AIM: To compare the 12-month outcomes of visual performance and patient satisfaction of a higher-order aspheric monofocal intraocular lens (IOL) and a conventional monofocal IOL. METHODS: Prospective, randomized, comparative, double-blinded study including 22 patients who underwent bilateral cataract surgery with implantation of the Tecnis Eyhance ICB00 IOL in one eye (ICB00 group) and the Tecnis ZCB00 IOL in the fellow eye (ZCB00 group). Uncorrected distance (UDVA), corrected distance (CDVA), uncorrected intermediate (UIVA), distance-corrected intermediate (DCIVA), uncorrected near (UNVA), and distance-corrected near visual acuities (DCNVA) were evaluated during a 12-month follow-up. Contrast sensitivity, defocus curves, and reading text size were also evaluated. Patient satisfaction was assessed with a questionnaire at the 6-month postoperative visit. RESULTS: Mean postoperative logMAR UDVA was 0.01±0.12 and -0.02±0.10 in ICB00 and ZCB00 groups, respectively (P=0.37). Mean logMAR UIVA was 0.32±0.19 and 0.45±0.16 in ICB00 and ZCB00 groups, respectively (P=0.010). Differences between groups in UNVA did not reach statistical significance (P=0.16). The intermediate reading acuity at 66 cm (P=0.02) and 80 cm (P=0.04) was significantly better in the ICB00 group. Postoperative contrast sensitivity results did not differ significantly between groups (P>0.05). Patients reported high overall satisfaction, with 62% of patients using spectacles for reading in everyday life. CONCLUSION: The eyes of patients implanted with the enhanced monofocal IOL evaluated have significantly better visual acuity for intermediate distances with the same contrast sensitivity as a conventional monofocal IOL.

• Klíčová slova
• Tecnis Eyhance, contrast sensitivity, enhanced monofocal intraocular lens, intermediate visual acuity,
• Publikační typ
• časopisecké články MeSH

PURPOSE: To evaluate the long-term results of combining cataract surgery, intraocular lens (IOL) implantation, and Descemet membrane endothelial keratoplasty with peripheral stromal support (DMEK-S). METHODS: The outcomes of 107 eyes of 37 patients who had undergone a combination of cataract surgery, IOL implantation, and DMEK-S between October 2007 and February 2015 were retrospectively evaluated. The average follow-up duration was 18.2 ± 18.3 months (range, 6-84 months). Changes in uncorrected and corrected distance visual acuity, spherical equivalent, and corneal endothelial cell density were analyzed. Intraoperative and postoperative complications were also recorded. RESULTS: The mean logMAR uncorrected distance visual acuity improved from 0.92 ± 0.60 preoperatively to 0.33 ± 0.33, 0.28 ± 0.25, 0.24 ± 0.20, and 0.27 ± 0.27 at 6, 12, 24, and 36 months postoperatively (P < 0.001), respectively. The mean logMAR corrected distance visual acuity improved from 0.62 ± 0.65 preoperatively to 0.17 ± 0.29, 0.13 ± 0.21, 0.07 ± 0.16, and 0.11 ± 0.23 at 6, 12, 24, and 36 months postoperatively (P < 0.001), respectively. The mean endothelial cell density decreases were 50.7% ± 21.1%, 50.8% ± 19.8%, 60.7% ± 16.6%, 62.2% ± 11.8%, and 61.8% ± 20.0% at 6, 12, 24, 36, and 48 months after surgery, respectively. Similar trends, although with slightly better visual outcomes, were found in the subgroup of patients without other eye diseases. The mean final deviation from intended spherical equivalent was 0.77 ± 1.19 D, representing a hyperopic shift. CONCLUSIONS: A combined procedure of cataract surgery, IOL implantation, and DMEK-S is an effective method of treatment in patients with combined corneal disease and cataract, maintaining visual rehabilitation in the long term. Future developments should be performed to minimize the incidence of complications.

• MeSH
• fakoemulzifikace * MeSH
• implantace nitrooční čočky MeSH
• katarakta komplikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• nemoci rohovky komplikace   MeSH
• počet buněk MeSH
• poruchy zraku rehabilitace   MeSH
• retrospektivní studie MeSH
• rohovkový endotel patologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stroma rohovky chirurgie   MeSH
• úbytek endoteliálních buněk rohovky patofyziologie   MeSH
• výsledek terapie MeSH
• zadní lamelární keratoplastika * MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To compare the visual and refractive outcomes obtained with the implantation of a rotationally asymmetric refractive multifocal IOL after femtosecond laser-assisted cataract surgery (FLACS) and conventional lens extraction (CLE). METHODS: A total of 78 eyes of 58 patients that had undergone conventional phacoemulsification (36 eyes, CLE group) or FLACS (37 eyes, FLACS group) with the implantation of the toric multifocal IOL LU-313 MF30T (Oculentis, Germany) were enrolled in this retrospective study. Mean age was 57.0 years at the time of surgery, ranging from 44 to 69 years. Visual and refractive outcomes were evaluated during a 12-month follow-up. Likewise, contrast sensitivity was assessed at the end of the follow-up. RESULTS: Significant improvements were observed in both groups in uncorrected distance (UDVA) and near visual acuity (UNVA) at 1 month postoperatively (p < 0.001). Differences between groups in these parameters as well as in sphere and cylinder did not reach statistical significance during the whole follow-up (p ≥ 0.079), except for UNVA only at 12 months postoperatively (p = 0.018). Concerning corrected near visual acuity, only significant differences between groups were found preoperatively (p = 0.020). Furthermore, only a minimal but significant difference between groups was found at 12 months postoperatively in contrast sensitivity for the spatial frequency of 18 cycles/° (p = 0.029). CONCLUSIONS: The rotationally asymmetric toric multifocal IOL LU-313 MF 30T provides good visual rehabilitation for near and distance vision after presbyopic lens extraction in eyes with preexisting astigmatism, independently whether the cataract surgery is performed with the FLACS or conventional technique.

