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This was a prospective study to evaluate the feasibility of the photic phenomena test (PPT) for quantifying glare, halo, and starburst. We compared two presbyopia-correcting intraocular lenses (IOLs), the Symfony IOL and the PanOptix IOL, as well as the monofocal Clareon IOL in 111 IOL-implanted eyes of 111 patients who underwent the PPT 1 month postoperatively. The reproducibility of photic phenomena with the PPT was assessed in 39 multifocal IOL-implanted eyes of 20 patients and among the examiners. Patients with ocular diseases, except for refractive errors, were excluded. The mean values of the groups were evaluated. Bland-Altman plots were used to analyze statistical data (Easy R version 1.37; R Foundation for Statistical Computing, Vienna, Austria). The PPT reproducibility assessment revealed no fixed bias or regressive significance. Reproducibility was confirmed. The glare size did not differ significantly between the Symfony, PanOptix, and Clareon groups. The halo size was significantly larger in the Symfony group (p < 0.01) than in the PanOptix group. The halo intensity was significantly brighter in the PanOptix group (p < 0.01) than in the Symfony group. In contrast, no halos were perceived in the Clareon group. The starburst size or intensity did not differ significantly between the Symfony, PanOptix, and Clareon groups. We identified the photic phenomenon related to various IOLs., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Uveitis-Glaucoma-Hyphema syndrome (UGH) is caused by mechanical chafing of anterior segment structures by an intraocular lens, especially an anterior chamber lens. The objective of this study was to characterise the clinical course and risk factors of UGH syndrome at a time when posterior chamber implantation is the gold standard., Patients and Methods: This was a retrospective study of 30 cases of UGH syndrome managed between January 2014 and September 2018. Data from the initial clinical examination, the type of implant involved and the clinical management were analysed., Results: Thirty eyes of 28 patients were included. Intra ocular lenses were iris-sutured (15/30, 50 %), in the bag (6/30, 20 %), scleral-fixated (4/30, 13.3 %), in the ciliary sulcus (3/30,10 %) or "in and out" (2/30, 6.7 %). Initial management was medical (18 eyes) or surgical (12 eyes). Surgical procedures were explantation (n=4), IOL repositioning (n=7) or trabeculectomy (n=1). Recurrences occurred with medical treatment (9/18), but not in the surgical group (p=0.02). Ocular hypertension became chronic in 19 cases out of 30 (63.3 %)., Conclusion: UGH syndrome can be caused by any type of pseudophakic lens. An intraocular lens in the bag should not rule out the diagnosis. Despite the decreasing popularity of anterior chamber intraocular lens implantation, UGH syndrome remains a current condition and must be recognised in order to adapt therapeutic management., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Introduction: We performed a systematic review and meta-analysis to evaluate whether accommodative intraocular lenses (AC-IOLs) are superior for cataract patients compared with monofocal IOLs (MF-IOLs)., Methods: Pubmed, Embase, Cochrane library, CNKI, and Wanfang databases were searched through in August 2018 for AC-IOLs versus MF-IOLs in cataract patients. Studies were pooled under either fixed-effects model or random-effects model to calculate the relative risk (RR), weighted mean difference (WMD), or standard mean difference (SMD) and their corresponding 95% confidence interval (CI). Distance-corrected near visual acuity (DCNVA) was chosen as the primary outcome. The secondary outcomes were corrected distant visual acuity (CDVA), pilocarpine-induced IOL shift, contrast sensitivity, and spectacle independence., Results: Seventeen studies, involving a total of 1764 eyes, were included. Our results revealed that AC-IOLs improved DCNVA (SMD = -1.84, 95% CI = -2.56 to -1.11) and were associated with significantly greater anterior lens shift than MF-IOLs (WMD = -0.30, 95% CI = -0.37 to -0.23). Furthermore, spectacle independence was significantly better with AC-IOLs than with MF-IOLs (RR = 3.07, 95% CI = 1.06-8.89). However, there was no significant difference in CDVA and contrast sensitivity between the 2 groups., Conclusion: Our study confirmed that AC-IOLs can provide cataract patients with DCNVA and result in more high levels of spectacle independence than MF-IOLs. Further studies with larger data set and well-designed models are required to validate our findings.

Purpose: The goal of our retrospective, single-center study of a case series was to compare the total, corneal, and internal astigmatism, and the visual acuity at one year after combined or stand-alone surgery consisting of iris fixation of an iris-claw intraocular lens (ARTISAN aphakia) in aphakic patients, according to whether the lens was fixated to the anterior (n=21) or posterior (n=51) surface of the iris., Results: We did not find a significant difference between these two types of fixation for any of the studied variables. The surgically induced astigmatism was 1.67 D at 176° in group A versus 1.19 D at 11° in group P., Conclusion: Although this surgery creates additional corneal astigmatism, it has not been proven that it differs depending on the type of fixation of the iris-claw. If we adhere to the notion that the posterior fixated iris-claw decreases the risk of endothelial decompensation in case the implant becomes disenclavated, then reverse iris fixation of the iris-claw makes sense., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Introduction: The published literature on toric intraocular lenses (IOL) reports postoperative refractive cylinder less than or equal to 0.5 D in anywhere from 25% to 100% of implantations with both the Acrysof ® Toric and Tecnis ® Toric IOL, depending upon the article. However, the majority of articles tend to cite rates between 70% and 80%., Purpose: The purpose was to evaluate my personal outcomes for both models of toric IOL, in terms of one-month postoperative refractive cylinder, after implementation of new methods of IOL selection, calculation and implantation., Materials and Methods: The new protocol included measurement of centroid surgically induced astigmatism by vector analysis; calculations using only the Barrett toric calculator, for which the keratometry values were obtained by optical biometry, while the keratometric axes were chosen by visual inspection of the axial topographic map; preoperative marking with the toriCAM cell phone appliance; and corneal incisions performed either manually or with a femtosecond laser. A prospective, observational study was conducted of all consecutive monofocal toric IOL implantations from September 2016 through April 2017. One-month postoperative refractive cylinder was recorded for each eye., Results: Seventy eyes were implanted with monofocal toric IOL, 31 Acrysof ® Toric and 39 Tecnis ® Toric. Mean postoperative refractive cylinder was 0.48 D (0.00-1.50) for the Acrysof ® Toric group and 0.46 D (0.00-1.00) for the Tecnis ® Toric group. There were no statistically significant differences in postoperative refractive cylinder between IOL models or methods of incision. The percentage of eyes achieving postoperative refractive cylinder ≤0.50 D ("success") was 77% for the Acrysof ® Toric group (82% for laser-assisted and 75% for manual) and 72% for the Tecnis ® Toric group (80% for laser-assisted and 69% for manual)., Conclusion: The implementation of the new protocol resulted in an overall surgical success rate of 77% for Acrysof ® Toric IOL and 72% for Tecnis ® Toric IOL (P=0.7702). Femtosecond laser-assisted surgery resulted in higher success rates than manual surgery (82% vs. 75% for Acrysof ® Toric and 80% vs. 69% for Tecnis ® Toric), but these differences were not statistically significant (Acrysof ® Toric P=0.7336; Tecnis ® Toric P=0.8862)., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Perforating keratoplasty shows good morphological results with a clear cornea; however, a limiting factor is often the resulting astigmatism, which cannot be corrected with either glasses or contact lenses (CL) in up to 20% of the patients. We retrospectively investigated 15 patients after pseudophakic perforating keratoplasty, who received implantation of toric add-on intraocular lenses (IOL) to correct astigmatism. The mean preoperative astigmatism of 6.5 diopter (dpt) could be reduced to a mean postoperative value of 1.0 dpt. The mean visual acuity could be improved from a preoperative value of sc <0.05 (cc 0.6) to a postoperative value of sc 0.4 (cc 0.63). There were no complications except for one case of a lens extension tear. Based on our good experiences we now provide toric add-on IOL to all patients with pseudophakic perforating keratoplasty when this cannot be corrected or only insufficiently corrected by conservative methods.

