1
|
Prager AJ, Henning N, Burns L, Ramaprasad A, Basti S, Laronda MM. Utilizing 3D Printing Technology to Create Prosthetic Irises: Proof of Concept and Workflow. Bioengineering (Basel) 2023; 10:1287. [PMID: 38002411 PMCID: PMC10669136 DOI: 10.3390/bioengineering10111287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/01/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
PURPOSE There are currently limited treatment options for aniridia. In this context, 3D printed iris implants may provide a cost-effective, cosmetically acceptable alternative for patients with aniridia. The purpose of this study was to develop a proof-of-concept workflow for manufacturing 3D printed iris implants using a silicone ink palette that aesthetically matches iris shades, identified in slit lamp images. METHODS Slit lamp iris photos from 11 healthy volunteers (3 green; 4 blue; 4 brown) were processed using k-means binning analyses to identify two or three prominent colors each. Candidate silicone inks were created by precisely combining pigments. A crowdsourcing survey software was used to determine color matches between the silicone ink swatches and three prominent iris color swatches in 2 qualifying and 11 experimental workflows. RESULTS In total, 54 candidate silicone inks (20 brown; 16 green; 18 blue) were developed and analyzed. Survey answers from 29 individuals that had passed the qualifying workflow were invited to identify "best matches" between the prominent iris colors and the silicone inks. From this color-match data, brown, blue, and green prototype artificial irises were printed with the silicone ink that aesthetically matched the three prominent colors. The iris was printed using a simplified three-layer five-branch starburst design at scale (12.8 mm base disc, with 3.5 mm pupil). CONCLUSIONS This proof-of-concept workflow produced color-matched silicone prosthetic irises at scale from a panel of silicone inks using prominent iris colors extracted from slit lamp images. Future work will include printing a more intricate iris crypt design and testing for biocompatibility.
Collapse
Affiliation(s)
- Alisa J. Prager
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA (A.R.); (S.B.)
| | - Nathaniel Henning
- Stanley Manne Children’s Research Institute, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA; (N.H.); (L.B.)
- Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Lauren Burns
- Stanley Manne Children’s Research Institute, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA; (N.H.); (L.B.)
- Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Abhijit Ramaprasad
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA (A.R.); (S.B.)
| | - Surendra Basti
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA (A.R.); (S.B.)
- Stanley Manne Children’s Research Institute, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA; (N.H.); (L.B.)
| | - Monica M. Laronda
- Stanley Manne Children’s Research Institute, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA; (N.H.); (L.B.)
- Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| |
Collapse
|
2
|
Lisbjerg K, Jordana JT, Brandt VN, Kjølholm C, Kessel L. Vision-Related Quality of Life in Danish Patients with Albinism and the Impact of an Updated Optical Rehabilitation. J Clin Med 2023; 12:5451. [PMID: 37685518 PMCID: PMC10488237 DOI: 10.3390/jcm12175451] [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: 07/06/2023] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: Albinism is characterized by a lack of pigment in eyes, hair, and skin and developmental changes in the eye such as foveal hypoplasia. Patients require optical rehabilitation due to low vision, refractive errors, and photosensitivity. We aimed to assess vision-related quality of life in patients with albinism and to evaluate how this was affected by optical rehabilitation. (2) Methods: Patients with ocular or oculocutaneous albinism were invited for the study. Free-of-charge optical rehabilitation was provided as needed, including filters, glasses for near or distance, contact lenses, magnifiers or binoculars. Vision-related quality of life was assessed prior to and after optical rehabilitation using the visual function questionnaire (VFQ39) and the effect of optical rehabilitation was evaluated after accounting for age, gender, and visual acuity. (3) Results: Seventy-eight patients filled out the VFQ39 at the initial visit. Fifty patients (64.1%) returned the questionnaire 3-6 months after optical rehabilitation. The mean age of included patients was 35.9 years (standard deviation 16.6), and their best corrected distance visual acuity was 56 ETDRS letters (range 3-81). The VFQ39 composite score improved significantly from a median of 62.5 (range 14.2-77.0) to 76.5 (20.6-99.6). Significant improvements were seen for ocular pain, social functioning, mental health, role difficulties, and dependency, whereas self-assessed distance or near visual functions did not change. (4) Conclusions: Optical rehabilitation improved the self-reported vision-related quality of life in Danish patients with albinism on a number of parameters related to leading an independent and worry-free life, whereas visual improvement for distance and near tasks was likely limited by the nature of the disease and by the fact that most patients already had access to some optical aids prior to the study.
