PURPOSE: To investigate the change of morphometric characteristics of the corneal cells by confocal microscopy in long-term soft contact lens wearer. METHODS: Confocal microscopy (ConfoScan 2.0, Fortune Technology, Italy) was used to obtain data from healthy volunteers and soft contact lens wearers for 10 years. We evaluated the morphological images of the corneal epithelium (superficial cell, wing cell), Bowman's membrane, stromal cells (anterior, middle, and posterior keratocyte), Descemet's membrane, and endothelium. RESULTS: In comparison with control, the wing cells from corneal epithelium of contact lens wearer appeared to have irregular and blurred cell borders, and enlarged subepithelial nerve plexus. The bowman's membrane and the anterior stroma showed an increased reflectivity. The keratocyte from a highly reflective area showed no definite cell border anteriorly and more distinct shape with less cellularity posteriorly. Descemet's membrane showed an evidence of vertical fold and keratocytes with long processes were arranged in parallel. The endothelial layer showed polymegathism and polymorphism with some gutta. CONCLUSIONS: According to these data, it would be suggested that a long-term wearing of soft contact lens could influence the morphology of corneal epithelium and stroma as well as of corneal endothelium.
Bowman Membrane ; Contact Lenses, Hydrophilic* ; Cornea* ; Corneal Stroma ; Descemet Membrane ; Endothelium ; Endothelium, Corneal ; Epithelium, Corneal ; Healthy Volunteers ; Microscopy, Confocal ; Stromal Cells

When the continuous circular capsulorhexis (CCC) is being performed, the nucleus delivery using nucleus dislocation into the anterior chamber is safer and easier than using conventional "push and pull" method to maintain an intact lens capsule. This method include such procedures that after CCC, the nucleus being freed in the capsular bag by hydrodissection and hydrodelineation, then hooked with a Sinskey hook and drawn out to the anterior chamber by rotation. It may damage the corneal endothelium because of the manipulation in the anterior chamber. To investigate an effect of this method on the corneal endothelium, we performed two months time analysis of changes of the central corneal endothelial cell density (CECD) in two groups--a group with an extracapsular cataract extraction (ECCE) using nucleus dislocation into the anterior chamber and a group with a conventional ECCE. Eighteen eyes of 18 cataract patients who were operated on with ECCE using nucleus dislocation into the anterior chamber method, and ten eyes of 10 cataract patients who were operated on with a conventional ECCE method were included. The CECD was measured by specular microscopy, preoperatively, postoperatively at 1 month and 2 months. The average endothelial cell loss at postoperative 1 month was 7.20 +/- 2.98% in the experimental group and 7.88 +/- 2.93% in the control group, and at postoperative 2 months was 9.05 +/- 2.96% in the experimental group and 9.34 +/- 2.95% in the control group. The change in CECD between two groups was not statistically significant.
Adult ; Aged ; Anterior Chamber/*surgery ; Cataract Extraction/*methods ; Cell Count ; Endothelium, Corneal/*pathology ; Female ; Humans ; Lens Capsule, Crystalline/*surgery ; Lens Nucleus, Crystalline/*surgery ; Male ; Middle Aged

