In order to investigate the efficiency of a new quantitative head-band formed ocular compressor to reduce intraocular pressure (IOP), ocular compression by this new reducer with 40 mmHg for 10 min was performed on 87 cataractous eyes of 78 cases. The changes of IOP (87 eyes) and anterior chamber depth (ACD) were observed. There was a significant decrease of IOP and increase of ACD within 30 min after decompression (P < 0.001). The mean decrease of IOP was 5.62 +/- 2.41 mmHg and the mean increase of ACD was 0.18 +/- 0.09 mm within 5 min after decompression. The IOP 5 min after decompression had no significant difference with that 10 min after decompression (P > 0.05). IOP below 10 mmHg could last for about 15 min. This apparatus had been successfully applied to 80 eyes for extracapsular cataract extraction. It was suggested that this device had the advantages of safety, accurate quantification, reliable effect, casually adjusting pressure according to various demands and time-saving.
Cataract/*physiopathology ; *Cataract Extraction ; Compressive Strength ; Equipment Design ; *Intraocular Pressure ; Manometry/instrumentation ; Preoperative Care

BACKGROUNDThe advent of wavefront technology in the past five years has provided some insight into the optical outcomes of cataract surgery. The Tecnis Z9001 intraocular lens (Tecnis IOL, AMO) with a modified prolate anterior surface was claimed to reduce or even eliminate ocular spherical aberration to improve the visual quality. The purpose of this study was to determine whether Tecnis IOLs can improve the quality of vision as evaluated by measuring visual acuity, wavefront aberration, and contrast sensitivity.

METHODSIn an intraindividual prospective study, 20 patients with bilateral cataract were randomly assigned to receive a modified prolate anterior surface IOL (Tecnis Z9001, AMO) in one eye and a biconvex spherical surface IOL (CeeOn 911A, AMO) in the other. After 3 months, the following were investigated: best corrected visual acuity, pupil diameter, photopic and mesopic contrast sensitivity, and wavefront aberration of the whole eye (ocular), cornea, and internal plane.

RESULTSThe differences in the best corrected visual acuity and pupil diameter between the two groups were not statistically significant. Negative 4th-order spherical aberration (Z(4)(0)) was found in the Tecnis group, whereas positive Z(4)(0) found in the CeeOn group for the internal and ocular plane. Statistically significant differences were found at the ocular higher-aberrations between the two IOLs. Contrast sensitivity testing showed significantly better results in the Tecnis group at visual angles higher than 1.0 degree under photopic conditions and at visual angles higher than 1.6 degree under mesopic conditions both without glare and with glare in comparison with the CeeOn group.

CONCLUSIONSThe Tecnis Z9001 IOL with a modified prolate anterior surface produces negative spherical aberration and consequently reduces the higher-order aberrations in pseudophakic eyes. This leads to enhanced contrast sensitivity and improved functional vision compared to conventional spherical IOLs.

Cataract ; physiopathology ; therapy ; Contrast Sensitivity ; Humans ; Lenses, Intraocular ; Prospective Studies

OBJECTIVETo understand the perception for the use of cataract surgical services in a population of acceptors and non-acceptors of cataract surgery in urban Beijing.

METHODSFrom a community-based screening program a total of 158 patients with presenting visual acuity of less than 6/18 on either eye due to age-related cataract were informed about the possibility of surgical treatment. These patients were interviewed and re-examined 36 to 46 months after initial screening. The main reasons for not accepting surgery were obtained using a questionnaire. Vision function and vision-related quality of life scores were assessed in those who received and did not receive surgery.

RESULTSAt the follow-up examination 116 of the 158 patients were available and 36 (31.0%) had undergone cataract surgery. Cases who chose surgery had higher education level than those who did not seek surgery (OR=2.64, 95% CI: 1.08-6.63, P=0.02). There were no significant differences in vision function (P=0.11) or quality of life scores (P=0.16) between the surgery group and the non-surgery group. Main reasons for not having surgery included no perceived need (50.0%), feeling of being "too old" (19.2%), and worry about the quality of surgery (9.6%). Cost was cited by 1 (1.9%) subject as the main reason for not seeking surgery.

