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  • 1
    Online Resource
    Online Resource
    Change in Subfoveal Choroidal Thickness following Cataract Surgery Imaged with Enhanced Depth Imaging Optical Coherence Tomography
    Georg Thieme Verlag KG ; 2023
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 240, No. 08 ( 2023-08), p. 989-996
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 240, No. 08 ( 2023-08), p. 989-996
    Abstract: Background Due to its invasive nature, cataract surgery can lead to inflammatory processes in the posterior segment, which can result in prolonged recovery times, reduced functional outcomes, and late-onset complications. The aim of the current study was to identify wherever phacoemulsification parameters play a role in choroidal thickness change following cataract surgery. Methods This prospective single-center study enrolled 31 patients (31 eyes) scheduled to undergo routine cataract surgery. Patients with previous ocular surgeries, pathologies or general disorders affecting vision were excluded. Patients were examined preoperatively, as well as 1, 4, and 12 weeks after surgery. Corrected distance visual acuity (CDVA), intraocular pressure (IOP) as well as cumulative dissipated energy (CDE), ultrasound time (UT), and fluids used during surgery were recorded. Subfoveal choroidal thickness was measured manually by two masked independent experts using enhanced depth imaging (EDI) optical coherence tomography (OCT). Furthermore, cataract density was automatically calculated using a custom MATLAB script and an anterior segment OCT. Results Subfoveal choroidal thickness increased significantly (p  〈  0.001, Studentʼs paired sample t-test) and continuously during the 12-week-long follow-up period. Both the nuclear lens density and the improvement in CDVA correlated significantly with this increase (r = 0.413, p = 0.021 and r = 0.421, p = 0.018, respectively). Neither the CDE (r = 0.334, p = 0.071), the UT (r = 0.102, p = 0.629), the amount of fluid used (r = 0.237, p = 0.27) nor the decrease in IOP (r = − 0.197, p = 0.288) showed any significant correlation with the choroidal swelling. Conclusion Cataract surgery leads to an increase in subfoveal choroidal thickness. While no statistically significant correlation to the phacoemulsification parameters could be established, this might be because of a selection bias due to the technological constraints of the OCT. Nevertheless, the choroid might play a central role in early- and late-onset complications.
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-2120-7415
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2039754-9
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  • 2
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    In vivo comparison of implantation behavior and laboratory analysis of two preloaded intraocular lens injectors
    SAGE Publications ; 2023
    In:  European Journal of Ophthalmology
    Details
    In: European Journal of Ophthalmology, SAGE Publications
    Abstract: We evaluated implantation behavior and injector damage of two different IOL injector systems, the Multisert and the AutonoMe. Design Prospective, randomized, comparative study with laboratory investigation. Methods We examined used injectors from 48 bilateral cataract cases and assessed video recordings of each Implantation. All eyes were intraindividually randomized for treatment with one of the two IOL injectors. Implantation videos were reviewed for inadvertent events and the time for different implantation steps was determined. The injector nozzle tips were examined using light and scanning electron microscopy (SEM). Damage was graded using the Heidelberg Score for IOL injector damage (HeiScore). Three months postoperatively, IOLs were assessed for material changes. Results Implantation was without critical events in 96 of 96 eyes. Mean implantation time was 41.90 ± 7.11 s with the Multisert and 52.22 ± 12.06 s with the AutonoMe. In the AutonoMe group, we observed 4 eyes (8.3%) with a failed docking attempt, 28 eyes (58.3%) with a haptic adherence, one case (2.1%) of straight leading haptic and 2 cases (4.2%) of intrawound IOL manipulation. There were no events observed in the Multisert group. The mean HeiScore values were 0.87 ± 0.61 and 3.68 ± 0.47 for the AutonoMe and Multisert. 3 months postoperatively, IOL material changes were absent. Conclusions Both injectors allowed safe and controlled implantation. Using Multisert, implantation behavior was more consistent. The injectors showed different damage profiles with a higher damage score for the Multisert. The study is registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien; reference number: DRKS00007837).
