European Journal of Implant and Refractive Surgery最新文献

OBJECTIVE: To assess the degree of inflammation in the anterior chamber following 4- or 8-incision radial keratotomy (RK). STUDY DESIGN: The eyes of 21 patients who had undergone Radial Keratotomy were studied with a laser flare meter LFM 500. SETTING: Department of Ophthalmology, Verona University. MAIN OUTCOME MEASURES: Subjective assessment of corneal oedema, subjective assessment of flare in the anterior chamber, objective measurement of flare by a Kowa laser flare meter. RESULTS: The flare in the anterior chamber was 4.34 ± 0.48 phot/ms before surgery. In eyes with 4-incision RK, the flare was 8.0 ± 1.73 phot/ms after 24 h, and was 4.82 ± 1.8 phot/ms after 7 days. In eyes with 8-incision RK, the flare was 14.16 ± 2.8 phot/ms after 24 h, and was 7.71 ± 2.5 phot/ms after 7 days. Only 1 eye showed some degree of inflammation when examined by slip-lamp. CONCLUSIONS: Radial keratotomy led to some degree of flare in the anterior chamber in our study. The reason could lie in the cutting of corneal nerves.

OBJECTIVE: The effect of one PMMA and, two different silicone IOLs on contrast sensitivity and glare disability was evaluated in a selected series of patients (best cases) following clearcorneal incision phacoemulsification. STUDY DESIGN: Prospective clinical study of visual function 6 months postoperatively. SETTING: Department of Ophthalmology, University of Giessen, Germany. PATIENTS: Forty-two patients with visual acuity (VA) of 0.8 (logMAR unit) or better. MAIN OUTCOME MEASURES: Contrast sensitivity (CS) under photopic conditions using a sinusoidal grating pattern wall chart (Vistech Consultants, Dayton, Ohio); CS and glare disability under mesopic conditions using the Mesotest (Oculus, Wetzlar, Germany). RESULTS: No significant difference in CS and glare disability between the different IOL groups can be demonstrated. Differentiating according to age showed that patients in the 70-and-over age group had significantly lower CS values compared with patients in the 70-and-below age group. No difference in glare disability between the age groups could be determined. CONCLUSIONS: Examination of visual function by means of contrast sensitivity and glare disability testing after successful clear-corneal cataract surgery shows no difference between the different silicone IOLs and PMMA IOL, respectively. Patient age is a more important factor in CS than IOL-type and material in good VA and absence of other ocular pathology.

Spontaneous postoperative dislocation of a foldable implant into the anterior chamber has not previously been recorded. Such a case of spontaneous implant (Chiron 32-C10XX) dislocation in the early postoperative period is described following a phacotrabeculectomy procedure along with its successful surgical management. Possible mechanisms of spontaneous implant dislocation in this case were the development of a large post-operative choroidal detachment and the presence of a large capsulorrhexis.

It is hoped that this brief summary of some of the underlying principles of phaco-emulsification equipment will enable the surgeon to understand better what the machine is doing at different times, and that intelligent use can be made of this information to enhance the effectiveness and safety of cataract operations. Suggestions about how these principles can be implemented during surgery are contained in a complementary article [3].

OBJECTIVES: To assess the efficacy of secondary photorefractive keratectomy in the treatment of corneal haze, comparing the results obtained with 2 methods of treatment: group A, mechanical removal of the epithelium followed by ablation with scanning system; group B, laser ablation of epithelium and large area ablation. MAIN OUTCOME MEASURES: Regression rate, best corrected visual acuity, haze. RESULTS: Regression was higher in group A achieving only 21.63% of the attempted correction, while in group B we obtained a 97.37% correction. Haze was nearly unchanged in group A (from a mean value of 1.69 preoperatively to 1.63 postoperatively), while it improved in group B from 1.71 preoperatively to 0.5 postoperatively. CONCLUSIONS: Laser removal of the epithelium and large area ablation seems to be a safer and more effective method for treating corneal haze than manual debridement and scanning ablation.

A case of acute onset calcific band keratopathy in a patient with severe dry eyes is described. Calcific bands appeared on 2 different occasions within 72 h of commencement of steroid eye drops. The possible aetiological role of phosphate-containing steroid drops in this condition is discussed. Usage of acetate rather than phosphate-containing steroid eye drops is suggested in patients with the predisposing factors for band keratopathy.

Objective: This study was aimed at answering the question whether surface-passivated intraocular lenses (IOL) have a smoother surface structure than ordinary PMMA IOL, since the surface roughness of PMMA is known to have an influence on the attachment of cells and bacteria to the material. Material and Methods: High-resolution surface analysis was performed in ordinary (n = 5) and surface passivated (n = 6) PMMA IOL using the atomic force microscope. Results: The mean roughness R_a was calculated to be 3.556 ± 0.334(S.D.) nm for the surface-passivated IOL and 2.743 ± 0.109(S.D.) nm for the unmodified PMMA IOL. Conclusion: This study demonstrated that surface passivated IOL were not smoother than unmodified IOL, but showed a significantly rougher surface than ordinary PMMA IOL. Possible clinical implications of our study are discussed in connection with other in vitro and clinical biocompatibility studies.

Objective: To compare the space maintaining capacity of Healon® and Healon® GV in the anterior chamber and capsular bag during implantation of a soft intraocular lens (IOL). Study Design and Patients: Fifteen patients undergoing phacoemulsification and soft IOL implantation were randomized to have either Healon® or Healon® GV during surgery. All patients were operated with scleral tunnel incision, capsulorhexis, posterior chamber phacoemulsification, widening of the incision to 4.0 mm and implantation of a folded silicone IOL with 6.0 mm optic (SI18NB), using a prodigy inserter. Setting: S:t Erik's Eye Hospital, Stockholm, Sweden. Main Outcome Measures: Qualitative evaluation of space maintaining capacity of the anterior chamber and ability to widen the capsular bag during soft IOL implantation. Intraocular pressure (IOP). Results: The space maintaining capacity was significantly better with Healon® GV than with Healon® both in the anterior chamber (P = 0.03) and in the capsular bag (P = 0.02). There was no significant difference in postoperative IOP Conclusions: The use of Healon® GV leads to better maintenance of space within the eye and potentially increased safety during soft IOL implantation.