16 years who had unilateral cataract surgery by a single pediatric ophthalmologist between 1986 and 1996. Before 1992 all patients underwent standard lensectomy with vitrectomy. Beginning in 1992 posterior chamber intraocular lens (IOL) implantation was offered as a choice to families and was performed on most patients. RESULTS: Monocular vision outcomes were not significantly different in 20 IOL and 31 lensectomy-vitrectomy patients, with 85% of the IOL group and 77% of the lensectomy-vitrectomy group showing better than 20/100 final acuity. Binocularity, however, was much better in the IOL group, with 90% demonstrating at least 400 seconds of arc stereopsis, as opposed to 39% in the lensectomy-vitrectomy group (p = 0.003). Subgroups of patients with traumatic or nontraumatic cataract origin, age at surgery less than 7 years, and preoperative visual acuity less than 20/100 compared very similarly. CONCLUSION: Posterior chamber IOL implantation appears to provide significantly better binocular function than conventional management of unilateral cataract in childhood but does not substantially improve visual acuity results.

Adolescent↗
PubMed1990

The use of contact lenses to correct aphakia in a clinical trial of cataract management.

In a prospective study, 110 eligible patients (111 eyes) were randomly selected to have contact lenses for aphakia (CL). The lens of first choice was a daily-wear hard (DWH) PMMA contact lens. Extended-wear (XW) lenses were fitted to those who failed with DWH lenses. The numbers in the two groups were approximately equal. Eighty per cent of eyes were successfully wearing CLs six months post-operatively and 72% were still wearing them after five years. The mean age of both groups of patients was greater than 70 years but the DWH group was significantly younger (p less than 0.001). However, XW lens wearers suffered more serious complications, needed more follow-up and more lens replacements. There were also more drop-outs from the XW group compared to the DWH group.

Aged↗
PubMed1991

Binocular diplopia in unilateral aphakia: the role of botulinum toxin.

We have treated 12 unilaterally aphakic patients, with a manifest squint and binocular diplopia, with botulinum toxin injection to the appropriate horizontal rectus muscle, in an attempt to reduce the angle of squint and thereby resolve the diplopia. In all cases a short-term reduction in the angle of squint was achieved. In nine patients, whose aphakia was corrected with a contact lens, and eight of whom had had their lenses removed because of trauma, this reduction was only temporary. In three patients, however, who had had a non-traumatic cataract removed, replaced with a posterior chamber implant, control of the deviation was maintained long after the acute effect of the toxin had disappeared, with the development of coarse binocular single vision, a fusion range, and abolition of all diplopia. The possible reasons for these different responses are discussed and it is suggested that in cases of binocular diplopia following lens extraction, botulinum toxin treatment should be considered prior to any extraocular muscle surgery, as temporary reduction of the deviation may be sufficient to allow recovery of binocular single vision.

Adolescent↗
PubMed2002

Use of contact lenses to correct aphakia in children.

BACKGROUND: Contact lenses play an important role in the management of childhood aphakia. However, the use and care of the lenses can be challenging. The aim of this study was to determine how parents coped and what problems they encountered. METHODS: Thirty-one families of aphakic children who were fitted with contact lenses between 1990 and 1997 were contacted and invited to participate in a telephone survey. RESULTS: Thirty families agreed to participate. Eighteen families (60%) were still using contact lenses successfully at the time of the study. Four families (13.3%) stopped using contact lenses within a year because of overwhelming difficulties handling the lenses. There was an initial learn-ing process that was often stressful and frustrating. The learning curve lasted from 1 to 24 months (first quartile 2.0 months; median 3.3 months; third quartile 15.0 months). The personality of the parent, temperament of the child and the frequency at which problems occurred may all have contributed to how each family coped with the lenses. Common initial problems included inserting the lenses into the eyes of an uncooperative child and the loss of lenses. Other problems included irritation associated with dryness, and the financial cost of maintaining the lenses. CONCLUSION: Although most parents initially found contact lenses daunting, 70% of families surveyed eventually learned to cope well. Parents felt that proper education of both parents and children on why the lenses were required, a good appreciation of problems that may occur, a strong social support network and adequate financial aid were important factors in learning to cope.

Adaptation, Psychological↗
PubMed1995

[Sandwich intraocular lens implant: a concept for aphakia correction in children].

