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Kelly AR, Glover DJ. Information Transmission through Biotic-Abiotic Interfaces to Restore or Enhance Human Function. ACS APPLIED BIO MATERIALS 2024; 7:3605-3628. [PMID: 38729914 DOI: 10.1021/acsabm.4c00435] [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: 05/12/2024]
Abstract
Advancements in reliable information transfer across biotic-abiotic interfaces have enabled the restoration of lost human function. For example, communication between neuronal cells and electrical devices restores the ability to walk to a tetraplegic patient and vision to patients blinded by retinal disease. These impactful medical achievements are aided by tailored biotic-abiotic interfaces that maximize information transfer fidelity by considering the physical properties of the underlying biological and synthetic components. This Review develops a modular framework to define and describe the engineering of biotic and abiotic components as well as the design of interfaces to facilitate biotic-abiotic information transfer using light or electricity. Delineating the properties of the biotic, interface, and abiotic components that enable communication can serve as a guide for future research in this highly interdisciplinary field. Application of synthetic biology to engineer light-sensitive proteins has facilitated the control of neural signaling and the restoration of rudimentary vision after retinal blindness. Electrophysiological methodologies that use brain-computer interfaces and stimulating implants to bypass spinal column injuries have led to the rehabilitation of limb movement and walking ability. Cellular interfacing methodologies and on-chip learning capability have been made possible by organic transistors that mimic the information processing capacity of neurons. The collaboration of molecular biologists, material scientists, and electrical engineers in the emerging field of biotic-abiotic interfacing will lead to the development of prosthetics capable of responding to thought and experiencing touch sensation via direct integration into the human nervous system. Further interdisciplinary research will improve electrical and optical interfacing technologies for the restoration of vision, offering greater visual acuity and potentially color vision in the near future.
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Affiliation(s)
- Alexander R Kelly
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Dominic J Glover
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia
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Fernández-Vigo JI, Serrano González-Peramato MT, Nunila Gómez-de-Liaño C, Sánchez-Guillén I, Fernández-Vigo JÁ, Macarro-Merino A. Glistening on intraocular lenses: A review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:493-506. [PMID: 37369324 DOI: 10.1016/j.oftale.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
The glistening in intraocular lenses (IOLs) is a phenomenon in which tiny water-filled microvacuoles (MVs) form within the IOL material, causing light to scatter and create a sparkling or shimmering effect. The presence of glistening is common in many types of IOL materials and models and has been extensively studied in recent years to determine its incidence, risk factors, evolution, and possible clinical relevance. Classically, it has been studied in vitro in the laboratory or by means of photography obtained with a slit lamp, but these were techniques that required either specific technology or an expert explorer, complex image processing, and required a lot of time. In recent years, proposals based on the Scheimpflug camera and optical coherence tomography have emerged to try to simplify the analysis of glistening in IOLs. It has been described that the manufacturing process, the hydrophobic acrylic material, or the time since surgery are risk factors for the appearance of glistening. In addition, many issues related to this phenomenon are still unknown, such as not knowing from what number of points or their size they may have relevance to visual function since different optical phenomena related to glistening have been described on the IOLs.
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Affiliation(s)
- J I Fernández-Vigo
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
| | | | - C Nunila Gómez-de-Liaño
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - I Sánchez-Guillén
- Servicio de Oftalmología, Hospital Perpetuo Socorro, Badajoz, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain
| | - J Á Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain; Departamento de Oftalmología, Facultad de Medicina, Universidad de Extremadura, Badajoz, Spain
| | - A Macarro-Merino
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain
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Objective Classification of Glistening in Implanted Intraocular Lenses Using Optical Coherence Tomography: Proposal for a New Classification and Grading System. J Clin Med 2023; 12:jcm12062351. [PMID: 36983351 PMCID: PMC10057385 DOI: 10.3390/jcm12062351] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 03/22/2023] Open
Abstract
Purpose: To propose a classification of the glistening in intraocular lenses (IOL) using swept-source optical coherence tomography (SS-OCT) by means of a simple, objective and reproducible method that allows the quantification of the presence and severity of glistening. Methods: A cross-sectional study on a sample of 150 eyes of 150 patients who underwent cataract surgery in at least 600 days before the exam and attended a routine examination. Each subject was examined by SS-OCT after pupil dilation, identifying the presence of glistening or hyperreflective foci (HRF) in the central area of the IOL. The degree of glistening was classified into four categories: 0: ≤5 HRF; 1: 6 to 15 HRF; 2: 16 to 30 HRF; and 3: >30 HRF. The intra and interobserver reproducibility (intraclass correlation coefficient, ICC) in the quantification and classification of the glistening were calculated. The correlation between the horizontal and vertical scan of the IOL was also assessed. Results: Glistening was present in the IOL in 42.7% of the patients. The mean number of HRF or glistening microvacuoles was 10.4 ± 26.2 (range 0 to 239). In total, 63.3% of the IOLs had a grade 0, 20% grade a 1, 6.7% grade a 2 and 10% a grade 3. The intraobserver and interobserver reproducibility were very high, both for the absolute quantification of the glistening (ICC ≥ 0.994) and for the severity scale (ICC ≥ 0.967). There was an excellent correlation in the quantification of the IOL glistening between the horizontal and vertical scans (R ≥ 0.834; p < 0.001). Conclusions: The use of SS-OCT makes it possible to identify, quantify and classify IOL glistening in a simple, objective and reproducible way. This technique could provide relevant information for the study of the glistening on IOLs.