Collapse
Affiliation(s)
- Kristian Lisbjerg
- Department of Ophthalmology, Copenhagen University Hospital—Righospitalet, 2600 Glostrup, Denmark; (K.L.); (J.T.J.); (V.N.B.); (C.K.)
| | - Joaquim Torner Jordana
- Department of Ophthalmology, Copenhagen University Hospital—Righospitalet, 2600 Glostrup, Denmark; (K.L.); (J.T.J.); (V.N.B.); (C.K.)
| | - Vibeke N. Brandt
- Department of Ophthalmology, Copenhagen University Hospital—Righospitalet, 2600 Glostrup, Denmark; (K.L.); (J.T.J.); (V.N.B.); (C.K.)
| | - Christine Kjølholm
- Department of Ophthalmology, Copenhagen University Hospital—Righospitalet, 2600 Glostrup, Denmark; (K.L.); (J.T.J.); (V.N.B.); (C.K.)
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital—Righospitalet, 2600 Glostrup, Denmark; (K.L.); (J.T.J.); (V.N.B.); (C.K.)
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen N, Denmark
| |
Collapse
|
3
|
Yang J, Wu S, Zhang C, Yu W, Dai R, Chen Y. Global trends and frontiers of research on pathologic myopia since the millennium: A bibliometric analysis. Front Public Health 2022; 10:1047787. [PMID: 36561853 PMCID: PMC9763585 DOI: 10.3389/fpubh.2022.1047787] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
Background and purpose Pathologic myopia (PM) is an international public health issue. This study aimed to analyze PM research trends by reporting on publication trends since 2000 and identifying influential journals, countries, authors, and keywords involved in PM. Methods A bibliometric analysis was performed to evaluate global production and development trends in PM since 2000 and the keywords associated with PM. Results A total of 1,435 publications were retrieved. PM has become a fascinating topic (with relative research interest ranging from 0.0018% in 2000 to 0.0044% in 2021) and a global public health issue. The top three countries with the highest number of publications were China, the USA, and Japan. The journals, authors, and institutions that published the most relevant literature came from these three countries. China exhibited the most rapid increase in the number of publications (from 0 in 2000 to 69 in 2021). Retina published the most papers on PM. Kyoko Ohno-Matsui and Tokyo Medical and Dental University contributed the most publications among authors and institutions, respectively. Based on keyword analysis, previous research emphasized myopic choroidal neovascularization and treatment, while recent hotspots include PM changes based on multimodal imaging, treatment, and pathogenesis. Keyword analysis also revealed that deep learning was the latest hotspot and has been used for the detection of PM. Conclusion Our results can help researchers understand the current status and future trends of PM. China, the USA, and Japan have the greatest influence, based on the number of publications, top journals, authors, and institutions. Current research on PM highlights the pathogenesis and application of novel technologies, including multimodal imaging and artificial intelligence.
Collapse
Affiliation(s)
- Jingyuan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Shan Wu
- Department of Anaesthesiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chenxi Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Weihong Yu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Rongping Dai
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,*Correspondence: Youxin Chen
| |
Collapse
|
4
|
Miyoshi LH, Hollaender MA, Giglio VB, Villela FF, Alves MR. Piggyback Photochromic Contact Lens for Visual Rehabilitation and Photophobia Management in Traumatic Aniridia. Eye Contact Lens 2021; 47:677-679. [PMID: 34653042 DOI: 10.1097/icl.0000000000000833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT We report herein a case of fitting with a photochromic silicone hydrogel contact lens under a rigid gas-permeable lens (piggyback system) for photophobia and low vision correction after traumatic aniridia and aphakia. A 40-year-old woman was referred to our practice for contact lens fitting in her right eye, which was left aphakic after an open globe injury. She also presented traumatic aniridia in the right eye, and her left eye had been previously eviscerated. A successful fitting was obtained with a photochromic silicone hydrogel (senofilcon A) contact lens, with a Dk/t of 121 × 10-9, under an aspheric design, +13.00 D rigid gas-permeable lens. The patient displayed visual acuity and contrast sensitivity improvement and reported decreased photophobia.
