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Purpose: To use finite element (FE) analysis to assess what morphologic and biomechanical factors of the iris and anterior chamber are more likely to influence angle narrowing during pupil dilation. Methods: The study consisted of 1344 FE models comprising the cornea, sclera, lens, and iris to simulate pupil dilation. For each model, we varied the following parameters: anterior chamber depth (ACD = 2-4 mm) and anterior chamber width (ACW = 10-12 mm), iris convexity (IC = 0-0.3 mm), iris thickness (IT = 0.3-0.5 mm), stiffness (E = 4-24 kPa), and Poisson's ratio (v = 0-0.3). We evaluated the change in (△∠) and the final dilated angles (∠f) from baseline to dilation for each parameter. Results: The final dilated angles decreased with a smaller ACD (∠f = 53.4° ± 12.3° to 21.3° ± 14.9°), smaller ACW (∠f = 48.2° ± 13.5° to 26.2° ± 18.2°), larger IT (∠f = 52.6° ± 12.3° to 24.4° ± 15.1°), larger IC (∠f = 45.0° ± 19.2° to 33.9° ± 16.5°), larger E (∠f = 40.3° ± 17.3° to 37.4° ± 19.2°), and larger v (∠f = 42.7° ± 17.7° to 34.2° ± 18.1°). The change in angles increased with larger ACD (△∠ = 9.37° ± 11.1° to 15.4° ± 9.3°), smaller ACW (△∠ = 7.4° ± 6.8° to 16.4° ± 11.5°), larger IT (△∠ = 5.3° ± 7.1° to 19.3° ± 10.2°), smaller IC (△∠ = 5.4° ± 8.2° to 19.5° ± 10.2°), larger E (△∠ = 10.9° ± 12.2° to 13.1° ± 8.8°), and larger v (△∠ = 8.1° ± 9.4° to 16.6° ± 10.4°). Conclusions: The morphology of the iris (IT and IC) and its innate biomechanical behavior (E and v) were crucial in influencing the way the iris deformed during dilation, and angle closure was further exacerbated by decreased anterior chamber biometry (ACD and ACW).

Asunto(s)

Análisis de Elementos Finitos , Iris , Pupila , Humanos , Iris/anatomía & histología , Pupila/fisiología , Fenómenos Biomecánicos , Glaucoma de Ángulo Cerrado/fisiopatología , Presión Intraocular/fisiología , Cámara Anterior/diagnóstico por imagen , Cámara Anterior/anatomía & histología , Córnea/fisiología , Córnea/anatomía & histología , Esclerótica

RESUMEN

Purpose: We aimed to examine the normative profile of crystalline lens power (LP) and its associations with ocular biometric parameters including age, axial length (AL), spherical equivalent refraction (SE), corneal radius (CR), lens thickness, anterior chamber depth, and AL/CR ratio among a cynomolgus monkey colony. Methods: This population-based cross-sectional Non-human Primate Eye Study recruited middle-aged subjects in South China. All included macaques underwent a detailed ophthalmic examination. LP was calculated using the modified Bennett's formula, with biometry data from an autorefractometer and A-scan. SPSS version 25.0 was used for statistical analysis. Results: A total of 301 macaques with an average age of 18.75 ± 2.95 years were collected in this study. The mean LP was 25.40 ± 2.96 D. Greater LP was independently associated with younger age, longer AL, and lower SE (P = 0.028, P = 0.025, and P = 0.034, respectively). LP showed a positive correlation with age, SE, CR, AL, lens thickness, and anterior chamber depth, whereas no correlation was observed between LP and AL/CR ratio. Conclusions: Our results suggested the LP distribution in the nonhuman primate colony and indicated that AL and SE strongly influenced the rate of LP. Therefore, this study contributed to a deeper understanding of the relative significance of the LP on the optics of the crystalline lens study.

Asunto(s)

Longitud Axial del Ojo , Biometría , Cristalino , Macaca fascicularis , Refracción Ocular , Animales , Cristalino/anatomía & histología , Estudios Transversales , Refracción Ocular/fisiología , Masculino , Femenino , Biometría/métodos , Cámara Anterior/anatomía & histología , Córnea/anatomía & histología