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Noguchi S, Nakakura S, Noguchi A, Tabuchi H. Visual Performance of a Violet-Filtering Intraocular Lens versus a Blue-Filtering Intraocular Lens of New/Old Manufacturing Processes. J Clin Med 2023; 12:jcm12031195. [PMID: 36769842 PMCID: PMC9917951 DOI: 10.3390/jcm12031195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/18/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
This article compares the visual performance of a violet light-filtering colored lens (ZCB00V) and blue light-filtering intraocular lens (IOL; SN60WF) before and after modifying the manufacturing process for glistening suppression. In this retrospective study, conducted at Saneikai Tsukazaki Hospital, Himeji, Japan, a consecutive sample of 8943 eyes of 5119 patients were included and implanted with blue-filtering IOLs before and after modifying the manufacturing process (SN60WF-J (1318 eyes) and SN60WF-Q,A (1418 eyes), respectively), noncolored UV-cut IOLs (ZCB00 (1418 eyes)), and ZCB00V (3717 eyes). For each patient, the corrected distance visual acuity (CDVA) at 3 months postoperative (3MCDVA) and the area under log contrast sensitivity function (AULCSF) were measured. The 3MCDVA was -0.076 ± 0.1, -0.11 ± 0.13, -0.10 ± 0.17, and -0.11 ± 0.13, for SN60WF-J, SN60WF-Q,A, ZCB00, and ZCB00V, respectively. The SN60WF-J group revealed significant differences as compared to the other three groups (all p < 0.05). The mesopic AULCSF was 2.59 ± 0.20, 2.68 ± 0.19, -2.69 ± 0.18, and 2.76 ± 0.19, respectively, whereas the photopic AULSCF was 2.63 ± 0.23, 2.76 ± 0.25, -2.77 ± 0.25, and 2.88 ± 0.25. The SN60WF-J and ZCB00V groups exhibited significant differences as compared to the other three groups, whereas no significant differences were noted between the SN60WF-Q,A and the ZCB00 groups (all p < 0.05). The violet-filtering lens offers higher visual acuity and contrast sensitivity than the clear and blue-filtering lens. It was also found that the above functions were improved by modifying the manufacturing process.
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Affiliation(s)
- Santaro Noguchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji 671-1227, Japan
- Correspondence: ; Tel.: +81-79-272-8555
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji 671-1227, Japan
| | - Asuka Noguchi
- ASUCA Eye Clinic Sendai Mark One, Sendai 980-0011, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji 671-1227, Japan
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Kanclerz P, Yildirim TM, Khoramnia R. Microscopic Characteristics of Late Intraocular Lens Opacifications. Arch Pathol Lab Med 2021; 145:759-767. [PMID: 33091924 DOI: 10.5858/arpa.2019-0626-ra] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The increases in overall life expectancy and in lens surgeries performed on younger patients have resulted in a significant increase in the anticipated duration of artificial intraocular lenses (IOLs) in the eye. Thus, the physicochemical properties of the IOL become a critical issue, and several types of postoperative IOL opacifications have been reported. OBJECTIVE.— To describe the microscopic characteristics of opacified IOLs. Glistenings and subsurface nanoglistenings are fluid-related phenomena developing mainly in hydrophobic acrylic IOLs and are associated with aqueous influx into the IOL matrix. Calcification presents in hydrophilic acrylic or silicone IOLs as deposits of hydroxyapatite or other phases of calcium. Snowflake degeneration is less common, and it manifests in older polymethyl methacrylate IOLs. DATA SOURCES.— PubMed and ScienceDirect databases were searched for the following keywords: intraocular lens, IOL, cataract surgery, phacoemulsification, opacification, glistening, subsurface nanoglistenings, calcification, snowflake degeneration. English-language articles published up to October 15, 2019 were included in the study. The manuscript contains mainly a literature review; however, it was supplemented with original investigations from the David J. Apple International Laboratory for Ocular Pathology. CONCLUSIONS.— Glistenings and subsurface nanoglistenings should be evaluated in a hydrated state and at room temperature; they manifest as microvacuoles sized from 1.0 to greater than 25.0 μm and less than 200 nm, respectively. Calcification deposits are situated on or underneath the surface of the IOL and can be stained with a 1% alizarin red solution or with the von Kossa method. Snowflake degeneration manifests as "particles" or "crystals," causing whitish IOL discoloration. Scanning electron microscopy or energy dispersive X-ray spectroscopy may improve the diagnostic accuracy.
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Affiliation(s)
- Piotr Kanclerz
- From the Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland (Kanclerz)
| | - Timur Mert Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Germany (Yildirim, Khoramnia)
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Germany (Yildirim, Khoramnia)
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Surface light scattering from 1-piece hydrophobic acrylic intraocular lenses with hydroxyethyl methacrylate: contralateral observation for 7 years. J Cataract Refract Surg 2021; 47:702-705. [PMID: 33769764 DOI: 10.1097/j.jcrs.0000000000000621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/11/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To quantitatively and intraindividually compare surface light scattering for 7 years after implantation of Clareon and AcrySof intraocular lenses (IOLs). SETTING Miyata Eye Hospital, Miyazaki, Japan. DESIGN Retrospective comparative case series. METHODS Clinical records of eyes that had contralateral implantation of SN60WF and SY60WF IOLs were reviewed. Light scattering on the anterior surface of IOLs, corrected distance visual acuity (CDVA), and mesopic and photopic contrast sensitivities were examined at 1 year, 3 years, and 7 years postoperatively, and they were intraindividually compared. RESULTS 34, 19, and 16 patients visited at 1 year, 3 years, and 7 years postoperatively, respectively. Surface light scattering in eyes with SY60WF IOL was significantly reduced, and the rate of increase was 2.74 computer compatible tapes per year. Although there were prominent increases in eyes with SN60WF IOL, no statistically significant difference was found in their CDVA and contrast sensitivities. CONCLUSIONS In eyes with Clareon IOLs, the development of surface light scattering was suppressed up to 7 years. The increase rate demonstrated that the visual acuity would be least deteriorated up to 12 years postoperatively, whereas the influence of straylight induced should be investigated.
