Purpose: After initial encouraging results with the accommodative 1CU posterio r chamber lens (PCIOL), we investigated the rate, the postoperative time point o f posterior capsular opacification (PCO) necessitating YA...Purpose: After initial encouraging results with the accommodative 1CU posterio r chamber lens (PCIOL), we investigated the rate, the postoperative time point o f posterior capsular opacification (PCO) necessitating YAG capsulotomy and the a ccommodative range after Nd: YAG capsulotomy in patients with 1CU-PCIOL. Patien ts and methods: This prosective clinical study included 65 patients who underwen t phacoemulsification and implantation of the accommodative 1CU-PCIOL with post operative follow-up from 3 to 24 months. Postoperative examination was performe d 3, 6 and 12 months after surgery, then before and 6 weeks after Nd: YAG capsul otomy. Measurements included: the best corrected distance visual acuity, distanc e refraction, near visual acuity (Birkhauser charts in 35 cm) obtained with be st distance correction, accommodative range measured by subjective near point wi th an accodommometer and defocusing with a visual acuity fall to 0.4. Results: B oth best corrected distance visual acuity (1.1±0.1) and near visual acuity with best distance correction (0.4±0.1) remained stable over the follow-up period until 12 months postoperatively. The accommodative range determined by near poin t was stable (mean 2.0±0.5 D). Also, the defocusing range remained stable over 12 months (1.8±0.4 D). A clinically relevant posterior c apsule opacification with a significant decrease of visual acuity (0.4±0.2) and a need for Nd: YAG capsulotomy was diagnosed in 12 patients between 15 and 22 ( mean 20±4, median 20) months postoperatively. All capsulotomies were performed without complication. Six weeks after capsulotomy, best corrected distance visua l acuity was improved (1.1±0.1), near visual acuity with best distance correcti on was 0.4±0.1 and the accommodative range determined by near point was 1.95±0 .6 D and by defocusing was 1.88±0.47 D. Six weeks after capsulotomy, measuremen ts of the accommodative range did not show any statistical difference to the 12 -month results before the occurrence of PCO (P >0.5). Con展开更多
Purpose: Most trials that study the lens movement of accommodative intraocular lens (IOLs) use pilocarpine to stimulate ciliary muscle contraction. The aim of this study is to assess in vivo whether a more physiologic...Purpose: Most trials that study the lens movement of accommodative intraocular lens (IOLs) use pilocarpine to stimulate ciliary muscle contraction. The aim of this study is to assess in vivo whether a more physiologic, stimulus- driven accommodation is comparable to pilocarpine- induced IOL movement. Design: Controlled patient- and examiner- masked clinical trial. Participants: The study population included 38 eyes with accommodative IOL implants (1CU) and a control group of 28 eyes with conventional open- loop IOLs. Methods: A highprecision biometry technique, partial coherence interferometry, was used tomeasure IOL position. Anterior chamber depthwas measured during physiologic (near point) and pharmacological (pilocarpine 2% ) stimulation. In a subgroup of 14 1CU eyes, IOL position was determined repeatedly within 90 minutes after pilocarpine administration. A different subgroup was investigated as to the effect of cyclopentolate on IOL position. Best- corrected distance visual acuity (VA), best- corrected near VA, and distance- corrected near VA (DCNVA) were assessed using logarithm of the minimum angle of resolution charts. Main Outcome Measures: Anterior chamber depth change under pilocarpine and near- point- driven accommodation. Results: Near- point accommodation did not induce movement of either the accommodating 1CU or the control IOLs. Pilocarpine induced a 201± 0.137 mm anterior movement of the 1CU IOL (P< 0.001), compared with no movement within the control IOL groups (P >0.05). There was no significant (P >0.05) difference in DCNVA between the accommodative and open- loop IOLs. No correlation between near point- or pilocarpine- stimulated IOL movement and DCNVA was found. Concerning the time course of movement after pilocarpine administration, most of the 1CU IOLs showed somemovement 30 minutes after application. Cyclopentolate- induced ciliary muscle relaxation caused a posterior IOL movement, as compared with the relaxed state, when focusing on a distant target. Conclusion: Pilocarpine- induced c展开更多
文摘Purpose: After initial encouraging results with the accommodative 1CU posterio r chamber lens (PCIOL), we investigated the rate, the postoperative time point o f posterior capsular opacification (PCO) necessitating YAG capsulotomy and the a ccommodative range after Nd: YAG capsulotomy in patients with 1CU-PCIOL. Patien ts and methods: This prosective clinical study included 65 patients who underwen t phacoemulsification and implantation of the accommodative 1CU-PCIOL with post operative follow-up from 3 to 24 months. Postoperative examination was performe d 3, 6 and 12 months after surgery, then before and 6 weeks after Nd: YAG capsul otomy. Measurements included: the best corrected distance visual acuity, distanc e refraction, near visual acuity (Birkhauser charts in 35 cm) obtained with be st distance correction, accommodative range measured by subjective near point wi th an accodommometer and defocusing with a visual acuity fall to 0.4. Results: B oth best corrected distance visual acuity (1.1±0.1) and near visual acuity with best distance correction (0.4±0.1) remained stable over the follow-up period until 12 months postoperatively. The accommodative range determined by near poin t was stable (mean 2.0±0.5 D). Also, the defocusing range remained stable over 12 months (1.8±0.4 D). A clinically relevant posterior c apsule opacification with a significant decrease of visual acuity (0.4±0.2) and a need for Nd: YAG capsulotomy was diagnosed in 12 patients between 15 and 22 ( mean 20±4, median 20) months postoperatively. All capsulotomies were performed without complication. Six weeks after capsulotomy, best corrected distance visua l acuity was improved (1.1±0.1), near visual acuity with best distance correcti on was 0.4±0.1 and the accommodative range determined by near point was 1.95±0 .6 D and by defocusing was 1.88±0.47 D. Six weeks after capsulotomy, measuremen ts of the accommodative range did not show any statistical difference to the 12 -month results before the occurrence of PCO (P >0.5). Con
文摘Purpose: Most trials that study the lens movement of accommodative intraocular lens (IOLs) use pilocarpine to stimulate ciliary muscle contraction. The aim of this study is to assess in vivo whether a more physiologic, stimulus- driven accommodation is comparable to pilocarpine- induced IOL movement. Design: Controlled patient- and examiner- masked clinical trial. Participants: The study population included 38 eyes with accommodative IOL implants (1CU) and a control group of 28 eyes with conventional open- loop IOLs. Methods: A highprecision biometry technique, partial coherence interferometry, was used tomeasure IOL position. Anterior chamber depthwas measured during physiologic (near point) and pharmacological (pilocarpine 2% ) stimulation. In a subgroup of 14 1CU eyes, IOL position was determined repeatedly within 90 minutes after pilocarpine administration. A different subgroup was investigated as to the effect of cyclopentolate on IOL position. Best- corrected distance visual acuity (VA), best- corrected near VA, and distance- corrected near VA (DCNVA) were assessed using logarithm of the minimum angle of resolution charts. Main Outcome Measures: Anterior chamber depth change under pilocarpine and near- point- driven accommodation. Results: Near- point accommodation did not induce movement of either the accommodating 1CU or the control IOLs. Pilocarpine induced a 201± 0.137 mm anterior movement of the 1CU IOL (P< 0.001), compared with no movement within the control IOL groups (P >0.05). There was no significant (P >0.05) difference in DCNVA between the accommodative and open- loop IOLs. No correlation between near point- or pilocarpine- stimulated IOL movement and DCNVA was found. Concerning the time course of movement after pilocarpine administration, most of the 1CU IOLs showed somemovement 30 minutes after application. Cyclopentolate- induced ciliary muscle relaxation caused a posterior IOL movement, as compared with the relaxed state, when focusing on a distant target. Conclusion: Pilocarpine- induced c