RESUMEN

PURPOSE: This study aimed to compare the differences between the Zeiss IOL Master and Oculus Pentacam in keratometry and central anterior chamber depth (ACD) measurements in patients with high myopia and cataracts. METHODS: Between January 2019 and December 2020, 89 patients (103 eyes) with cataracts and high myopia who underwent preoperative cataract evaluation at Nanchang First Hospital were selected for retrospective analysis. Keratometry (K1, K2) and ACD were measured with the IOL Master and Pentacam. Paired t-tests were performed to compare the differences, while the Bland-Altman method was used to evaluate the agreement. RESULTS: The K1 value was (43.15±2.44) D for the IOL Master and (42.98±2.47) D for the Pentacam, and the difference between the two instruments was statistically significant (P<0.01). The K2 value was (44.55±2.63) D for the IOL Master and (44.32±2.55) D for the Pentacam. The ACD was (3.44±0.33)mm for the IOL Master and (3.39±0.36)mm for the Pentacam. There were statistically significant differences between the two instruments in both keratometry and ACD (P<0.01). The absolute values of the maximum difference between the two instruments for K1 and K2 were 1.1 and 1.07; thus, the consistency of the two instruments with respect to this measurement was poor. However, the absolute value of the maximum difference between the two instruments for ACD was 0.34, so the consistency of the two instruments in relation to this measurement was good. CONCLUSIONS: Both the IOL Master and the Pentacam can be used in the measurement of keratometry and ACD in patients with high myopia and cataracts, but the keratometry measurements should be compared in clinical application.

Asunto(s)

Catarata , Miopía , Humanos , Catarata/diagnóstico , Catarata/patología , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Miopía/diagnóstico , Miopía/patología , Adulto , Segmento Anterior del Ojo/diagnóstico por imagen , Segmento Anterior del Ojo/patología , Cámara Anterior/patología , Cámara Anterior/diagnóstico por imagen , Extracción de Catarata , Anciano de 80 o más Años

RESUMEN

Proliferative diabetic retinopathy (PDR) is a vision-threatening complication of diabetes mellitus (DM). Anterior chamber (AC) flare and intraocular cytokines are potent biomarkers reflecting the intraocular immune status in PDR. This study aimed to elucidate the complex interrelationship between AC flare and intraocular cytokines in PDR eyes. A retrospective observational study was conducted on 19 PDR eyes of 19 patients with type 2 DM, and on 19 eyes of 19 patients with idiopathic macular hole or epiretinal membrane as controls. AC flare was measured before pars plana vitrectomy (PPV). Aqueous humor (AH) and vitreous fluid (VF) samples were collected at the time of PPV, and the quantities of 27 cytokines in both intraocular fluids were analyzed. In the PDR and control groups, Spearman's rank correlation analysis revealed a positive correlation between AC flare and IL-8 level in both AH and VF. Additionally, IL-8 levels in AH correlated positively with IL-8 levels in VF. In the PDR group, receiver operating characteristic curve analysis identified IL-8 level in AH as a significant predictor for both diabetic macular edema (DME) and vitreous hemorrhage (VH) complications. The cut-off values of IL-8 were established at ≥26.6 pg/mL for DME and ≥7.96 pg/mL for VH. Given the positive correlation between AC flare and AH IL-8 level, the present findings suggest that AC flare value may potentially be a non-invasive biomarker for predicting DME.

Asunto(s)

Cámara Anterior , Humor Acuoso , Retinopatía Diabética , Cuerpo Vítreo , Humanos , Retinopatía Diabética/inmunología , Retinopatía Diabética/metabolismo , Retinopatía Diabética/patología , Retinopatía Diabética/etiología , Masculino , Femenino , Cámara Anterior/patología , Cámara Anterior/metabolismo , Cámara Anterior/inmunología , Persona de Mediana Edad , Anciano , Humor Acuoso/metabolismo , Humor Acuoso/inmunología , Estudios Retrospectivos , Cuerpo Vítreo/metabolismo , Cuerpo Vítreo/patología , Edema Macular/etiología , Edema Macular/metabolismo , Edema Macular/inmunología , Edema Macular/patología , Vitrectomía , Biomarcadores , Citocinas/metabolismo , Interleucina-8/metabolismo , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/inmunología , Curva ROC

RESUMEN

PURPOSE: To evaluate the impact of anterior chamber phakic intraocular lens (pIOL) on swept-source optical coherence tomography (SS-OCT) biometric measurements and IOL power calculation. METHODS: This retrospective analysis of 67 eyes of 49 patients with previous anterior chamber pIOL implantation analyzed the accuracy of automatic segmentation of the anterior surface of the crystalline lens and its impact on anterior chamber depth (ACD, measured from epithelium to lens), lens thickness measurements, and IOL power calculation. The sample was divided into two groups: correct detection of the anterior surface of the crystalline lens and inaccurate detection. Segmentation of eyes from the inaccurate detection group was manually corrected and ACD and lens thickness were calculated using ImageJ software. IOL power was calculated using 7 formulas for both measurements. RESULTS: The anterior surface of the crystalline lens was mis-identified in 13 (19.4%) eyes. ACD was underestimated (Δ -0.85 ± 0.33 mm, P < .001) and lens thickness was overestimated (Δ +0.81 ± 0.25 mm, P < .001). Manual correction changed the target spherical equivalent only in the Haigis formula (P = .009). After correction for segmentation bias, the Pearl DGS, Cooke K6, and EVO 2.0 formulas showed the lowest prediction error, with the Pearl DGS showing greatest accuracy within ±1.00 diopters of prediction error range (81.0%). CONCLUSIONS: SS-OCT biometry misidentifies the anterior surface of the crystalline lens in a significant proportion, resulting in significant IOL power calculation error in the Haigis formula. Manual proofing of segmentation is mandatory in every patient with anterior chamber pIOL implantation. After correct segmentation, the Pearl DGS, Cooke K6, and EVO seem to be the best formulas. [J Refract Surg. 2024;40(8):e562-e568.].