CONCLUSIONSThe data suggest that in China's capital urban center for patients with moderate visual impairment there is a relative low acceptance rate of cataract surgery, mainly due to people's perception of marginal benefits of surgery. Cost is not a determining factor as barrier to undergo surgery and patients with poorer education are less likely to undertake surgery.

Aged ; Aging ; pathology ; Animals ; Cataract ; complications ; physiopathology ; Cataract Extraction ; utilization ; China ; Female ; Follow-Up Studies ; Humans ; Male ; Urban Population ; Vision Disorders ; etiology ; physiopathology

BACKGROUNDThe evaluation of retinal image quality in cataract eyes has gained importance and the clinical modulation transfer functions (MTF) can obtained by aberrometer and double pass (DP) system. This study aimed to compare MTF derived from a ray tracing aberrometer and a DP system in early cataractous and normal eyes.

METHODSThere were 128 subjects with 61 control eyes and 67 eyes with early cataract defined according to the Lens Opacities Classification System III. A laser ray-tracing wavefront aberrometer (iTrace) and a double pass (DP) system (OQAS) assessed ocular MTF for 6.0 mm pupil diameters following dilation. Areas under the MTF (AUMTF) and their correlations were analyzed. Stepwise multiple regression analysis assessed factors affecting the differences between iTrace- and OQAS-derived AUMTF for the early cataract group.

RESULTSFor both early cataract and control groups, iTrace-derived MTFs were higher than OQAS-derived MTFs across a range of spatial frequencies (P < 0.01). No significant difference between the two groups occurred for iTrace-derived AUMTF, but the early cataract group had significantly smaller OQAS-derived AUMTF than did the control group (P < 0.01). AUMTF determined from both the techniques demonstrated significant correlations with nuclear opacities, higher-order aberrations (HOAs), visual acuity, and contrast sensitivity functions, while the OQAS-derived AUMTF also demonstrated significant correlations with age and cortical opacity grade. The factors significantly affecting the difference between iTrace and OQAS AUMTF were root-mean-squared HOAs (standardized beta coefficient = -0.63, P < 0.01) and age (standardized beta coefficient = 0.26, P < 0.01).

CONCLUSIONSMTFs determined from a iTrace and a DP system (OQAS) differ significantly in early cataractous and normal subjects. Correlations with visual performance were higher for the DP system. OQAS-derived MTF may be useful as an indicator of visual performance in early cataract eyes.

Aberrometry ; methods ; Adult ; Aged ; Cataract ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Visual Acuity ; physiology

BACKGROUNDContrast sensitivity (CS) testing can detect differences in functional vision and is highly correlated with visual performance. This study was designed to investigate the association between CS and the grading score using the lens opacities classification system (LOCS) III as well as the association between CS and visual acuity (VA) in nuclear or cortical age-related cataract (ARC) patients.

METHODSA total of 270 eyes with ARC and 30 control eyes were divided into nuclear opacity (NO), nuclear color (NC), cortical cataract (C) based on LOCS III. The CS values measured at all spatial frequencies under photopic and glare conditions that resulted in contrast sensitivity function (CSF) were evaluated, and LogMAR VA was tested with the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. The correlation between CSF and LOCS III grading scores, and between CSF and LogMAR VA were analyzed.

RESULTSCompared to the controls, CSF of the nuclear or cortical ARC significantly declined. There are significant correlation between CSF and LogMAR VA, and between CSF and LOCS III grading scores. Compared to the VA, a stronger correlation existed between CSF and LOCS III grading score than that of LogMAR VA and LOCS III grading score. CS at some spatial frequencies is significantly influenced with LOCS III grading score.

CONCLUSIONSCSF significantly declined with the increasing ARC grading scores. Comparing to VA, CSF reflected the severity of cataract more comprehensively. CS at low spatial frequency is significantly influenced by ARC. Therefore, CS is more precise than VA in assessing the visual function of ARC patients.

