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Mohammadpour M, Mazloumi M, Khorrami-Nejad M. Anterior Uveitis with Posterior Synechia and Iris Atrophy Following Implantation of a Phakic Intraocular Lens. Int Med Case Rep J 2020; 13:225-228. [PMID: 32547261 PMCID: PMC7264153 DOI: 10.2147/imcrj.s255085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/14/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe a case with acute postoperative uveitis, posterior synechia and iris atrophy following iris-claw phakic intraocular lens (pIOL) implantation. Methods A case report. Results A 26-year-old man with high myopia had implantation of a −14.0 diopter, foldable, iris-claw Artiflex (model 401) anterior chamber pIOL (Ophtec B.V.) in both eyes. On the third postoperative day, the patient had significant postoperative inflammation in the left eye and received topical steroids and mydriatic eye drops. On the fifth postoperative day, the right eye had a round pupil and centered pIOL, but the left eye had an atrophic iris and dilated pupil with significant posterior synechias over the inferior half of the pupil. Despite intensive topical steroid application, the synechias remained one year after surgery. Conclusion Severe uveitis with posterior synechia can occur after iris-claw pIOL implantation. We hypothesized that excessive iris tissue enclavation in the pIOLs haptics and large iridotomies may be an associated factor.
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Affiliation(s)
- Mehrdad Mohammadpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mazloumi
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Masoud Khorrami-Nejad
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.,School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wang LY, Li BC, Sheng B, Xu BL, Huang YS, Ni ZJ, Zhang DW. Optimized multielement accommodative intraocular lens with a four-freeform-surface Alvarez lens and a separate aspheric lens. APPLIED OPTICS 2019; 58:7609-7614. [PMID: 31674416 DOI: 10.1364/ao.58.007609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/27/2019] [Indexed: 06/10/2023]
Abstract
This paper proposes an accommodative intraocular lens (IOL), which consists of a two-element Alvarez lens and an aspheric lens for changing focal power and refractive power, respectively. The four-freeform-surface Alvarez lens is optimized for a multiple field of view; further, the aspheric lens also corrects the aberrations induced by the corneal asphericity of the human eye over the whole range of accommodation. A simulation using optical design software demonstrates its excellent performance in that the values of the modulation transfer function at 100 cycles/mm all reach ∼0.4 with a ±5° field of view for 3 and 5 mm pupils.
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Tahmaz V, Bachmann B, Tahmaz E, Schickhardt S, Fang H, Auffarth G, Cursiefen C. [Explantation of two historical posterior chamber phakic intraocular lenses 31 years after implantation]. Ophthalmologe 2019; 117:452-455. [PMID: 31324958 DOI: 10.1007/s00347-019-0942-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This article reports the case of a 56-year-old male patient who had undergone implantation of posterior chamber phakic intraocular lenses in 1987 in Russia. The patient presented to this clinic 31 years after the initial surgery with anterior cortical cataracts and initial stages of corneal decompensation in both eyes. Strategic planning and execution of surgical treatment and the further clinical course are portrayed in this report.
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Affiliation(s)
- V Tahmaz
- Medizinische Fakultät und Uniklinik Köln, Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
| | - B Bachmann
- Medizinische Fakultät und Uniklinik Köln, Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - E Tahmaz
- MVZ ADTC Mönchengladbach/Erkelenz, Erkelenz, Deutschland
| | - S Schickhardt
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg. Untersützt durch die Klaus Tschira Stiftung, Heidelberg, Deutschland
| | - H Fang
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg. Untersützt durch die Klaus Tschira Stiftung, Heidelberg, Deutschland
| | - G Auffarth
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg. Untersützt durch die Klaus Tschira Stiftung, Heidelberg, Deutschland
| | - C Cursiefen
- Medizinische Fakultät und Uniklinik Köln, Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
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Baumeister M. [Scheimpflug photography for the examination of phakic intraocular lenses]. Ophthalmologe 2014; 111:935-41. [PMID: 25332044 DOI: 10.1007/s00347-013-2963-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND High myopia phakic intraocular lenses (IOL) have become an established means of surgical correction for high ametropia. Scheimpflug photography is one of the methods which are frequently applied for postoperative examination of the implants. MATERIAL AND METHODS Results from published studies employing Scheimpflug photography for examination of anterior chamber angle-fixated, iris-fixated and sulcus-fixated phakic IOLs were evaluated. RESULTS In several published studies Scheimpflug photography was used to examine the position of the implant and opacification of the crystalline lens. The results provided valuable evidence for the improvement of phakic IOL design. CONCLUSION Scheimpflug photography offers an easy to use, rapid non-contact examination of phakic IOLs.
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Affiliation(s)
- M Baumeister
- Klinik für Augenheilkunde, Klinikum Bad Hersfeld, Seilerweg 29, 36251, Bad Hersfeld, Deutschland,
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Bamashmus MA, Mohamed AA, Alakhlee HA. A retrospective analysis of the first Yemeni experience on Artisan phakic intraocular lens for the treatment of moderate and high myopia. Oman J Ophthalmol 2013; 5:175-80. [PMID: 23439933 PMCID: PMC3574514 DOI: 10.4103/0974-620x.106098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To evaluate the outcome and safety of the iris-fixated Artisan phakic intraocular lens (PIOL) for the correction of moderate and high myopia. MATERIALS AND METHODS A retrospective non-controlled clinical study of the data of patients who underwent Artisan PIOLs between March 2006 and July 2008 was evaluated. Pre-operative examination included age, gender, refraction, uncorrected (UCVA) and best spectacle corrected (BSCVA) visual acuity, predictability and safety were analyzed. Post-operative time course ranged from 12 to 36 months. RESULTS An Artisan myopia lens was implanted in 62 eyes of 39 patients. The mean pre-operative spherical equivalent (SE) was -13.17 ± 5.62 D. The pre-operative myopia ranged from -4.5 to -24 D. Mean patient age was 25.44 ± 5.22 years. At last follow-up visit, residual SE was within ±1.00 D in 36 eyes (58.1%) and ±2.00 D in 56 eyes (90.3%). In the last visit UCVA was equal to or better than pre-operative BSCVA in 57 (91.9%) of the eyes. One eye (1.6%) lost one Snellen line, three eyes (4.8%) lost two or more Snellen lines and one eye lost vision (1.6%). Post-operative complications included anterior chamber reaction in one eye, rise in intraocular pressure in two eyes and retinal detachment in one eye. CONCLUSION When laser keratorefractive surgery is not an option, implantation of Artisan PIOL to correct moderate to high myopia results in a stable and good refractive result with few complications that must be kept in mind.
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Affiliation(s)
- Mahfouth A Bamashmus
- Department of Eye, Faculty of Medicine and Health Sciences, Sana'a University, Republic of Yemen ; Refractive Surgery Unit, Magrabi Eye Hospital, Sana'a, Republic of Yemen
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Mirshahi A, Wesemann W, Bühren J, Kohnen T. Factors influencing the reliability of autorefractometry after LASIK for myopia and myopic astigmatism. Am J Ophthalmol 2010; 150:774-9. [PMID: 20951976 DOI: 10.1016/j.ajo.2010.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 06/18/2010] [Accepted: 06/19/2010] [Indexed: 11/25/2022]
Abstract
PURPOSE To study the factors influencing the reliability (accuracy) of autorefractometry before and after laser in situ keratomileusis (LASIK) for myopia and myopic astigmatism. DESIGN Retrospective case series. METHODS A total of 250 consecutive eyes (132 patients, mean age 37 years) were included from the Department of Ophthalmology, J.W. Goethe University, Frankfurt, Germany. The mean preoperative spherical equivalent of the subjective refraction (SR) was -6.59 diopters (D) (-1.38 to -15.13). The patient data were reviewed before and 1 month after LASIK, including SR, objective automated refraction (AR), and visual acuity. Subgroup analysis was performed with regard to the preoperative myopia and the excimer laser optical zone (OZ). The Holm-Sidak and Wilcoxon matched-pairs tests were used for statistical analysis. RESULTS The correlation coefficient between AR und SR is r = 0.98 before LASIK versus r = 0.79 afterwards (P < .001). The mean difference between the spherical equivalents (DSE) is +0.13 ± 0.51 D preoperatively versus -0.30 ± 0.58 D after LASIK (P < .001). With a small optical zone size (5.0-5.5 mm) the postoperative difference is -0.61 D, versus -0.36 D for OZ 5.6-6.0, versus -0.16 for OZ 6.1-7.0 mm. With a rising preoperative amount of myopia, the postoperative AR results become increasingly more myopic than the SR. CONCLUSIONS Following LASIK, autorefractometry is less accurate than in nonoperated eyes. The reliability of the AR is influenced by the OZ and the preoperative amount of myopia, with a small OZ and high myopia resulting in a greater difference between AR and SR and with the AR determining more myopic results.
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Han KE, Jun RM. Measurement of White-to-White Diameter and Anterior Chamber Depth by Dual Scheimpflug Camera. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2010. [DOI: 10.3341/jkos.2010.51.2.169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kyung-Eun Han
- Department of Ophthalmology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Roo Min Jun
- Department of Ophthalmology, Ewha Womans University School of Medicine, Seoul, Korea
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Meltendorf C, Cichocki M, Kohnen T. Laser in situ Keratomileusis following the Implantation of Iris-Fixated Phakic Intraocular Lenses. Ophthalmologica 2008; 222:69-73. [DOI: 10.1159/000112621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Accepted: 02/08/2007] [Indexed: 11/19/2022]
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Kohnen T, Strenger A, Klaproth OK. Basic knowledge of refractive surgery: correction of refractive errors using modern surgical procedures. DEUTSCHES ARZTEBLATT INTERNATIONAL 2008; 105:163-70; quiz 170-2. [PMID: 19633786 DOI: 10.3238/arztebl.2008.0163] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Accepted: 10/19/2007] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Refractive ophthalmic surgery allows refractive errors to be corrected permanently in a safe, effective, and reliable way with few complications. METHODS Selective literature review with special reference to the guidelines of the German Commission for Refractive Surgery. RESULTS With a total of almost 18 million treatments performed to date, laser in-situ keratomileusis (LASIK) is the most commonly used refractive surgical procedure worldwide. Alternatives to LASIK include surface ablation procedures (PRK, LASEK, Epi-LASIK) and phakic intraocular lens implantation. If ocular accommodation is lost, removal of the crystalline lens and implantation of modern multifocal intraocular lenses (refractive lens exchange) provide an alternative means of correcting myopia, hyperopia and presbyopia. DISCUSSION The treatment effect is maximized and complications kept to a minimum if strict inclusion criteria are applied and a high technical standard maintained during the procedure.
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Affiliation(s)
- Thomas Kohnen
- Klinik für Augenheilkunde der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, Frankfurt am Main, Germany.
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Bühren J, Kohnen T. [Application of wavefront analysis in clinical and scientific settings. From irregular astigmatism to aberrations of a higher order--Part II: examples]. Ophthalmologe 2008; 104:991-1006; quiz 1007-8. [PMID: 18030477 DOI: 10.1007/s00347-007-1648-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In recent years, wavefront analysis has ceased to be purely a laboratory application and emerged as a method used in ophthalmological diagnosis. This development has been promoted mainly by the widespread use of wavefront-guided LASIK (laser in situ keratomileusis). However, aberrometry is still not a common diagnostic technique, and for many ophthalmologists interpretation of the results is difficult. The second part of this serial paper reviews findings that are relevant for the ophthalmological community and highlights current scientific applications in this area.
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Affiliation(s)
- J Bühren
- Advanced Physiological Optics Lab, Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA
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Abstract
BACKGROUND In this article a retrospective analysis of patients presenting at a German university following refractive surgery abroad is presented. PATIENTS AND METHODS A total of 20 cases of patients who had undergone treatment between 1998 and 2006 in China (1 case), Greece (1 case), Iran (1 case), Russia (2 cases), Switzerland (1 case), Slovakia (1 case), Spain (2 cases), South Africa (3 cases), Turkey (6 cases) and the USA (2 cases) were analyzed retrospectively. RESULTS The following complications were observed: epithelial ingrowth into the interface with or without melting of the flap (6 cases), corneal ectasia (2 cases), dislocation of a phakic posterior chamber intraocular lens and prolapse into the anterior chamber with endothelial cell loss (1 case), secondary increase of intraocular pressure following implantation of a phakic intraocular lens (1 case), flap-related complications following laser-in-situ keratomileusis (LASIK) (2 cases), keratitis (1 case), dislocation of the complete flap (1 case), diffuse lamellar keratitis (DLK) grade IV (1 case), hyperopia as a consequence of radial keratotomy (1 case), and under correction/over correction and poor optical quality following laser epithelial keratomileusis (LASEK) and LASIK for high myopia (5 cases) with possible early corneal ectasia. CONCLUSIONS There are four important problems arising from refractive surgery abroad, often referred to as "LASIK tourism": wrong indications, insufficient management of complications, lack of postoperative care and the health economic aspect.