Objective: To compare visual quality and satisfaction after multifocal toric intraocular lens (Acrysof IQ Restor toric, ART) and monofocal toric intraocular lens implantation in patients. Methods: It was a prospective nonrandomized Phase Ⅲ clinical trial. Patients with age-related cataract and corneal astigmatism were enrolled and accepted phacoemulsification combined with implantation of intraocular lens (IOL) in Henan Provincial Eye Hospital during March 2013 to December 2014. Fifty-six cases were divided into two groups according to which IOL they chose. ART group included 28 cases (3l eyes) aged from 41.0 to 72.0 years, with an average age of 61.5 years; toric group included 28 cases (33 eyes) aged from 42.0 to 75.0 years, with an average age of 63.5 years. Three months postoperatively, uncorrected distance visual acuity (UDVA) at 5, 70, 40 cm, corrected distance, intermediate, and near visual acuities, defocus curve, residual refractive astigmatism, rotational stability of the IOL, contrast sensitivity and patientsatisfaction were evaluated. All data were processed by statistic package deal SPSS 16.0. Postoperative visual acuity, residual astigmatism, IOL axial rotation and contrast sensitivity were compared by independent samples t test; preoperative and postoperative corneal astigmatism were compared by paired t -test; spectacle independency and halo incidence were processed by χ(2) test; visual satisfaction score was analyzed by Mann-Whitney test. Results: At 3 months postoperatively, in ART group, UDVA was (0.04±0.05), UIVA was (0.24±0.15), UNVA was (0.20±0.24). While in Toric group, UDVA was (0.06±0.04), UIVA was (0.30±0.13), UNVA was (0.47±0.21). There was no significant difference in UDVA between two groups( t= 0.79, P= 0.433). But in ART group, UIVA and UNVA were markedly better than those in Toric group( t= 2.74, P= 0.008; t= 3.45, P< 0.01). Depth of focus was 5.50 D (+2.00--3.50 D) in the ART group and 2.50 D (+1.00--1.50 D) in the Toric group. Average postoperative residual astigmatism was (-0.45±0.41)D in ART group and (-0.41±0.32)D in the Toric group. There was no significant difference between two groups ( t= 1.05, P= 0.304). Average IOL rotation test was (2.95°±1.34°) in the ART group and (2.75°±1.64°) in the Toric group. There was no significant difference between two groups ( t= 0.67, P= 0.452). Spectacle independency was achieved by 85.7% of patients in the ART group and 32.1% in the Toric group. There was no signifcant difference in distant visual satisfaction scores between the two groups( Z =0.71, P >0.05), while the intermediate and near visual satisfaction scores were significantly different( Z =2.27, P <0.05; Z =2.60, P <0.05) Conclusions: Both of the ART IOL and toric IOL can correct patients astigmatism. Implantation of ART IOL in patients with cataract and corneal astigmatism provided excellent distance, intermediate, and near visual outcomes. It provided better predictability of the refractive results, nice rotational stability, and good optical performance. At the same time, it improved the spectacle independency of cataract patients with astigmatism. (Chin J Ophthalmol, 2017, 53: 274-280) .

Introduction: Implantation of scleral fixation intraocular lens for the surgical management of aphakia cases without capsular support is a safe procedure., Methods: Prospective study was carried out at Lumbini Eye Institute, Bhairahawa. A total of 32 patients underwent scleral fixation intraocular lens implantation within a period of two years from February 2014 to February 2016., Results: The age range was from 15 to 79 years; mean age was 47.56 ± 20.16 SD. Among them 14 (43.75%) were male and 18 (56.25%) were female. The follow-up lasted for 24 months., Conclusions: SFIOL for the surgical management of aphakia in the absence of capsular support is a safe procedure. The long-term follow-up is needed for an accurate evaluation of outcomes.

Purpose: To compare the development of posterior capsule opacification (PCO) and survival rate without capsulotomy after implantation of a hydrophobic or hydrophilic acrylic intraocular lens (IOL) at the 9-year postoperative follow-up., Methods: One of 3 experienced cataract surgeons performed standard phacoemulsification in one eye of 120 patients with cataract. The patients were randomized to implantation of either a hydrophobic acrylic IOL or a hydrophilic acrylic IOL. Both IOLs had sharp posterior edges. Retroillumination images of PCO were obtained with a fundus camera 9 years postoperatively and analyzed semiobjectively using POCOman computer software., Results: Seventy-eight of the 120 patients completed the 9-year follow-up examination. Patients implanted with the hydrophilic IOL had significantly (p<0.001) more and denser PCO. The survival rate without Nd:YAG capsulotomy was significantly higher (p<0.001) in eyes with the hydrophobic IOL., Conclusions: After 9 years, more and denser PCO developed in eyes with the hydrophilic IOL than the hydrophobic IOL. The survival rate without the need for capsulotomy was higher in eyes with the hydrophobic IOL.

