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Cinar E, Yuce B, Aslan F, Erbakan G. Influence of Nd:YAG laser capsulotomy on toric intraocular lens rotation and change in cylinder power. J Cataract Refract Surg 2024; 50:43-50. [PMID: 37702513 DOI: 10.1097/j.jcrs.0000000000001306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To investigate toric monofocal intraocular lens (TIOL) rotation and associated changes in cylinder power caused by Nd:YAG laser capsulotomy performed due to posterior capsule opacification (PCO). SETTING Ekol Eye Hospital, Izmir, Turkey. DESIGN Prospective case series. METHODS 41 eyes of 20 women and 21 men were included in the study. Before and 1 month after Nd:YAG laser capsulotomy, TIOL tilt and decentration were determined with Scheimpflug camera, and TIOL axial rotation and the change in cylinder power induced by this rotation were measured by ray tracing aberrometry. The time interval between cataract surgery and Nd:YAG laser capsulotomy was noted. RESULTS Rotational misalignment of the TIOL was measured as 4.65 ± 2.75 degrees (range 0 to 11 degrees) before vs 6.97 ± 2.92 degrees (range 0 to 13 degrees) after capsulotomy, and absolute rotation was 2.75 ± 1.94 degrees (range 0 to 7 degrees, P = .028). Before and after Nd:YAG laser capsulotomy, cylinder power was 0.24 ± 0.70 diopter (D) (range 0.00 to 0.63 D) vs 0.56 ± 0.77 D (range 0.02 to 0.91 D), respectively, with an absolute change in cylinder power of 0.34 ± 0.22 D (range 0.01 to 0.90 D, P = .001). After capsulotomy, there was a significant decrease in IOL tilt in the horizontal and vertical planes and an increase in decentration ( P < .05). Time interval (33.02 ± 12.9 months) and IOL horizontal decentration were independent factors affecting IOL rotation after capsulotomy ( P < .05). CONCLUSIONS Nd:YAG laser capsulotomy may cause TIOL rotation as well as tilt and decentration, resulting in a change in the TIOL's corrective effect on corneal astigmatism. Although this change was clinically insignificant, it may be beneficial to consider that TIOL rotational misalignment may occur in patients undergoing early capsulotomy.
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Affiliation(s)
- Esat Cinar
- From the Ekol Eye Hospital, Izmir, Turkey (Cinar, Erbakan); İzmir Tepecik Training and Research Hospital Ophthalmology Clinic, University of Health Sciences, Izmir, Turkey (Yuce); Department of Ophthalmology, Alaattin Keykubat University, Antalya, Turkey (Aslan)
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LoBue SA, Martin CR, Benson KK, Trosclair KB, Shelby CL, Coleman III WT. The Role of Early Nd:YAG Laser Capsulotomy in Improving Visual Performance in Mild to Moderately Symptomatic Trifocal Patients. Clin Ophthalmol 2023; 17:3991-4000. [PMID: 38148832 PMCID: PMC10750775 DOI: 10.2147/opth.s448784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose To determine the effect of early Nd:YAG (neodymium:yttrium-aluminum-garnet) laser capsulotomy on objective and subjective visual quality in symptomatic trifocal intraocular lens (IOL) patients. Methods A single-center, prospective study examined symptomatic patients after bilateral cataract extraction with trifocal IOL implantation. A ten-question survey was conducted one month after surgery. Study endpoints included the assessment of monocular and binocular uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), contrast sensitivity (CS), and subjective visual quality before and after Nd:YAG capsulotomy prior to 4 months after cataract surgery. Results A total of 38 eyes from 21 patients were included with a TFAT00 (n = 23) or TFAT30-60 (n = 15). Overall satisfaction with the IOL was 8.55 ± 1.77 (range 5-10). A Nd:YAG capsulotomy was performed at 55 ± 26 days. Monocular UDVA and UNVA > 20/25 before Nd:YAG were 53.0% and 42.0%, which improved post-Nd:YAG to 63.0% and 66.0%, respectively (P = 0.41, P = 0.051). Binocular UDVA and UNVA >20/25 before Nd:YAG were 82.0% and 63.0%, which increased to 97% and 97%, respectively (P < 0.05, P < 0.001). CS increased in all post-Nd:YAG capsulotomies (P < 0.01). The presence of glare was documented at 74% pre-Nd:YAG, which decreased to 41% post-Nd:YAG (P < 0.01). Glare which limited activities was documented at 24%, which decreased to 5% post-Nd:YAG (P = 0.21). Conclusion Early treatment of posterior capsule opacities in mild to moderately dissatisfied trifocal IOL patients may be beneficial in improving CS, visual quality, and reducing the presence and severity of dysphotopsias.
