[The role of peripheral iridectomy in retinal detachment in aphakia and pseudo-aphakia].
Explore the source record for details and available documents.
Aphakia, Postcataract↗
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.
[The macular edema of aphakia and pseudo-aphakia].
Explore the source record for details and available documents.
Animals↗
[Aniseikonia and intraocular optics in aphakia and pseudophakia. 2: Aniseikonia and intraocular optics in aphakia].
Explore the source record for details and available documents.
Aniseikonia↗
Epikeratoplasty for adult and pediatric aphakia, myopia, and keratoconus: the Massachusetts Eye and Ear Infirmary experience.
Between February, 1985 and February, 1987, 49 eyes of 47 patients underwent epikeratoplasty for one of the following indications: adult aphakia (21 eyes; 20 patients), pediatric aphakia (10 eyes; 10 patients), myopia (7 eyes; 6 patients), and keratoconus (11 eyes; 11 patients). Follow-up at least 12 months (average = 18 months) is available for all 49 eyes. Of 49 eyes, 44 (90%) were anatomically successful with an intact, clear lenticule at least 12 months post-operatively, with no significant difference between the four groups (adult aphakia = 90%, pediatric aphakia = 90%, myopia = 86%, and keratoconus = 91%). The functional success rate, however, was 91% for keratoconus, 81% for adult aphakia, 80% for pediatric aphakia, and only 43% for myopia. We conclude that epikeratoplasty can be an effective tool in the treatment of carefully selected patients with adult or pediatric aphakia and keratoconus, but has only limited applicability in the management of myopia.
Adult↗
Abnormal accumulation of sulphated materials in lens tissue of mice with the aphakia mutation.
Sulphated materials were tested for in the eyes of late gestational and postnatal normal mice and mice with the aphakia mutation using Spicer's high iron diamine staining method. Qualitative identification of these materials was attempted with bovine testicular hyaluronidase and nitrous acid digestion methods. The grossly abnormal morphology of the aphakia lens made it necessary to confirm identification of lens-derived tissue by testing for lens crystallins using standard immunohistological methods. As seen in normal mouse lens maturation, accumulated inter- and intracellular sulphated materials were observed in aphakia lens tissue from just before birth through juvenile maturation. Large cyst-like structures consisting of lens-derived tissue were commonly seen in the eyes of young postnatal mutant mice. Sulphated materials formed basal lamina-like structures on many of these lens-derived units, but a well-defined lens capsule never formed. Abnormal fibrillar structures rich in sulphated materials were seen in the intraocular cavity in many older mutant specimens, most of which were largely resistant to both digestion methods. These results indicate that the potential to elaborate sulphated materials qualitatively similar to those seen in normal mouse lens maturation is present in the aphakia mutant, although the mode of accumulation is grossly disturbed.
Animals↗
[Intra-ocular optics and contact lens correction in unilateral aphakia].
After an explanation of intra-ocular optics, the first results of combined contact lens correction in 42 patients are reported. As opposed to the conventional type of contact lens treatment in monolateral aphakia, this method has four main advantages: 1. It enables practically identical sight in both eyes, thus providing the necessary conditions for binocular vision both at a distance and close-up. 2. The recovery of sensomotor haptics in both eyes prevents squinting, even in the case of incipient cataract of the other eye. 3. Premature lens extraction in the second eye can be postponed and delay in lens extraction in the first affected eye can be avoided. 4. In cases where dioptric aniseikonia is very marked, as in myopia, a bilateral spectacle-contact lens combination enables tolerable binocular vision to be achieved even without an aniseikonic lens. Our findings indicate that the conventional contact-lens correction of monolateral aphakia is never satisfactory in cases with a moderate to high degree of myopia and in all refraction defects in young patients. Echometry, objective measurement of aniseikonia and combined contact lens correction helps most of these patients to regain binocular vision, both close-up and at a distance. In practice, rules of thumb and principles can be established. Even without the aid of echometry and objective aniseikonic measurement, Rule 1 enables us to prescribe combined contact lens correction for 80% of all presbyopic patients, thus enabling them to regain comfortable binocular vision. We all know that monolateral aphakia is, unfortunately, no triumph of ophthalmological science, but rather a serious eye defect that we must correct as best we can. Conventional contact lens correction, delay in operation for cataract of the first affected eye, as well as premature operation of the second eye are, in many cases, of as little help to our patients as monolateral cataract spectacles, with occlusion of the healthy eye with normal or dark glass. In contrast, combined contact lens correction in many cases of monolateral aphakia enables the patient to regain binocular vision.
Adolescent↗
[The judgement of the degree of disability in cases of aphakia and pseudoaphakia (author's transl)].
Since more than 40 years the judgement of the degree of disability in cases of unilateral aphakia is discussed. This means the effort toward an advisory objectivity on the one hand and human understanding for the patient's damage on the other hand. It is supposed to repeal the 4th emergency ordinance of 1932 and to pay pensions below 20% of the degree of disability, too. As long as new legislatory measurements do not exist, the maintenance of a pragmatic authoritative activity is plead for, which assigns for a pension-duty compensation in cases of unilateral aphakia and/or pseudoaphakia independent on the optic result.--The situation in cases of bilateral aphakia is also discussed.
Aphakia↗
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↗
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↗
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↗
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↗
Corneal topography of patients with excellent Snellen visual acuity after epikeratophakia for aphakia.