Purpose: Many different models and types of special intraocular lenses (IOL) are now available for refractive lens surgery. In particular, toric and multifocal IOL need specific conditions to achieve satisfactory results. For multifocal IOL, many models with different optical principles are available. For optimal individual patient-centred care, it is necessary to consider several different options. With special refractive lenses, the principle objective for the patients is to become less dependent on glasses., Material and Methods: Different IOL are evaluated on the basis of published studies and our own experience and data., Results: IOL filtering blue light should not be classified as special IOL, but should be used as standards. Aspherical IOL are only beneficial in special situations. Toric IOL give reliable and good results, as long as certain specific requirements are considered. Multifocal IOL are still an optical compromise, although they are the only IOL that can reliably make the patient independent of glasses. To achieve satisfying results, the optimal IOL model should be selected individually., Conclusion: Many refractive needs can now be adequately satisfied by special IOL. The surgeon should provide ideal perioperative conditions, and he should be aware of the different IOL principles if he is to give the patient optimal advice. This can help to avoid upsetting both patients and ophthalmologists., (Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: Evaluation of the clinical data 3 months after implantation of a new diffractive multifocal intraocular lens (MIOL) with a reduced near add power of + 2.75 D., Methods: In a prospective study, patients who underwent cataract surgery or refractive lens exchange with implantation of an MIOL (Tecnis ZKB00, Abbott Medical Optics, Santa Ana, California, USA) were included. Three months postoperative corrected and uncorrected visual acuities at different distances were measured and evaluated. Those patients that underwent bilateral MIOL implantation additionally filled out a questionnaire 3 months postoperatively., Results: Between October 2013 and August 2014, 115 eyes of 62 patients were implanted with the ZKB00 IOL. Mean postoperative refractions were - 0.27 ± 0.44 D for the spherical equivalent, respectively. Mean binocular CDVA was - 0.01 ± 0.3 logMAR with a mean binocular UDVA of 0.06 ± 0.08 logMAR. For near distance in 40 cm, an UNVA of 0.07 ± 0.10 logMAR three months postoperatively was measured., Conclusion: The ZKB00 IOL belongs to a group of novel MIOL with an increased intermediate visual performance. Our study shows good visual acuity at all distances, as well as a high rate of satisfaction and subjectively good image quality., (Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: To report the incidence of endophthalmitis after senile cataract surgery and to describe the epidemiology and main risk factors., Design: Retrospective, single-center, cross-sectional descriptive study., Participants: Patients who underwent cataract surgery in Farabi Eye Hospital from 2006 through 2014., Methods: All patients were evaluated retrospectively to compare risk factors, epidemiologic factors, and prophylaxis methods related to endophthalmitis. Patient records were used to gather the data., Main Outcome Measures: Epidemiologic factors, systemic diseases, other ocular pathologic characteristics, complications during the surgery, technique of cataract surgery, intraocular lens type, method of antibiotic prophylaxis, surgeon experience, vitreous culture, and vision outcome were evaluated in these patients., Results: One hundred twelve endophthalmitis cases among 480 104 operations reported, equaling an incidence of 0.023%. Patients with diabetes mellitus (14.3%) and of older age (mean age, 81 years), perioperative communication with the vitreous (17.9%), extracapsular cataract surgery procedure (11%), and surgery on the left eye (58.9% vs. 41.1% for right eye; P = 0.03) showed a statistically significant association with endophthalmitis. Short-term treatment with topical or systemic preoperative antibiotics or postoperative subconjunctival injection was associated with a 40% to 50% reduced odds of endophthalmitis compared with no prophylaxis (P = 0.2). No cases of endophthalmitis were observed among the 25 920 patients who received intracameral cefuroxime, suggesting that this approach to antibiotic prophylaxis may be far more effective than traditional topical or subconjunctival approaches., Conclusions: The incidence of endophthalmitis after cataract surgery in our center was 0.023%, comparable with that of other previously published international studies. Older rural patients with immune suppressive diseases, such as diabetes mellitus, are particularly more prone to endophthalmitis. Vitreous loss at the time of surgery was associated with a significantly increased risk. Whereas antibiotic prophylaxis overall showed a 40% to 50% reduction in risk, intracameral cefuroxime was 100% effective in preventing endophthalmitis in this series., (Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: The aim of this study was to make an evaluation of the pseudoaccommodation span and clinical results after implantation of a diffractive, apodised and trifocal multifocal intraocular lens (MIOL)., Methods: In a prospective, single-centre study 28 eyes of 14 patients were evaluated after in the bag implantation of the Micro-F MIOL (PhysIOL, Belgium) during routine microsurgical cataract surgery. Two to four months postoperatively the final examinations were performed. Refraction, visual acuity monocular and binocular (near in 40 cm, intermediate in 80 cm and distance) as well as binocular defocus curves were evaluated., Results: Mean monocular UDVA (uncorrected distance visual acuity) increased significantly (p < 0.0001) from 0.471 ± 0.22 logMAR to 0.144 ± 0.14 logMAR. For the monocular UNVA (uncorrected near visual acuity) and UIVA (uncorrected intermediate visual acuity) postoperative values of 0.127 ± 0.117 and 0.158 ± 0.20 logMAR compared to binocular results of 0.057 ± 0.137 and 0.094 ± 0.181 logMAR were found. In the analysis of the binocular defocus curve two peaks could be found between 0.0 and - 0.5 D with a visual acuity of 0.0 logMAR and at - 3.0 D with a visual acuity of 0.068 logMAR. In the intermediate range a constant pseudoaccommodation of 0.2 logMAR could be found., Conclusions: The trifocal, diffractive MIOL shows good functional results in all distances with a span of pseudoaccommodation of 3D and a mean visual acuity of 0.2 logMAR and better. Indeed it is offering a high level of spectacle independency without the typical intermediate gap of bifocal diffractive MIOLs., (Georg Thieme Verlag KG Stuttgart · New York.)

Background: Cataract formation often occurs in people with uveitis. It is unclear which intraocular lens (IOL) type is optimal for use in cataract surgery for eyes with uveitis., Objectives: To summarize the effects of different IOLs on visual acuity, other visual outcomes, and quality of life in people with uveitis., Search Methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2013), EMBASE (January 1980 to August 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 14 August 2013. We also performed forward and backward searching using the Science Citation Index and the reference lists of the included studies, respectively, in August 2013., Selection Criteria: We included randomized controlled trials (RCTs) comparing hydrophobic or hydrophilic acrylic, silicone, or poly(methyl methacrylate) (PMMA) IOLs with or without heparin-surface modification (HSM), with each other, or with no treatment in adults with uveitis, for any indication, undergoing cataract surgery., Data Collection and Analysis: We used standard methodological procedures expected by The Cochrane Collaboration. Two review authors screened the search results and for included studies, assessed the risk of bias and extracted data independently. We contacted study investigators for additional information. We did not perform a meta-analysis due to variability in reporting and follow-up intervals for the primary and secondary outcomes of interest., Main Results: We included four RCTs involving 216 participants (range of 2 to 140 participants with uveitic cataract per trial) and comparing up to four types of IOLs. The largest study was an international study with centers in Brazil, Egypt, Finland, France, Japan, the Netherlands, Slovak Republic, Spain, and the USA; two studies were conducted in Germany and one in Saudi Arabia. There was substantial heterogeneity with respect to the ages of participants and etiologies of uveitis within and across studies. The length of follow-up among the studies ranged from 1 to 24 months after cataract surgery. The studies were at low risk of selection bias, but two of the four studies did not employ masking and only one study included all randomized participants in the final analyses. The funding source was disclosed by investigators of the largest study (professional society) and not reported by the other three. Due to heterogeneity in lens types evaluated and outcomes reported among the trials, we did not combine data in a meta-analysis.In the largest study (140 participants), the study eye of each participant was randomized to receive one of four types of IOLs: hydrophobic acrylic, silicone, HSM PMMA, or unmodified PMMA. Proportions of participants with one or more Snellen lines of visual improvement were similar among the four treatment groups at one year' follow-up: 45 of 48 (94%) in the hydrophobic acrylic IOL group, 39 of 44 (89%) in the silicone IOL group, 18 of 22 (82%) in the HSM PMMA IOL group, and 22 of 26 (85%) in the unmodified PMMA IOL group. When comparing hydrophobic acrylic IOLs with silicone IOLs, the risk ratio (RR) was 1.06 (95% confidence interval (CI) 0.93 to 1.20). At one year' follow-up, fewer eyes randomized to hydrophobic acrylic IOLs developed posterior synechiae when compared with eyes receiving silicone IOLs (RR 0.18, 95% CI 0.04 to 0.79); the effects between these groups were less certain with respect to developing posterior capsule opacification (PCO) (RR 0.74, 95% CI 0.41 to 1.37), corneal edema (RR 0.49, 95% CI 0.22 to 1.12), cystoid macular edema (RR 0.10, 95% CI 0.01 to 1.84), or mild IOL decentration (RR 0.92, 95% CI 0.06 to 14.22).Two intra-individual studies also compared HSM PMMA IOLs with unmodified PMMA IOLs at three or six months of follow-up. These studies, including a combined total of 16 participants with uveitis, were insufficiently powered to detect differences in outcomes among eyes of people with uveitis randomized to receive HSM PMMA IOLs when compared with fellow eyes receiving unmodified PMMA IOLs.In the fourth study (60 participants), the study eye of each participant was randomized to receive a hydrophobic or hydrophilic acrylic IOL. At three months, there were no statistical or clinical differences between hydrophobic and hydrophilic acrylic IOL types in the proportions of participants with two or more Snellen lines of visual improvement (RR 1.03, 95% CI 0.87 to 1.22). There were similar rates in the development of PCO between hydrophobic or hydrophilic acrylic IOLs at six months' follow-up (RR 1.00, 95% CI 0.80 to 1.25). The effect of the lenses on posterior synechiae was uncertain at six months' follow-up (RR 0.50, 95% CI 0.05 to 5.22).None of the included studies reported quality of life outcomes., Authors' Conclusions: Based on the trials identified in this review, there is uncertainty as to which type of IOL provides the best visual and clinical outcomes in people with uveitis undergoing cataract surgery. The studies were small, not all lens materials were compared in all studies, and not all lens materials were available in all study sites. Evidence of a superior effect of hydrophobic acrylic lenses over silicone lenses, specifically for posterior synechiae outcomes comes from a single study at a high risk of performance and detection bias. However, due to small sample sizes and heterogeneity in outcome reporting, we found insufficient information to assess these and other types of IOL materials for cataract surgery for eyes with uveitis.