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Yildirim TM, Schickhardt SK, Wang Q, Friedmann E, Khoramnia R, Auffarth GU. Quantitative evaluation of microvacuole formation in five intraocular lens models made of different hydrophobic materials. PLoS One 2021; 16:e0250860. [PMID: 33930084 PMCID: PMC8087009 DOI: 10.1371/journal.pone.0250860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/15/2021] [Indexed: 11/29/2022] Open
Abstract
In this laboratory study, we assessed the resistance to microvacuole (glistening) formation in hydrophobic intraocular lenses (IOLs). Glistenings were induced in five lenses each of five different hydrophobic acrylic IOL models, using an established in vitro laboratory model: 800C (Rayner, Worthing, UK), AcrySof SN60WF (Alcon, Fort Worth, USA), Tecnis ZCB00 (Johnson & Johnson Vision, Santa Ana, USA), Vivinex XY1 (Hoya, Tokyo, Japan) and CT Lucia 611P (Zeiss, Oberkochen, Germany). We evaluated the number of microvacuoles per square millimeter (MV/mm2) in the central part of each IOL. Results were analyzed statistically, and mean glistening numbers were ranked, with the highest in the SN60WF which had 66.0 (±45.5) MVs/mm, followed by the 611P with 30.7 (±8.4) MVs/mm2. The 800C and XY1 showed comparable values of 2.0 (±3.6) and 2.7 (±2.4) MVs/mm2, respectively. ZCB00 had the lowest number with 0.9 (±0.6) MVs/mm2. This study shows that the resistance to glistening formation differs depending on the hydrophobic acrylic copolymer composition of the IOL material. Some IOLs from current clinical use are still prone to develop glistenings whereas others, including the ZCB00, 800C and XY1 show high resistance to microvacuole formation.
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Affiliation(s)
- Timur M. Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Sonja K. Schickhardt
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Qiang Wang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
- Department of Ophthalmology, The Third Affiliated Hospital of Wenzhou Medical University, Rui’an, Zhejiang, China
| | - Elfriede Friedmann
- Faculty of Mathematics and Natural Sciences, University of Kassel, Kassel, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U. Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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Abstract
PURPOSE OF REVIEW Phacoemulsification cataract surgery is one of the most commonly performed surgical procedure worldwide. In the majority of cases, intraocular lenses (IOLs) are implanted. Due to the increasing life expectancy and the fact that cataract surgery is performed in earlier stages, the anticipated IOL duration in the eye has increased over the last decades. The aim of this study was to review the types and describe the characteristics of late intraocular lens opacifications. RECENT FINDINGS Calcification was the most commonly reported type of opacification in hydrophilic IOLs; it usually negatively impacted the visual function and required IOL explantation. Glistening manifested in hydrophobic acrylic lenses and was frequent in some IOL models. In most cases glistening and subsurface nanoglistenigs do not lead to a decline in visual acuity or require IOL exchange. Current studies indicate that fluid-related phenomena may induce straylight, leading to a decrease of comfort and quality of vision. SUMMARY Several reports on late IOL opacifications have been published in recent years. In some cases, particularly in glistening, the development of the opacifications might be related to IOL aging. The influence of the fluid-related microvacuoles on the quality of vision requires further research.
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Affiliation(s)
- Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland
| | - Timur M Yildirim
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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Grzybowski A, Markeviciute A, Zemaitiene R. A narrative review of intraocular lens opacifications: update 2020. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1547. [PMID: 33313292 PMCID: PMC7729367 DOI: 10.21037/atm-20-4207] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The opacifications of intraocular lenses (IOLs) can significantly impact patients visual quality. Despite the identification of specific risk factors, manufacturing changes, opacifications are not eliminated. Likewise, more attention in recent studies was paid to possible new risk factors, however one of the most important purposes of the studies remains opacifications effect on visual performance, which could be disturbed in different aspects. The aim of this review is to discuss the main risk factors of IOLs opacification in particular IOL types, and its impact on vision quality. Different risk factors were discussed in the study, including the material of IOLs, the impact of the breakdown of blood-aqueous barrier (BAB), and certain surgeries that can be associated with opacification formation. Glistenings occur more often in a hydrophobic material, however, the changes in water content of the IOLs can significantly reduce the formation of glistenings. The studies showed a significant effect of intraocular injection of exogenous air or gas during Descemet-stripping endothelial keratoplasty, Descemet-stripping automated endothelial keratoplasty, Descemet membrane endothelial keratoplasty, and pars plana vitrectomy on calcification formation. It raises a concern, as the incidence of these surgeries is increasing. Visual acuity decreases significantly after the calcification in IOLs occurs, and it usually causes IOLs exchange. However, disability glare seems to be more affected in patients with IOLs, which were affected by glistenings than visual acuity. Disability glare is associated with increased levels of straylight, which was widely evaluated in recent studies and it was reported to be a susceptible measurement to detect the presence of IOLs pathology. For future researches, it should be noticed that disability glare and straylight are more appropriate in evaluating IOLs opacification effect on visual quality than visual acuity. While reviewing the main risk factors of IOLs opacifications particular attention must be paid on calcification occurrence in hydrophilic acrylic IOLs after surgeries with intraocular injection of exogenous air or gas.
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Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.,Institute for Research in Ophthalmology, Poznan, Poland
| | - Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Mid-term and long-term clinical assessments of a new 1-piece hydrophobic acrylic IOL with hydroxyethyl methacrylate. J Cataract Refract Surg 2020; 46:682-687. [DOI: 10.1097/j.jcrs.0000000000000142] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grzybowski A, Kanclerz P, Beiko GHH. IOLs glistenings and quality of vision. Graefes Arch Clin Exp Ophthalmol 2019; 257:2795-2796. [PMID: 31630230 DOI: 10.1007/s00417-019-04496-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/13/2019] [Accepted: 09/20/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland. .,Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 60-554 Gorczyczewskiego 2/3, Poznan, Poland.