A case of congenital corneal staphyloma was presented. This 4 year-old boy was premature born and received oxygen in theLincubator during one month after birth. He showed mental retardation, articulation disturbance and gait disturbance. The right eye was free from any anomaly. The left eye was undergone enucleation for cosmetic improvement because of corneal opacity at birth. A detailed histologic examination of the congenital corneal staphyloma was given; epidermidialization of the corneal epithelium, scarring and vascularization of the stroma, with an absence of Bowman's membrane were shown. Descemet-endotheliallayer was completely defective in keratoiridic and corneal-abnormal pigment layer adhesions, but found in the seperated portion between cornea and iris. Iris root was not found in normal position. An abnormal pigment epithelial layer from ciliary epithelium was covered the surface of trabecular meshwork(anterior chamber angle) and an abnormal pigmentation of the trabecular meshwork poorly developed, which was running on iris pigment epithelium and covering inner surface of the cornea. The ciliary body, especially the process was atrophic. The lens was thin membranous and cataractous. Abnormal fibrinous band in the retinal capillary bed was argyrophilic strand. It was suggested that these findings of anterior corneal staphyloma was resulted from primary developmental anomaly of mesodermal and/or neuroectodermal tissue.
Bowman Membrane ; Capillaries ; Cataract ; Child, Preschool ; Cicatrix ; Ciliary Body ; Cornea ; Corneal Opacity ; Epithelium ; Epithelium, Corneal ; Fibrin ; Gait ; Humans ; Intellectual Disability ; Iris ; Male ; Mesoderm ; Neural Plate ; Oxygen ; Parturition ; Pigmentation ; Retinaldehyde ; Running ; Trabecular Meshwork

PURPOSE: To report the confocal morphological changes of keratoconus in comparison with that of normal cornea. METHODS: Confocal microscopy (ConfoScan 2.0, Fortune Technology, Italy) was used to obtain data from healthy volunteers and keratoconus. We evaluated corneal morphological images of the corneal epithelium, Bowman's layer, stromal layer (anterior, middle, and posterior keratocyte), Descemet's membrane, and endothelium. RESULTS: In keratoconus cornea, the wing cells of epithelium had somewhat irregular margin, and the subepithelial nerve bundle was slightly enlarged. Near Bowman's membrane, highly reflective changes and tear like structure were visible. While the anterior stromal keratocyte had nuclei with a highly reflective density and indefinite cell border, posterior keratocyte had a more distinct shape with less cellularity. Near descemet's membrane, vertical fold (Vogt's striae) was observed and keratocytes with long processes arranged nearly in parallel. Morphological change was not observed in the endothelium. CONCLUSIONS: Our confocal microscopic findings of keratoconus may help early diagnosis and assessment of prognosis in the management of keratoconus.
Bowman Membrane ; Cornea ; Descemet Membrane ; Early Diagnosis ; Endothelium ; Epithelium ; Epithelium, Corneal ; Healthy Volunteers ; Keratoconus* ; Microscopy, Confocal ; Prognosis

PURPOSE: In this study, we examined the stability of the lens-angle supporter (LAS) for accommodation restoration by comparing intraocular lens (IOL) location, after-cataract and ciliary body damage after cataract surgery in rabbits. METHODS: Eight rabbits were divided into experimental and control groups of four rabbits each. Phacoemulsification and irrigation and aspiration were performed in all rabbits. This was followed by an LAS and IOL insertion in the four experimental rabbits. In the four control rabbits, only an IOL insertion was performed. Six months after the surgery, the location of the IOL, the conditions of the lens capsule and ciliary body were evaluated using a slitl-amp examination and Miyake-Apple view. RESULTS: For the experimental group, the ultrasound biomicroscope results showed normal LAS and IOL positioning in all four cases. According to the slitlamp examination and Miyake-Apple view, the IOL was positioned at the center, with less after-cataract and damage to the ciliary body. For the control group, ultrasound biomicroscope results indicated a higher IOL position than normal, as well as a single case of IOL decentering. According to the slit-lamp examination and Miyake-Apple view, the IOL was decentered with more severe after-cataract and ciliary body damage. CONCLUSIONS: The LAS has the potential to maintain a stable IOL position while producing less after-cataract when used in lens-angle reconstruction for correction of presbyopia. Moreover, LAS implantation incurs less damage to the ciliary body.
Accommodation, Ocular/physiology ; Animals ; Anterior Eye Segment ; Ciliary Body/injuries ; Disease Models, Animal ; Eye Injuries/*surgery ; Lens Capsule, Crystalline/*surgery ; *Lens Implantation, Intraocular ; Microscopy, Acoustic ; *Phacoemulsification ; Rabbits ; *Reconstructive Surgical Procedures