A computer-based corneal topographic analysis system was used to evaluate the patterns of power distribution in five patients with at least six months of postoperative follow-up who obtained excellent visual and refractive results after epikeratophakia for aphakia. All grafts were well centered relative to the visual axis. The range of surface power seen within the central 5 mm of the individual grafts ranged from 4.00 to 6.50 diopters. Each graft showed a unique, moderately irregular pattern of power distribution. Fair correlation was seen between the expected corneal power and that shown in the power map displays. These data suggest that moderate degrees of irregular astigmatism are compatible with good Snellen visual acuity after epikeratophakia for aphakia, though the effect of this irregularity on visual performance remains unclear.
Aged↗
The nationwide study of epikeratophakia for aphakia in children.
In the nationwide study of epikeratophakia, 97 surgeons performed a total of 335 procedures in 314 eyes for the correction of aphakia in children under the age of 8 years 1 month. Fifteen children underwent bilateral surgery. Thirty-six tissue lenses were removed and 21 of these eyes underwent a second epikeratophakia procedure. Overall, the success rate for procedures was 89%, and with repeated surgery it was 95% for eyes. Seventy-three percent of the patients were within 3 diopters of emmetropia after surgery. Visual acuity results in patients able to provide verbal responses to the illiterate E, Allen card, or Snellen line chart testing showed improvement in most cases. The safety of epikeratophakia makes it a desirable option for the correction of aphakia in children who are spectacle or contact-lens intolerant, and the permanence of the correction eliminates the problem of optical noncompliance.
Aphakia↗
Hard contact lens corrections in aphakia.
Hard contact lens correction of aphakia is best performed with a single cut lens by a trial lens fitting. Lenticular design may be necessary. Continuous wear over age 70 may be necessary to achieve success and acceptance in more than 30% of aphakic wearers. Soft lenses are usually not practical in the author's experience. The increased use of intraocular lenses is decreasing the need for aphakic contact lenses. Merits of the hard contact lens in aphakia are discussed as a practical approach to the correction of vision by the ophthalmologist, and indications for single cut lenses and lenticular design are outlined.
Age Factors↗
Extended-wear contact lens correction of aphakia in infant primates. Corneal studies.
Extended-wear contact lenses (EWCL) are being used increasingly for the correction of aphakia in infants, but there is a lack of data documenting their effects on the corneas of young children. Therefore, corneal studies were performed on infant monkeys wearing EWCL for the correction of surgical aphakia. Nine newborn monkeys underwent unilateral lensectomy and anterior vitrectomy. Seven eyes were fitted with aphakic EWCL postoperatively and two wore no lenses. After at least six months, corneas were studied with slit-lamp and specular microscopy, and with light microscopy (LM) and electron microscopy (EM). Small central corneal opacities developed in two aphakic eyes corrected with EWCL after episodes of keratoconjunctivitis. One of these corneas was found to have a mildly increased coefficient of variation (CV) of endothelial cell size (polymegathism). Although EWCL are well tolerated by the corneas of aphakic infant primates, their association with endothelial polymegathism, which may indicate physiologic compromise, mandates careful long-term follow-up.
Animals↗
Synthetic keratophakia for the correction of aphakia.
Although the majority of aphakic patients will have intraocular lens implants (IOLs), there are several groups of patients for whom IOLs are not indicated. Synthetic keratophakia for the correction of aphakia has several inherent advantages over alternative forms of refractive surgery which use lathed corneal tissue. For example, the ability to produce a synthetic lens to precise specifications before surgery is a dramatic advantage over the use of lathed tissue lenses whose refractive properties cannot be determined until weeks or months after the lens is in place on the recipient cornea. Synthetic materials appear to behave in a predictable manner and are biocompatible. Both polysulfones and hydrogel materials can be used to correct aphakia in clinical situations where other modalities are less appropriate.
Animals↗
Extended-wear contact lenses for the treatment of pediatric aphakia.
The practicality of extended-wear contact lenses in the refractive correction of pediatric aphakia was assessed with 240 eyes in 184 patients. Patient ages at the time of contact lens fitting ranged from 18 days to 9.8 years. One hundred forty-one eyes were fit from 1 day to 55 months postoperatively and then followed for 6 months to 5.7 years (average, 29 months). Only five patients lost more than five lenses. The overall loss rate was less than one lens per year of follow-up. No patient had contact lens-related complications with permanent visual sequelae. Only 14% of patients had contact lens problems or factors related to parental inability to care for the lens which resulted in discontinuation of contact lens therapy. The authors were unable to identify any subset of patients who should be considered for primary surgical optical correction of their aphakia.
Aphakia, Postcataract↗
The correction of aphakia in infants with hydrogel extended-wear contact lenses. Corneal studies.
Although hydrogel extended-wear contact lenses (EWCLs) have been used extensively in the correction of aphakia in neonates, little is known about the effects of these lenses on infant corneas. Recent studies have demonstrated that long-term contact lenses can induce endothelial morphometric changes, including an increased coefficient of variation (CV) of mean endothelial cell area. Using wide-field specular microscopy, the authors studied 11 eyes of 10 patients, 1 to 3 years of age who, after lensectomy for congenital cataracts, wore EWCLs for the correction of aphakia. Except for two corneas in which increased pachometric readings and CV developed after repeated episodes of lens loss and inflammation, the EWCL were well tolerated and associated with few complications in this study.
Aphakia, Postcataract↗