Asunto(s)

Cámara Anterior , Biometría , Implantación de Lentes Intraoculares , Lentes Intraoculares Fáquicas , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Biometría/métodos , Estudios Retrospectivos , Masculino , Adulto , Femenino , Cámara Anterior/diagnóstico por imagen , Refracción Ocular/fisiología , Persona de Mediana Edad , Óptica y Fotónica , Cristalino/diagnóstico por imagen , Miopía/cirugía , Miopía/fisiopatología , Agudeza Visual/fisiología , Adulto Joven

RESUMEN

PURPOSE: To compare the outcomes of anterior chamber intraocular lens (AC-IOL) implantation versus the four-flanged scleral fixation technique in eyes with loss of capsular support during routine cataract surgery. METHODS: This was a retrospective cohort study of all patients in whom an IOL was implanted either during or after short-term aphakia due to loss of capsular and sulcus support in a routine cataract surgery with at least 6 months of follow-up time between 2015 and 2023 in a tertiary medical center in Israel. Two different IOL implantation techniques were compared: the implantation of an angle-supported ACIOL and four-flanged scleral fixation. Main outcome measures included postoperative complications such as pseudophakic bullous keratopathy, loss of intraocular pressure control and glaucoma, IOL subluxation, and retinal detachment. RESULTS: Sixty-five eyes of 65 patients were included in the study, 33 eyes in the AC-IOL group and 32 eyes in the flange group. Follow-up time was 29.92 ± 20.02 months in the AC-IOL group and 20.17 ± 15.56 months in the flange group (P = .087). Pseudophakic bullous keratopathy was observed in 10 (30.3%) patients in the AC-IOL group and in 1 (3.1%) patient in the flange group (P = .04). This association remained significant using survival analysis (P = .006). In 4 (12.1%) patients in the AC-IOL group, a glaucoma filtering procedure was performed to control the intraocular pressure compared with none in the flange group (P = .042). CONCLUSIONS: In the setting of loss of capsular support during routine cataract surgery, four-flanged scleral fixation showed an overall lower rate of complications and significantly reduced rate of subsequent surgical interventions. [J Refract Surg. 2024;40(8):e520-e526.].

Asunto(s)

Cámara Anterior , Implantación de Lentes Intraoculares , Esclerótica , Agudeza Visual , Humanos , Implantación de Lentes Intraoculares/métodos , Estudios Retrospectivos , Esclerótica/cirugía , Femenino , Masculino , Anciano , Agudeza Visual/fisiología , Persona de Mediana Edad , Cámara Anterior/cirugía , Complicaciones Posoperatorias , Técnicas de Sutura , Estudios de Seguimiento , Presión Intraocular/fisiología , Lentes Intraoculares , Extracción de Catarata/métodos , Facoemulsificación/métodos , Anciano de 80 o más Años , Cápsula del Cristalino/cirugía , Seudofaquia/fisiopatología