Aim: The aim of this study was to evaluate the functional effect of bilateral implantation of apodised diffractive versus progressive multizonal refractive multifocal intraocular lenses compared to standard monofocal intraocular lenses., Patients and Method: 229 patients underwent cataract extraction; 66 Array SA40N (AMO, Irvine, CA, USA), 76 SA60D3 ReSTOR (Alcon, Fort Worth, TX, USA), and 87 MA60AC (Alcon, Fort Worth, TX, USA) were implanted. In this retrospective trial the main outcome measures were near, intermediate, and distance visual acuity and assessment of subjective function by questionnaire., Results: Mean follow-up was 4.7 ± 1.4 years with monofocal, 6.6 ± 1.7 with Array and 4.3 ± 1.1 with ReSTOR implants. Uncorrected binocular distance visual acuity was equivalent in the three groups. Uncorrected binocular near and intermediate visual acuity and spectacle independence were significantly higher in the two multifocal groups (p < 0.001). Glare and halos were more bothersome with multifocal than monofocals implants (p < 0.05) and adverse visual symptoms at night with Array implants but equivalent between ReSTOR patients and monofocal patients. Between the two multifocal groups spectacle independence was higher and adverse visual symptoms lower in ReSTOR patients than in Array patients (p < 0.05). ReSTOR patients reported a higher overall visual satisfaction than the other groups (p < 0.001) and rated their vision at 8.8 ± 1.8. Monofocal patients reported a slightly higher satisfaction at 7.6 ± 1.7 compared to Array patients at 6.9 ± 2.6 (p = 0.05)., Conclusion: In this long-term study the highest overall visual satisfaction could be achieved by bilateral implantation of apodised diffractive intraocular lenses., (Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: To determine the most appropriate analysis technique for the differentiation of multifocal intraocular lens (MIOL) designs by using defocus curve assessment of visual capability., Methods: Four groups of 15 subjects were implanted bilaterally with either monofocal intraocular lenses, refractive MIOLs, diffractive MIOLs, or a combination of refractive and diffractive MIOLs. Defocus curves between -5.0 D and +1.5 D were evaluated by using an absolute and relative depth-of-focus method, the direct comparison method, and a new "area-of-focus" metric. The results were correlated with a subjective perception of near and intermediate vision., Results: Neither depth-of-focus method of analysis was sensitive enough to differentiate between MIOL groups (P > 0.05). The direct comparison method indicated that the refractive MIOL group performed better at +1.00 diopter (D), -1.00 D, and -1.50 D and worse at -3.00 D, -3.50 D, -4.00 D, and -5.00 D than did the diffractive MIOL group (P < 0.05). The area-of-focus intermediate zone was greater with the refractive than with the diffractive MIOL group (P = 0.005) and the near zone was better with the diffractive (P = 0.020) and "mix and match" (P = 0.039) groups than with the refractive MIOL group. The subjective perception of intermediate and near vision agreed best with the area-of-focus metric for the intermediate (r(s) = 0.408, P = 0.010) and near zone (r(s) = 0.484, P < 0.001)., Conclusions: Conventional depth-of-focus metrics provide a single value to quantify the useful range of vision; however, they fail to provide sufficient detail to differentiate between MIOL designs. The direct comparison method provides a large amount of information, although the results can be complex to interpret. The proposed area-of-focus metric provides a simple, but differentiating method of evaluating MIOL defocus curves.

Purpose of Review: To discuss the development of presbyopia-correcting intraocular lenses (IOLs), what we have learned since their introduction a few decades ago, what are the options currently on the market, and where the technology is heading in the future., Recent Findings: Multifocal and accommodating IOLs have gone through several modifications to improve distance, intermediate and near vision compared to their predecessors. These modifications have also targeted unwanted side-effects such as glare and halos in the multifocal lenses and inconsistent near-vision results in the accommodating IOLs and although the results have improved, they are far from perfect. Therefore, careful patient selection for each of these technologies is crucial for success and patient satisfaction., Summary: Presbyopia correction remains a great challenge in cataract and refractive surgery. In this article, we review the development of presbyopia-correcting IOLs, starting from the simple, two-zone, multifocal, refractive models introduced 2 decades ago, the current Food and Drug Administration (FDA) approved multifocal and accommodating lenses as well as those undergoing FDA trials and take a look into developing technologies that may be available to us in the future.

