The capsular tension ring (CTR) is a useful aid in cataract surgery involving zonular impairment. In standard implantation with tweezers or injectors, there is limited control of the leading eyelet, and this can cause excessive stress on the zonular fibers and lead to damage of the capsular bag. Several techniques have been investigated with the aim of reducing these risks. In this study, a simple new modification of the suture-guided CTR technique is described. Adding a loop to the suture can facilitate manipulation during implantation and removal of cortex residues at the end of cataract extraction.
- MeSH
- extrakce katarakty * MeSH
- fakoemulzifikace * MeSH
- implantace nitrooční čočky MeSH
- lidé MeSH
- pouzdro oční čočky * chirurgie MeSH
- protézy a implantáty MeSH
- sutura MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: To evaluate the efficacy of epithelium-on photorefractive intrastromal crosslinking (PiXL), a noninvasive procedure to reduce refractive error in patients with low hyperopia. SETTING: Gemini Eye Clinic, Zlin, Czech Republic. DESIGN: Prospective single-center study. METHODS: Twenty-two low hyperopic eyes were enrolled and underwent PiXL treatment according to a standardized treatment protocol. Visual acuity, subjective distance refraction, keratometry, topography, pachymetry, subjective discomfort, and endothelial cell density (ECD) were recorded during 12-month follow-up. RESULTS: In 22 eyes, the median manifest refraction decreased significantly (P < .0001) from +0.75 diopters (D) (interquartile range [IQR], +0.63 to +1.06 D), median and IQR) diopters (D) preoperatively to +0.25 D (IQR, 0.0 to +0.50 D) at 12-month follow-up and remained stable. Seventy-seven percent of eyes achieved refraction within ± 0.50 D of emmetropia by 1 month postoperatively and was stable through 12-month follow-up. ECD was stable and did not show significant changes. There was low incidence of postoperative pain and dry eye. CONCLUSIONS: PiXL is a promising alternative to conventional laser refractive surgeries for low hyperopia. Further studies are warranted to optimize treatment parameters for a wider range of refractive errors and to evaluate the potential to improve precision.
- MeSH
- fotochemoterapie metody MeSH
- fotosenzibilizující látky terapeutické užití MeSH
- hypermetropie farmakoterapie metabolismus patofyziologie MeSH
- kolagen metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- pachymetrie rohovky MeSH
- pilotní projekty MeSH
- prospektivní studie MeSH
- reagencia zkříženě vázaná * MeSH
- refrakce oka fyziologie MeSH
- riboflavin terapeutické užití MeSH
- senioři MeSH
- stroma rohovky účinky léků metabolismus MeSH
- ultrafialové záření MeSH
- výsledek terapie MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: To report the initial experience with a new presbyopic phakic intraocular lens (pIOL) in the correction of high myopia and presbyopia. SETTING: Gemini Eye Clinic, Zlin, Czech Republic. DESIGN: Prospective cohort study. METHODS: Presbyopic eyes with moderate to high myopia were implanted with a presbyopic posterior chamber pIOL (IPCL). The visual acuities at near and distance, endothelial cell density, and ocular condition were examined 1 week, 3 months, 1 year and 2 years postoperatively. RESULTS: The mean uncorrected distance visual acuity improved significantly from 1.25 logarithm of the minimum angle of resolution (logMAR) (1.15 to 1.35 95% confidence interval [CI]) to 0.11 logMAR (95% CI, 0.03 to 0.17) (P < .0001). No eye lost 1 or more lines of corrected distance visual acuity. The mean distance refraction improved significantly from -6.9 diopters (D) (range -8.6 to -5.3 D) preoperatively to -0.35 D (range -0.55 to -0.15 D, P < .0001) with less than -0.5 D residual refraction in 11 of 17 eyes. Fifteen of 17 eyes had improved uncorrected near visual acuity to J1 (Jaeger chart) at the 2-year follow-up. The near addition at the 2-year follow-up decreased from preoperatively +1.26 D (range 0.19 to 2.34 D) to +0.39 D (range 0.18 to 0.60 D). The mean endothelial cell density was reduced from 2552 cells/mm (range 2421 to 2682 cells/mm) to 2299 cells/mm (range 2108 to 2490 cells/mm) after 2 years. All patients were subjectively satisfied with the outcomes. CONCLUSIONS: The new pIOL provided good visual outcomes in near and far distances in an initial case series of patients.