| | | | - George H H Beiko
- Department of Surgery, McMaster University, Hamilton, Canada.,Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Canada
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Werner L, Thatthamla I, Ong M, Schatz H, Garcia-Gonzalez M, Gros-Otero J, Cañones-Zafra R, Teus MA. Evaluation of clarity characteristics in a new hydrophobic acrylic IOL in comparison to commercially available IOLs. J Cataract Refract Surg 2019; 45:1490-1497. [PMID: 31399323 DOI: 10.1016/j.jcrs.2019.05.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/26/2019] [Accepted: 05/11/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To perform in vitro assessments of surface haze and roughness, subsurface nanoglistenings (SSNGs), and glistenings of a new hydrophobic acrylic intraocular lens (IOL) in comparison to commercially available IOLs. SETTING Universities of Utah and Alcalá, and Alcon Vision, LLC. DESIGN Experimental study. METHODS The IOLs used were Clareon CNA0T0, Tecnis ZCB00 and Tecnis OptiBlue ZCB00V, Eternity W-60, enVista MX60, and Vivinex XY1. Surface haze was assessed by the pixel intensity units (PIU) from cross-sectional slitlamp images, and it was correlated to atomic force microscopy roughness. For SSNGs, the IOLs were artificially aged up to 10 years, followed by Scheimpflug densitometry (computer-compatible tape unit [CCTU]) measurements. For glistenings, the IOLs were immersed in a water bath and subjected to temperature changes before analysis. RESULTS The surface haze (n = 10, PIU) was 4.25 ± 0.87 (SD) (CNA0T0), 9.50 ± 1.66 (ZCB00), 39.48 ± 1.97 (ZCB00V), 46.68 ± 3.16 (W-60), 44.70 ± 4.00 (MX60), and 4.42 ± 0.71 (XY1) (P < .001), which showed a strong correlation with surface roughness measurements (R = 0.94, P = .006). The densitometry (n = 10, CCTU at 10 years) was 7.30 ± 1.36 (CNA0T0), 11.88 ± 3.10 (ZCB00), 38.12 ± 2.24 (ZCB00V), 48.13 ± 9.44 (W-60), 20.20 ± 3.84 (MX60), and 6.75 ± 6.66 (XY1) (P < .001), with no significant differences between CNA0T0 vs. ZCB00 and XY1. The glistenings density (n = 30) was the lowest for the CNA0T0, W-60, and MX60 IOLs. CONCLUSIONS The new Clareon CNA0T0, which is manufactured from a hydrophobic acrylic material, exhibited among the lowest levels of surface haze and roughness, SSNGs, and glistenings compared with other commercially available hydrophobic acrylic IOLs.
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Affiliation(s)
- Liliana Werner
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
| | | | - Marcia Ong
- Alcon Vision, LLC, Fort Worth, Texas, USA
| | | | | | | | | | - Miguel A Teus
- Clinica Novovisión, Madrid, Spain; Universidad de Alcalá, Madrid, Spain
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13
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Stanojcic N, Hull C, O'Brart DP. Clinical and material degradations of intraocular lenses: A review. Eur J Ophthalmol 2019; 30:823-839. [PMID: 31387387 DOI: 10.1177/1120672119867818] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To review the published scientific literature concerning clinical and material degradations of intraocular lenses after implantation in cataract surgery. METHODS A search was undertaken using the following databases: CENTRAL (including Cochrane Eyes and Vision Trials Register; The Cochrane Library: Issue 2 of 12 February 2019), Ovid MEDLINE (R) without Revisions (1996 to February week 2, 2019), Ovid MEDLINE (R) (1946 to February week 2, 2019), Ovid MEDLINE (R) Daily Update 19 February 2019, MEDLINE and MEDLINE non-indexed items, Embase (1980-2019, week 7), Embase (1974-2019, 19 February), Ovid MEDLINE (R) and Epub Ahead of Print, in-Process & Other Non-Indexed Citations and Daily (1946 to 19 February 2019), Web of Science (all years), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrial.gov) and the WHO International Clinical Trials Registry Platform (www.who.int/ictrp/search/en). Only published articles in English were selected. Search terms/keywords included 'IOL' or 'intraocular lens', combined with 'opacification', degradation, glistenings, nanoglistenings, whitening, transmittance, light scatter, discolouration/discoloration, performance, quality, material, biocompatibility, calcification, explantation and ultraviolet/UV radiation. Relevant in-article references not returned in our searches were also considered. RESULTS After review of the available articles, the authors included 122 publications in this review, based on the quality of their methodology and their originality. The studies included in this review were randomized controlled trials, cohort studies, case-controlled studies, case series, case reports, laboratory studies and review papers. Differing material degradations of intraocular lenses have been described and their associated pathophysiology studied. Reported anomalies include photochemical alterations, water vacuoles, internal and surface calcific deposits, surface coatings and discolouration. The nature of such changes has been shown to depend on the type of intraocular lenses material used and/or manufacturing processes and storage conditions employed. Changes in the intraocular lens can also be influenced by surgical technique, coexisting ocular pathologies and topical and systemic medications. The clinical significance of these degradations is variable, with some resulting in significant visual disturbance and the need for intraocular lens explantation and others producing only minimal visual impairments. Failure to recognize the precise nature of the problem may lead to unnecessary laser capsulotomy procedures. CONCLUSION Clinical degradations of intraocular lenses are uncommon but have been reported following the implantation of intraocular lenses made of differing biomaterials. Their correct identification and thorough investigation to determine the underlying cause is necessary for optimal patient management and the prevention of such problems. Choosing a lens made of a particular material may be important in patients with certain ocular conditions.