Cataract surgery has greatly developed over recent years, mainly due to the introduction and availability of newer intraocular lenses (IOLs) with modern platforms and better visual outcomes. Aspheric, multifocal, and toric lenses are among these new lenses. Glaucomatous eyes have a number of particularities that can influence the way these implants are indicated and used. Contrast sensitivity is usually reduced in eyes with glaucoma and, sometimes, a poor IOL choice can aggravate the disease. Small pupils and zonular weakness are frequently associated with certain types of glaucoma (e.g. pseudoexfoliative glaucoma) and can limit the indication of some of the newer IOLs. Lastly, in some cases of combined surgery, the postoperative axial length and anterior chamber depth can change after surgery, requiring adjustments in the IOL power calculation. The purpose of this article is to quickly review some of the specific features of cataract surgery in the glaucomatous eye, some of the IOL choices, and the necessary precautions for these eyes., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Purpose: To compare visual function in pseudophakic patients with bilateral implantation of Tecnis multifocal aspheric and conventional monofocal spherical intraocular lenses (IOL)., Methods: A prospective study of 100 consecutive cases (200 eyes) was conducted. All cataract patients underwent phacoemulsification were randomized to receive multifocal aspheric IOL (Tecnis ZM900, AMO, multifocal aspheric group) or conventional spherical IOL (Akreos Adapt, Bausch & Lomb, monofocal spherical group). The following investigations were performed to assess the uncorrected and distance-corrected visual acuity of distance, intermediate and near distances, accommodative amplitude, spherical aberrations of total eye, contrast sensitivity, glare sensitivity and near stereoacuity. Patients were surveyed for visual disturbances and lifestyle visual quality. The independent-samples t test was used to compare the measure data which met normal distribution and the Mann-Whitney U test was used to compare the measure data which didn't meet. The chi-square test was applied to compare categorical variables., Results: The uncorrected and distance-corrected bilateral visual acuity of multifocal aspheric group at 30 cm and 40 cm were 0.24 ± 0.12 and 0.22 ± 0.11 (logMAR), better than monofocal spherical group (Z = -8.261, P = 0.000; Z = -5.508, P = 0.000), but the visual acuity at other distances had no statistical difference between two groups. Patients with multifocal aspheric IOL had significantly higher accommodative amplitude than those with monofocal spherical IOL, improved about 2.3 ∼ 2.8 D (Z = -10.655, P = 0.000; Z = -2.709, P = 0.007). Mean spherical aberration of multifocal aspheric group was (0.027 ± 0.160) µm and (0.006 ± 0.083) µm, significantly lower than that of monofocal spherical group (0.269 ± 0.161) µm, (0.037 ± 0.205) µm at 5 mm and 3 mm pupil diameter (Z = -8.815, P = 0.000; Z = -2.791, P = 0.005). The difference of contrast sensitivity was not significant, but glare sensitivity was higher for monofocal spherical group than for multifocal aspheric group. Multifocal aspheric group showed statistically better uncorrected stereoacuity (72.4 ± 29.9)″ than monofocal spherical group (92.8 ± 35.7)″ (Z = -3.089, P = 0.002)., Conclusions: The present clinical results demonstrated that Tecnis multifocal aspheric group had better near visual acuity, accommodative amplitude and near stereoacuity as compared to conventional monofocal spherical group. The aspheric design reduced spherical aberration of total eye and improved contrast sensitivity in some way.

Background: The aim of this study was to evaluate the incidence of posterior capsule opacification up to 50 months following 1.7-mm bimanual MICS-cataract surgery., Methods: Bimanual MICS cataract surgery was performed in 197 eyes (135 patients) via two 1.7-mm corneal incisions. Four MICS acrylic foldable IOLs were implanted: AcriSmart 48S-5, n = 54 (Acritec GmbH, Hennigsdorf, now AT.Smart 48S Carl-Zeiss-Meditec, AG, Jena, Germany), ThinLens UltraChoice 1.0, n = 53 (Technomed GmbH, Baesweiler, Germany), AcriFlex 46, n = 41 und AcriFlex 48 CSE, n = 7 (Acrimed GmbH, Berlin, now: Lentis L-303, Oculentis GmbH, Berlin, Germany) and CareFlex, n = 43 (w2o Medizintechnik AG, Bruchsal, Germany). Statistical analysis was performed using the Kaplan-Meier technique., Results: High levels of completeness of follow-up rates were: ThinLens 96%, CareFlex 100%, AcriSmart 93%, AcriFlex 92%. The capsulotomy rate was 43.13% for ThinLens within a mean/max. follow-up period of 801/1131 days, 34.88% for CareFlex (565/872 days), 40% for AcriSmart (988/1506 days) and 15.91% for AcriFlex (728/975 days). By limiting the follow-up period to a comparable maximum of 850 days for all four IOLs, our capsulotomy rates were as follows: ThinLens 33.33%, CareFlex 32.56 %, AcriSmart 20.0% and AcriFlex 11.36%. MICS IOLs have higher capsulotomy rates than hydrophobic acrylic lenses and sharp-edged silicone lenses. In literature comparisons MICS-IOLs do not exceed the variance levels of capsulotomy rates of PMMA, hydrophilic acrylic and silicone lenses without sharp edges. Cases of decentration or luxation of MICS-IOLs following Neodym:YAG laser capsulotomy were not detected. Capsulotomy frequency with the CareFlex was statistically significantly higher in comparison to the AcriSmart (Log Rank Mantel Cox Test, p = 0.007) and AcriFlex (log rank Mantel Cox test, p = 0.002)., Conclusions: Capsulotomy rates observed varied for the four MICS-IOL-types tested. The posterior capsule opacification frequency of the two best MICS-IOLs (AcriFlex, AcriSmart) did not exceed the higher variance levels of posterior capsule opacification rates of the round-edged "conventional" non-MICS IOLs of PMMA, silicone or hydrophilic acryl material. Sharp-edged silicone or hydrophobic acrylic "conventional" lenses have shown lower posterior capsule opacification rates., (Georg Thieme Verlag KG Stuttgart, New York.)