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Affiliation(s)
- Stephen A LoBue
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Curtis R Martin
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Krysta K Benson
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Krystle B Trosclair
- Department of Graduate Medical Education, Statistics, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Christopher L Shelby
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Wyche T Coleman III
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
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Zhou Y, Xiang J, Xu F, Jiang Z, Liu F. Objective quantification of posterior capsule opacification after cataract surgery with swept-source optical coherence tomography. BMC Ophthalmol 2023; 23:299. [PMID: 37407917 DOI: 10.1186/s12886-023-03064-3] [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: 03/23/2023] [Accepted: 06/28/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE To evaluate the application of swept-source optical coherence tomography (SS-OCT) and pentacam scheimpflug tomography in posterior capsule opacification (PCO) severity assessment. METHODS The posterior capsule image region segmentation and adaptive threshold algorithm are used to process the SS-OCT scanned image to obtain the posterior capsule thickness (PCT). Scheimpflug tomography reconstructed and analysized by image J software can obtain the average gray value and evaluate the effectiveness with the two methods. RESULT One hundred sixty-two IOL eyes of 101 patients were divided into two groups, laser group (65 eyes) with the mean PCT was 8.0 ± 2.7 pixel unit and the mean gray value of the eyes was 66 ± 33 pixel unit. However, these figures in the control group (97 eyes) were 5.0 ± 0.9 and 11 ± 17. The sensitivity, specificity and area under curve(AUC) of SS-OCT PCT were 85%, 74% and 0.942,the sensitivity, specificity and AUC of Pentacam gray value were 91%, 76% and 0.947, respectively. After using the multivariable model of generalized estimation equation to corrected the dependence of subjects' eyes, it was found that SS-OCT PCT, Pentacam gray value, low vision quality of life questionnaire (LVQ questionnaire) for distance vision, and mobility and lighting dimension were significantly correlated with the PCO score (P = 0.012, P = 0.001, P = 0.005, respectively). CONCLUSION The region segmentation and adaptive threshold algorithm of posterior capsule image will accurately quantify the posterior capsule. Computer aided quantifications of posterior capsule are of great significance in the early surgical decision-making of PCO. The average occurrence time of most PCO was around 34 months, and the severity of PCO worsened with increasing postoperative time.
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Affiliation(s)
- Yu Zhou
- Department of Ophthalmology, Tenth People's Hospital Affiliated of Tongji University, Shanghai, China
- Department of Ophthalmology, Rui Jin Hospital, LuWan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Xiang
- Department of Ophthalmology, Tenth People's Hospital Affiliated of Tongji University, Shanghai, China
| | - Fang Xu
- Department of Ophthalmology, Tenth People's Hospital Affiliated of Tongji University, Shanghai, China
| | - Ziyuan Jiang
- Department of Ophthalmology, Tenth People's Hospital Affiliated of Tongji University, Shanghai, China
| | - Fang Liu
- Department of Ophthalmology, Tenth People's Hospital Affiliated of Tongji University, Shanghai, China.