Collapse
|
5
|
Álvarez de Toledo Elizalde J, López García S, Benítez Del Castillo JM, Durán de la Colina J, Gris Castejón O, Celis Sánchez J, Herreras Cantalapiedra JM. Aniridia and the ocular surface: Medical and surgical problems and solutions. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96 Suppl 1:15-37. [PMID: 34836585 DOI: 10.1016/j.oftale.2021.04.003] [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: 12/09/2020] [Accepted: 04/12/2021] [Indexed: 06/13/2023]
Abstract
Congenital aniridia is a multisystemic genetic disease due to a mutation in PAX6 gene which severely affects the development and functionality of the human eyes. In patients affected by the mutation, aside from the absence or defects of iris tissue formation, abnormalities in position or opacities of the crystalline lens, macular hypoplasia, ocular surface disease is the main cause of visual loss and the deterioration of the quality of life of most patients. Limbal stem cell deficiency combined with tear film instability and secondary dry eye cause aniridic keratopathy which, in advanced stages, ends up in corneal opacification. In this paper, the actual knowledge about congenital aniridia keratopathy physiopathology and medical and surgical treatment options and their efficacy are discussed. Indications and results of topical treatments with artificial tears and blood-derivatives in its initial stages, and different surgical techniques as limbal stem cell transplantation, keratoplasty and keratoprostheses are reviewed. Finally, recent advances and results in regenerative medicine techniques with ex vivo stem cell cultivation or other types of cultivated cells are presented.
Collapse
Affiliation(s)
| | - S López García
- Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - J M Benítez Del Castillo
- Cátedra de Oftalmología, Hospital Clínico San Carlos, Universidad Complutense, Clínica Rementería, Madrid, Spain
| | - J Durán de la Colina
- Cátedra de Oftalmología, Universidad del País Vasco, Instituto Clínico-Quirúrgico de Oftalmología, Bilbao, Spain
| | - O Gris Castejón
- Departamento de Córnea y Superficie Ocular, Instituto de Microcirugía Ocular de Barcelona (IMO), Barcelona, Spain
| | - J Celis Sánchez
- Unidad de Córnea y Superficie ocular, Hospital La Mancha-Centro, Alcázar de San Juan, Spain
| | - J M Herreras Cantalapiedra
- Instituto Universitario de Oftalmobiología Aplicada (IOBA) de la Universidad de Valladolid, Servicio de Oftalmología del Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| |
Collapse
|
6
|
Vásquez Quintero A, Pérez-Merino P, Fernández García AI, De Smet H. Smart contact lens: A promising therapeutic tool in aniridia. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96 Suppl 1:68-73. [PMID: 34836591 DOI: 10.1016/j.oftale.2021.01.004] [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: 12/01/2020] [Accepted: 01/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The perform pre-clinical testing using optical design tools to simulate the optical quality of a smart artificial iris platform encapsulated in a scleral contact lens. These tools allow us to generate aniridia eye models and evaluate different metrics of visual quality and retinal illumination based on the aperture of the artificial iris based on liquid crystals. METHOD The OCT imaging technique was used to measure the geometry of the anterior segment in a patient with aniridia and, from these data, the eye model was generated with the Zemax optical design program and specific programs developed in Matlab. Ocular aberrations were calculated and the visual function of the anirida eye model was evaluated in three scenarios: (i) without optical correction, (ii) with correction with a commercial scleral contact lens, and (iii) with correction with an optical lens. Intelligent contact based on artificial iris. RESULTS Optical quality in patients with aniridia is limited by the magnitude of high-order aberrations. Conventional scleral contact lens design accurately corrects for blur but is unable to compensate for high-order ocular aberrations, especially spherical aberrations. The artificial iris-based smart contact lens design enables virtually all high-order aberrations to be compensated with active control of the pupillary diameter (activation of liquid crystal cells based on ambient lighting). In addition to minimizing high-order aberrations, reducing the pupil size would increase the depth of focus. CONCLUSIONS This article demonstrates by means of optical simulations the concept of an intelligent artificial iris platform encapsulated in a scleral contact lens and its possible application in patients with aniridia. Furthermore, it allows us to anticipate possible visual results in clinical trials with healthy patients (after application of mydriatic agents) and in patients with aniridia. The results demonstrate a better visual quality and a decrease in retinal illumination.