RESUMEN

PURPOSE: To research the accuracy of intraocular lens (IOL) calculation formulas and investigate the effect of anterior chamber depth (ACD) and lens thickness (LT) measured by swept-source optical coherence tomography biometer (IOLMaster 700) in patients with posterior chamber phakic IOL (PC-pIOL). METHODS: Retrospective case series. The IOLMaster 700 biometer was used to measure axial length (AL) and anterior segment parameters. The traditional formulas (SRK/T, Holladay 1 and Haigis) with or without Wang-Koch (WK) AL adjustment, and new-generation formulas (Barret Universal II [BUII], Emmetropia Verifying Optical [EVO] v2.0, Kane, Pearl-DGS) were utilized in IOL power calculation. RESULTS: This study enrolled 24 eyes of 24 patients undergoing combined PC-pIOL removal and cataract surgery at Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China. The median absolute prediction error in ascending order was EVO 2.0 (0.33), Kane (0.35), SRK/T-WKmodified (0.42), Holladay 1-WKmodified (0.44), Haigis-WKC1 (0.46), Pearl-DGS (0.47), BUII (0.58), Haigis (0.75), SRK/T (0.79), and Holladay 1 (1.32). The root-mean-square absolute error in ascending order was Haigis-WKC1 (0.591), Holladay 1-WKmodified (0.622), SRK/T-WKmodified (0.623), EVO (0.673), Kane (0.678), Pearl-DGS (0.753), BUII (0.863), Haigis (1.061), SRK/T (1.188), and Holladay 1 (1.513). A detailed analysis of ACD and LT measurement error revealed negligible impact on refractive outcomes in BUII and EVO 2.0 when these parameters were incorporated or omitted in the formula calculation. CONCLUSION: The Kane, EVO 2.0, and traditional formulas with WK AL adjustment displayed high prediction accuracy. Furthermore, the ACD and LT measurement error does not exert a significant influence on the accuracy of IOL power calculation formulas in highly myopic eyes implanted with PC-pIOL.

Asunto(s)

Biometría , Catarata , Lentes Intraoculares Fáquicas , Refracción Ocular , Tomografía de Coherencia Óptica , Humanos , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos , Femenino , Masculino , Persona de Mediana Edad , Biometría/métodos , Refracción Ocular/fisiología , Catarata/complicaciones , Adulto , Óptica y Fotónica , Reproducibilidad de los Resultados , Anciano , Longitud Axial del Ojo/diagnóstico por imagen , Longitud Axial del Ojo/patología , Cámara Anterior/diagnóstico por imagen , Agudeza Visual/fisiología , Implantación de Lentes Intraoculares/métodos

Asunto(s)

Cámara Anterior , Tomografía de Coherencia Óptica , Uveítis , Humanos , Cámara Anterior/diagnóstico por imagen , Cámara Anterior/patología , Recuento de Células , Tomografía de Coherencia Óptica/métodos , Uveítis/diagnóstico

RESUMEN

BACKGROUND: Accurate prediction of postoperative vault in implantable collamer lens (ICL) implantation is crucial; however, current formulas often fail to account for individual anatomical variations, leading to suboptimal visual outcomes and necessitating improved predictive models. We aimed to verify the prediction accuracy of our new predictive model for vaulting based on anterior and posterior chamber structural parameters. METHODS: This retrospective observational study included 137 patients (240 eyes) who previously underwent ICL surgery. Patients were randomly divided into the model establishment (192 eyes) or validation (48 eyes) groups. Preoperative measurements of the anterior and posterior chamber structures were obtained using Pentacam, CASIA2 anterior segment optical coherence tomography (AS-OCT), ultrasound biomicroscopy, and other devices. Stepwise multiple linear regression analysis was used to evaluate the relationship between the vault and each variable (WL formula). The Friedman test was performed for the vaulting prediction results of the WL, NK (Ver. 3), and KS formulas (Ver. 4) in CASIA2 AS-OCT, as well as the Zhu formula and vault measurements. The proportions of prediction error within ± 250 µm per formula were compared. RESULTS: The predicted vault values of the WL, NK, KS, and Zhu formulas and vault measurements were 668.74 ± 162.12, 650.85 ± 248.47, 546.56 ± 128.99, 486.56 ± 210.76, and 716.06 ± 233.84 µm, respectively, with a significant difference (χ2 = 69.883, P = 0.000). Significant differences were also found between the measured vault value and Zhu formula, measured vault value and KS formula, WL formula and Zhu formula, WL formula and KS formula, NK formula and KS formula, and NK formula and Zhu formula (P < 0.001) but not between other groups. The proportions of prediction error within ± 250 µm per formula were as follows: WL formula (81.3%) > NK formula (70.8%) > KS formula (66.7%) > Zhu formula (54.2%). CONCLUSIONS: The WL formula, which considers the complexity of the anterior and posterior chamber structures, demonstrates greater calculation accuracy, compared with the KS (Ver. 4) and Zhu formulas. The proportion of absolute prediction error ≤ 250 µm is higher with the WL formula than with the NK formula (ver. 3). This enhanced predictive capability can improve ICL sizing decisions, thereby increasing the safety and efficacy of ICL implantation surgeries.