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Moshirfar M, Basharat NF, Seitz TS, Peterson CM, Stapley SR, Ziari M, Bundogji N, Ronquillo YC, Hoopes PC. Refractive Changes After Nd:YAG Capsulotomy in Pseudophakic Eyes. Clin Ophthalmol 2023; 17:135-143. [PMID: 36644604 PMCID: PMC9833321 DOI: 10.2147/opth.s395605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose To analyze refractive changes after neodymium: yttrium-aluminum-garnet (Nd:YAG) posterior capsulotomy in pseudophakic eyes. Patients and Methods Patients who underwent Nd:YAG capsulotomy after cataract surgery from January 2013 to April 2022 were included in this retrospective study. Sphere, cylinder, spherical equivalent (SE), axis, and corrected distance visual acuity (CDVA) were compared pre- and postoperatively in 683 eyes of 548 patients at one month (n = 605 eyes) and one year (n = 211 eyes). Patients with both one-month and one-year follow-ups (n = 133) were also compared. Eyes were stratified into single-piece (n = 330), three-piece (n = 30), and light adjustable lenses (LALs) (n = 16). Pre- and postoperative measurements were analyzed within each group. Results Cylinder was significantly decreased at one-month (difference: 0.042±0.448 D, p = 0.006) and one-year (difference: 0.101±0.455 D, p = 0.003) compared to preoperative measurements. No significant change in sphere or axis was observed at follow-up visits (p > 0.05). CDVA significantly improved at both time points (p < 0.05). No significant change in any parameters between the one-month and one-year groups was observed (p > 0.05). There was significant improvement in CDVA in the single and three-piece lens groups (p < 0.0001 and p = 0.026, respectively), with no change in the LAL group (p > 0.05). Conclusion There were no changes in sphere, axis, or spherical equivalent after Nd:YAG capsulotomy. However, cylindrical error and CDVA were significantly better after the procedure. Lens type did not impact refractive parameters postoperatively.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, 84020, USA,John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA,Utah Lions Eye Bank, Murray, UT, USA,Correspondence: Majid Moshirfar, Hoopes Vision Research Center, 11820 S, State Street Suite #200, Draper, UT, 84020, Tel +1-801-568-0200, Fax +1-801-563-0200, Email
| | - Noor F Basharat
- University of Arizona College of Medicine – Phoenix, Phoenix, AZ, USA
| | - Tanner S Seitz
- Midwestern University Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | | | - Seth R Stapley
- Midwestern University Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Melody Ziari
- University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Nour Bundogji
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Phillip C Hoopes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, 84020, USA
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Borkenstein AF, Borkenstein EM, Omidi P, Langenbucher A. Evaluating impact of Nd: YAG laser associated defects on optical quality of hydrophilic and hydrophobic intraocular lenses using visualization of light propagation and USAF test targets. BMC Ophthalmol 2022; 22:494. [PMID: 36527032 PMCID: PMC9756656 DOI: 10.1186/s12886-022-02738-8] [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: 10/27/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Neodymium:yttrium aluminum garnet (Nd:YAG) laser capsulotomy is a well-accepted, safe, and effective measure in the treatment of posterior capsule opacification. However, iatrogenic intraocular lens damage is a relatively common side effect that happens due to inappropriate focusing during the procedure. This experimental study analyzes the impact of YAG-pits to obtain qualitative information. METHODS Acrylic, monofocal hydrophilic and hydrophobic intraocular lenses (IOLs) with 6.0 mm optic and the with the same power (21D) were studied. First, all measurements were done with unmodified IOLs. Damage was intentionally created, performing YAG-pits (n = 5) in the central area of the lens optic (3.0 mm) using a photodisruption laser with the same energy level of 1.8 mJ. To simulate the cruciate pattern, the 5 defects were created in a cross shape within the 3.0 mm optical zone. Afterwards, all laboratory measurements were repeated: These included the United States Air Force (USAF) resolution test chart to study the imaging performance of the IOL, light field measurements to show the course of the rays behind the IOL and the modulation transfer function (MTF) measurements were analyzed. RESULTS Evaluating USAF showed that unmodified lenses produced a sharper image. Damaged lenses led to a more blurred image and to the impression of a lower contrast with a kind of halo/glare effect. The light field measurement showed that YAG-pits led to a kind of dispersion and scattering effect, which was higher in hydrophobic IOLs. MTF showed a deterioration in damaged hydrophilic and hydrophobic IOLs, respectively. CONCLUSION Our experimental study confirms that YAG-pits can reduce imaging quality of intraocular lenses. These defects behave as a new Huygens source, distribute a spherical wave that additionally illuminate the background of the USAF target. It can be assumed that material properties of the IOL (water content, refractive index) play an important role and affect results. The impact level is strongly dependent on the number, size and position of YAG-pits within the optic. LIMITATION Only monofocal IOLs have been investigated so far, further tests with various IOL optics have to follow. In addition, simulating the circular pattern of YAG capsulotomy is necessary.
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Affiliation(s)
- A. F. Borkenstein
- Borkenstein & Borkenstein private practice, Privatklinik der Kreuzschwestern Graz, Kreuzgasse 35, 8010 Graz, Austria
| | - E. M. Borkenstein
- Borkenstein & Borkenstein private practice, Privatklinik der Kreuzschwestern Graz, Kreuzgasse 35, 8010 Graz, Austria
| | - P. Omidi
- grid.11749.3a0000 0001 2167 7588Institut für Experimentelle Ophthalmologie, Universität des Saarlandes, Saar 66424 Homburg, Deutschland
| | - A. Langenbucher
- grid.11749.3a0000 0001 2167 7588Institut für Experimentelle Ophthalmologie, Universität des Saarlandes, Saar 66424 Homburg, Deutschland
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Liu CF, Ou-Yang Y, Huang CY, Jao SW, Kuo YK, Chen HC, Cheng SC, Wang NK, Chuang LH, Chen YH, Chen WY. Zebrafish (Danio rerio) Is an Economical and Efficient Animal Model for Screening Potential Anti-cataract Compounds. Transl Vis Sci Technol 2022; 11:21. [PMID: 35994266 PMCID: PMC9419454 DOI: 10.1167/tvst.11.8.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/28/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose To develop a zebrafish cataract model for screening potential anti-cataract compounds. Methods Living zebrafish were anesthetized and exposed to ultraviolet-C (UV-C) irradiation at a dosage of 3250 mJ/cm2/d until they developed severe cataracts. These cataracts were graded based on photographs analyzed with ImageQuant TL version 7.0. Fish with severe cataracts were used to evaluate a range of compounds for cataract treatment, including the previously demonstrated hit compound lanosterol. For the initial evaluation, fish were divided into four groups: no treatment, balanced salt solution, β-cyclodextrin (β-CD), and lanosterol dissolved in β-CD. The treatments were performed for 10 days, and the clarity of lenses was evaluated. To assess the persistence of treatment, fish were treated with β-CD and lanosterol dissolved in β-CD for seven consecutive days followed by monitoring for three days without treatment. Results The average time for zebrafish to develop severe cataracts using the present UV-C irradiation protocol was 7.8 days (range 4-15 days). Both study designs required only another 10 days to determine the effect of hit compounds. The total experimental period could be completed within one month, and the entire experiment was economical. Conclusions We could assay a large number of hit compounds at a reasonable cost and within a short time using this newly developed zebrafish cataract model. These assays may allow development of an efficient platform for screening potential anti-cataract compounds. Translational Relevance The results may facilitate the development of ani-cataract medication for humans after further experiments and investigations.
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Affiliation(s)
- Chun-Fu Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Medicine, College of Medicine Chang Gung University, Taoyuan, Taiwan
- Program in Molecular Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen Ou-Yang
- Department of Chemistry, Tamkang University, Tamsui, New Taipei City, Taiwan
| | - Ching-Ying Huang
- Institute of Biochemistry and Molecular Biology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Wei Jao
- Department of Chemistry, Tamkang University, Tamsui, New Taipei City, Taiwan
- Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Kai Kuo
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Medicine, College of Medicine Chang Gung University, Taoyuan, Taiwan
| | - Hung-Chi Chen
- Department of Medicine, College of Medicine Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Center for Tissue Engineering, Chang Memorial Hospital, Linkou, Taiwan
| | - Shu-Chun Cheng
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Nan-Kai Wang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY, USA
| | - Lan-Hsin Chuang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Medicine, College of Medicine Chang Gung University, Taoyuan, Taiwan
| | - Yau-Hung Chen
- Department of Chemistry, Tamkang University, Tamsui, New Taipei City, Taiwan
| | - Wei-Yi Chen
- Program in Molecular Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Biochemistry and Molecular Biology, National Yang Ming Chiao Tung University, Taipei, Taiwan
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