Objective: To compare the corneal astigmatism and wavefront aberration differences of patients with cataract coexisting corneal astigmatism after phacoemulsification surgery through traditional superior clear corneal incision or phacoemulsification surgery through clear corneal incision guided by corneal topography and implantation of different spherical aberration intraocular lenses (IOL)., Methods: In a prospective randomized sample controlled clinical trial, 90 patients (90 eyes) with age-related cataract and corneal astigmatism were randomly divided into 3 groups: (Group A) traditional superior corneal incision phacoemulsification surgery and AcrySof SN60AT IOL implantation, (Group B) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60AT IOL implantation and (Group C) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60WF IOL implantation. Corneal topography tests were performed at 1 week, 1 month, 3 months and 6 months postoperatively. The Wavefront aberration was measured using a custom built Tscherning wavefront sensor-ALLEGRETTO WAVE Analyze at 90 days postoperatively. Third-, 4th-, 5th-, total and higher-order aberration (HOA) root-mean-square (RMS), spherical aberration and coma aberration were compared at virtual pupil diameters of 6 mm postoperatively. Statistical analyses were performed using the analysis of chi square test, repeated measurement data analysis of variance, one-way analysis of variance (ANOVA), and multiple comparisons Students-Newman-Keuls test., Results: Corneal topography tests indicated that no significant difference for corneal astigmatism was found between these three groups preoperatively (F = 0.08, P > 0.05). The corneal astigmatism was decomposed into J(0), J(45) and P with a Vector-based method, and statistically analyzed. When compared with Group B and GroupC, Group A had higher values of corneal J(0) (F = 9.54, P < 0.01) and P (F = 18.69, P < 0.01). For corneal J(0) and P, no significant difference was found between Group B and Group C (P > 0.05). However groups and times had interactions (F = 13.45, 50.22, P < 0.01, respectively). For astigmatic vectors, there were statistical significances between different times in 3 groups (F = 74.33, 92.11, P < 0.01, respectively). Wavefront aberration test results indicated that the mean values of RMSg (root mean square of general aberration), coma aberration, RMSh, RMS(3), RMS(5) and RMS(6) of Group A were obviously higher than that of Group B and C (F = 93.40, 471.94, 176.95, 216.99, 44.37, 37.19, P < 0.01, respectively). And the values of RMS(4) and spherical aberration in Group A were significantly higher than that in Group C (q = 25.30, 26.23, P < 0.01, respectively). No statistically significant was found between Group A and Group B of RMS(4) and spherical aberration (q = 0.57, 2.34, P > 0.05, respectively). The values of RMS(4), RMSh, RMSg and spherical aberration in Group B were statistically significantly higher than that in Group C (q = 24.73, 7.90, 6.41, 23.89, P < 0.01, respectively)., Conclusions: Corneal topography guiding incision phacoemulsification surgery and the implantation of negative spherical aberration IOL is a more favorable solution for cataract patients coexisting corneal astigmatism, which can correct the corneal astigmatism, decrease the spherical aberration, high-order aberration and general aberration of pseudophakic eyes and therefore improve the visual quality of patients.

Purpose: To evaluate intraindividual visual acuity, wavefront errors and modulation transfer functions in patients implanted with two diffractive multifocal intraocular lenses., Methods: This prospective study examined 40 eyes of 20 cataract patients who underwent phacoemulsification and implantation of a spherical multifocal ReSTOR intraocular lens in one eye and an aspheric Tecnis ZM900 multifocal intraocular lens in the other eye. The main outcome measures, over a 3-month follow-up period, were the uncorrected photopic distance and near visual acuity and the defocus curve. The visual acuity was converted to logMAR for statistical analysis and is presented in decimal scale. The wavefront error and modulation transfer function were also evaluated in both groups., Results: At the 3-month postoperative visit, the mean photopic distance uncorrected visual acuity (UCVA) was 0.74 +/- 0.20 in the ReSTOR group and 0.76 +/- 0.22 in the Tecnis group (p=0.286). The mean near UCVA was 0.96 +/- 0.10 in the ReSTOR group and 0.93 +/- 0.14 in the Tecnis group (p=0.963). The binocular defocus curve showed measurements between the peaks better than 0.2 logMAR. The total aberration, higher-order aberration and coma aberration were not significantly different between the groups. The spherical aberration was significantly lower in the Tecnis group than in the ReSTOR group. (p=0.004). Both groups performed similarly for the modulation transfer function., Conclusion: The ReSTOR SN60D3 and Tecnis ZM 900 intraocular lenses provided similar photopic visual acuity at distance and near. The diffractive intraocular lenses studied provided a low value of coma and spherical aberrations, with the Tecnis intraocular lens having a statistically lower spherical aberration compared to the ReSTOR intraocular lens. In the 5 mm pupil diameter analyses, both intraocular lens groups showed similar modulation transfer functions.

Work presents surgical strategy in case of cataract and glaucoma in patient with simple nanophthalmus. Moreover optimal manner of calculation of the IOL and treatment in case of occurrence of complication from disturbed structure of eyeball. Surgical procedure included removal of cataract by using phacoemulsification, implantation of artificial Acri.Lyc Extreme lens, account from Haigis rule. Because of high intraocular pressure in early postoperative period we decided to implant Ahmed devices--children's type with drain placed in posterior chamber combined with posterior vitrectomy. We obtained stabilization of intraocular pressure and effective visual acuity.

Background: To evaluate the rotational stability of the three types of AcrySof SA60TT toric intraocular lenses (Alcon, Switzerland) in cataract surgery after the first postoperative week., Methods: A retrospective study of 44 eyes in 33 patients. All patients underwent similar uncomplicated phacoemulsification cataract surgery. Seven eyes with corneal astigmatism of less than 1.5 D were implanted with the AcrySof SA60T3 intraocular lens. Seventeen eyes with astigmatism between 1.5 D and 2.25 D received the SA60T4 intraocular lens, and 20 eyes with more than 2.25 D of corneal astigmatism received the SA60T5 intraocular lens. Intraoperatively, the axis of the toric lens was aligned to the steepest axis of the corneal astigmatism. Main outcome measure was the postoperative position of the lens, assessed at 1 week and 3 months, using a specially designed angle measuring eyepiece for the slit lamp., Results: There was no significant difference in the rotational stability of the three types of toric intraocular lenses. Overall, the postoperative rotation was within 5 degrees in 95% and within 2 degrees in 68% of eyes. The mean absolute rotation was 2.2 +/- 2.2 degrees. No lens showed more than 9 degrees of rotation, and no lens required secondary repositioning. There was no trend for either clockwise or anti-clockwise rotation. The surgical procedure did not change the corneal astigmatism., Conclusion: Once placed to it's position, each of the three types of the AcrySof SA60TT toric intraocular lenses demonstrate rotational stability in the capsular bag.

Purpose: To examine postoperative refraction changes following phacoemulsification cataract surgery and to assess their influential factors, including intraocular lens (IOL) materials and anterior chamber depth (ACD) of the implanted IOL., Methods: In this prospective study, 339 eyes were randomly assigned to receive a rigid polymethylmethacrylate (PMMA) IOL (811C or 824C), an acrylic IOL (MA60BM), or a silicone IOL (AQ110NV). All patients were followed for 48 weeks after surgery. Postoperative spherical equivalent refraction and ACD were measured by a refractometer and by an anterior eye segment image analyzer, respectively., Results: In the silicone IOL group, statistically significant myopic shift was observed at 8 weeks after the surgery and continued throughout the follow-up period. Mean myopic shift at the end (48 weeks) was -0.53 D. Concomitantly shortened ACD was also confirmed at 12 weeks after the surgery. In the other groups, postoperative refraction and IOL position did not change after surgery., Conclusions: The eyes with silicone IOL caused postoperative myopic shift due to the anterior IOL movement. It is important to be aware of the characteristics of each IOL and to take myopic shift into consideration when silicone IOL is implanted. Preferably the A-constant for silicone IOL should be reconsidered to obtain rather accurate postoperative refraction.