Asunto(s)

Implantación de Lentes Intraoculares , Tomografía de Coherencia Óptica , Humanos , Estudios Retrospectivos , Femenino , Masculino , Tomografía de Coherencia Óptica/métodos , Adulto , Implantación de Lentes Intraoculares/métodos , Cámara Anterior/diagnóstico por imagen , Lentes Intraoculares Fáquicas , Miopía/cirugía , Microscopía Acústica/métodos , Adulto Joven , Persona de Mediana Edad , Agudeza Visual , Biometría/métodos , Refracción Ocular/fisiología

RESUMEN

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a persistent, chronic inflammatory disease of the lungs. Tiotropium, used in the treatment of COPD, is a muscarinic receptor antagonist that provides long-acting bronchodilation. Our study aimed to investigate the effects of Tiotropium on anterior chamber parameters. METHODS: The study was conducted as an observational cross-sectional and prospectively between October 2023 and April 2024. Patients were examined in three groups: Group 1 consisted of untreated COPD patients; Group 2 consisted of healthy volunteers similar age and gender, and Group 3 included COPD patients receiving Tiotropium 18 mcg via HandiHaler. Anterior chamber parameters, intraocular pressure values, and photopic-mesopic pupil diameters were measured at the initial visit for Group 1 and Group 2 patients, and at the third month of treatment for Group 3 patients. RESULTS: Thirty-six patients were included in each group in the study. No significant differences were observed in ocular findings between the patient and control groups. In COPD patients receiving Tiotropium, narrowing of angle parameters, an increase in photopic-mesopic pupil diameters, and intraocular pressure were observed at the third month of treatment. CONCLUSION: This study is the first research that investigate the effects of Tiotropium on anterior chamber parameters, pupil diameters, and intraocular pressure in COPD treatment. In conclusion, patients with COPD receiving Tiotropium therapy for three months showed narrowing in angle parameters, an increase in intraocular pressure, and photopic-mesopic pupil diameter; however, no patients developed drug-induced acute angle closure glaucoma. TRIAL REGISTRATION: An independent ethics committee approved the study (Giresun EAH KEAK 2023/180 and 9.10.2023/02) which was performed in accordance with the Declaration of Helsinki, Guidelines for Good Clinical Practice. The study was conducted as prospectively, observational case-control. The Clinical Trial Number obtained for the study is NCT06525051 and was taken on 2024-07-29.

Asunto(s)

Broncodilatadores , Presión Intraocular , Enfermedad Pulmonar Obstructiva Crónica , Bromuro de Tiotropio , Humanos , Bromuro de Tiotropio/uso terapéutico , Bromuro de Tiotropio/administración & dosificación , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Femenino , Masculino , Estudios Transversales , Persona de Mediana Edad , Estudios Prospectivos , Anciano , Presión Intraocular/efectos de los fármacos , Broncodilatadores/uso terapéutico , Cámara Anterior/efectos de los fármacos , Pupila/efectos de los fármacos

Asunto(s)

Cámara Anterior , Antibacterianos , Extracción de Catarata , Endoftalmitis , Infecciones Bacterianas del Ojo , Humanos , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Cámara Anterior/efectos de los fármacos , Infecciones Bacterianas del Ojo/prevención & control , Endoftalmitis/prevención & control , Infección de la Herida Quirúrgica/prevención & control

RESUMEN

We investigate the ocular dimensions and shape by using Lenstar900 (LS900), A-scan ultrasonography, and Magnetic Resonance Imaging (MRI) in highly myopic Macaca fascicularis. The ocular dimensions data of LS900, A-scan ultrasonography and MRI was assessed from 8 eyes (4 adult male cynomolgus macaque) with extremely high myopia (≤-1000DS) and compared by means of coefficients of concordance and 95% limits of agreement. Multiple regression analysis was performed to explore the associations between ocular biometry, volume, refraction and inter-instrument discrepancies. Test-retest reliability of three measurements of ocular parameters at two time points was almost equal (intraclass correlation = 0.831 to 1.000). The parallel-forms reliability of three measurements was strong for vitreous chamber depth (VCD) (coefficient of concordance = 0.919 to 0.981), moderate for axial length (AL) (coefficient of concordance = 0.486 to 0.981), and weak for anterior chamber depth (ACD) (coefficient of concordance = 0.267 to 0.621) and lens thickness (LT) (coefficient of concordance = 0.035 to 0.631). The LS900 and MRI systematically underestimated the ACD and LT comparing to A-scan ultrasonography (P < 0.05). Notably, the average AL on LS900 displayed a significant correlation with those on MRI (r = 0.978, P < 0.001) and A-scan ultrasonography (r = 0.990, P < 0.001). Almost 4/5 eyeballs were prolate. The mean eyeball volume positively correlated with AL (r = 0.782, P = 0.022), the width (r = 0.945, P = 0.000), and the length (r = 0.782, P = 0.022) of eyeball, while negatively correlated with SER (r = -0.901, P = 0.000). In conclusion, there was a high inter-instrument concordance for VCD with LS900, A-scan ultrasonography and MRI, while ACD and LT were underestimated with LS900 compared to A-scan ultrasonography, and the LS900 and A-scan ultrasonography could reliably measure the AL. MRI further revealed an equatorial globe shape in extremely myopic non-human primates.