PURPOSE: The goal of the present study was to compare the stability of the 3-piece (Tecnis ZA9003) and single-piece (AcrySof IQ) aspheric intraocular lenses (IOL) by testing decentration, tilt, anterior chamber depth, and refraction. METHODS: The subjects of this study consisted of 101 eyes who had undergone cataract surgeries with a 3-piece aspheric IOL (54 eyes) and with a single-piece aspheric IOL (47 eyes). The decentration, tilt, anterior chamber depth, and refraction were measured on postoperative day 1, 1 month, and 2 months, using an anterior eye segment analysis system (EAS-1000, Nidek, Japan). RESULTS: There was a statistically significant difference in the decentration on the postoperative day 1 (p = 0.04). However, there was no statistically significant difference on postoperative 1 month (p = 0.15) and 2 months (p = 0.13). There was no statistically significant difference in the tilt on postoperative day 1, 1 month, and 2 months. There was no statistically significant difference in the anterior chamber depth on postoperative day 1, 1 month, and 2 months. There was a statistically significant difference in the refraction on postoperative day 1 (p = 0.03). However, there was no statistically significant difference on postoperative 1 month (p = 0.07) and 2 months (p = 0.07). CONCLUSIONS: There was no statistically significant difference in the decentration, anterior chamber depth, and refraction between the 3-piece and single-piece aspheric IOL. Therefore, there is no difference between the 3-piece and single-piece aspheric IOL in the capsular bag stability until 2 months postoperatively.
Anterior Chamber ; Anterior Eye Segment ; Cataract ; Eye ; Lenses, Intraocular

PURPOSE: To compare the anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) and refractive change after cataract surgery between 3-piece and 1-piece aspheric intraocular lens (IOL) implantation. METHODS: The present study consisted of 16 patients (25 eyes) having 3-piece aspheric Tecnis(R) ZA9003 IOL and 21 patients (30 eyes) having 1-piece aspheric Tecnis(R) ZCB00 IOL. The ACD, ACV, and ACA were measured using an anterior eye segment analysis system (Pentacam, Oculus, Wetzlar, Germany) preoperatively and postoperatively 1 week and 1 month. Refractive outcomes were evaluated using an autokeratometer. RESULTS: When comparing the 3-piece (Tecnis(R) ZA9003) and 1-piece (Tecnis(R) ZCB00) IOL with the same optic, ACD, ACV, and AVA increased significantly after cataract surgery. The 1-piece IOL showed deeper ACD than the 3-piece IOL at postoperative 1 week and 1 month. Postoperative refraction showed slight myopic shift compared with target diopter, but was stable in both groups. CONCLUSIONS: There was significant increase in ACD, ACV, and ACA after cataract surgery in both IOL-inserted groups. Results showed stable refraction after cataract surgery in both groups. Consideration of the A-constant will be needed because of myopic change with the 1-piece IOL.
Anterior Chamber ; Anterior Eye Segment ; Cataract ; Humans ; Lenses, Intraocular

PURPOSE: To compare the anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) and refractive change after cataract surgery between 3-piece and 1-piece aspheric intraocular lens (IOL) implantation. METHODS: The present study consisted of 16 patients (25 eyes) having 3-piece aspheric Tecnis(R) ZA9003 IOL and 21 patients (30 eyes) having 1-piece aspheric Tecnis(R) ZCB00 IOL. The ACD, ACV, and ACA were measured using an anterior eye segment analysis system (Pentacam, Oculus, Wetzlar, Germany) preoperatively and postoperatively 1 week and 1 month. Refractive outcomes were evaluated using an autokeratometer. RESULTS: When comparing the 3-piece (Tecnis(R) ZA9003) and 1-piece (Tecnis(R) ZCB00) IOL with the same optic, ACD, ACV, and AVA increased significantly after cataract surgery. The 1-piece IOL showed deeper ACD than the 3-piece IOL at postoperative 1 week and 1 month. Postoperative refraction showed slight myopic shift compared with target diopter, but was stable in both groups. CONCLUSIONS: There was significant increase in ACD, ACV, and ACA after cataract surgery in both IOL-inserted groups. Results showed stable refraction after cataract surgery in both groups. Consideration of the A-constant will be needed because of myopic change with the 1-piece IOL.
Anterior Chamber ; Anterior Eye Segment ; Cataract ; Humans ; Lenses, Intraocular

PURPOSE: To compare the decentration, tilt and anterior chamber depth between aspheric AcrySof(R) IQ IOL (SN60WF) and spheric AcrySof(R) Natural IOL (SN60AT). METHODS: The subjects of this study consisted of 22 patients (26 eyes) using an aspheric AcrySof(R) IQ IOL and 26 patients (31 eyes) using spheric AcrySof(R) Natural IOL. All lenses were inserted into the capsular bag after 5 mm continuous curvilinear capsulorhexis and phacoemulsification. The decentration, tilt and anterior chamber depth of both IOLs were measured on the 1st, 30th and 60th postoperative day using an anterior eye segment analysis system (Scheimpflug camera, EAS-1000, Nidek, Japan). RESULTS: There was no statistically significant difference in the decentration between the IQ IOL and Natural IOL on the 1st (p=0.05), 30th (p=0.09) and 60th (p=0.06) postoperative day. There was a statistically significant difference in tilt between IQ IOL and Natural IOL on the 1st (p=0.000053) and 30th (p=0.018) postoperative day. However, there was no statistically significant difference in tilt on the 60th postoperative day (p=0.05). The anterior chamber depth of IQ IOL was decreased, but was not statistically significant on the 1st (p=0.10), 30th (p=0.07) or 60th (p=0.06) postoperative day. CONCLUSIONS: There were no significant differences between AcrySof(R) IQ IOL and AcrySof(R) Natural IOL in decentration, tilt or anterior chamber depth, showing that posterior aspheric surface causes little effect on the IOL stability.
Anterior Chamber ; Anterior Eye Segment ; Capsulorhexis ; Humans ; Lenses, Intraocular ; Phacoemulsification

Keratoconus (conical cornea) is a condition, beginning about puberty and developing mainly in females, in which the apex of the cornea thins gradually and usually bilaterally. The etiology is unknown. The presenting symptom is a reduction of the patient's vision owing to the development of a high degree of irregular myopic astigmatism. Early in the course of the disease the cornea does not look conical. The diagnosis of Keratoconus is confirmed by the distorted reflex observed with a Placido's disc and abnormal keratometer readings. In more advanced stages, signs include the obvious cone-shaped cornea and indentation of the lower lid by the cornea. By slit lamp biomicroscopy, vertical lines are noted in the deep layers of the stroma: the corneal nerve fibers are increasingly visible; and in about 50% of cases a yellow or green line is present around the base of the corn (Fleischer's ring). In advanced cases Bowman's membrane and Descemet's membrane rupture. Microscopically there is thinning of the tissue spaces between the corneal lamellae, fragmentation of the basement membrane of the comeal epithelium, fibrillation of Bowman's membrane, and folds or ruptures in Descemet's membrane. Acute hydrops may occur when Descemet's membrane ruptures. This is characterized by sudden cloudiness of vision due to imbibition of aqueous in the corneal stroma. However, as Descemet's membrane regenerates, the edema subsides. Permanent scarring may result if Bowman's membrane ruptures. Acute hydrops of the cornea was developed respectively in left eye on Oct, 1976 and in right eye on Dec, 1976 in a 13 year old Korean girl with Keratoconus O.U.
Adolescent ; Astigmatism ; Basement Membrane ; Bowman Membrane ; Cicatrix ; Cornea* ; Corneal Stroma ; Descemet Membrane ; Diagnosis ; Edema* ; Epithelium ; Female ; Humans ; Keratoconus* ; Nerve Fibers ; Puberty ; Reading ; Reflex ; Rupture ; Zea mays