Collapse
Affiliation(s)
| | - P Pérez-Merino
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Medical Engineering Development and Innovation Center, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - H De Smet
- Ghent University/IMEC, Zwijnaarde, Belgium
| |
Collapse
|
7
|
Alipour F, Jamshidi Gohari S, Azad N, Mehrdad R. Miniscleral Contact Lens in Pediatric Age Group: Indications, Safety, and Efficacy. Eye Contact Lens 2021; 47:408-412. [PMID: 34001712 DOI: 10.1097/icl.0000000000000798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To report indications, fitting feasibility, and safety of miniscleral design (MSD) lenses in children. METHODS Medical records of patients aged <18 years at the time of referral to Contact Lens Clinic of Farabi Eye Hospital, because of inadequate spectacle-corrected visual acuity, rigid gas-permeable or soft contact lens intolerance, and ocular surface disease were reviewed. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), best-corrected vision with the lens (CCVA), lens parameters, and comfortable daily wearing time (CDWT) were documented. RESULTS Seventy-two eyes of 52 pediatric patients were fitted with MSD lens over a 9-year period. The indications for MSD lens fitting were keratoconus (29 eyes), corneal scarring from ocular trauma (16 eyes), ocular surface diseases (25 eyes), and postkeratitis corneal scar (2 eyes). The average UCVA and the mean difference between CCVA and BSCVA were 1.20 and 0.55 logarithm of the minimal angle of resolution, respectively, which shows statistically significant improvement. This significant increase in vision was even seen in those who were referred for the management of ocular surface diseases. The mean CDWT for most patients was 10 hr/day. CONCLUSION Miniscleral design lens can be used as a safe and helpful modality to provide good vision and comfort in children experiencing ectatic disorders, traumatic corneal scars, and ocular surface diseases.
Collapse
Affiliation(s)
- Fateme Alipour
- Eye Research Center (F.A., S.J.G.), Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran ; School of Biology, College of Science (N.A.), University of Tehran, Tehran, Iran; and Center for Research on Occupational Diseases (R.M.), Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | |
Collapse
|
8
|
Vásquez Quintero A, Pérez-Merino P, Fernández García AI, De Smet H. Smart contact lens: a promising therapeutic tool in aniridia. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:S0365-6691(21)00029-0. [PMID: 33627237 DOI: 10.1016/j.oftal.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/05/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To perform pre-clinical testing using optical design tools to simulate the optical quality of a smart artificial iris platform encapsulated in a scleral contact lens. These tools allow us to generate aniridia eye models and evaluate different metrics of visual quality and retinal illumination based on the aperture of the artificial iris based on liquid crystals. METHOD The OCT imaging technique was used to measure the geometry of the anterior segment in a patient with aniridia and, from these data, the eye model was generated with the Zemax optical design program and specific programs developed in Matlab. Ocular aberrations were calculated and the visual function of the anirida eye model was evaluated in three scenarios: (i) without optical correction, (ii) with correction with a commercial scleral contact lens, and (iii) with correction with an optical lens. intelligent contact based on artificial iris. RESULTS Optical quality in patients with aniridia is limited by the magnitude of high-order aberrations. Conventional scleral contact lens design accurately corrects for blur but is unable to compensate for high-order ocular aberrations, especially spherical aberrations. The artificial iris-based smart contact lens design enables virtually all high-order aberrations to be compensated with active control of the pupillary diameter (activation of liquid crystal cells based on ambient lighting). In addition to minimizing high-order aberrations, reducing the pupil size would increase the depth of focus. CONCLUSIONS This article demonstrates by means of optical simulations the concept of an intelligent artificial iris platform encapsulated in a scleral contact lens and its possible application in patients with aniridia. Furthermore, it allows us to anticipate possible visual results in clinical trials with healthy patients (after application of mydriatic agents) and in patients with aniridia. The results demonstrate a better visual quality and a decrease in retinal illumination.
Collapse
Affiliation(s)
| | - P Pérez-Merino
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, España; Medical Engineering Development and Innovation Center, Universidad Autónoma de Madrid, Madrid, España
| | | | - H De Smet
- Ghent University/IMEC, Zwijnaarde, Bélgica
| |
Collapse
|
9
|
Ozcelik F, Ozturk Karabulut G, Ocak OB. The efficacy of low vision aids with contact lenses in pediatric population. Int Ophthalmol 2020; 40:2677-2681. [PMID: 32488591 DOI: 10.1007/s10792-020-01449-7] [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: 07/22/2019] [Accepted: 05/23/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare the efficacy of contact lens use with low vision aids (LVA) with the efficacy of spectacle use with low vision aids. METHODS Thirty-six pediatric patients with low vision were enrolled in this study between January 2015 and March 2017. The patients were examined for best-corrected visual acuity (BCVA) with spectacles, spectacles with LVA, contact lenses and contact lenses with LVA. Toleration of the patients with contact lenses and LVA were recorded at the final follow-up exam. RESULTS The mean BCVA with spectacles was detected as 1.11 ± 0.25 log MAR and the mean BCVA improved to 0.35 ± 0.13 log MAR with the use of spectacles and LVA, which was statistically significant. The mean BCVA with contact lens, which was 0.99 ± 0.22 log MAR, improved to 0.40 ± 0.21 log MAR with contact lens and LVA, which was also significant. There was a statistically significant improvement in BCVA of the patients with contact lenses only when compared to spectacles only. The mean BCVA significantly improved in patients using LVA with contact lenses when compared to LVA with spectacles. Tolerations of the patients with contact lenses and LVA were found to be well at 29 of 36 (80.55%) at final follow-up (26.11 ± 6.85 months). CONCLUSION Contact lens use in pediatric patients with low vision especially with LVA offers better visual acuity, a decrease in nystagmus amplitude, wider field of view and comfort.
Collapse
Affiliation(s)
- Ferah Ozcelik
- Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421, Istanbul, Turkey
| | | | - Osman Bulut Ocak
- Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421, Istanbul, Turkey. .,, Istanbul, Turkey.
| |
Collapse
|
10
|
Slip-and-slide technique for combined small-incision artificial iris and IOL implantation. J Cataract Refract Surg 2020; 46:1433-1435. [PMID: 32483078 DOI: 10.1097/j.jcrs.0000000000000254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A surgical technique is described for reducing surgically induced astigmatism (SIA) during combined implantation of IOL and artificial iris. The CUSTOMFLEX ARTIFICIALIRIS was implanted in 2 patients who suffered from aphakia and complete traumatic aniridia. Implantation of the prosthesis was accompanied by insertion of an IOL that was fixed at the iris implant. Although prosthesis and IOL can be implanted through small incisions individually, the combined package usually requires a larger incision causing greater SIA. The new technique minimizes the SIA because both components are fixed together but can be inserted separately. Final assembling of the iris-IOL package is performed after separate implantation. The technique to implant the artificial iris combined with a nontoric or a toric IOL is described. The slip-and-slide technique was a safe and an effective way to implant an iris-IOL package while keeping the SIA small and reducing the incision size.
Collapse
|
11
|
A novel collaboration: Multifocal RGPs and low vision aids increase quality of life in visually impaired. Cont Lens Anterior Eye 2020; 43:274-276. [DOI: 10.1016/j.clae.2019.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/20/2019] [Accepted: 11/28/2019] [Indexed: 11/24/2022]
|
12
|
Vincent SJ, Fadel D. Optical considerations for scleral contact lenses: A review. Cont Lens Anterior Eye 2019; 42:598-613. [DOI: 10.1016/j.clae.2019.04.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 01/07/2023]
|
13
|
Ruiz-Medrano J, Montero JA, Flores-Moreno I, Arias L, García-Layana A, Ruiz-Moreno JM. Myopic maculopathy: Current status and proposal for a new classification and grading system (ATN). Prog Retin Eye Res 2019; 69:80-115. [PMID: 30391362 DOI: 10.1016/j.preteyeres.2018.10.005] [Citation(s) in RCA: 195] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/18/2018] [Accepted: 10/22/2018] [Indexed: 02/09/2023]
Abstract
Myopia is a highly frequent ocular disorder worldwide and pathologic myopia is the 4th most common cause of irreversible blindness in developed countries. Pathologic myopia is especially common in East Asian countries. Ocular alterations associated with pathologic myopia, especially those involving the macular area-defined as myopic maculopathy-are the leading causes of vision loss in patients with pathologic myopia. High myopia is defined as the presence of a highly negative refractive error (>-6 to -8 diopters) in the context of eye elongation (26-26.5 mm). Although the terms high myopia and pathologic myopia are often used interchangeably, they do not refer to the same eye disease. The two key factors driving the development of pathologic myopia are: 1) elongation of the axial length and 2) posterior staphyloma. The presence of posterior staphyloma, which is the most common finding in patients with pathologic myopia, is the key differentiating factor between high and pathologic myopia. The occurrence of staphyloma will, in most cases, eventually lead to other conditions such as atrophic, traction, or neovascular maculopathy. Posterior staphyloma is for instance, responsible for the differences between a myopic macular hole (MH)-with and without retinal detachment-and idiopathic MH. Posterior staphyloma typically induces retinal layer splitting, leading to foveoschisis in myopic MH, an important differentiating factor between myopic and emmetropic MH. Myopic maculopathy is a highly complex disease and current classification systems do not fully account for the numerous changes that occur in the macula of these patients. Therefore, a more comprehensive classification system is needed, for several important reasons. First, to more precisely define the disease stage to improve follow-up by enabling clinicians to more accurately monitor changes over time, which is essential given the progressive nature of this condition. Second, unification of the currently-available classification systems would establish standardized classification criteria that could be used to compare the findings from international multicentric studies. Finally, a more comprehensive classification system could help to improve our understanding of the genetic origins of this disease, which is clearly relevant given the interchangeable-but erroneous-use of the terms high and pathologic myopia in genetic research.
Collapse
Affiliation(s)
- Jorge Ruiz-Medrano
- Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain
| | - Javier A Montero
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain; Red Temática de Investigación Cooperativa en Salud: ""Prevención, detección precoz, y tratamiento de la patología ocular prevalente, degenerativa y crónica" (RD16/0008/0021), Spanish Ministry of Health, Instituto de Salud Carlos III, Spain; Retina Unit, Oftalvist, Madrid, Spain
| | | | - Luis Arias
- Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain
| | - Alfredo García-Layana
- Red Temática de Investigación Cooperativa en Salud: ""Prevención, detección precoz, y tratamiento de la patología ocular prevalente, degenerativa y crónica" (RD16/0008/0021), Spanish Ministry of Health, Instituto de Salud Carlos III, Spain; Department of Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain
| | - José M Ruiz-Moreno
- Red Temática de Investigación Cooperativa en Salud: ""Prevención, detección precoz, y tratamiento de la patología ocular prevalente, degenerativa y crónica" (RD16/0008/0021), Spanish Ministry of Health, Instituto de Salud Carlos III, Spain; Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain; Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain; Vissum Corporation, Spain.
| |
Collapse
|
14
|
|