Asunto(s)

Longitud Axial del Ojo , Biometría , Macaca fascicularis , Imagen por Resonancia Magnética , Ultrasonografía , Animales , Masculino , Imagen por Resonancia Magnética/métodos , Ultrasonografía/métodos , Longitud Axial del Ojo/diagnóstico por imagen , Longitud Axial del Ojo/patología , Reproducibilidad de los Resultados , Imagenología Tridimensional , Refracción Ocular/fisiología , Modelos Animales de Enfermedad , Miopía Degenerativa/diagnóstico por imagen , Cámara Anterior/diagnóstico por imagen , Cámara Anterior/patología , Miopía/diagnóstico por imagen , Miopía/fisiopatología , Ojo/diagnóstico por imagen

RESUMEN

Background and Objectives: To compare the biometry of eyes obtained with two swept-source optical coherence tomography-based biometers-Argos (A), using an individual refractive index, and IOLMaster 700 (IM), using an equivalent refractive index-for all structures. Materials and Methods: The biometry of 105 eyes of 105 patients before cataracts were analyzed in this study. Parameters such as axial length (AL), anterior chamber depth (ACD), and lens thickness (LT) were compared from both devices. According to the axial length measurements, patients were divided into three groups, as follows: group 1-short eyes (AL < 22.5 mm), group 2-average eyes (22.5 ≤ AL ≤ 26.0 mm), and group 3-long eyes (AL > 26.0 mm). Results: The correlation coefficiency among all compared parameters varies from R = 0.92 to R = 1.00, indicating excellent reliability of IM and A. A statistical significance in axial length was indicated in the group of short eyes (n = 26)-mean AL (A) 21.90 mm (±0.59 mm) vs. AL (IM) 21.8 mm ± (0.61 mm) (p < 0.001)-and in the group of long eyes (n = 5)-mean AL (A) 27.95 mm (±2.62 mm) vs. mean AL (IM) 28.10 mm (±2.64) (p < 0.05). In the group of average eyes (n = 74), outcomes were similar-mean AL (A) 23.56 mm (±0.70 mm) vs. mean AL (IM) 23,56 mm (±0.71 mm) (p > 0.05). The anterior chamber depth measurements were higher when obtained with Argos than with IOLMaster 700-mean ACD (A) 3.06 mm (±0.48 mm) vs. mean ACD (IM) 2.92 mm (±0.46) p < 0.001. There was no statistical significance in mean LT-mean LT (A) 4.75 mm (±0.46 mm) vs. mean LT (IM) 4.72 mm (±0.44 mm) (p = 0.054). The biometry of one eye with dense cataracts could be measured only with Argos, using the Enhanced Retinal Visualization mode. Conclusions: Axial length measurements from both devices were different in the groups of short and long eyes, but were comparable in the group of average eyes. The anterior chamber depth values obtained with Argos were higher than the measurements acquired with IOLMaster 700. These differences may be particularly important when selecting IOLs for patients with extreme AL values.

Asunto(s)

Biometría , Catarata , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Biometría/métodos , Masculino , Femenino , Anciano , Persona de Mediana Edad , Longitud Axial del Ojo/diagnóstico por imagen , Reproducibilidad de los Resultados , Cámara Anterior/diagnóstico por imagen , Cámara Anterior/anatomía & histología , Anciano de 80 o más Años

RESUMEN

Purpose: To investigate the effects of anterior chamber pigment dispersion on ocular immune privilege and the possible mechanisms involved in a DBA/2J mouse model of pigmentary glaucoma. Methods: DBA/2J mice were utilized as a pigment dispersion model, and age-matched C57BL/6J mice were used as the control group in this study. Proteins in the aqueous humor (AH) and serum were quantified using the bicinchoninic acid assay. Immune cells in the AH were detected using hematoxylin and eosin staining and immunocytochemistry. The expression of TGF-ß2 in the AH and cytokine levels (IL-10, IFN-γ) in serum were measured using ELISA. Anterior chamber-associated immune deviation (ACAID) was induced in DBA/2J mice by injecting antigens into the anterior chamber. Delayed-type hypersensitivity (DTH) assays were used to assess the induction of ACAID. In DBA/2J mice, before and after pigment dispersion, following anterior chamber injection of pigment particles, and after ACAID modeling, the expression of regulatory T cells (Tregs) was detected using flow cytometry. Results: Compared to C57BL/6J mice, the protein concentration, immune cell count, and TGF-ß2 levels in the AH were elevated in DBA/2J mice. Protein concentration and IL-10 levels in serum were increased, while IFN-γ levels were decreased in DBA/2J. Additionally, the expression of Treg cells in the spleen of DBA/2J mice was significantly increased after pigment dispersion and anterior chamber injection of pigment particles. At 3 and 6 months, DTH responses in DBA/2J mice were not inhibited, thus preventing ACAID induction. However, the opposite was observed at 9 months in DBA/2J mice. Furthermore, the ACAID group exhibited an augmented expression of Treg cells. Conclusions: Dispersion of pigment particles in the anterior chamber of the eye enhances the state of ocular immune privilege by influencing the immunosuppressive microenvironment and inducing more Treg cells to reestablish ACAID.