Objective: To define and classify the major types of intraocular lens (IOL) calcification., Design: Retrospective observational case series with clinicopathologic correlation., Participants: More than 400 IOLs explanted because of opacification., Methods: The authors reviewed the clinical information and histologic findings of all IOLs that had been explanted because of opacification or calcification of the IOLs accessioned in their laboratory between January 1999 and December 2004., Main Outcome Measure: The proposed mechanism that led to calcification of each IOL design., Results: Three major types of calcification were identified: (1) primary calcification, (2) secondary calcification, and (3) false-positive calcification or pseudocalcification. The primary form refers to calcification that is inherent in the IOL, that is, is based on possible inadequate formulation of the polymer, fabrication of the IOL, or issues with its packaging process. The calcification presumably occurs in otherwise normal eyes and generally is not associated with preexisting diseases. The secondary form refers to deposition of calcium onto the surface of the IOL most likely the result of environmental circumstances (e.g., changes in the aqueous milieu surrounding the implanted IOL associated with preexisting or concurrent diseases or indeed any condition that has disrupted the blood-aqueous barrier). By definition, it is not related to any problem with the IOL itself. The false-positive or pseudocalcification refers to those cases in which other pathology is mistaken for calcification or false-positive staining for calcium occurs., Conclusions: When evaluating the pathogenesis and nature of IOL calcification in or on any given design, one should categorize it according to these types. Primary calcification is IOL related and the IOL should be withdrawn or modified to correct the problem. After the cause is identified and the lens is implanted again, patients should be followed up for up to 2 years to be sure the problem is alleviated. Secondary calcification is by definition not IOL related; it may occur with virtually all IOL designs implanted under various adverse circumstances. No IOL, hydrophilic or hydrophobic, is immune to secondary calcification. The false-positive form is recognized readily in the laboratory and this erroneous diagnosis is avoided.

Purpose: A variety of techniques for treating presbyopia are available. However, these techniques are often disparate in the mechanisms used to cope with the lack of accommodation. Multizone-refractive, diffractive, and apodized intraocular lens technologies are currently being used. This article evaluates the optical performance of these markedly different technologies in a simple and comparable manner., Methods: The Defocus Transfer Function is a mathematical technique for illustrating the Optical Transfer Function for all levels of defocus. By calculating the Defocus Transfer Function, the simulated performance of presbyopia correction technologies on distance, intermediate, and near vision can be evaluated simultaneously. Simulations of an opaque annular ring, a zonal refractive lens, a full-aperture diffractive lens, and an apodized diffractive lens are analyzed at pupil sizes of 3, 4, and 6 mm with this technique., Results: The opaque annulus begins to act like a Fresnel amplitude zone plate for small pupils. The diffractive lens technologies had sharp optical performance at two distinct foci with a shift in performance from balanced to distance-biased for the apodized diffractive lens. The zonal refractive lens exhibited a multifocal effect. However, the optical performance of this technology fell below that of the diffractive lenses., Conclusions: The Defocus Transfer Function is a useful tool for analyzing presbyopia treatments. Different strategies for creating simultaneous vision or extended depth of field are easily compared. It may also be possible to reverse this technique to create an ideal pupil function that meets a desired multifocal performance specification.

Purpose: To evaluate visual and refractive outcome and complications after microincision cataract surgery (MICS) with implantation of an Acri. Smart 48S intraocular lens (IOL)., Material and Methods: This study comprised 22 eyes of 11 patients having bilateral microincision cataract surgery. MICS was performed through a 1.4 mm clear corneal incision using the MacKool System and low ultrasound power. The IOL was implanted through a 1.7 or smaller clear corneal incision with a Acri. Smart Glide System. The final size of the clear corneal incision, postoperative uncorrected and best corrected distance visual acuity, best corrected near visual acuity (Snellen, Jaeger Table), astigmatism, pseudoaccommodation possibility of Acri. Smart 48S IOL, complications and patient satisfaction were analyzed. The follow up was 1 month., Results: The Acri. Smart 48S lens was implanted through mean incision of 1.56 +/- 0.07 mm. One month after surgery the mean uncorrected distance visual acuity (UCVA) and the best corrected visual acuity (BCVA) significantly improved (UCVA: preoperatively--0.49 +/- 0.33; postoperatively--0.97 +/- 0.11; p < 0.001; BCVA: preoperatively 0.68 +/- 0.3; postoperatively--1.0; p < 0.001) as well as BCVA for near (BCVA: preoperatively--5.27 +/- 3.30; postoperatively--2.91 +/- 1.48; p = 0.002). One month after surgery, there was not significant increase of astigmatism and the pseudoaccommodative ability of Acri. Smart 48S was not observed. There were no serious intraoperative and postoperative complications. All the patients were highly satisfied with the quality of the vision., Conclusions: Our preliminary results show that MICS with Acri. Smart 48S lens implantation is safe and effective procedure. This conclusion has to be confirmed by studies with longer follow up period and larger series of patients.

Objective: We compared wavefront aberration in pseudophakic eyes with 3 types of intraocular lenses (IOLs) implantation in order to obtain an objective evaluation of the optical quality of these pseudophakic eyes., Methods: This prospective study comprised 76 cataract patients (80 eyes) who had phacoemulsification surgery. The intraocular lenses of AcrySof MA30BM, Hydroview H60M, and Canon Staar, KS-1 were implanted in the patients at the numbers of 26, 27 and 27 eyes in each group respectively. Three months after cataract surgery, aberrations in the eyes were measured in un-dilated pupil using a Hartmann-Shack-type aberrometer (Asclepion-Meditec). The same measurements were done in 26 normal phakic eyes in age-matched persons. Individual Zernike polynomials, coma-like aberration, spherical aberration, the RMS value of total aberrations and total high order aberrations in the each group were compared., Results: The total high order aberrations (the RMS value of 3rd and 4th aberrations) in AcrySof group was higher than Canon Staar group (P = 0.011), and the Z (3, 1) Zernike coefficient in AcrySof group was significant difference compared with Hydroview group (P = 0.038)., Conclusion: No significant differences in higher-order aberrations among eyes are demonstrated after implantation with 3 types IOLs in un-dilated pupil. The results suggest that there is no difference in the retinal image of pseudophakic eyes with 3 types of IOLs in regular condition.

Purpose: Comparison of CSF in groups with diffractive lens SA60D3 and with monofocal lens MA60BM, and applying results to healthy population., Material and Methods: The study included 3 groups of patients. First group consisted of 10 patients, who have undergone implant surgeries with diffractive lenses SA60D3 in both eyes; second group included 9 patients after implant surgeries with monofocal lenses MA60BM in both eyes. Third group included 10 patients with clear own lens. Groups were homogenous to number of patients, age and gender structure, as well as BCVA. CSF was determined for each eye. In the case of operated patients studies were performed 6 months after surgery. Homogeneity of groups was determined with Kruskal-Wallis test, but results of the studies were tested with variance. Results were shown in normalized CSF version., Results: In conducted studies there was no statistical difference in specific evaluated cpd (3, 6, 12, 18) between SA60D3 group and MA60BM group after 6 months from surgery (p = 0.892, p = 0.926, p = 0.564, p = 0.9953). The above results were obtained by testing variance at confidence level p < or = 0.01. At the higher confidence level p < or = 0.05 there was significant difference between SA60D3 group, MA60BM group and healthy control., Conclusions: Diffractive lenses SA60D3 decrease CSF in comparable range as monofocal MA60BM lenses, which does not change acceptable standard for quality vision for monofocal lenses, that is currently accepted.