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Affiliation(s)
- Nick Stanojcic
- Department of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London Frost Eye Research Unit, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Christopher Hull
- Division of Optometry and Visual Sciences, School of Health Science, City, University of London, London, UK
| | - David Ps O'Brart
- Department of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London Frost Eye Research Unit, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Miyata K, Ogata M, Honbo M, Mori Y, Minami K. Suppression of surface light scattering in intraocular lenses manufactured using an improved production process. J Cataract Refract Surg 2018; 42:1716-1720. [PMID: 28007102 DOI: 10.1016/j.jcrs.2016.09.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/19/2016] [Accepted: 09/25/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To clinically examine the suppression of surface light scattering after implantation of an intraocular lens (IOL) manufactured using an improved production process. SETTING Miyata Eye Hospital, Miyazaki, Japan. DESIGN Comparative case series. METHODS The prospective case series comprised eyes receiving hydrophobic acrylic Acrysof SN60WF IOLs that were manufactured before and after the improvement. Light scattering on the anterior IOL surface was examined up to 3 years postoperatively using an EAS-1000 anterior segment analyzer. The changes during the postoperative period were evaluated and the 2 IOLs compared. The corrected distance visual acuity (CDVA) and contrast sensitivity under photopic and mesopic conditions were also examined 3 years postoperatively. RESULTS The case series comprised 24 eyes (received IOL before improvement) and 27 eyes (received IOL after improvement). After the improvement, the IOLs showed no increase in surface light scattering up to 2 years, while there were increases after 2 years in the other IOLs. The light scattering with the improved IOL was significantly reduced at all observations (P < .048, t test with Holm correction). No difference was found in the CDVA and contrast sensitivity. CONCLUSIONS The improvement in the production process effectively decreased and slowed the development of surface light scattering. The slower increase in the improved IOL 3 years postoperatively showed that the development of water aggregates would not be completely prevented. FINANCIAL DISCLOSURE None of the authors has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
| | | | | | - Yosai Mori
- From the Miyata Eye Hospital, Miyakonojo, Japan
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15
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Luo F, Bao X, Qin Y, Hou M, Wu M. Subjective Visual Performance and Objective Optical Quality With Intraocular Lens Glistening and Surface Light Scattering. J Refract Surg 2018; 34:372-378. [DOI: 10.3928/1081597x-20180406-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 04/02/2018] [Indexed: 01/19/2023]
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16
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Oshika T, Ando H, Inoue Y, Eguchi S, Sato Y, Sugita T, Nishimura T, Hayashi K, Fujita Y, Miyata A, Sasaki N, Miyata K. Influence of surface light scattering and glistenings of intraocular lenses on visual function 15 to 20 years after surgery. J Cataract Refract Surg 2018; 44:219-225. [DOI: 10.1016/j.jcrs.2017.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 11/29/2017] [Accepted: 12/03/2017] [Indexed: 11/16/2022]
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17
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Beiko GH, Gostimir M, Haj-Ahmad L. A comparison of mesopic visual acuity and objective visual quality following cataract surgery with hydrophobic acrylic intraocular lenses. Clin Ophthalmol 2017; 11:641-646. [PMID: 28435215 PMCID: PMC5391164 DOI: 10.2147/opth.s131607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate mesopic visual acuity and visual quality as measured by objective scatter index (OSI) in pseudophakic eyes with long-term follow-up after implantation of hydrophobic acrylic lenses made from two different lens materials. SETTING This study was carried out in a private clinic. DESIGN This study was an observational cohort study. METHODS This pilot study included 181 eyes of 136 patients who had undergone cataract surgery with implantation of monofocal hydrophobic acrylic intraocular lenses (IOLs), either Alcon AcrySof (82 eyes) or Abbott Medical Optics' Tecnis (99 eyes). The monocular corrected distance visual acuity (CDVA) of the subjects was recorded under mesopic room illumination and OSI was measured by an optical quality analysis system using double-pass wavefront method. RESULTS Mean follow-up duration was 60.07±18.82 months. Eyes implanted with Tecnis IOLs had statistically significantly better mesopic CDVA (0.08±0.08) compared to those implanted with AcrySof IOLs (0.11±0.07) (P=0.020). Mesopic CDVA of 20/25 or better was found in 79.8% of eyes in the Tecnis group compared to 62.2% of eyes in AcrySof group. Similarly, OSI was also found to be statistically significantly better for Tecnis IOLs compared to AcrySof IOL group (mean OSI, Tecnis: 1.65±0.92, AcrySof: 2.01±1.36; P=0.033). When glaucomatous eyes were excluded, OSI was still significantly better (P=0.028) in the Tecnis IOL group. CONCLUSION The eyes implanted with Tecnis IOLs showed better long-term optical performance in terms of both OSI and mesopic visual acuity in comparison to those with AcrySof IOLs.
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Affiliation(s)
- George Hh Beiko
- University of Toronto, Toronto.,McMaster University, Hamilton
| | - Miso Gostimir
- Ottawa University Medical School, Ottawa University, Ottawa, ON
| | - Lila Haj-Ahmad
- McGill University Medical School, McGill University, Montreal, QC, Canada
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Oshika T, Eguchi S, Goto H, Ohashi Y. Outbreak of Subacute-Onset Toxic Anterior Segment Syndrome Associated with Single-Piece Acrylic Intraocular Lenses. Ophthalmology 2017; 124:519-523. [DOI: 10.1016/j.ophtha.2016.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/06/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022] Open
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19
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Hiraoka T, Miyata K, Hayashidera T, Iida M, Takada K, Minami K, Oshika T. Influence of intraocular lens subsurface nanoglistenings on functional visual acuity. PLoS One 2017; 12:e0173574. [PMID: 28328997 PMCID: PMC5362055 DOI: 10.1371/journal.pone.0173574] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 02/23/2017] [Indexed: 11/22/2022] Open
Abstract
To investigate the influence of intraocular lens subsurface nanoglistenings (SSNGs) on functional visual acuity (FVA), thirty-nine eyes of 29 patients were examined in this study. The SSNG group comprised 19 eyes of 14 patients (75.7± 5.4 years, mean ± standard deviation), and the control group comprised 20 eyes of 15 patients (73.6 ± 6.5 years). The SSNGs were diagnosed on the basis of the typical whitish IOL appearance upon slit-lamp examination and results of densitometry regarding surface light scattering using Scheimpflug images. The FVA measurement system (AS-28; Kowa, Aichi, Japan) was used to examine changes in continuous visual acuity (VA) over time, and visual function parameters such as FVA, visual maintenance ratio (VMR), maximum VA, minimum VA, standard deviation of VA, and number of blinks were assessed. The results were compared between the SSNG and control groups, and correlations of FVA parameters with the intensity of surface light scattering, time after surgery, and age were also evaluated. There were significant differences in VMR (P = 0.035) and standard deviation of VAs (P = 0.031) between the two groups, although no significant differences were found in baseline VA, FVA, maximum VA, minimum VA, and number of blinks. None of the FVA parameters showed any significant correlations with the intensity of surface light scattering, time after surgery, or age. There is a possibility that VA is unstable during a continuous gazing task in patients with SSNGs.
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Affiliation(s)
- Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
- * E-mail:
| | - Kazunori Miyata
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Takeshi Hayashidera
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masaharu Iida
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Keita Takada
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Keiichiro Minami
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Evaluation of paraxial forward scattering from intraocular lens with increased surface light scattering using goniophotometry and Hartmann-Shack wavefront aberrometry. Jpn J Ophthalmol 2017; 61:189-194. [DOI: 10.1007/s10384-016-0495-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/30/2016] [Indexed: 10/20/2022]
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21
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Change in light scattering caused by glistenings in hydrophobic acrylic intraocular lenses from 10 to 15 years after surgery. J Cataract Refract Surg 2016; 42:864-9. [DOI: 10.1016/j.jcrs.2016.02.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 11/19/2022]
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22
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Shiraya T, Kato S, Minami K, Miyata K. Influence of surface light scattering in hydrophobic acrylic intraocular lenses on laser beam transmittance. Int Ophthalmol 2016; 37:251-255. [PMID: 27221266 DOI: 10.1007/s10792-016-0256-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 05/12/2016] [Indexed: 10/21/2022]
Abstract
The aim of this study was to experimentally examine the changes in the transmittances of photocoagulation lasers when surface light scattering increases in AcrySof intraocular lenses (IOLs). SA60AT IOLs (Alcon) were acceleratingly aging for 0, 3, 5, and 10 years to simulate surface light scattering, and the surface light-scattering intensities of both IOL surfaces were measured using a Scheimpflug photographer. The powers of laser beams that passed from a laser photocoagulator through the aged IOLs were measured at 532, 577, and 647 nm. Changes in the laser power and transmittance with the years of aging and the intensities of surface light scattering were examined. Although the intensity of surface light scattering increased with the years of aging, the laser power did not change with the years of aging (P > 0.30, Kruskal-Wallis test). There were no significant changes in the laser transmittance with the years of aging or the laser wavelength (P > 0.30 and 0.57, respectively). The intensity of surface light scattering revealed no significant association with the laser transmittance at any wavelength (P > 0.37, liner regression). The increases in the surface light scattering of the AcrySof IOLs would not influence retinal photocoagulation treatments for up to 10 years after implantation.
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Affiliation(s)
- Tomoyasu Shiraya
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Satoshi Kato
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | | | - Kazunori Miyata
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Miyata Eye Hospital, Miyakonojo, Miyazaki, Japan
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23
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DeHoog E, Doraiswamy A. Evaluation of loss in optical quality of multifocal intraocular lenses with glistenings. J Cataract Refract Surg 2016; 42:606-12. [PMID: 27113885 DOI: 10.1016/j.jcrs.2015.10.071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 10/07/2015] [Accepted: 10/18/2015] [Indexed: 11/26/2022]
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Werner L, Stover JC, Schwiegerling J, Das KK. Light scattering, straylight, and optical quality in hydrophobic acrylic intraocular lenses with subsurface nanoglistenings. J Cataract Refract Surg 2016; 42:148-56. [DOI: 10.1016/j.jcrs.2015.07.043] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/15/2015] [Accepted: 07/22/2015] [Indexed: 11/28/2022]
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25
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Minami K, Honbo M, Mori Y, Kataoka Y, Miyata K. Area densitometry using rotating Scheimpflug photography for posterior capsule opacification and surface light scattering analyses. J Cataract Refract Surg 2015; 41:2444-9. [DOI: 10.1016/j.jcrs.2015.05.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/20/2015] [Accepted: 05/22/2015] [Indexed: 11/24/2022]
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Beiko GHH, Grzybowski A. Intraocular lens implants: Do they come with a life time guaranty? Saudi J Ophthalmol 2015; 29:247-8. [PMID: 26586972 PMCID: PMC4625136 DOI: 10.1016/j.sjopt.2015.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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27
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Beiko GH. A pilot study to determine if intraocular lens choice at the time of cataract surgery has an impact on patient-reported driving habits. Clin Ophthalmol 2015; 9:1573-9. [PMID: 26357458 PMCID: PMC4559235 DOI: 10.2147/opth.s90886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To determine if intraocular lens (IOL) choice at the time of cataract surgery affects driving habits. MATERIALS AND METHODS Pseudophakes who were 28-35 months postbilateral cataract surgery with one of two contemporary one-piece hydrophobic acrylic IOLs (SN60WF or ZCB00) were asked to complete the Driving Habits Questionnaire, a validated instrument for determining self-reported driving status, frequency, and difficulty. To determine if there were any differences in driving habits between the two groups, t-tests and χ (2) tests were used. RESULTS Of 90 respondents, 72 (40 SN60WF and 32 ZCB00) were still active drivers. The SN60WF-implanted subjects were less likely to drive at the same speed or faster than the general flow of traffic, less likely to rate their quality of driving as average/above average, less likely to have traveled beyond their immediate neighborhood, less likely to drive at night, more likely to have moderate-to-severe difficulty driving at night, and more likely to have self-reported road traffic accidents. The differences did not reach statistical significance. CONCLUSION Changes in patients' driving habits 2-3 years after cataract surgery may be associated with the type of IOL implanted. A larger study, powered to demonstrate statistical significance, is needed to verify the trends identified in this pilot study and discover possible contributing factors.