    Type of Medium: Online Resource
    ISSN: 1120-6721 , 1724-6016
    URL: Article
    DOI: 10.1177/11206721231204382
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 1475018-1
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  • 3
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    Online Resource
    Comparison of Five Presbyopia-Correcting Intraocular Lenses: Optical-Bench Assessment with Visual-Quality Simulation
    MDPI AG ; 2023
    In:  Journal of Clinical Medicine Vol. 12, No. 7 ( 2023-03-27), p. 2523-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 12, No. 7 ( 2023-03-27), p. 2523-
    Abstract: Presbyopia correction through implantation of a trifocal intraocular lens (IOL) is a modality offered to both cataract and refractive-lens exchange patients. To maximize postoperative satisfaction, IOL selection needs to be made based on patients’ requirements aligned with the available technology. Five Trifocal IOLs were assessed in this study, and their differentiating features were identified: Triumf POD L GF, AT Lisa Tri, Tecnis Synergy, AcrySof IQ PanOptix, and Acriva Trinova Pro C. The optical quality was assessed using the modulation-transfer-function principle. Simulated defocus curves were derived from a non-linear formula. Far-focus simulated visual acuity (simVA) was 0.03 logMAR or better for all the studied IOLs, showing minimal differences. However, each IOL’s intermediate focus position differed across a range from 61 cm to 80 cm; and for the near focus, it was 36 cm to 44 cm. Triumf demonstrated improved intermediate point at the expense of the near focus resulting in a lower predicted near VA. PanOptix exhibited the shortest range of vision without a clear distinction between intermediate and near-point. The remaining lenses presented three foci of comparable optical quality and, thus, simVA performance. Each model, however, revealed a different aperture-change response. Trinova function improved at intermediate but was worse at near for larger pupils. The opposite was observed for AT Lisa. Synergy’s optical quality change was predominantly associated with lower pupil diameter. In conclusion, the trifocal IOLs can be differentiated according to their secondary-foci position, light-energy distribution, and pupil-size-related behavior. The observed differences may translate directly into a clinical effect showing that the trifocal IOLs vary in their ability to deliver optimal vision at different distances, with some providing improved intermediate while others favor reading distance. The knowledge gained through this objective testing can support IOL selection, postoperative patient counselling and increase the chance of spectacle independence after surgery.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm12072523
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662592-1
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  • 4
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    Impact of Phacoemulsification Parameters on Central Retinal Thickness Change Following Cataract Surgery
    MDPI AG ; 2023
    In:  Diagnostics Vol. 13, No. 17 ( 2023-09-04), p. 2856-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 17 ( 2023-09-04), p. 2856-
    Abstract: Cataract surgery can lead to inflammatory processes in the retina due to its invasive nature, resulting in prolonged recovery times and reduced functional outcomes. The aim of the current study is to explore the impact that phacoemulsification parameters have on macular thickness following surgery. This prospective single-center study enrolled 46 healthy patients (46 eyes) who underwent uneventful cataract surgery. Retinal thickness was assessed using optical coherence tomography (OCT) preoperatively, as well as 1, 4, and 12 weeks after surgery. The macula was divided into a central (CMT), inner (IMT), and outer ring (OMT). Cataract density was automatically determined using an anterior segment OCT and a custom MATLAB script. Corrected distance visual acuity (CDVA), intraocular pressure (IOP) as well as cumulative dissipated energy (CDE), ultrasound time (UT), and fluids used during phacoemulsification were recorded. Retinal thickness and volume increased significantly following cataract surgery, reaching its maximum 4 weeks post-operatively. Statistically significant correlations were found between the CDE and IMT, OMT and retinal volume change (rIMT = 0.356, rOMT = 0.298, rvolume = 0.357 with p 〈 0.05) as well as between the ultrasound time and IMT, OMT, and retinal volume change (rIMT = 0.369, rOMT = 0.293 and rvolume = 0.409 with p 〈 0.05). Changes in CMT did not correlate with any surgical metrics. Additionally, no correlation was found to the amount of fluid used, whether CDVA or IOP. However, a link between nuclear cataract density and changes in OMT (r = 0.310, p 〈 0.05) was established. How ultrasound energy impacts the choroidea, and to what extent retinal metabolism changes after surgery, needs to be explored in future studies.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13172856
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 5
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    Online Resource
    Traumatic iris defect: implantation of an artificial iris to restore function and aesthetics
    Springer Science and Business Media LLC ; 2022
    In:  Spektrum der Augenheilkunde Vol. 36, No. 5 ( 2022-10), p. 123-127
    Details
    In: Spektrum der Augenheilkunde, Springer Science and Business Media LLC, Vol. 36, No. 5 ( 2022-10), p. 123-127
    Abstract: To present the case of a patient with a traumatic iris defect who underwent surgical iris reconstruction with a CUSTOMFLEX Artificial Iris (AI, HumanOptics AG, Erlangen, Germany) 4 months after the initial trauma, which took place in the context of a bicycle accident. Observation At the initial presentation, we observed an open eyeball injury, that was immediately surgically treated including vitrectomy, anterior chamber irrigation and suturing of the sclera and C 3 F 8 gas endotamponade. After secondary IOL implantation at another clinic, the patient complained about increased glare sensitivity and decreased visual acuity in the right eye. Corrected distance visual acuity was 1.4 logMAR for the right eye and 0.10 logMAR for the left eye. Slit lamp examination revealed a large iris defect with residual iris tissue from 4 o’clock to 8 o’clock. Both eyes were pseudophakic and funduscopy was unremarkable. The patient underwent sulcus fixated AI implantation of the right eye. Visual acuity improved to 0.30 logMAR. Subjective glare sensitivity improved considerably. Contrast sensitivity measured with the Pelli-Robson chart improved from 0.15 log units preoperatively to 1.05 log units postoperatively. Conclusion We observed a very good aesthetic and functional result after surgical iris reconstruction with an artificial iris. This case demonstrates how correction of glare sensitivity can lead to a significant increase in visual acuity and in contrast sensitivity.