Objective: To research the difference in vision after UV and UVCY two types of intraocular lens implantation (The light 380-790 nm may transmit through the UV lens, and the UVCY lens may partly filter the light < 640 nm including part of the light < 460 nm.)., Methods: MCT 8000 contrast tester was used in the postoperative two months., Results: The contrast sensitivity of the patients with UVCY lenses was superior to that with UV lenses obviously (P < 0.05) under the condition of glare and 3 c/d, 6 c/d space frequency., Conclusion: The UVCY lens is more advantageous to improve visual function.

Purpose: To determine the relationship between various intraocular lens (IOL) types and the incidence of unwanted light images., Setting: The Moran Eye Center, University of Utah, Salt Lake City, Utah, USA., Methods: A telephone questionnaire was administered to 302 postoperative patients who had received 1 of 6 commonly used IOLs between January and September 1998. Patients were included only if they had uneventful cataract surgery, no additional ocular pathology, and a postoperative best corrected visual acuity of 20/25 or better. A control group of 50 patients with the diagnosis of presbyopia only also participated in the questionnaire. Patients reported on incidence of glare, light sensitivity, and unwanted images. The data were analyzed for statistically significant relationships between incidence of photopsias and IOL type., Results: The AcrySof 5.5 mm, AcrySof 6.0 mm, and SI-40 groups reported significantly more unwanted images than the control group (P =.0014). The 2 AcrySof groups also reported a greater incidence of light to the side causing a central flash, and the SI-40 group, a higher incidence of glare. The control group was more likely to experience symptoms of glare than any pseudophakic group. Overall, a mean of 49% of patients reported some light-related phenomenon postoperatively. The majority in all groups reported being satisfied with their eyesight despite the light-related problems., Conclusions: A significant number of pseudophakic patients reported symptoms of dysphotopsia. Patients who received an acrylic IOL with flattened edges were at increased risk of experiencing images associated with edge reflections. The SI-40 lens group, although less than the AcrySof groups, reported a higher incidence of glare than the non-AcrySof groups; however, it also had the highest number of patients still driving at night. The phakic population commonly experienced glare reported as more severe than several of the IOL groups.

Goal: The purpose of this study is to assess the degree of desirable ametropia in cataract surgery., Material and Methods: A scale for evaluation was created. It allows to measure the desired distance for a neat uncorrected vision (desired ametropia) after cataract surgery that presbyopic patients (monocular vision) would like to obtain. This scale helps to calculate the power of the intraocular lens to be implanted. The scale was shown to a series of 50 consecutive presbyopic patients. Refraction was the same in both eyes. The interest of patients in the evaluation of their desirable ametropia was measured on a scale from 0 to 5., Results: Interest was good for 50% of patients (grade > or = 3). Mean distance desired by patients for a neat uncorrected vision was 1 meter. Preoperative myopia and hyperopia have no significantive influence upon the distance desired for a neat uncorrected vision., Conclusion: The choice of the power of the lens implanted during cataract surgery should take into account the patients' desires. An evaluation of the postoperative desirable ametropia should be systematic.

Purpose: To prospectively evaluate use of the laser flare meter the inflammatory response after phacoemulsification with four different types of intraocular lenses., Methods: Measurements with the Kowa laser flare meter FC-500 were done before surgery and at 1, 6 and 21 days following standard phacoemulsification with corneal incision in 157 patients. The patients were randomized in four groups to receive HSM IOL (group I), foldable acrylic IOL (group II), foldable three-piece silicone (group III), and foldable single-piece silicone (group IV)., Results: Overall, mean flare values were increased at D1, and decreased rapidly to normal values at D21. Intragroup analysis showed a slight increase of flare value observed in the PMMA group (p = 0.0015) and silicone monobloc group (p = 0.001) at D21 compared to D0. There was no statistical difference found between D0 and D21 in the acrylic and the silicone three pieces groups. At D1, a significant increase of flare values was observed in the PMMA (28.9 ph/ms) and silicone three pieces (28.8 ph/ms) groups, as compared to silicone monobloc group (22 ph/ms). At D21, the acrylic group had a significantly lower mean value than PMMA and silicone monobloc groups. No statistical difference was observed between acrylic and three-piece silicone at D21., Conclusion: This study shows that the inflammation in the four groups was very low after phacoemulsification by a corneal incision and attempts to explain the impact of the incision length on the breakdown of blood-aqueous barrier.

We've studied a number of 20 cases of pseudophakic explantation performed in the Eye Center Timişoara between 1991-1997 from 2605 pseudophakic implantations. The interval between implantation and the moment of explantation was between 4 days and 7 years. The causes which indicated pseudophakic explantation were: pseudophakic bullous keratopathy, IOL decentration and dislocation, uveitis, persistent secondary glaucoma. The study refers to the established treatment for avoiding the explantation and also to the functional results obtained after pseudophakic explantation. Most of the explanted artificial lens cases were anterior chamber lens--13, all of them ALCON type, also we've explanted 4 pupillary implants Fedorov type. The visual acuities obtained after explantation were between hand movement perception and 10/10. Before surgery, visual acuity was between light perception and 10/10. The best functional results were obtained in pseudophakic decentration and dislocation cases and the worst in pseudophakic bullous keratopathy, uveitis and secondary glaucoma cases.

This proposed rule would establish in regulations a process under which interested parties may request, with respect to a class of new technology intraocular lenses (IOLs), a review of the appropriateness of the current payment amount for IOLs furnished by Medicare-participating ambulatory surgical centers. The rule implements section 141(b) of the Social Security Act Amendments of 1994, which requires us to develop and implement this process.

Purpose: To determine whether intraocular lens (IOL) type affects the bacterial count in anterior chamber aspirates obtained immediately after cataract surgery., Setting: L.V. Prasad Eye Institute, Hyderabad, India., Methods: This in vivo study evaluated two groups of eyes that had uneventful cataract extraction and implantation of one of two types of IOLs: all poly(methyl methacrylate) (PMMA) (n = 73) or polypropylene haptic (n = 83). Anterior chamber fluid aspirates (0.1 mL) were obtained with a 30 gauge cannula at the end of surgery and inoculated onto chocolate agar and in thioglycolate broth. Microbiology evaluation was performed using standard methods., Results: Seven eyes (9.5%) with all-PMMA IOLs and 21 (25.3%) with polypropylene haptic IOLs were positive for bacterial isolates (P = .0322; chi-square test). Mean colony count (+/-SD) was 11.43 +/- 3.78 and 13.16 +/- 4.78 colony-forming units/ milliliter in the PMMA and polypropylene haptic IOL groups, respectively. No eye developed endophthalmitis., Conclusion: Polypropylene haptic IOLs were associated with a significant increase in bacteria in the anterior chamber.

The paper presents some complications specific to the IOL implant corelated with the 3 main groups of pseudofac: anterior chamber, irian fixation and posterior chamber pseudofac. The introducing, the fixation type and the position occupied by every IOL type determines the more frequent occurrence of some complications specific to the pseudofac implant. The therapy of these complications varies too with the implant type.