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Affiliation(s)
- George Hh Beiko
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada ; Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, ON, Canada
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Miyata K, Honbo M, Nejima R, Minami K, Amano S. Long-term observation of surface light scattering in a foldable acrylic intraocular lens. J Cataract Refract Surg 2015; 41:1205-9. [DOI: 10.1016/j.jcrs.2014.09.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 08/31/2014] [Accepted: 09/21/2014] [Indexed: 10/23/2022]
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29
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Beheregaray S, Yamamoto T, Hiraoka T, Oshika T. Influence on visual function of forward light scattering associated with subsurface nanoglistenings in intraocular lenses. J Cataract Refract Surg 2014; 40:1147-54. [DOI: 10.1016/j.jcrs.2013.10.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 10/15/2013] [Accepted: 10/30/2013] [Indexed: 10/25/2022]
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Evaluation of the impact of light scatter from glistenings in pseudophakic eyes. J Cataract Refract Surg 2014; 40:95-103. [PMID: 24355722 DOI: 10.1016/j.jcrs.2013.10.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 05/28/2013] [Accepted: 06/05/2013] [Indexed: 11/22/2022]
Abstract
PURPOSE To study the impact of light scatter from glistenings in pseudophakic eyes using ray tracing in a model eye SETTING Department of Research, Advanced Vision Science, Inc., Goleta, California, USA. DESIGN Mathematical modeling and simulation. METHODS A pseudophakic eye model was constructed in Zemax using the Arizona eye model as the basis. The Mie scattering theory was used to describe the intensity and direction of light as it scatters for a spherical particle immersed in a given media (intraocular lens [IOL]). The modeling and evaluation of scatter and modulation transfer function (MTF) were performed for several biomaterials with various size and density of glistenings under scotopic, mesopic, and photopic conditions. RESULTS As predicted by the Mie theory, the amount of scatter was a function of the relative difference in refractive index between the media and the scatterer, the size of the scatterer, and the volume fraction of the scatterer. The simulation demonstrated that an increase in density of glistenings can lead to a significant drop in the MTF of the IOL and the pseudophakic eye. This effect was more pronounced in IOLs with smaller cavitations, and the observation was consistent for all tested biomaterials. CONCLUSIONS Mathematical modeling demonstrated that glistenings in IOLs will lead to reduction in the MTF of the IOL and the pseudophakic eye. The loss in MTF was more pronounced at high densities and small cavitation sizes across all biomaterials. Inconsistent and poor clinical quantification of glistenings in IOLs may explain some inconsistencies in the literature.
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Morris C, Werner L, Barra D, Liu E, Stallings S, Floyd A. Light scattering and light transmittance of cadaver eye-explanted intraocular lenses of different materials. J Cataract Refract Surg 2014; 40:129-37. [PMID: 24355724 DOI: 10.1016/j.jcrs.2013.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 07/01/2013] [Accepted: 07/02/2013] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate light scattering and light transmittance in cadaver eye-explanted intraocular lenses (IOLs) manufactured from different materials. SETTING John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. DESIGN Experimental study. METHODS Forty-nine pseudophakic cadaver eyes were selected according to IOL material/type and implantation duration, and the IOLs were explanted. Hydrophobic acrylic, hydrophilic acrylic, poly(methyl methacrylate) (PMMA), and silicone IOLs were included. Gross and light microscopy was performed for all IOLs. Light scattering was measured with an EAS 1000 Scheimpflug camera, and light transmittance was assessed using a Lambda 35 UV/Vis spectrophotometer (single-beam configuration with an RSA PE-20 integrating sphere). Analyses were performed at room temperature in the hydrated state and compared with analyses of controls. RESULTS The highest levels of surface light scattering were measured for 3-piece hydrophobic acrylic, which was also the IOL type with the longest implantation duration among the Acrysof hydrophobic acrylic IOLs. Hydrophilic acrylic, PMMA, and silicone IOLs exhibited relatively low light-scattering levels. The lowest light-scattering levels were observed with PMMA IOLs (1-piece looped and 3-piece) and plate silicone IOLs, which represent the IOL types with the longest implantation duration in this series. Light transmittance values measured for all IOL types appeared to be similar to the values of the corresponding control IOLs. CONCLUSIONS The phenomenon of surface light scattering (nanoglistenings) is more particularly related to hydrophobic acrylic IOLs and increases with implantation time. No significant effect of surface light scattering on IOL light transmittance was found.
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Affiliation(s)
- Caleb Morris
- From the Department of Ophthalmology and Visual Sciences (Morris, Werner, Liu, Stallings, Floyd), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA; and Visão Institutos Oftalmológicos Associados (Barra), Brasília, DF, Brazil
| | - Liliana Werner
- From the Department of Ophthalmology and Visual Sciences (Morris, Werner, Liu, Stallings, Floyd), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA; and Visão Institutos Oftalmológicos Associados (Barra), Brasília, DF, Brazil.