    Type of Medium: Online Resource
    ISSN: 0930-4282 , 1613-7523
    URL: Article
    DOI: 10.1007/s00717-021-00504-7
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2010368-2
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  • 6
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    Spherical Aberration of Astigmatic Corneas in a Cataract Population
    SLACK, Inc. ; 2023
    In:  Journal of Refractive Surgery Vol. 39, No. 8 ( 2023-08), p. 532-538
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 39, No. 8 ( 2023-08), p. 532-538
    Abstract: To study the distribution of spherical aberration (SA) in astigmatic corneas in a cataract population and the relationship between magnitude of corneal astigmatism and fourth-order corneal SA. Methods: Data routinely collected using a Scheimpflug camera (Pentacam; Oculus Optikgeräte GmbH) were retrospectively analyzed. Patients with a minimum age of 60 years were included. Total corneal SA (from anterior and posterior corneal surface) was obtained for a 6-mm cor-neal area aligned with the pupil center. Exclusion criteria were insufficient measurement quality, total deviation index (Belin/Ambrósio Deviation) greater than 1.60, and corneal thickness at the thinnest point of less than 490 μm. One eye per patient was chosen randomly. Eyes were divided into low (≤ 1.00 diopters [D] ), moderate ( 〉 1.00 to ≤ 2.00 D), and high ( 〉 2.00 D) astigmatism groups according to the Scheimpflug measurements. Results: A total of 528 eyes were included in this analysis. Low astigmatism was found in 129 patients, moderate astigmatism in 265 patients, and high astigmatism in 134 patients. Mean astigmatism was 0.68 ± 0.24, 1.45 ± 0.28, and 2.91 ± 0.95 D in the low, moderate, and high astigmatism groups, respectively. Mean corneal SA in patients with moderate and high astigmatism was higher than in the low astigmatism group. The difference reached the significance level for the comparison of low and high astigmatism groups ( P = .023). The fourth-order SA increased gradually with the magnitude of astigmatism with a slope of 0.015. Conclusions: SA was significantly larger in the cataract population with high corneal astigmatism. The increase of positive sign SA with the magnitude of astigmatism suggests that patients with moderate to high astigmatism may benefit more from intraocular lenses with negative sign SA correction. [ J Refract Surg . 2023;39(8):532–538.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20230717-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2023
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  • 7
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    Acute Retinal Necrosis: Signs, Treatment, Complications and Outcome
    MDPI AG ; 2022
    In:  Diagnostics Vol. 12, No. 2 ( 2022-02-02), p. 386-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 2 ( 2022-02-02), p. 386-
    Abstract: Background: The Acute Retinal Necrosis (ARN) is an inflammatory, rapidly progressive necrotizing retinitis and vasculitis, most frequently caused by Varicella-Zoster-Virus (VZV), followed by Herpes-Simplex-Virus (HSV), Cytomegalovirus (CMV) and Epstein-Barr-Virus (EBV). The diagnosis is based on clinical signs that were first defined by the American Uveitis Society in 1994 that include one or more foci of retinal necrosis, rapid progression without treatment, circumferential progression, occlusive vasculopathy, and inflammatory signs of the vitreous and anterior chamber Methods: In this retrospective analysis, we included 16 eyes of 10 patients, six patients with simultaneous or delayed bilateral affection, treated for ARN. Status of disease, corrected distance visual acuity (CDVA, decimal), intraocular pressure (IOP), pathogen proof, therapy, and complications were evaluated at diagnosis and 3 months later. Results: In nine patients, the pathogen was identified (six VZV, two HSV, one CMV, one EBV). All patients were treated with systemic and intravitreal virustatic agents. In nine eyes with a CDVA of 0.2 ± 0.2 at hospital admission, vitrectomy was performed, and in seven eyes with CDVA of 0.5 ± 0.3, no vitrectomy was performed (p = 0.04). After 3 