Intraocular lenses

Significant advances in intraocular lens designs have not been over the last year. The lack of successful lens implant designs to match the requirements of small-incision cataract surgery is frustrating. Although it is possible to comfortably remove the crystalline lens through a 2.7-mm incision, this incision inevitably has to be enlarged to accommodate even the most malleable lens implant available. Polymethyl methacrylate remains the preferred lens material for most surgeons, but silicone lens implants have gained consideration and have incited controversy. Acrylic polymers are in the early stages of clinical evaluation. Phakic lens implants for high myopia remain controversial while longer-term evidence for the safety of renewed designs is gathered.     

Intraocular lenses

Cataract remains a major source of blindness in many countries throughout the world. Although modern medicine and technology have combined to provide an almost ideal solution, availability of modern cataract and lens implant surgery is restricted, even in developed nations. The health care "cake" is not always divided fairly in favor of ophthalmology in general and lens implant surgery in particular. The transition to small-incision surgery continues, whereas intraocular lens technology attempts to catch up so that incision size for cataract extraction and lens implantation is compatible with both aspects of the process. Complications continue, although their degree may differ from former times. The world ophthalmic literature continues to record the enthusiasm and contribution of individual investigators who pioneered lens implantation as well as multicenter and university-based groups. American, Japanese, and European contributions dominate the literature from 1992 to 1993.     

Intraocular lenses

I have again reviewed the current state of the art in intraocular lens design in what has been a year of consolidation rather than dramatic discoveries. In foldable lenses, silicone reigns supreme, but there is the promising development of high-refractive-index foldable acrylic lenses. Heparin surface modification is now accepted as valuable in high-risk eyes, but there remains a question mark over surface passivation value. Small-incision lenses continue to proliferate with the design of new haptics to facilitate insertion after circular tear capsulorhexis. Some doubt has been raised concerning the optical qualities of ovoid lenses. Anterior-chamber myopic lenses for phakic myopic patients remain controversial. However, an increasing volume of data concerning their advantages and disadvantages is now available.     

Intraocular lenses

In reviewing the 1990 literature on intraocular lenses, it is evident that the increased popularity of phacoemulsification in North America has stimulated interest in lens designs that can be inserted through small incisions, and various methods for folding soft lenses. Critical evaluation of various multifocal lenses has now resulted in greater understanding of their advantages and drawbacks, and it is becoming apparent that there are guidelines of suitable candidates for such lenses. Use of multifocals has stimulated interest in contrast sensitivity testing, and new more accurate lens power formulas. Heparin surface modification of polymethylmethacrylate lenses now seems to be accepted as having value in reducing pigment deposits after surgery. Clinical trials of lenses for patients suffering from age-related macular degeneration hold some promise for this large group of unhappy patients. However, the use of anterior chamber lenses to correct high myopia in phakic eyes is now on hold because of reports of progressive endothelial cell loss in some eyes. More reports are available on the technique and results of suturing posterior chamber lenses to the sclera where there is absent or insufficient capsule to support a conventional sulcus fixated posterior chamber lens. Intraocular lenses remain alive and well in 1990 with increased usage worldwide.     

Intraocular lenses in age-related macular degeneration

Graefe's Archive for Clinical and Experimental Ophthalmology - The aim of this work is to review the lenses, assessing their advantages and disadvantages. We describe a total of seven types of...     

Fuchs综合征并发白内障的人工晶状体植入

目的　评价 Fuchs综合征并发白内障的手术方法。方法　对 11例 Fuchs综合征并发白内障患者行白内障囊外摘出 (ECCE)联合人工晶状体 (IOL)植入术。结果　 11例患者白内障囊外摘出联合人工晶状体植入术后无严重手术并发症 ,不同程度葡萄膜炎易被控制 ,无眼压增高 ,术后平均随访 18m o,矫正视力 0 .4～ 1.2 ,0 .5以上占 81.8% .结论　Fuchs综合征并发白内障的人工晶状体植入手术安全、疗效好     

Intraocular lenses and diabetes mellitus

I reviewed the records of 74 consecutive, unselected diabetic patients (91 eyes) who had cataract extraction with intraocular lens implantation. The retinopathy status remained unchanged in 79 eyes. Of the 12 in which retinopathy status changed, four eyes without previous retinopathy developed mild background retinopathy, seven eyes that had had mild background retinopathy progressed to moderate background retinopathy, and one eye that had had background retinopathy developed mild proliferative retinopathy. Sixty-four eyes (70.3%) achieved visual acuities of 20/40 or better. The examination, photography, and photocoagulation treatment of the retina were not affected by the presence of an intraocular lens.     

Intraocular lenses: an update

The use of intraocular lenses has been rapidly increasing in recent years. Improved designs and newer surgical techniques have reduced already low complication rates making implantation of an intraocular lens the procedure of choice for both patients and practitioners. Trends in lens design and a review of the most recent literature is offered for the practitioner.     

Intraocular lenses in patients with diabetes mellitus

Presented are personal experiences concerning the application of artificial intraocular lenses in patients with diabetes and cataract. Operated were patients aged 50-76 years in whom implantation of an artificial lens of Alcon or Cilco was performed either to the anterior or posterior chamber. During the qualification for surgery eliminated were patients with proliferating retinopathy, with rubeosis iridis (with or without secondary glaucoma) and with juvenile diabetes. In 16 patients the obtained visual acuity was 0.8-1.0, in one female patient 0.5; in the remaining 2 persons the visual acuity amounted 0.2 and 0.3. These patients exhibited a simple exudative retinopathy with a macular oedema and after surgery they were subjected to a laser therapy. Observation of our material showed that qualifying diabetic patients for cataract extraction and taking into consideration the over mentioned contraindications one can obtain good results similar as in other patients with cataract.