Foldable Lens Explantation and Exchange：The Reason and Solution

Objective: To report the explantation and exchange of Hydrophilic Acrylic foldableintraocular lens (IOL) on 14 patients who had visual disturbances caused by the changeof transparence on optic.Methods: Sixteen Hydrophilic Acrylic foldable intraocular lenses from 14 patients whopresented with decreased visual acuity from 6 months to 1 year after normalphacoemulsification and IOL implantation associated with extensive transparent changeon optic of the lens. The lenses were explanted with the bisection technique. All the eyeswere reinserted with Acrysof foldable lenses.Results: Sixteen lenses were removed successfully and exchanged with the new lens inthe capsule. The posterior capsular rupture and vitreous loss were found in the first twocases. One of them had the zonulysis due to the radial tear of the anterior capsule duringthe enlargement of the capsular opening. The anterior vitrectomy was performed with IOLfixed on the ciliary sulcus. The visual acuity of all the patients improved obvi     

【In Press】 Preloaded and non-preloaded intraocular lens delivery system and characteristics: human and porcine eyes trial

AIM: To compare characteristics of preloaded and non-preloaded intraocular lens (IOL) delivery systems during IOL delivery procedures. METHODS: Total 101 human eyes were included in this prospective observational case series. Delivery characteristics of 5 types of IOLs including iSert250 NC60 (NC60), EnVista MX60 (MX60), AcryS of IQ SN60WF (SN60WF), TECNIS ZCB00 (ZCB00), and TECNIS PCB00 (PCB00) were investigated. NC60 and PCB00 were injected via preloaded delivery systems and other IOLs were injected via non-preloaded systems. In the human trial, time taken from IOL loading to completion of implantation was measured in all eyes undergoing conventional cataract surgery. Using 4 excised porcine eyes, dynamics of ophthalmic viscosurgical device (OVD) between an IOL injector and a porcine eye was analyzed using fluorescein sodium-stained OVD. RESULTS: The average time for IOL implantation was 22.0s for NC60, 43.2s for MX60, 32.3 seconds for SN60WF, 41.4s for ZCB00, and 14.6s for PCB00 respectively. The number of cases with IOL manipulation with a second instrument was 6 for MX60, 2 for ZCB00, 0 for SN60WF, NC60, and PCB00. Amount of OVD pushed into a porcine eye was smaller with a preloaded system than with non-preloaded systems. CONCLUSION: IOL delivery with preloaded systems is faster and more predictable. Moreover, a preloaded delivery system shows relatively less OVD pushed into a porcine eye than non-preloaded systems.     

Determination of Intraocular Lens Tilt and Decentration Using Simple and Rapid Method

Purpose: To determine the tilt and decentration of implanted intraocular lens (IOL) in vivo one year postoperatively.Methods : A retrospective study was performed on 67 eyes by the method introduced by Guy-ton using the third and fourth Purkinje imagesm through undilated pupil. Results : The average decentration of implanted IOL was 0.68 mm, and the average tilt was 6.03°. The result was similar to the histopadiological study in postmortem eyes and the measurement in vivo.Linear-regression analysis showed there was no relationship between the tilt and decentration and the residual astigmatism ,axial length ,IOL power,etc. Conclusion: The result is similar to the other methods. The method using the third and fourth Purkinje images is simple and easy to perform. It can be used for determining the IOL position through undilated pupil and does not require special apparatus. Eye Science 1998; 14: 13 - 16.     

Retinoma and Phthisis Bulbi of Retinoblastoma 1.Clinical and Genetic Analysis

Retinoma and phthisis bulbi of retinoblastoma are rare entitiesfound in retinoblastoma patients and their relatives.Eleven cases of phthisisbulbi of retinoblastoma and 9 cases of retinoma were identified from 1966 to1991 in our center.The clinic data show that retinoma and phthisis bulbi areclosely related to the retinoblastoma gene.Enucleation should be carried outas soon as possible without hesitation for the phthisis of eyes with retinoblas-toma.Genetic counseling and frequent observation should be paid attention toretinoma patients and their offspring.The mechanism of retinoma developed isdiscussed.We propose that the diversity of second mutation might be thecause of retinoma.Eye Science 1992;8:117-121.     

Müller cell and neuronal remodeling in retinal detachment and reattachment and their potential consequences for visual recovery: a review and reconsideration of recent data

Recent evidence suggests that the adult mammalian retina is far more plastic than was previously thought. Retinal detachment induces changes beyond the degeneration of outer segments (OS). Changes in photoreceptor synapses, second- and even third-order neurons may all contribute to imperfect visual recovery that can occur after successful reattachment. Changes that occur in Müller cells have obvious effects through subretinal fibrosis and proliferative vitreoretinopathy, but other unidentified effects seem likely as well. Reattachment of the retina induces its own set of responses aside from OS re-growth. Reattachment halts the growth of Müller cell processes into the subretinal space, but induces their growth on the vitreal surface. It also induces the outgrowth of rod axons into the inner retina.     

Pupil size and Perimetry—a pharmacological model using increment and decrement stimuli

Background To assess the influence of natural and pharmacologically induced pupil size fluctuations on differential luminance sensitivity threshold (DLS) using bright (increment) and dark (decrement) stimuli. Methods Twelve healthy volunteers (20–30 years) were examined under the effect of phenylephrine 2%, dapiprazole 0.5%, and placebo. Pupil size was recorded by infra-red video camera in sessions without and with visual field examination (Tübingen Computer Campimeter). DLS was estimated at 9 locations within the central 20° visual field, using bright and dark 26 min-of-arc-stimuli (10 cd/m² background, 4-2-1 dB thresholding strategy, four reversals). Results There were substantial inter-individual differences in pupil size and pupil size fluctuations. Intra-individual differences were small. Independently of medication, pupil size fluctuations were reduced by more than one-third when a subject was undergoing perimetric examination. Pupil size affected DLS on its own (slope 0.21 dB/mm; 95% CI: 0.09–0.33 dB/mm), differently at different stimulus locations, and to a greater extent with increment than with decrement stimuli (slope difference 0.13 dB/mm; 95% CI: 0.00–0.26 dB/mm). Conclusions Campimetric examinations have a stabilising effect on pupil size fluctuations. Pupil size affects DLS with bright stimuli more than with dark stimuli; in normal young subjects this effect is not relevant for clinical or normative studies.     

Council Votes on Duke Elder, Francois and Gonin Medals and Pathology Award

At its meeting in Florence, the Council voted to award the three historic ICO medals as follows:·Gonin Medal to Al Sommer, MD ·International Duke Elder Medal to Bradley R. Straatsma, MD, JD. ·Jules Francois Medal to Bruce Spivey, MD. See the criteria and process defined for awarding each medal.The Council also voted to present the new ICO Ophthalmic Pathology Award, which it approved in October 2004, to Thaddeus P. Dryja, MD, Director of the Cogan Eye Pathology Laboratory …