Aged ; Cataract ; classification ; physiopathology ; Contrast Sensitivity ; physiology ; Female ; Humans ; Male ; Middle Aged ; Visual Acuity

PURPOSE: The objective was to evaluate the effect of co-implantation of a preloaded capsular tension ring (CTR) and aberration-free monofocal intraocular lens (IOL) on clinical outcomes and visual quality after cataract surgery. MATERIALS AND METHODS: Patients who underwent cataract surgery were randomized into two groups that were implanted with a CTR and IOL (group 1, 26 eyes) or an IOL only (group 2, 26 eyes). At 1 and 3 months after surgery, visual acuity, refractive errors, refractive prediction errors, ocular aberrations, and modulation transfer function (MTF) were analyzed. At 3 months postoperatively, anterior chamber depth (ACD) and contrast sensitivity were evaluated. RESULTS: Group 1 showed greater hyperopic shift, which caused the refractive prediction error at 3 months after surgery to be significantly different between the two groups (p=0.049). Differences in ACD between the preoperative and postoperative periods tended to be greater in group 1 than in group 2. At 3 months postoperatively, internal MTF values at 20, 25, and 30 cycles per degree were significantly better in group 1 than in group 2 (p=0.034, 0.017, and 0.017, respectively). Contrast sensitivity showed comparable results at almost all spatial frequencies between the groups. CONCLUSION: Regarding visual acuity and quality, both groups showed comparable results. Co-implantation of a CTR and aberration-free monofocal IOL was associated with hyperopic refractive outcomes. Surgeons should consider the position of the IOL when planning co-implantation of a CTR and IOL.
Aged ; Cataract/physiopathology ; *Cataract Extraction ; Contrast Sensitivity ; Female ; Humans ; Lens Implantation, Intraocular/*instrumentation ; Male ; Middle Aged ; Postoperative Period ; Prospective Studies ; Treatment Outcome

In order to investigate the efficiency of a new quantitative head-band formed ocular compressor to reduce intraocular pressure (IOP), ocular compression by this new reducer with 40 mmHg for 10 min was performed on 87 cataractous eyes of 78 cases. The changes of IOP (87 eyes) and anterior chamber depth (ACD) were observed. There was a significant decrease of IOP and increase of ACD within 30 min after decompression (P < 0.001). The mean decrease of IOP was 5.62 +/- 2.41 mmHg and the mean increase of ACD was 0.18 +/- 0.09 mm within 5 min after decompression. The IOP 5 min after decompression had no significant difference with that 10 min after decompression (P > 0.05). IOP below 10 mmHg could last for about 15 min. This apparatus had been successfully applied to 80 eyes for extracapsular cataract extraction. It was suggested that this device had the advantages of safety, accurate quantification, reliable effect, casually adjusting pressure according to various demands and time-saving.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cataract ; physiopathology ; Cataract Extraction ; Child ; Compressive Strength ; Equipment Design ; Female ; Humans ; Intraocular Pressure ; Male ; Manometry ; instrumentation ; Middle Aged ; Preoperative Care

PURPOSE: To evaluate the clinical characteristics and outcomes of cataract surgery in highly myopic Korean subjects. METHODS: We retrospectively reviewed the medical records of 694 eyes of 694 patients who underwent cataract surgery. The case group included 347 eyes of 347 patients whose axial lengths (AXL) were > or =26.00 mm, and the control group included 347 eyes of 347 patients with AXL between 22.00 and 25.99 mm. Cataract density was determined preoperatively using the Pentacam Scheimpflug imaging system. We compared age at operation, cataract type, coexisting disease, visual prognosis, and complications. RESULTS: The mean age at the time of the operation was 59.60 +/- 12.28 years in the case group and 67.47 +/- 11.36 years in the control group. The case group had a larger proportion of nuclear cataracts and posterior subcapsular cataracts (PSC), 40.63% and 26.22%, respectively, versus 25.07% and 11.82%, respectively, in the control group. Postoperative corrected visual acuity showed a negative correlation with AXL (R2 = 0.172), and severe funduscopic findings were related to poor visual prognosis (p = 0.05). The incidence of retinal detachment in the case group after cataract surgery was 1.72%, compared with 0.28% in the control group. CONCLUSIONS: Highly myopic eyes tend to develop cataracts earlier than normal eyes and to have a higher prevalence of coexisting disease and complications, such as retinal detachment. Nuclear cataracts and PSC were more common in the highly myopic group. Poor visual prognosis was associated with longer axial length and retinal myopic degeneration.
Aged ; *Asian Continental Ancestry Group ; Cataract/*complications/epidemiology/physiopathology ; *Cataract Extraction ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myopia/*complications/epidemiology/physiopathology ; Postoperative Period ; *Refraction, Ocular ; Republic of Korea/epidemiology ; Retrospective Studies ; *Visual Acuity

PURPOSE: To evaluate the long-term efficacy and rotational stability of the AcrySof toric intraocular lens (IOL) in correcting preoperative astigmatism in cataract patients. METHODS: This prospective observational study included 30 eyes from 24 consecutive patients who underwent implantation of an AcrySof toric IOL with micro-coaxial cataract surgery between May 2008 and September 2008. Outcomes of visual acuity, refractive and keratometric astigmatism, and IOL rotation after 1 day, 1 month, 3 months, and long-term (mean, 13.3+/-5.0 months) follow-up were evaluated. RESULTS: At final follow-up, 73.3% of eyes showed an uncorrected visual acuity of 20/25 or better. The postoperative keratometric value was not different from the preoperative value; mean refractive astigmatism was reduced to -0.28+/-0.38 diopter (D) from -1.28+/-0.48 D. The mean rotation of the toric IOL was 3.45+/-3.39 degrees at final follow-up. One eye (3.3%) exhibited IOL rotation of 10.3 degrees, the remaining eyes (96.7%) had IOL rotation of less than 10 degrees. CONCLUSIONS: Early postoperative and long-term follow-up showed that implantation of the AcrySof toric IOL is an effective, safe, and predictable method for managing corneal astigmatism in cataract patients.
*Acrylic Resins ; Adult ; Aged ; Aged, 80 and over ; Astigmatism/complications/physiopathology/*surgery ; Cataract/*complications/physiopathology ; Cataract Extraction/*methods ; Female ; Follow-Up Studies ; Humans ; *Lenses, Intraocular ; Male ; Middle Aged ; Prospective Studies ; Prosthesis Design ; Refraction, Ocular ; Time Factors ; Treatment Outcome ; Visual Acuity

PURPOSE: To evaluate factors associated with the direction of horizontal deviation in the sensory strabismus of patients with unilateral organic amblyopia. METHODS: The medical charts of 53 patients who had been diagnosed with sensory strabismus between 2000 and 2009 were reviewed retrospectively. The underlying ocular disease, time of onset and the duration of vision impairment, refractive error and axial length of the fixing eye, and the direction and angle of deviation were analyzed to determine the distribution of underlying diseases and any factors relevant to determining the direction of the horizontal deviation. RESULTS: Congenital cataracts were the most common underlying disease, found in 33 patients, followed by acquired cataracts, optic nerve disorders, retinal detachment, glaucoma and lens subluxation. Among the 50 patients with horizontal strabismus, 11 had esotropia and 39 had exotropia. The incidence of esotropia was significantly higher when the fixing eye had hyperopia or emmetropia, than when the eye was myopic. Age of onset of vision deterioration and at diagnosis of sensory strabismus, and the axial length of the fixing eye had no relationship to the direction of horizontal deviation. In addition, the duration of visual impairment had no significant relationship with the direction or extent of horizontal deviation. CONCLUSIONS: The most common cause of sensory strabismus was congenital cataracts and the most frequent type of strabismus was exotropia. With respect to the direction of horizontal strabismus, esotropia occurred significantly more often when the refractive error of the fixing eye was hyperopia or emmetropia than when the fixing eye was myopic.
Adolescent ; Adult ; Amblyopia/*complications/physiopathology ; Cataract/complications/congenital/physiopathology ; Child ; Child, Preschool ; Eye Movements/*physiology ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Oculomotor Muscles/*physiopathology ; Refractive Errors ; Retrospective Studies ; Risk Factors ; Strabismus/etiology/*physiopathology ; Visual Acuity ; Young Adult