| | - Daniel Barra
- From the Department of Ophthalmology and Visual Sciences (Morris, Werner, Liu, Stallings, Floyd), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA; and Visão Institutos Oftalmológicos Associados (Barra), Brasília, DF, Brazil
| | - Erica Liu
- From the Department of Ophthalmology and Visual Sciences (Morris, Werner, Liu, Stallings, Floyd), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA; and Visão Institutos Oftalmológicos Associados (Barra), Brasília, DF, Brazil
| | - Shannon Stallings
- From the Department of Ophthalmology and Visual Sciences (Morris, Werner, Liu, Stallings, Floyd), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA; and Visão Institutos Oftalmológicos Associados (Barra), Brasília, DF, Brazil
| | - Anne Floyd
- From the Department of Ophthalmology and Visual Sciences (Morris, Werner, Liu, Stallings, Floyd), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA; and Visão Institutos Oftalmológicos Associados (Barra), Brasília, DF, Brazil
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Minami K, Maruyama Y, Honbo M, Matsunaga J, Miyata K. In vitro examination of surface light scattering in hydrophobic acrylic intraocular lenses. J Cataract Refract Surg 2014; 40:652-6. [DOI: 10.1016/j.jcrs.2013.10.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 09/28/2013] [Accepted: 10/20/2013] [Indexed: 11/27/2022]
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Miyata K, Honbo M, Matsunaga J, Minami K. Surface light scattering in intraocular lenses manufactured with the optimized production process: 12-month results. J Cataract Refract Surg 2014; 40:498-9. [PMID: 24480561 DOI: 10.1016/j.jcrs.2014.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Indexed: 11/28/2022]
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34
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Light transmittance of 1-piece hydrophobic acrylic intraocular lenses with surface light scattering removed from cadaver eyes. J Cataract Refract Surg 2014; 40:114-20. [DOI: 10.1016/j.jcrs.2013.05.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/29/2013] [Accepted: 05/23/2013] [Indexed: 11/19/2022]
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35
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Optical performance of hydrophobic acrylic intraocular lenses with surface light scattering. J Cataract Refract Surg 2014; 40:104-13. [DOI: 10.1016/j.jcrs.2013.05.051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 05/14/2013] [Accepted: 05/15/2013] [Indexed: 11/23/2022]
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36
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Bissen-Miyajima H, Minami K, Yoshino M, Taira Y. Surface light scattering and visual function of diffractive multifocal hydrophobic acrylic intraocular lenses 6 years after implantation. J Cataract Refract Surg 2013; 39:1729-33. [DOI: 10.1016/j.jcrs.2013.05.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 05/17/2013] [Accepted: 05/21/2013] [Indexed: 10/26/2022]
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Yoshino M, Bissen-Miyajima H, Minami K, Taira Y. Five-year postoperative outcomes of apodized diffractive multifocal intraocular lens implantation. Jpn J Ophthalmol 2013; 57:510-513. [PMID: 24077812 DOI: 10.1007/s10384-013-0277-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 06/24/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the long-term postoperative visual performance of an apodized diffractive multifocal intraocular lens (IOL). METHODS Twenty-one patients (42 eyes) underwent cataract surgery with bilateral implantation of an apodized diffractive multifocal IOL. The monocular uncorrected and corrected distance visual acuities, uncorrected, distance-corrected and corrected near visual acuities, and manifest refractive spherical equivalent were measured 1 and 5 years postoperatively. The contrast sensitivity, incidence of glare or halos, and rate of neodynium:YAG (Nd:YAG) posterior capsulotomy were evaluated 5 years postoperatively. RESULTS No significant differences were found between the distance and near visual acuities at 1 and 5 years postoperatively. The contrast sensitivity was within the normal range for all spatial frequencies. No patients reported severe glare or halos. Six (14.3 %) eyes required Nd:YAG posterior capsulotomy. CONCLUSIONS The apodized diffractive multifocal IOL provides good, stable distance and near visual acuity levels over a 5-year follow-up period.
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Affiliation(s)
- Mami Yoshino
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, 2-9-18 Misaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan,
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van der Mooren M, Franssen L, Piers P. Effects of glistenings in intraocular lenses. BIOMEDICAL OPTICS EXPRESS 2013; 4:1294-1304. [PMID: 24009993 PMCID: PMC3756585 DOI: 10.1364/boe.4.001294] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/27/2013] [Accepted: 07/08/2013] [Indexed: 06/02/2023]
Abstract
Glistenings consist of multiple microvacuoles in intraocular lenses (IOLs) that cause retinal stray light and may affect quality of vision. For four IOL types, the microvacuole particle size distribution and particle volume density was measured using confocal light microscopy and dark field microscopy, and the corresponding extinction coefficient γ was determined. The light scatter contribution induced by microvacuoles was measured as function of both angle and extinction, and was verified by calculations using Mie theory. Two IOL types possessed significant glistenings having stray light levels higher than that of a healthy 20 year old crystalline lens corresponding to γ ≥ 0.08 mm(-1).
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Etiology of surface light scattering on hydrophobic acrylic intraocular lenses. J Cataract Refract Surg 2013; 38:1833-44. [PMID: 22999603 DOI: 10.1016/j.jcrs.2012.05.043] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 05/09/2012] [Accepted: 05/09/2012] [Indexed: 11/20/2022]
Abstract
PURPOSE To study the etiology of surface light scattering on hydrophobic acrylic intraocular lenses (IOLs). SETTING Alcon Research Laboratories, Fort Worth, Texas, USA. DESIGN Experimental study. METHODS Intraocular lenses were obtained from clinical explantations (n = 5), from human cadavers (n = 8), and from finished-goods inventory (controls). Surface light scattering was measured and imaged with the IOLs in various hydration states (dry, short-term wetted, and long-term hydrated) before and after proteins were quantified and removed. Selected IOL samples were analyzed with x-ray photoelectron spectroscopy, scanning electron microscopy (SEM) with energy-dispersion x-ray analysis, Fourier-transform infrared spectroscopy with attenuated total reflectance, and cryogenic SEM with a focused ion beam. RESULTS No inorganic deposits or organic changes were observed on any IOL surface. Under clinically relevant hydrated conditions, surface light-scattering intensity was independent of proteinaceous biofilm state (P≥.11). Instead, the hydration state of the IOLs significantly contributed to the intensity of surface light scattering (P<.001); clinically explanted and cadaver-eye IOLs (but not control IOLs) exhibited minimal scatter when dry, intermediate scatter when wetted, and maximum scatter when hydrated. Subsurface nanoglistenings with diameters less than a micron and with locations up to 120 μm from the surface of the IOLs were characterized by SEM with a focused ion beam and were identified as the source of the hydration-related surface light scattering. CONCLUSION Surface light scattering on hydrophobic IOLs was predominantly caused by hydration-related subsurface nanoglistenings within the acrylic IOL material.
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