BACKGROUND: In the management of congenital cataracts the correction of aphakia is still an unsatisfactorily solved problem. As far as surgical techniques and materials are concerned, the implantation of an IOL seems to be justified even in younger children; but choosing the refractive power of the lens is somewhat difficult regarding the expected growth of the eye. MATERIALS AND METHODS: A new type of IOL is presented as a solution for this problem. Being composed of a PMMA-fashioned optic and haptic it bears a silicone lens which is fastened on top of it. The supporting lens is made of PMMA (polymethylmethacrylate) with a biconvex surface with modified J-loops. The diameter of the optic is 6 mm, the overall diameter is 11 mm. The supplementary lens is made of the same silicone material as used for foldable intraocular lenses. Its diameter is 4.5 mm. This additional component can be removed from the implanted lens so that the needed reduction of refractive power after completed growth of the eye can be performed. The PMMA-fashioned basic component remains in situ just like a conventional posterior chamber lens. The lens was examined using scanning-electron microscopy. Im- and explantation was performed in isolated porcine eyes. RESULTS: The high quality of the lens could be demonstrated using scanning-electron microscopy. The technical feasibility of this concept could be demonstrated on isolated porcine eyes. DISCUSSION: Currently the sandwich lens is being tested in animal experiments. Our special interest is focussed on biocompatibility, formation of secondary cataract, biological reactions in the interface and the possibility of atraumatic explantation of the silicone lens.

Aphakia, Postcataract↗
PubMed1987

[Principles in correcting unilateral aphakia to preserve binocular functions].

A new concept for correcting unilateral aphakia has been developed for patients able to accommodate. This concept is based on the investigations of binocular tolerance observed in aniseikonia. The test method for binocularity should have a retinal image of adequate size and should respond sensitively to limitation of vertical disparity. These criteria are satisfied by the TNO test for stereopsis. The retinal image size can be assessed using a spectacle-contact lens combination similar to an inverted Galilean telescope system. The image size can be reduced as long as the patient perceives positive stereopsis by the TNO test. Some typical cases are discussed. In patients who had had conventional contact lenses fitted more than 2 years previously it was no longer possible to obtain positive TNO values.

Aniseikonia↗
PubMed1983

[Experiences with secondary implantation of the Choyce Mark IX anterior chamber lens in unilateral aphakia].

Choyce Mark IX lenses were implanted in 72 patients between 71 and 86 years of age suffering from unilateral aphakia, who could not be helped with contact lenses; 38 of the patients were observed for a period of more than 16 months. The lenses were attached in the angle of the anterior chamber. None of the patients showed signs of the previously feared complications such as corneal decompensation, secondary glaucoma or iridocyclitis. The Choyce lens is ideally suited for secondary implantation. The operation is simple and post-operative reactions disappear in less than a week. The lens sits firmly in the eye; it cannot be dislodged against the endothelium of the cornea. The pupil is dilatable and its condition is unimportant. There is no contraindication for implantation in cases in which vitreous is present in the anterior chamber. The marked subjective improvement, which all the patients remarked on, is especially worth noting.

Aged↗
PubMed1980

[Ominous retinal changes in aphakia].

Report on examinations of the retinal periphery with a three-mirror contact lens during the first year following cataract operation. Latent retinal defects found in six out of 169 eyes were submitted to active detachment prophylaxis. In two eyes manifest retinal detachment was discovered and treated successfully. During the same period we saw seven patients with aphakia and retinal detachment who had undergone cataract surgery up to 13 years previously. In these cases too, anatomic healing was achieved, although in some cases several interventions were necessary and the result was functionally useful only in five cases. Therefore, the author urges that a biomicroscopic examination of the fundus periphery be performed at the latest during the first six months following cataract operation.

Aged↗
PubMed1986

Schematic eye predictions of relative spectacle magnification in unilateral aphakia.

Computer ray tracing provides a simple technique for investigating binocular relative spectacle magnification (BRSM) in the patient with unilateral aphakia. BRSM is defined as the retinal image size in the corrected aphakic eye relative to the retinal image size in the corrected phakic eye. The influence of preoperative ametropia and the mode of correction on BRSM is investigated, using Gullstrand's number 2 schematic eye as a model.

Aphakia↗
PubMed1994

S-cone sensitivity in unilateral aphakia.

BACKGROUND: Exposure to ultraviolet radiation (UVR) and blue light has been shown to cause retinal damage in animals. In humans, it has been argued that the loss of short-wavelength (S) cone sensitivity during normal aging may be related to chronic light exposure. METHODS: We measured sensitivity to blue and yellow lights presented on bright yellow backgrounds at several retinal eccentricities in both eyes of an observer with long-standing unilateral aphakia. RESULTS: For yellow lights, where media absorption is not a major factor, there was a 2-fold loss in sensitivity of long (L) and medium (M) wavelength cone mechanisms in the aphakic eye relative to the phakic eye. For blue lights detected by S-cones, there was a 10-fold loss of S-cone mechanism sensitivity in the aphakic eye, after differences in ocular media density were taken into account. CONCLUSIONS: Our findings strongly support the hypothesis that chronic exposure to short wavelength radiation impairs S-cone function.

Adult↗
PubMed1984

The use of extended wear contact lenses in aphakia.

Guidelines for the selection and fitting of extended wear contact lenses in aphakia are presented. Important points in the management and the visual results of patients with these lenses are discussed.

Aphakia↗
PubMed1980

Traumatic aniridia and aphakia with scleral buckling: a case report.

A case is reported of a young man in whom blunt injury caused a horizontal corneal tear superiorly. Aniridia, aphakia, cyclodialysis with angle recession, minimal hyphaema, vitreous haemorrhage, choroidal rupture and striae, and scleral buckling resulted. Vision improved to 6/12+.

Adult↗
PubMed1988

Cyclic esotropia in a patient with unilateral traumatic aphakia: case report.

Cyclic esotropia is a rare and poorly understood condition normally treated by correcting the deviation measured on the squinting day. Control in some patients with this condition can be gained by correcting their refractive errors, thereby improving acuity. We report on an adult patient who developed cyclic esotropia after unilateral traumatic aphakia with failed contact lens wear whose squint was corrected by secondary intraocular lens implantation. This may be explained by the reduction in the degree of aneisokonia which subsequently improved steropsis.

Adult↗
PubMed1990

Epikeratophakia for aphakia, keratoconus, and myopia.

A series of 67 cases of epikeratophakia is presented with an average time from surgery of 12.2 months. For aphakia there was a delay in the recovery of vision, but by nine months 83% of 57 patients achieved an acuity equal to, or within 1 line of, the preoperative value. 57% were corrected to within 3 dioptres of emmetropia, but in the latter part of the series 75% were within this range. Astigmatism and reduced contrast sensitivity, especially in the presence of glare, were important complications. For keratoconus, 86% of seven patients with over two months of follow-up achieved a spectacle corrected acuity of 6/9 or better. One patient had surgery for myopia and obtained the desired refractive correction.

Adolescent↗
PubMed1978

[Peripheral retinal lesions in aphakia].

The peripheral retina of 150 aphakic eyes with uncomplicated extraction was studied with the Goldmann three-mirror contact lens. The patients were examined 1 month to more than 2 years after cataract extraction. In addition to degenerations which are descirbed everywhere and are seen both in phakic and aphakic eyes, the authoris have emphasized lesions which they consider to be specific of aphakia. These lesions are retinal haemorrhages of wich four types are described; pigmentary anomalies and retinal tears and holes. Taking into consideration the great frequency of aphakic retinal detachment in comparison with phakic detachment, it is evident that such lesions must be held liable in aphakic retinal detachment.

Adult↗
PubMed1978

[The vitreous in aphakia].

The authors have studied the vitreous in 150 aphakic eyes after uneventful operations. They were examined by the slit-lamp and the Goldmann three-mirror glass. Two types of lesions were revealed: (1) 42% showed rupture of the anterior hyaloid membrane; this is not considered dangerous. (2) 69.3% showed posterior detachment of the vitreous, a more serious lesion. It is often associated with retinal lesions such as haemorrhage, pigmentary anomalies, and retinal tears. In view of such lesions, one cannot consider the aphakic patient as a normal subject and aphakia as a physiological condition. The frequency of retinal detachment in the aphakic bears witness to it.

Adult↗