- MeSH
- degenerativní myopie patofyziologie chirurgie MeSH
- dospělí MeSH
- fakické nitrooční čočky * MeSH
- implantace nitrooční čočky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nitrooční tlak fyziologie MeSH
- presbyopie patofyziologie chirurgie MeSH
- prospektivní studie MeSH
- refrakce oka fyziologie MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: To compare the efficacy and safety of anterior capsulotomy creation with a new selective laser device (CAPSULaser) with those of manual capsulotomies. SETTING: GEMINI Eye Clinic, Zlin, Czech Republic. DESIGN: Prospective case series. METHODS: Patients were placed in cohorts based on age and cataract grade and randomly allocated to have laser capsulotomy or manual continuous curvilinear capsulorhexis (CCC). The anterior capsule was stained with microfiltered trypan blue 0.4%. The anterior capsulotomy was created with the laser device focused on the anterior capsule through a custom patient interface lens. Intraoperative video analysis with the use of an intraocular ruler and postoperative examinations were used to assess safety and efficacy (accuracy of capsulotomy size, circularity, centration). RESULTS: No intraoperative complications occurred in the laser group or the manual group. All capsulotomies in the laser group were free-floating with no tags or tears. The mean capsulotomy diameter was 5.03 mm overall (range 4.8 to 5.2 mm, laser group; 4.4 to 5.8 mm, manual group). In the laser group, all the capsulotomies were within 0.1 mm ± 0.1 (SD) of the target. The circularity accuracy was greater than 99.0% ± 1.0%; the mean centration of the capsulotomy in relation to the intraocular lens (IOL) was 0.1 ± 0.1 mm. All parameters were statistically significant (P < .01). The IOL-capsulotomy overlap was 360 degrees in all laser cases. CONCLUSIONS: Selective laser capsulotomy using a new proprietary trypan blue formulation was safe and effective in cataract surgery. The sizing, circularity, and centration of the laser capsulotomy were more accurate than those of the manual CCC, resulting in consistent 360-degree IOL coverage.
- MeSH
- barvicí látky aplikace a dávkování MeSH
- capsulorhexis metody MeSH
- dospělí MeSH
- fakoemulzifikace * metody MeSH
- implantace nitrooční čočky * MeSH
- katarakta komplikace MeSH
- laserová terapie škodlivé účinky přístrojové vybavení MeSH
- lidé středního věku MeSH
- lidé MeSH
- přední pouzdro oční čočky chirurgie MeSH
- prospektivní studie MeSH
- pseudofakie patofyziologie MeSH
- senioři MeSH
- trypanová modř aplikace a dávkování MeSH
- výsledek terapie MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: To evaluate the effect of accelerated corneal crosslinking (CXL) with a "higher peripheral intensity" profile setting compared with a standard "top hat" profile setting performed using different CXL systems. SETTING: Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany. DESIGN: Retrospective case series. METHODS: Eyes from patients with progressive keratoconus were included. Group 1 included eyes treated with the higher peripheral intensity profile. Group 2 included eyes treated with the top hat profile. Accelerated CXL was performed based on the modified Dresden protocol (9 mW/cm2, 10 minutes). Corneal-topography and tomography are characterized using the Pentacam Scheimpflug system. RESULTS: The study comprised 45 eyes (25 eyes in Group 1, 20 eyes in Group 2) from 45 patients. The keratometry (K) at the apex (maximum K) decreased significantly from 54.95 diopters (D) ± 6.73 (SD) to 53.21 ± 6.05 D for Group 1 (P < .001) and from 57.29 ± 7.16 D to 56.48 ± 6.88 D for Group 2 (P = .01). In Group 1, flat K (K1) and steep K (K2) decreased significantly after treatment (P < .05). The thinnest corneal thickness decreased significantly by -17.5 ± 21.9 μm (P = .001) in Group 1. In Group 2, no significant flattening was observed in K1 and K2 (P > .05), and the thinnest corneal thickness showed a slight but not significant thinning (P = .097). CONCLUSIONS: In Group 1 (the higher peripheral intensity group), the corneal topographic and tomographic parameters improved significantly after accelerated CXL. The higher peripheral intensity profile effect on keratoconic cornea flattening seemed to be more pronounced compared with the top hat profile.
- MeSH
- časové faktory MeSH
- dospělí MeSH
- fotochemoterapie metody MeSH
- fotosenzibilizující látky terapeutické užití MeSH
- keratokonus diagnóza farmakoterapie MeSH
- kolagen terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- následné studie MeSH
- pachymetrie rohovky metody MeSH
- reagencia zkříženě vázaná terapeutické užití MeSH
- retrospektivní studie MeSH
- riboflavin terapeutické užití MeSH
- rohovka patologie MeSH
- rohovková topografie metody MeSH
- zraková ostrost MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- extrakce katarakty * MeSH
- katarakta MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
A 71-year-old woman with Fuchs endothelial dystrophy in the right eye had uneventful phacoemulsification cataract surgery with implantation of a single-piece intraocular lens (IOL) (CT47S) in January 2012. Because of corneal problems and vision loss, uneventful Descemet-stripping automated endothelial keratoplasty (DSAEK) was performed in May 2013. Four months later, a new corneal lamella (repeat DSAEK) was implanted with reinjection of an air bubble into the anterior chamber. Six months after the initial DSAEK, the patient complained of blurred vision. On examination, the cornea was transparent but the IOL presented opacification in the central area. The opacified IOL was explanted and analyzed by light microscopy, which showed the presence of thin granular deposits distributed in an overall round pattern that stained positive for calcium. The opacification of hydrophilic acrylic IOLs is a complication that can occur after uneventful endothelial keratoplasty, especially when rebubbling is necessary.
- MeSH
- akrylové pryskyřice MeSH
- fakoemulzifikace MeSH
- Fuchsova endoteliální dystrofie chirurgie MeSH
- hydrofobní a hydrofilní interakce MeSH
- implantace nitrooční čočky MeSH
- injekce nitrooční MeSH
- kalcinóza etiologie patologie chirurgie MeSH
- lidé MeSH
- nitrooční čočky * MeSH
- odstranění implantátu MeSH
- poruchy zraku etiologie patologie chirurgie MeSH
- přední komora oční chirurgie MeSH
- selhání protézy * MeSH
- senioři MeSH
- vápník analýza MeSH
- vzduch * MeSH
- zadní lamelární keratoplastika * MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
PURPOSE: To evaluate the visual, refractive, contrast-sensitivity, and aberrometric outcomes during a 1-year follow-up after implantation of a trifocal intraocular lens (IOL). SETTING: Premium Clinic, Teplice, Czech Republic. DESIGN: Prospective case series. METHODS: This study included eyes of patients having cataract surgery with implantation of the trifocal IOL model AT Lisa tri 839MP. Distance, intermediate (66 and 80 cm), and near (33 and 40 cm) vision; contrast sensitivity; aberrometric outcomes; and the defocus curve were evaluated during a 12-month follow-up. The level of posterior capsule opacification (PCO) was also evaluated. RESULTS: In 120 eyes (60 patients), 1 month postoperatively, an improvement was observed in all visual parameters (P ≤ .03) except corrected near and intermediate visual acuities (both P ≥ .05). From 1 month to 12 months postoperatively, small but statistically significant changes were observed in uncorrected and corrected distance and near visual acuities (all P ≤ .03) and in uncorrected intermediate visual acuity (P = .01). In the defocus curve, no significant differences were found between visual acuities corresponding to defocus levels of -1.0 diopter (D) and -2.0 D (P = .22). The level of ocular spherical aberration decreased statistically significantly at 6 months (P < .001). Ocular and internal higher-order aberrations increased minimally but significantly from 6 to 12 months postoperatively (P < .001). The mean 12-month PCO score was 0.32 ± 0.44 (SD). Four eyes (3.3%) required neodymium:YAG capsulotomy. CONCLUSION: The trifocal IOL provided complete and stable visual restoration after cataract surgery during a 12-month follow-up, with good levels of visual quality. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
- MeSH
- aberometrie MeSH
- citlivost na kontrast fyziologie MeSH
- dospělí MeSH
- fakoemulzifikace * MeSH
- implantace nitrooční čočky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- nitrooční čočky * MeSH
- prospektivní studie MeSH
- protézy - design MeSH
- pseudofakie patofyziologie MeSH
- refrakce oka fyziologie MeSH
- rohovkové aberace patofyziologie MeSH
- senioři MeSH
- zkalení zadního pouzdra čočky diagnóza MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: To evaluate the visual, refractive, contrast sensitivity, and aberrometric outcomes as well as the patient quality of life and photic phenomena disturbances after cataract surgery with implantation of a new trifocal toric intraocular lens (IOL). SETTINGS: Premium Clinic, Regional Hospital in Havlickuv Brod, Czech Republic, and Vissum and Universidad Miguel Hernández, Alicante, Spain. DESIGN: Prospective consecutive series of cases. METHODS: The study involved eyes with corneal astigmatism of 1.25 D or more that were having cataract surgery with implantation of the trifocal toric IOL AT Lisa tri toric 939MP (Carl Zeiss Meditec). Visual outcomes and astigmatic changes analyzed by Alpins vector analysis were evaluated at 3 months postoperatively. Contrast sensitivity, quality of life, and photic phenomena were also evaluated. RESULTS: The study involved a total of 30 eyes of 16 patients, age 37 to 64 years. A significant improvement with surgery was observed in uncorrected distance, intermediate, and near visual acuity (P ≤ .01). A significant decrease in the refractive cylinder was observed postoperatively (P < .01), with all eyes showing a postoperative astigmatism below 1.00 D. The difference between targeted and surgically induced astigmatism was small (0.06 ± 0.30 D) but statistically significant (P = .04). The mean magnitude of angle of error was 5.80 ± 8.47 degrees. The low levels of higher-order aberrations found postoperatively were consistent with the good levels of contrast sensitivity achieved. Regarding quality of life, low to moderate levels of difficulty in performing various types of vision-related tasks were found. CONCLUSIONS: The trifocal toric IOL evaluated provides effective restoration of visual function after cataract surgery, with associated high levels of visual acuities and quality of life. FINANCIAL DISCLOSURE: The authors have no proprietary or commercial interest in the medical devices that are involved in this manuscript.
- MeSH
- citlivost na kontrast fyziologie MeSH
- dospělí MeSH
- fakoemulzifikace * MeSH
- implantace nitrooční čočky * MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- nitrooční čočky * MeSH
- prospektivní studie MeSH
- protézy - design MeSH
- průzkumy a dotazníky MeSH
- pseudofakie patofyziologie MeSH
- refrakce oka fyziologie MeSH
- rohovkové aberace patofyziologie MeSH
- spokojenost pacientů MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