Asunto(s)

Humor Acuoso , Modelos Animales de Enfermedad , Glaucoma de Ángulo Abierto , Privilegio Inmunológico , Ratones Endogámicos C57BL , Ratones Endogámicos DBA , Linfocitos T Reguladores , Animales , Humor Acuoso/metabolismo , Humor Acuoso/inmunología , Ratones , Linfocitos T Reguladores/inmunología , Glaucoma de Ángulo Abierto/inmunología , Cámara Anterior/inmunología , Factor de Crecimiento Transformador beta2 , Presión Intraocular/fisiología , Ensayo de Inmunoadsorción Enzimática , Citometría de Flujo , Interleucina-10 , Hipersensibilidad Tardía/inmunología , Interferón gamma/metabolismo , Inmunohistoquímica , Femenino

RESUMEN

PURPOSE: To assess the influence of ocular biometric parameters on intraocular lens (IOL) tilt and decentration after cataract surgery. METHODS: Patients scheduled for cataract surgery were screened for inclusion in this prospective cohort study. Tilt and decentration of the crystalline lens and IOL were measured using the CASIA2 (Tomey). Anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were preoperatively measured by the IOLMaster 700 (Carl Zeiss Meditec AG). Multivariate regression analysis was performed to assess the influence of ocular biometric parameters on IOL tilt and decentration after cataract surgery. RESULTS: In total, 191 eyes of 120 patients were included. Age was positively correlated with IOL tilt, whereas ACD and AL were negatively correlated with IOL tilt. A strong positive correlation was found between preoperative crystalline lenses and postoperative IOLs in tilt magnitude (r = 0.769, P < .001) and tilt direction (r = 0.688, P < .001). A positive correlation was found between preoperative and postoperative lens decentration magnitude and decentration direction. Greater postoperative IOL tilt and decentration were significantly associated with greater preoperative crystalline lens tilt (P < .001) and decentration (P = .027). CONCLUSIONS: IOL tilt was greater in older patients. Shorter AL and shallower ACD contributed to greater IOL tilt. The tilt and decentration of the IOL will be greater in patients with greater tilt and decentration of the crystalline lens. [J Refract Surg. 2024;40(7):e438-e444.].

Asunto(s)

Longitud Axial del Ojo , Biometría , Implantación de Lentes Intraoculares , Lentes Intraoculares , Facoemulsificación , Humanos , Estudios Prospectivos , Masculino , Femenino , Anciano , Persona de Mediana Edad , Longitud Axial del Ojo/patología , Anciano de 80 o más Años , Cámara Anterior/patología , Migracion de Implante de Lente Artificial/fisiopatología , Cristalino , Agudeza Visual/fisiología , Adulto , Seudofaquia/fisiopatología

RESUMEN

This study aimed to develop and analyze the accuracy of predictive formulae for postoperative anterior chamber depth, tilt, and decentration of low-added-segment refractive intraocular lenses. This single-center, retrospective, observational study included the right eyes of 96 patients (mean age: 72.43 ± 6.58 years), who underwent a cataract surgery with implantation of a low-added segmented refractive intraocular lens at the Medical University Hospital between July 2019 and January 2021, and were followed up for more than 1 month postoperatively. The participants were divided into an estimation group to create a prediction formula and a validation group to verify the accuracy of the formula. Anterior segment optical coherence tomography (CASIA 2, Tomey Corporation, Japan) and swept-source optical coherence tomography biometry (IOL Master 700, Carl Zeiss Meditec AG) were used to measure the anterior ocular components. A predictive formula was devised for postoperative anterior chamber depth, intraocular lens tilt, and intraocular lens decentration (p <0.01) in the estimation group. A significant positive correlation was observed between the estimated values calculated using the prediction formula and the measured values for postoperative anterior chamber depth (r = 0.792), amount of intraocular lens tilt (r = 0.610), direction of intraocular lens tilt (r = 0.668), and amount of intraocular lens decentration (r = 0.431) (p < 0.01) in the validation group. In conclusion, our findings reveal that predicting the position of the low-added segmented refractive intraocular lens enables the prognosis of postoperative refractive values with a greater accuracy in determining the intraocular lens adaptation.