• Klíčová slova
• Clear lens extraction, Femtosecond laser-assisted cataract surgery, Multifocal intraocular lens, Phacoemulsification, Presbyopia, Refractive lens extraction, Rotationally asymmetric multifocal intraocular lens,
• MeSH
• citlivost na kontrast MeSH
• dospělí MeSH
• fakoemulzifikace * metody   MeSH
• implantace nitrooční čočky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• multifokální intraokulární čočky * MeSH
• refrakce oka * MeSH
• retrospektivní studie MeSH
• senioři MeSH
• zraková ostrost MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

AIM: To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens (IOL) during a 12-month follow-up. METHODS: Prospective comparative study including 75 eyes of 38 patients (44-70y) undergoing uneventful cataract surgery. Each patient was randomly assigned to one type of IOL, bifocal (35 eyes) or trifocal (40 eyes). Visual, refractive, and contrast sensitivity changes were evaluated in a 12-month follow-up. The binocular defocus curve was also measured at 12mo postoperatively. RESULTS: No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities (P≥0.276). Postoperative corrected near visual acuity (33 cm) was significantly better in the trifocal group during all follow-up (P≤0.004) as well as 6-month uncorrected near (P=0.008) and distance-corrected near visual acuities (P=0.016) (33/40 cm). Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group (P<0.001), which was consistent with differences among groups in binocular defocus curve. Differences among groups in contrast sensitivity were minimal, being only significant at 6 months for some low to medium spatial frequencies (P≤0.006). CONCLUSION: Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up, with a clear benefit of the trifocal IOL for the intermediate vision.

• Klíčová slova
• bifocal intraocular lens, cataract surgery, contrast sensitivity, defocus curve, trifocal intraocular lens,
• Publikační typ
• časopisecké články MeSH

• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. PURPOSE: To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample of anisometropic amblyopic adults and to evaluate the potential usefulness of this option of treatment. METHODS: A total of 17 subjects (10 men, 7 women) with a mean age of 31.2 years (range, 17-69 year) and anisometropic amblyopia were enrolled. Best corrected visual acuity (BCVA) and stereoacuity (Stereo Randot graded circle test) changes were evaluated after 8 sessions (40 min per session) of dichoptic training with the computer game Diplopia Game (Vivid Vision) run in the Oculus Rift OC DK2 virtual reality head mounted display (Oculus VR). RESULTS: Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.58 ± 0.35 before training to a post-training value of 0.43 ± 0.38 (p < 0.01). Forty-seven percent of the participants achieved BCVA of 20/40 or better after the training as compared to 30% before the training. Mean stereoacuity changed from a value of 263.3 ± 135.1 before dichoptic training to a value of 176.7 ± 152.4 s of arc after training (p < 0.01). A total of 8 patients (47.1%) before dichoptic treatment had unmeasurable stereoacuity while this only occurred in 2 patients (11.8%) after training. CONCLUSIONS: Dichoptic training using a virtual reality head mounted display seems to be an effective option of treatment in adults with anisometropic amblyopia. Future clinical trials are needed to confirm this preliminary evidence. TRIAL REGISTRATION: Trial ID: ISRCTN62086471 . Date registered: 13/06/2017. Retrospectively registered.

• Klíčová slova
• Amblyopia, Dichoptic training, Oculus rift, Stereopsis, Virtual reality,
• MeSH
• amblyopie patofyziologie   terapie   MeSH
• časové faktory MeSH
• deformace percepce fyziologie   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• následné studie MeSH
• průzkumy a dotazníky MeSH
• retrospektivní studie MeSH
• senioři MeSH
• senzorická deprivace MeSH
• terapie pomocí virtuální reality metody   MeSH
• vidění binokulární fyziologie   MeSH
• výsledek terapie MeSH
• zobrazování trojrozměrné * MeSH
• zraková ostrost * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví 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
• Názvy látek
• akrylové pryskyřice MeSH
• vápník MeSH

PURPOSE: To describe the clinical and microscopic findings in 2 different patients of 2 cases of late opacification of the hydrophilic acrylic intraocular lens (IOL) Ioflex. METHODS: Two eyes of 2 patients (73 and 74 years old) had an uneventful phacoemulsification surgery with implantation of the Ioflex IOL (power +21.5 D). At 5 years after surgery, a dense IOL opacification was detected in both cases with significant visual degradation. The IOLs were explanted and analyzed by microscopy. RESULTS: In both cases, a satisfactory visual recovery was achieved (corrected distance visual acuity of 6/9 and 6/12). Microscopic examination of the explanted IOLs revealed multiple small granules on the surface/subsurface of the lens. Although histochemical or surface analyses were not performed, the aspect appears consistent with a process of calcification of this lens design. Other findings included few surface contaminants, such as fibers, crystals that may correspond to dry viscoelastic and/or salt solutions, as well as pigments and dust-like deposits. CONCLUSIONS: Opacification of the posterior chamber hydrophilic acrylic IOL Ioflex probably related to calcification can appear several years after its implantation and requires IOL exchange due to the significant visual loss induced. More studies are required to understand the causes of this complication.

• MeSH
• akrylové pryskyřice * MeSH
• fakoemulzifikace MeSH
• hydrofobní a hydrofilní interakce MeSH
• implantace nitrooční čočky MeSH
• lidé MeSH
• nitrooční čočky * MeSH
• selhání protézy * MeSH
• senioři MeSH
• zraková ostrost MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• akrylové pryskyřice * MeSH

• Publikační typ
• časopisecké články 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