1/4. Optical and atomic force microscopy of an explanted AcrySof intraocular lens with glistenings.PURPOSE: To assess the surface morphology and cause of glistenings in an explanted AcrySof intraocular lens (IOL). SETTING: Shakai Hoken Kobe Central Hospital, Kobe, japan. methods: A 63-year-old Japanese man had implantation of an AcrySof IOL in the capsular bag. One month postoperatively, he had a neodymium:YAG laser capsulotomy for posterior capsule opacification, which changed the IOL's position in the capsular bag. A few months later, the patient developed disabling night glare from intralenticular glistenings and progressive hyperopic refractive error. The IOL was explanted and then analyzed by optical microscopy and atomic force microscopy (AFM). Laboratory analysis of control AcrySof IOLs kept in a balanced salt solution at steady room and body temperature for 2 months was also performed to evaluate the cause of the glistenings observed clinically. RESULTS: Optical microscopy showed that the explanted AcrySof IOL had several microvacuoles; no abnormalities were observed in the control AcrySof IOLs before or after folding at the room and body temperatures. The AFM analysis showed a significant change in the surface morphology of the explanted IOL, including vacuolar formations in the posterior surface as well as numerous anterior surface irregularities. No microvacuoles or surface morphology alterations were observed in the control AcrySof IOLs by AFM analysis. CONCLUSIONS: The glistenings in the explanted AcrySof IOL were likely caused by temperature changes and not mechanical stress from folding.- - - - - - - - - - ranking = 1keywords = refractive error, error (Clic here for more details about this article) |
2/4. Piggyback intraocular lens implantation to correct myopic pseudophakic refractive error after penetrating keratoplasty.PURPOSE: To determine the safety and efficacy of implanting a second intraocular lens (IOL) to correct myopic pseudophakic refractive error after penetrating keratoplasty (PKP). SETTING: Department of ophthalmology, Toronto Western Hospital, Toronto, ontario, canada. methods: In this retrospective case series, 6 eyes of 6 post-PKP pseudophakic patients had a second piggyback IOL implantation to correct a residual myopic refractive error. The uncorrected visual acuity (UCVA) and the best corrected visual acuity (BCVA) were measured at regular intervals during a 7-month follow-up. Efficacy was determined by the achieved refractive correction and Snellen UCVA measurements. safety was measured by loss of BCVA and complications (intraoperative and postoperative). RESULTS: The UCVA improved in all cases. Five patients achieved a BCVA of 20/40 or better postoperatively. Before surgery, the mean spherical equivalent (SE) was -8.08 diopters (D) (range -6.13 to -12.00 D). After surgery, the mean SE was -0.94 D (range -2.38 to 0.25 D). Four patients were within /-1.50 D of emmetropia. There were no intraoperative or postoperative complications. CONCLUSION: Implanting a piggyback IOL was a safe and effective means of correcting myopic pseudophakic refractive error post PKP.- - - - - - - - - - ranking = 7keywords = refractive error, error (Clic here for more details about this article) |
3/4. Secondary artisan phakic intraocular lens for correction of progressive high myopia in a pseudophakic child.An 8-week-old infant underwent unilateral cataract extraction and posterior chamber intraocular lens implantation for total cataract in the left eye. After surgery, a residual progressive myopic error was observed, ranging from -4.5 diopters (D) 6 months after the operation to -14.0 D at the age of 3 years. Because of parental noncompliance for contact lens and spectacles use, secondary implantation of Artisan phakic IOL of -14.0 D power was performed. No intra- or postoperative complications were observed. Nine months after this second operation, myopia diminished to -3.25 D.- - - - - - - - - - ranking = 0.00077880115657216keywords = error (Clic here for more details about this article) |
4/4. Implantation of verisyse phakic intraocular lens to correct myopic refractive error after penetrating keratoplasty in pseudophakic eyes.PURPOSE: We report 2 cases in which a Verisyse phakic intraocular lens (PIOL) was used to successfully treat high myopia after penetrating keratoplasty (PK) in pseudophakic patients. methods: Case 1 involved a 69-year-old pseudophakic man with a manifest refraction (MR) of -6.50 1.75 x 048 and a best spectacle corrected visual acuity (BSCVA) of 20/40 approximately 16 months after PK in the right eye. Case 2 was a 78-year-old pseudophakic man who had an MR of -9.00 5.75 x 132 with a BSCVA of 20/100 approximately 24 months after PK in the left eye. RESULTS: In case 1, 10 months after Verisyse PIOL implantation, the MR was pl 2.00 x 135 with a BSCVA of 20/30. Endothelial cell density (ECD) in this patient decreased from 1926.1 to 815.3 cells/mm over 17 months. In case 2, 24 months after Verisyse PIOL implantation, the MR was -3.25 3.50 x 105 with a BSCVA of 20/60. ECD in this patient decreased from 2108.4 to 753.8 cells/mm in 30 months. CONCLUSION: The Verisyse PIOL may provide an alternative method to correct high myopia for anisometropia in pseudophakic patients after PK. In this report, PIOL implantation was associated with a decrease in ECD. Further studies are required to determine the long-term effects and ultimate safety of PIOL placement on the integrity of the cornea endothelium after corneal transplant in pseudophakic patients.- - - - - - - - - - ranking = 4keywords = refractive error, error (Clic here for more details about this article) |