Asunto(s)

Implantación de Lentes Intraoculares , Lentes Intraoculares , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Anciano , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Cámara Anterior/diagnóstico por imagen , Anciano de 80 o más Años , Biometría/métodos , Extracción de Catarata , Refracción Ocular/fisiología

RESUMEN

OBJECTIVE: To compare anterior chamber depth (ACD) and lens thickness (LT) measurements by ultrasound biomicroscopy (UBM), A-scan cross vector (CV) overlay with UBM, and immersion A-scan technique in pediatric eyes. METHODS: This prospective comparative cohort study comprised 43 eyes of 25 pediatric participants (mean age: 2.3±2.2 y). UBM and immersion A-scan biometry were performed prior to dilation and intraocular surgery. ACD and LT were measured by UBM image analysis, A-scan CV UBM overlay, and immersion A-scan technique. RESULTS: ACD and LT measurements obtained using immersion A-scan were significantly greater than with UBM image analysis with mean differences of 0.52 mm and 0.62 mm, respectively (p < 0.001). Immersion A-scan and UBM measurements were moderately correlated (r = 0.70 and 0.64, p < 0.001). ACD and LT measurements obtained using CV overlay were not significantly different than UBM measurements and the values were strongly positively correlated (r = 0.95 and 0.93, p < 0.001). CONCLUSION: Immersion A-scan may overestimate ACD and LT compared to UBM in pediatric patients due to oblique placement of the A-scan probe relative to the optical axis. Supplemental use of UBM and/or CV overlay is indicated to improve measurement accuracy in pediatric patients who cannot reliably fixate due to the ability to confirm proper alignment of the probe with the pupil by visualizing the anterior segment.

Asunto(s)

Cámara Anterior , Biometría , Cristalino , Microscopía Acústica , Humanos , Cámara Anterior/diagnóstico por imagen , Cámara Anterior/anatomía & histología , Microscopía Acústica/métodos , Femenino , Masculino , Cristalino/diagnóstico por imagen , Cristalino/anatomía & histología , Preescolar , Estudios Prospectivos , Biometría/métodos , Reproducibilidad de los Resultados , Niño , Lactante , Estudios de Cohortes , Sensibilidad y Especificidad

RESUMEN

Importance: Although the effectiveness of intracameral antibiotics to prevent postoperative endophthalmitis is described, selective use of antibiotics combined with 1% povidone iodine disinfection might be equally effective and could lead to cost reduction and avoidance of unnecessary use of antibiotics. Objective: To compare the incidence of postoperative endophthalmitis when 1% povidone iodine disinfection is applied in combination with selective intracameral antibiotics with the incidence after routine use of intracameral antibiotics in combination with 5% povidone iodine. Design, Setting, and Participant: This was a retrospective cohort study using incidence data from the ongoing endophthalmitis register of the Rotterdam Eye Hospital, a specialized hospital providing both secondary and tertiary ophthalmological care, when intracameral antibiotics were used only during cataract procedures with occurrence of a posterior capsular tear in comparison with results from cohorts described in the literature where routine antibiotics were used. All patients who had cataract (phacoemulsification) surgery at the Rotterdam Eye Hospital between 1993 and 2022 were included. No cataract surgical procedures combined with other intraocular procedures were included. Exposure: Povidone iodine disinfection and intracameral antibiotics during cataract surgery either routinely or only in case of posterior capsular tears. Main Outcome and Measure: Postoperative endophthalmitis incidence. Results: Postoperative endophthalmitis incidence after 56 598 cataract (phacoemulsification) surgical procedures in the Rotterdam Eye Hospital between 2016 and 2022 was 0.000 (95% CI, 0.000-0.000). A PubMed literature search until September 2023 with respect to the incidence of postoperative endophthalmitis after routine antibiotic prophylaxis yielded 37 publications with an overall postoperative endophthalmitis incidence of 0.000 (95% CI, 0.000-0.000). Conclusions and Relevance: No difference was observed between the postoperative endophthalmitis incidence during the last 7 years in the Rotterdam Eye Hospital and the overall postoperative endophthalmitis incidence after routine intracameral antibiotics prophylaxis as described in the literature. Disinfection with 1% povidone iodine in combination with selective antibiotic prophylaxis may be equally effective as routine antibiotic use and 5% povidone iodine.

Asunto(s)

Cámara Anterior , Antibacterianos , Profilaxis Antibiótica , Endoftalmitis , Infecciones Bacterianas del Ojo , Povidona Yodada , Humanos , Endoftalmitis/prevención & control , Endoftalmitis/epidemiología , