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Thomas BC, Müller A, Auffarth GU, Holzer MP. [Duration of Examination and Patient Comfort with a New Biometric Device, in Comparison to Three Established Devices]. Klin Monbl Augenheilkd 2016; 233:933-7. [PMID: 27560200 DOI: 10.1055/s-0042-105566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to evaluate the duration of the preoperative examination and patient comfort in measurements with an Image Guided System (Verion, Alcon), which is used for the calculation and intraoperative alignment of toric intraocular lenses, in comparison to established keratometry devices. PATIENTS AND METHODS In a prospective, monocentric, open, ethics committee controlled study, 150 eyes of 150 ophthalmologically healthy volunteers were examined by a single examiner. Three measurements were performed with the Verion Image Guided System and - for comparison - one measurement each with IOLMaster 500, Lenstar LS900 and Pentacam HR. The measurement time was recorded with a stopwatch. For the analysis, patients were divided into three age groups (young, middle, old). Patient comfort was assessed using a questionnaire, which focussed on grading the whole measurement, as well as brightness of light, head posture and subjective duration. RESULTS The mean age of the volunteers was 40.5 years (18-78 years). The mean duration of measurement was as follows: first Verion measurement 54.0 ± 42.7 seconds (n = 149), second Verion measurement 42.0 ± 20.5 s (n = 144), third Verion measurement 44.7 ± 25.2 s (n = 143), IOLMaster 500 46.3 ± 22.4 s (n = 147), Lenstar LS900 46.6 ± 14.4 s (n = 146) and Pentacam HR 46.6 ± 25.5 s (n = 147). Only the first and second Verion measurements were statistically different (p < 0.01). There were no statistical differences between the age groups, with the single exception of young versus old with the Pentacam (p < 0.01). Subjective patient comfort (n = 143) was very high for all devices and rated as "not uncomfortable" or "slightly uncomfortable". CONCLUSION The duration of the preoperative examination with the Verion Image Guided System is comparable to established keratometry devices. However, IOL calculation with the Verion requires measurement of axial length and anterior chamber depth with another biometric device, which requires additional time. No age dependent differences were found. The examination can be easily integrated into clinical routine and is well tolerated by patients.
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Affiliation(s)
- B C Thomas
- International Vision Correction Research Centre (IVCRC), Universitätsaugenklinik Heidelberg
| | - A Müller
- International Vision Correction Research Centre (IVCRC), Universitätsaugenklinik Heidelberg
| | - G U Auffarth
- International Vision Correction Research Centre (IVCRC), Universitätsaugenklinik Heidelberg
| | - M P Holzer
- International Vision Correction Research Centre (IVCRC), Universitätsaugenklinik Heidelberg
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Auerbach FN, Holzer MP, Auffarth GU, Khoramnia R, Thomas BC, Saure D, Rabsilber TM. [Influence of corneal pachymetric changes on functional results after cataract surgery]. Ophthalmologe 2015; 112:834-9. [PMID: 26040794 DOI: 10.1007/s00347-015-0009-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the early postoperative period following uncomplicated cataract surgery, the correlation of corrected distance visual acuity (CDVA) and the increase in corneal thickness and anterior chamber depth (ACD) are investigated. PATIENTS AND METHODS A total of 54 cataract patients with a mean age of 70 ± 8.4 years were included in this prospective study. Surgery was carried out on one eye of each patient according to the study protocol. Refraction, CDVA and ACD were evaluated 1 day and 1 week postoperatively and compared with the pachymetry results measured with the Pentacam. RESULTS The mean postoperative CDVA significantly improved from 0.31 ± 0.24 logMAR to 0.18 ± 0.22 logMAR after one day and up to 0.06 ± 0.13 logMAR one week after surgery (p < 0.05). The mean spherical equivalent was - 0.52 ± 0.69 D after one day and - 0.50 ± 0.82 D one week after surgery and showed only minimal differences compared to the mean target refraction of - 0.39 ± 0.70 D. Postoperative corneal thickness showed a significant increase compared to the preoperative results (p < 0.05) on both visits: the mean difference was 33.26 ± 50.20 µm (- 17 to 315 µm) on the first day and 20.22 ± 23.15 µm (- 10 to 99 µm) one week after surgery. Up to 7 days postoperatively the increase in corneal thickness and CDVA showed only moderate or no correlations (r = 0.465 vs. r = 0.072, respectively). Regarding pachymetry and ACD values, no or only low correlations were found. CONCLUSION The significant increase in corneal thickness on the first and seventh day shows no to moderate correlation to the CDVA. Nevertheless, a good and early rehabilitation of visual acuity following uncomplicated cataract surgery is possible. Intraocular pressure measurement can lead to false high results due to an increase in corneal thickness.
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Affiliation(s)
- F N Auerbach
- International Vision Correction Research Centre, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - M P Holzer
- International Vision Correction Research Centre, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - G U Auffarth
- International Vision Correction Research Centre, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - R Khoramnia
- International Vision Correction Research Centre, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - B C Thomas
- International Vision Correction Research Centre, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - D Saure
- Institut für Medizinische Biometrie und Informatik, Universitätsklinikum Heidelberg, 69120, Heidelberg, Deutschland
| | - T M Rabsilber
- International Vision Correction Research Centre, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
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Khoramnia R, Fitting A, Rabsilber TM, Auffarth GU, Holzer MP. [Postoperative Results after Implantation of a Toric, Aspheric Intraocular Lens]. Klin Monbl Augenheilkd 2015; 232:867-73. [PMID: 25853945 DOI: 10.1055/s-0034-1396179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the functional results and quality of vision after implantation of an aspheric, aberration-neutral, monofocal toric intraocular lens (IOL). PATIENTS AND METHODS 18 eyes of 13 patients were enrolled in this prospective clinical study. The T-flex aspheric, aberration-free toric IOL (Rayner Intraocular Lenses Limited, U. K.) was implanted after femtosecond or standard phacoemulsification. Follow-up examinations were performed two to four months after surgery; these included subjective refraction, ETDRS uncorrected (UDVA) and corrected distance visual acuity (CDVA), wavefront analysis, measurements of stray light (C-Quant), and a questionnaire. RESULTS Median UDVA was 0.06 logMAR (range: 0.30 to - 0.18 logMAR) postoperatively. Median CDVA increased from 0.20 logMAR (range: 0.64 to 0.00 logMAR) preoperatively to - 0.07 logMAR (range: 0.16 to - 0.26 logMAR) postoperatively. The median difference between achieved versus intended spherical equivalent was - 0.08 D (range: - 1.25 to + 0.65 D). Median subjective cylinder improved from - 2.00 D (range: - 6.50 to - 0.25 D) preoperatively to - 0.50 D (range: - 1.25 to 0.00 D) postoperatively. The median spherical aberrations (6 mm pupil size) were - 0.38 µm (range: - 0.69 to - 0.10 µm) postoperatively. Measurements of stray light (C-Quant) revealed a median value of 1.28 log(s) (range: 0.92 to 1.61 log[s]). CONCLUSION The T-flex aspheric toric IOL provided beneficial and predictable functional results after surgery. The implantation of the T-flex is an effective method to correct a large range of corneal astigmatism.
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Affiliation(s)
- R Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
| | - A Fitting
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
| | - T M Rabsilber
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
| | - G U Auffarth
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
| | - M P Holzer
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
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Khoramnia R, Fitting A, Rabsilber TM, Thomas BC, Auffarth GU, Holzer MP. [Functional results after implantation of an aspheric, aberration-neutral intraocular lens]. Klin Monbl Augenheilkd 2014; 232:181-8. [PMID: 25178043 DOI: 10.1055/s-0034-1382849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study was to perform a clinical evaluation of the functional results and quality of vision after implantation of an aspheric, aberration-neutral, monofocal intraocular lens (IOL). PATIENTS AND METHODS 47 eyes of 34 patients (median age: 68 years) with cataract were enrolled in this prospective clinical study that had Ethics Committee approval. The C-flex or Superflex aspheric IOL (Rayner, UK) was implanted after phacoemulsification. Follow-up examinations were performed two to four months after surgery including subjective refraction, ETDRS uncorrected (UDVA) and corrected distance visual acuity (CDVA), wavefront analysis, analysis of stray light (C-Quant), contrast sensitivity under different lighting conditions (F. A. C. T.) and a questionnaire. RESULTS Two to four months after surgery, median UDVA was 0.08 logMAR (range: 0.64 to - 0.18 logMAR, n = 41). Median CDVA increased from 0.30 logMAR (range: 1.00 to - 0.02 logMAR) preoperatively to - 0.08 logMAR (range: 0.16 to - 0.22 logMAR) postoperatively (n = 47). Median difference between achieved vs. intended (Holladay 1-formula) spherical equivalent was + 0.06 D (range: - 1.06 to + 0.87 D). Median total HOA RMS (6 mm pupil size) was 0.66 µm (range: 0.41 to 1.19 µm). The median spherical aberrations were - 0.36 µm (range: - 0.70 to - 0.17 µm). Analysis of stray light (C-Quant) revealed a median value of 1.21 log(s) (range: 0.79 to 1.57 log[s]). CONCLUSION The C-flex and Superflex aspheric IOLs provide good and predictable functional results. Patients are not negatively influenced by stray light and show slightly negative spherical aberrations.
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Affiliation(s)
- R Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
| | - A Fitting
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
| | - T M Rabsilber
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
| | - B C Thomas
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
| | - G U Auffarth
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
| | - M P Holzer
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg
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Schmidt S, Holzer MP, Khoramnia R, Auffarth GU. [Graft failure based on immunology? Reply ]. Ophthalmologe 2013; 110:470. [PMID: 23814866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Khoramnia R, Holzer MP, Fitting A, Auffarth GU, Rabsilber TM. Funktionelle Ergebnisse nach Korrektur der Presbyopie mittels bilateraler intrastromaler Femtosekundenlaserbehandlung. Ophthalmologe 2013; 110:1163-70. [DOI: 10.1007/s00347-012-2760-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Schmidt S, Holzer MP, Khoramnia R, Auffarth GU. [Immunological graft rejection after autologous contralateral keratoplasty]. Ophthalmologe 2012; 109:1014-6. [PMID: 22532039 DOI: 10.1007/s00347-012-2560-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Autologous keratoplasty from an amblyopic eye to the fellow oculus ultimus is a rarely used procedure. This is due to the relatively uncommon constellation of pathology. The following article reports the case of a graft rejection after autologous keratoplasty, while the homologous graft on the amblyopic fellow eye remained clear.
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Affiliation(s)
- S Schmidt
- International Vision Correction Research Centre, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg.
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Abstract
BACKGROUND Biometric measurements and the knowledge of interrelationships of structures within the eye are especially mandatory for cataract and refractive surgery. As the number of pseudophakic patients steadily increases because cataract surgery becomes more easily available all over the world, exact biometry of eyes with crystalline lenses as well as pseudophakic eyes is gaining interest. In the present study we compared biometric measurements in pseudophakic eyes using a new optical low-coherence reflectometry (OLCR) device with results measured by the IOLMaster. PATIENTS AND METHODS In this prospective study 140 pseudophakic eyes from 123 adult volunteers following uneventful cataract surgery and IOL implantation were examined at the International Vision Correction Research Centre (IVCRC) at the University of Heidelberg, Germany. The aim of this study was to evaluate a functional prototype of the new LENSTAR LS 900 (Haag-Streit)/ALLEGRO BioGraph (Wavelight) biometer and the IOLMaster V.5 (Carl Zeiss Meditec) and to compare axial length (AL) and keratometry measurements with those obtained by the IOLMaster. Additionally we investigated whether the LENSTAR/BioGraph can detect anterior chamber depth (ACD) and the effective lens position (ELP) of IOLs by OLCR in pseudophakic eyes. Patients with corneal or intraocular pathology and patients who had undergone other surgery in the investigated eye or whose cataract surgery dated back less than 4 weeks were not included in the study. Measurements were repeated with both devices as recommended by the manufacturers. Results were compared using Bland-Altman plots, Passing Bablok regression analysis and Pearson correlation calculations (MedCalc version 7.3.0.1). RESULTS Valid axial length measurements were available in 137 eyes. The mean values were 23.75 mm for both devices (SD±2.08 with the IOLMaster, ±1.7 with the LENSTAR/BioGraph). The mean corneal radius (R) was 7.7±0.27 mm (IOLMaster) vs. 7.74±0.29 mm (LENSTAR/BioGraph). Valid ACD measurements with the LENSTAR/BioGraph were achieved in 30% of all cases. In 98.6% of the eyes in which ACD was analyzed manually a mean ACD of 4.73±0.53 mm was found. CONCLUSIONS Both devices tested in this study showed a high correlation for AL and keratometry measurements. ACD measurements performed with the LENSTAR/BioGraph showed a measurable signal but the prototype calculated a value only in the minority (30%) of cases. This study showed that on the one hand the LENSTAR/BioGraph has the potential to be a reliable and useful machine for clinical everyday routine: This space and time-saving device includes several features which make it a patient and user friendly tool for diagnostics as well as screening. On the other hand we found that the software used in the prototype could be improved especially in order to identify IOLs and to measure reliable ACD values in pseudophakic patients. IOL surfaces did not generate sufficient interference signals in the LENSTAR/BioGraph and although the light reflected by the IOL surfaces was recognized by the device the software version used in this study did not generate numerical results for ACD.
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Affiliation(s)
- A L Hildebrandt
- International Vision Correction Research Centre, Universitäts-Augenklinik Heidelberg, Heidelberg, Deutschland
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Ehmer A, Mannsfeld A, Rabsilber TM, Sanchez MJ, Holzer MP, Auffarth GU. Streulichtanalyse bei unterschiedlichen multifokalen Prinzipien in Intraokularlinsen. Klin Monbl Augenheilkd 2010. [DOI: 10.1055/s-0030-1249477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Millonig G, Holzer MP, Tolle G, Auffarth GU, Muckenthaler MU, Seitz HK, Mueller S. [Hereditary hyperferritinemia cataract syndrome--the first family in Germany]. Z Gastroenterol 2009; 47:1211. [PMID: 19994473 DOI: 10.1055/s-0028-1109523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report on a 23-year-old woman who presented with elevated serum ferritin values at our department. She had undergone cataract surgery at the age of 14 and her family pedigree showed hereditary autosomal-dominant cataract. The combination of isolated hyperferritinemia with autosomal-dominant hereditary cataract led to the diagnosis of the hereditary hyperferritinemia cataract syndrome (HHCS) which we now describe in a German family for the first time. HHCS was confirmed by detection of a causal mutation at position 32 within the iron responsive element (IRE) of L-ferritin leading to a guanine to adenine exchange and the pathognomonic star-shaped cataract. This mutation interrupts the post-transcriptional control of L-ferritin. It prevents binding of the iron regulatory protein 1 (IRP1) to the 5alpha untranslated region of L-ferritin resulting in uncontrolled L-ferritin synthesis and high serum ferritin levels independent of the body iron stores. Premature cataract is eventually caused by deposition of L-ferritin crystals in the lens of the eye. Our family shows the typical autosomal-dominant inheritance of HHCS over four generations affecting a total of 17 family members. The causal mutation, star-shaped cataract and typical laboratory configuration were confirmed in five patients. Thus, in gastroenterological practice, HHCS should be added as a differential diagnosis of hyperferritinemia in Germany. Importantly, patients with HHCS can be spared from invasive diagnostics such as liver biopsy.
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Affiliation(s)
- G Millonig
- Alkoholforschungszentrum Universität Heidelberg und Medizinische Klinik, KH Salem, Heidelberg, Germany.
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Abstract
AIMS Precise biometry is an essential preoperative measurement for refractive surgery as well as cataract surgery. A new device based on partial coherence interferometry technology was tested and evaluated for accuracy of measurements. METHODS In a prospective study 200 eyes of 100 healthy phakic volunteers were examined with a functional prototype of the new ALLEGRO BioGraph (Wavelight AG)/LENSTAR LS 900 (Haag Streit AG) biometer and with the IOLMaster V.5 (Carl Zeiss Meditec AG). As recommended by the manufacturers, repeated measurements were performed with both devices and the results compared using Spearman correlation calculations (WinSTAT). RESULTS Spearman correlation showed high correlations for axial length and keratometry measurements between the two devices tested. Anterior chamber depth, however, had a lower correlation between the two biometry devices. In addition, the mean values of the anterior chamber depth differed (IOLMaster 3.48 (SD 0.42) mm versus BioGraph/LENSTAR 3.64 (SD 0.26) mm); however, this difference was not statistically different (p>0.05, t test). CONCLUSION The new biometer provided results that correlated very well with those of the IOLMaster. The ALLEGRO BioGraph/LENSTAR LS 900 is a precise device containing additional features that will be helpful tools for any cataract or refractive surgeon.
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Affiliation(s)
- M P Holzer
- International Vision Correction Research Centre, IVCRC, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
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Schmack I, Holzer MP, Auffarth GU. Aktuelle Trends und Entwicklungen der refraktiven Chirurgie in Deutschland. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ehmer A, Borkenstein AFM, Holzer MP, Auffarth GU. Ablehnungsgründe für refraktive Eximer-Laser-Behandlungen. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rabsilber TM, Jepsen C, Hildebrandt L, Auffarth GU, Holzer MP. Berechnung der Intraokularlinsenstärke mit einem neuen Biometriegerät. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sánchez B, Ehmer A, Holzer MP, Auffarth GU. Analyse der postoperativen Visusentwicklung nach Excimerlaserbehandlungen in 2 unterschiedlichen Altersgruppen. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Heggemann Y, Limberger IJ, Mannsfeld A, Ehmer A, Holzer MP, Auffarth GU. Dynamische Stimulationsaberrometrie zur objektiven Evaluierung der Akkommodationsfähigkeit bei Patienten mit phaken IOL. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Holzer MP, Mannsfeld A, Ehmer A, Auffarth GU. Erste klinische Ergebnisse nach intraCOR zur Presbyopiekorrektur. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mannsfeld A, Ehmer A, Holzer MP, Auffarth GU. Power-Vektor-Analyse bei phaken und pseudophaken Patienten. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ehmer A, Rabsilber TM, Borkenstein AFM, Holzer MP, Auffarth GU. Evaluierung der funktionellen Ergebnisse der torischen IOL LU 303 T. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mannsfeld A, Holzer MP, Ehmer A, Auffarth GU. Lesevermögen und Patientenzufriedenheit nach der intraCOR-Presbyopiebehandlung. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sanchez MJ, Mannsfeld A, Borkenstein AFM, Ehmer A, Limberger IJ, Holzer MP, Auffarth GU. [Wavefront analysis in ophthalmologic diagnostics]. Ophthalmologe 2008; 105:818-24. [PMID: 18758787 DOI: 10.1007/s00347-008-1822-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Modern aberrometry measures standard and so-called higher-order refractory aberrations. Ophthalmology and optometry use Zernike polynomials to describe aberrations of the retina and lens causing refractory errors. Aberrations of a higher order sometimes follow successful laser surgery, causing reduced vision and inducing patient dissatisfaction; enhanced wavefront data can help to avoid this. Aberrometry is used also for objective measurement of refractory changes. Wavefront techniques and their clinical application enable many options for understanding the delicate balance of eye optics. The future of refractive surgery lies in increasingly individualized treatment to suppress higher degrees of aberration and thus improve clinical results. Patients will continue placing greater demand on individualized intraocular lenses that correct higher-order aberrations.
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Affiliation(s)
- M J Sanchez
- International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg, Ruprecht Karls-Universität Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Deutschland.
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Mannsfeld A, Limberger IJ, Ehmer A, Holzer MP, Auffarth GU. Funktionelle Ergebnisse nach Implantation moderner Multifokallinsen. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1058003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Holzer MP, Mannsfeld A, Limberger IJ, Auffarth GU. Patientenzufriedenheit und funktionelle Ergebnisse nach refraktivem Linsenaustausch und Implantation einer Multifokallinse. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1058008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ehmer A, Holzer MP, Auffarth GU. Asphärische Ablationsergebnisse mit dem ESIRIS Excimer-Laser. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1057978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sanchez MJ, Ehmer A, Holzer MP, Auffarth GU. Neuartiges UBM zur Evaluierung komplizierter Vorderabschnittsbefunde. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1057967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ehmer A, Rabsilber TM, Holzer MP, Auffarth GU. K-Wert- und Pupillengrößenanalyse mit verschiedenen Messgeräten. Klin Monbl Augenheilkd 2007. [DOI: 10.1055/s-2007-976269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sánchez MJ, Holzer MP, Rabsilber TM, Ehmer A, Auffarth GU. Klinische Ergebnisse und Wellenfront-Analyse der neuen asphärischen Tecnis Z9003 IOL. Klin Monbl Augenheilkd 2007. [DOI: 10.1055/s-2007-976246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Holzer MP, Goebels S, Auffarth GU. Altersspezifische Verteilung totaler, kornealer und interner Aberrationen des Auges. Klin Monbl Augenheilkd 2007. [DOI: 10.1055/s-2007-976278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
BACKGROUND Aspherical intraocular lenses (IOLs) are presumed to optimize the optical characteristics of IOLs. In order to profit from these characteristics, exact calculation of the IOL power and good centration of the lens are essential. METHODS In all, 43 eyes of 43 patients with an average age of 70.9+/-8.3 years underwent implantation of a Tecnis IOL (AMO, Ettlingen) after uneventful cataract surgery with topical anesthesia. IOL power calculation was performed using the Holladay, Haigis, and SRK II formulas. Spherical equivalent refraction and centration and position of the implanted IOLs were measured 6 months postoperatively. Centration of the IOL was analyzed using digital slit lamp photographs and an image analysis program. RESULTS Best corrected visual acuity (BCVA) increased from 0.47+/-0.25 (LogMAR) preoperatively to 0.1+/-0.11 6 months postoperatively (spherical equivalent +0.3+/-0.6 D). The intraindividual difference between target refraction and achieved postoperative refraction was 0.64+/-0.11 D for the Holladay formula, -0.21+/-0.11 D for the Haigis formula, and 0.97+/-0.15 D for the SRK II formula. The mean decentration of the IOL from the center of the corneal limbus was 0.4+/-0.1 mm. CONCLUSIONS For the aspherical Tecnis IOL very good postoperative functional results are reported, which are supported by an accurate calculation of the IOL power and a good centration of the IOL inside the capsular bag. In this study the Haigis formula showed the lowest difference between target refraction and achieved postoperative refraction.
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Affiliation(s)
- K A Becker
- Heidelberger Forschungsgruppe IOL & Refraktive Chirurgie, Universitätsaugenklinik, INF 400, 69120 Heidelberg
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Abstract
Modern cataract surgery has advanced tremendously over the past 20 years. Improved surgical techniques, as well as improved implant materials and designs, have enlarged patient profiles and indications not only for cataract surgery, but also for refractive lens exchange surgery. This has also created much higher patient expectations. The loss of accommodation is a loss of quality of life for presbyopic and especially young pseudophakic patients. Multifocal intraocular lenses (MIOL) have been implanted since 1986, starting with 2-3 zone refractive and diffractive designs. Due to the surgical techniques available at that time, MIOL decentration and surgically induced astigmatism were possible complications. In addition, reduced contrast perception and increased glare were common problems of MIOL because of their optical principles. New developments in this field in recent years such as the folding, multizonal, progressive refractive MIOL and aspheric diffractive MIOL in combination with improved surgical techniques have overcome those initial problems. Therefore, modern MIOL (and in the future also accommodative IOL) can be considered not only for the correction of aphakia but also for refractive purposes.
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Affiliation(s)
- M P Holzer
- Heidelberger Forschungsgruppe IOL & Refraktive Chirurgie, Universitäts-Augenklinik Heidelberg
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Holzer MP, Auffarth GU, Rabsilber TM. Perforierende Keratoplastik mittels Femtosekundenlaser: Histopathologische Untersuchungen der Schnittqualität. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-946963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Auffarth GU, Vucic D, Sánchez M, Nishi Y, Holzer MP. Erste Erfahrungen mit dem AMO Sovereign-Upgrade mit ICE- und CASE-Technologie. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-947002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Reuland AJ, Reuland MS, Sassenroth M, Holzer MP, Auffarth GU. Messung der sphärischen Aberration von Intraokularlinsen. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-947012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sassenroth M, Holzer MP, Auffarth GU. Intraindividueller Vergleich von kornealen und totalen Aberrationen des Auges. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-946919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Auffarth GU, Holzer MP, Schweipert J, Reuland MS, Epstein D. Refraktive Umfrage der DGII. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-946966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Holzer MP, Rabsilber TM, Auffarth GU. Femtosecond laser assisted penetrating keratoplasty. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-946938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wacker B, Holzer MP, Auffarth GU. Gründe für die Explantation von Intraokularlinsen. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-946946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Holzer MP, Rabsilber TM, Auffarth GU. LASIK-Flapschnitte mittels Femtosekundenlaser: Schnittgenauigkeit und histopathologische Analyse. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-946969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Auffarth GU, Holzer MP, Rabsilber TM. Erste klinische Erfahrungen mit der perforierenden Keratoplastik mittels Femtosekundenlaser. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-946958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rabsilber TM, Holzer MP, Auffarth GU. How to implant toric intraocular lenses. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-946942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rabsilber TM, Bültmann S, Holzer MP, Auffarth GU. Einfluss der Applanationstonometrie auf die Berechnung der Intraokularlinsenstärke. Klin Monbl Augenheilkd 2006. [DOI: 10.1055/s-2006-947008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
PURPOSE To evaluate intraocular lens (IOL) power calculation using ray tracing in patients presenting with cataract after excimer laser surgery. METHODS Ten eyes of seven consecutive patients who presented for cataract surgery following excimer laser treatment without any pre-refractive biometry data were enrolled in this prospective clinical study. Preoperatively, IOL power calculation was performed using a ray tracing software called OKULIX. Keratometry data (C-Scan) were imported and axial length (IOLMaster) was entered manually. Accuracy of IOL power calculation was investigated by subtracting attempted and achieved spherical equivalent. RESULTS Mean spherical equivalent was -3.51+/-2.77 D (range -10.38 to -0.5 D) preoperatively and -1.01+/-1.08 D (range -2.5 to +0.75 D) postoperatively. Mean error was 0.31+/-0.84 D, mean absolute error was 0.74+/-0.46 D, and IOL calculation errors ranged from -1.39 to +1.47 D. A total of 40% of eyes were within +/-0.5 D, 70% within +/-1.0 D, and 100% within +/-1.5 D. Three eyes with corneal radii over 10 mm showed calculation errors exceeding +/-1.0 D. Mean best-corrected visual acuity increased from 20/60 to 20/30 postoperatively. CONCLUSIONS IOL power calculation after excimer laser surgery can be difficult, especially when pre-refractive keratometry values are not available. In these cases, ray tracing combined with corneal topography measurements provides reliable and satisfactory postoperative results. However, it is advisable to be careful when calculating IOL power for eyes with corneal radii exceeding 10 mm because of slightly higher prediction errors.
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Affiliation(s)
- T M Rabsilber
- Heidelberg IOL and Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
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Rabsilber TM, Reuland AJ, Entz BB, Holzer MP, Limberger IJ, Auffarth GU. Quantitative Nachstarevaluierung von Acrylat- und Silikonintraokularlinsen mit scharfem Kantendesign. Ophthalmologe 2006; 103:25-9. [PMID: 15983779 DOI: 10.1007/s00347-005-1241-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND At the Department of Ophthalmology, Heidelberg, Germany, posterior capsule opacification (PCO) of a silicone and an acrylic intraocular lens (IOL) with a sharp optic edge design was evaluated. PATIENTS AND METHODS In a prospective study either the AMO ClariFlex silicone IOL or the Sensar AR40e hydrophobic acrylic IOL were implanted in 47 patients following uneventful phacoemulsification. Mean patient age was 76.2+/-7.8 (ClariFlex) and 73.4+/-12.9 years (AR40e), respectively. The mean follow-up time was 19.7+/-5.34 in the ClariFlex and 21.9+/-1.89 months in the AR40e group. PCO development was evaluated postoperatively using the EPCO 2000 analysis software (scale 0-4). Areas of interest were the total IOL optic, the central 3-mm zone as well as the capsulorhexis. RESULTS In both groups, all patients achieved a BCVA of 20/32 (AR40e) and 20/25 (ClariFlex), respectively. There was a very low incidence of PCO development with a mean EPCO score of 0.07+/-0.2 (ClariFlex and 0.15+/-0.2 (AR40e). Within the 3-mm zone and the capsulorhexis, there was a tendency for even lower EPCO scores in both groups. We calculated a statistically significant difference for the two lens materials for all investigated IOL areas (Wilcoxon's test, p<0.05). CONCLUSION Both IOLs with a sharp edge design showed good functional results, a stable position in the capsular bag as well as a low incidence of PCO development. However, the silicone IOL showed statistically significantly lower PCO scores.
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Holzer MP, Neens N, Rabsilber TM, Limberger IJ, Auffarth GU. Klinische Ergebnisse nach Implantation von Minuslinsen bei Kataraktpatienten mit Myopia magna. Klin Monbl Augenheilkd 2005. [DOI: 10.1055/s-2005-863841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rabsilber TM, Limberger IJ, Reuland AJ, Holzer MP, Auffarth GU. Langzeitergebnisse der Nachstarquantifizierung der Rayner Centerflex 570H. Klin Monbl Augenheilkd 2005. [DOI: 10.1055/s-2005-863966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rabsilber TM, Limberger IJ, Reuland AJ, Schweipert JT, Holzer MP, Auffarth GU. Intraokularlinsenberechnung mit dem Okulix-Programm. Klin Monbl Augenheilkd 2005. [DOI: 10.1055/s-2005-863911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rabsilber TM, Holzer MP, Auffarth GU. LASIK Flaps mittels Femtosekundenlaser: Histopathologische Analyse. Klin Monbl Augenheilkd 2005. [DOI: 10.1055/s-2005-863918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Reuland AJ, Limberger IJ, Leuchtenberger MS, Rabsilber TM, Holzer MP, Auffarth GU. Miyake/Apple posterior view video analysis of capsular bag changes during sealed capsule irrigation. Klin Monbl Augenheilkd 2005. [DOI: 10.1055/s-2005-863852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Holzer MP, Reuland AJ, Rabsilber TM, Limberger IJ, Auffarth GU. Refractive Surgery – Beyond LASIK. Klin Monbl Augenheilkd 2005. [DOI: 10.1055/s-2005-863851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Holzer MP, Auffarth GU, Reuland AJ, Entz BB, Becker KA. Clear Lens Extraction mit Implantation torischer Intraokularlinsen (MS6116 Microsil) als refraktiver Eingriff. Klin Monbl Augenheilkd 2004. [DOI: 10.1055/s-2004-820103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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