months, CDVA of the vitrectomized eyes decreased to 0.1 ± 0.1 vs. 0.4 ± 0.3 (p = 0.01) without vitrectomy. CDVA of fellow eyes affected was 0.6 ± 0.2 at initial presentation vs. 0.2 ± 0.2 for eyes affected first and 0.4 ± 0.3 vs. 0.1 ± 0.1 after 3 months. We observed several complications including retinal detachment, recurrence of the disease, and bulbar hypotony. Conclusion: For fellows eyes affected, diagnosis could be confirmed earlier, leading to a more successful treatment. The success of vitrectomy is difficult to evaluate because vitrectomy is most frequently performed just in the advanced stages of the disease. Early treatment with an appropriate approach is essential to avoid loss of vision.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12020386
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662336-5
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  • 8
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    Visualization of Ray Propagation through Extended Depth-of-Focus Intraocular Lenses
    MDPI AG ; 2022
    In:  Diagnostics Vol. 12, No. 11 ( 2022-11-02), p. 2667-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 11 ( 2022-11-02), p. 2667-
    Abstract: Extended depth-of-focus (EDoF) presbyopia-correcting intraocular lens (IOL) models differ in their optical design and performance. In the laboratory, we compared the ray propagation and light intensity profiles of four IOLs: the non-diffractive AcrySof IQ Vivity (Alcon Inc., Fort Worth, TX, USA) and two diffractive models, Symfony ZXR00 (Johnson & Johnson Vision, Jacksonville, FL, USA) and AT Lara 829 MP (Carl Zeiss Meditec, Berlin, Germany). A fourth lens, the monofocal AcrySof IQ SN60WF (Alcon Inc.) acted as the control. We projected a 520 nm laser light through each submerged lens in a bath of fluorescein solution. A camera mounted on a microscope captured the light that emerged from the IOL. We recorded the IOLs’ point spread function (PSF) to determine the presence of unwanted visual effects. The ray propagation visualization and light intensity profile of the monofocal control showed one distinct focus, while the AcrySof IQ Vivity demonstrated an extended focus area. We observed two distinct foci with each diffractive IOL. We found a lower level of light spread beyond the PSF center for the AcrySof IQ Vivity compared to the diffractive IOLs. In conclusion, we could confirm the extended range of focus for all the EDoF IOL models. However, the non-diffractive AcrySof IQ Vivity appears to have a smoother transition from a far to an intermediate range. We discuss whether, in clinical use, the higher level of spurious light we found in the diffractive designs may translate into increased dysphotopsia.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12112667
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 9
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    Unilateral implantation of a new extended range of vision intraocular lens in a young patient
    Springer Science and Business Media LLC ; 2022
    In:  Der Ophthalmologe Vol. 119, No. 1 ( 2022-01), p. 65-70
    Details
    In: Der Ophthalmologe, Springer Science and Business Media LLC, Vol. 119, No. 1 ( 2022-01), p. 65-70
    Type of Medium: Online Resource
    ISSN: 0941-293X , 1433-0423
    URL: Article
    DOI: 10.1007/s00347-020-01285-1
    RVK:
    XA 10000
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 3128800-5
    detail.hit.zdb_id: 1462970-7
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  • 10
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    Traumatic aniridia: conservative or surgical therapeutic approach?
    Springer Science and Business Media LLC ; 2022
    In:  Der Ophthalmologe Vol. 119, No. 4 ( 2022-04), p. 395-399
    Details
    In: Der Ophthalmologe, Springer Science and Business Media LLC, Vol. 119, No. 4 ( 2022-04), p. 395-399
    Type of Medium: Online Resource
    ISSN: 0941-293X , 1433-0423
    URL: Article
    DOI: 10.1007/s00347-021-01367-8
    RVK:
    XA 10000
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 3128800-5
    detail.hit.zdb_id: 1462970-7
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