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Affiliation(s)
- E Terzi
- Klinik für Augenheilkunde, Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590 Frankfurt am Main
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Viestenz A, Walter S, Viestenz A, Behrens-Baumann W, Langenbucher A. Torische Intraokularlinsen und Astigmatismuskorrektur. Ophthalmologe 2007; 104:620-7. [PMID: 17583816 DOI: 10.1007/s00347-007-1576-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Toric intraocular lenses (tIOLs) have the potential to correct corneal astigmatism. The purpose of this review paper is: 1. to describe the biometric, keratometric and topographic conditions for implantion of tIOLs, 2. to highlight the advantages and disadvantages of tIOLs, 3. to define indications for and contraindications to tIOL implantation, 4. to provide clinical recommendations for the implantation of toric lenses, and 5. to report the specifications of all tIOLs that are currently available commercially.
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Affiliation(s)
- Arne Viestenz
- Augenklinik mit Poliklinik, Otto-von-Guericke-Universität, Leipziger Strasse 44, Haus 60b, 39120 Magdeburg, Deutschland.
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Abstract
At a time when some of the limitations of photoablation have been defined, such as worry concerning secondary ectasia, a renewed interest in phakic implantation has arisen. This is driven by the goal of avoiding correcting high ametropia with LASIK and is based on the development of soft foldable biomaterials. When all phakic IOLs are in front of the natural lens, two varieties of lenses can be distinguished, depending on whether it is located in the anterior or posterior chamber. The various models available in 2006 and those under current evaluation are reviewed. We do not report details of clinical studies that vary in cohort size and follow-up. The advantages and limitations are discussed for each type of phakic IOL. Adequate although not exclusive indications are deduced. There is no phakic lens that has proved to be superior to the others in terms of safety. All have the ability to provide a visual benefit with a gain in best corrected visual acuity. The difference is based on anatomical effects, requiring long-term follow-up in the evaluation of angles, lens, iris, and endothelium.
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Kohnen T, Thomala MC, Cichocki M, Strenger A. Internal anterior chamber diameter using optical coherence tomography compared with white-to-white distances using automated measurements. J Cataract Refract Surg 2006; 32:1809-13. [PMID: 17081862 DOI: 10.1016/j.jcrs.2006.08.023] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2006] [Accepted: 08/17/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare internal horizontal anterior chamber (AC) diameter determined by optical coherence tomography (OCT) and horizontal corneal diameter (white-to-white [WTW]) using automated measurements. SETTING Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. METHODS Internal AC diameter and WTW distance was measured in 52 eyes of 26 patients using the Visante OCT (Carl Zeiss Meditec), IOLMaster (Carl Zeiss Meditec), and Orbscan IIz topography system (Bausch & Lomb). Statistical evaluation was performed using the Bland-Altman method and regression analysis for comparison of measurement techniques. The Kruskal-Wallis test was used to measure the repeatability of each device. RESULTS The mean internal AC diameter was 12.45 mm +/- 0.53 (SD) with OCT; the mean WTW distance was 12.17 +/- 0.45 mm with the IOLMaster and 11.84 +/- 0.41 mm with the Orbscan IIz. A positive regression was determined for AC diameter and both WTW measurements. Measurement values varied little between both WTW measurement systems (R(2) = 0.9384). CONCLUSIONS Anterior chamber measurement using optical coherence tomography (Visante OCT) was easy to handle and showed good repeatability. The internal horizontal diameter of the AC was larger than the horizontal corneal diameter determined by automated WTW measurements (IOLMaster, Orbscan IIz). Optical coherence tomography with the Visante OCT allows direct measurement of the AC width.
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Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
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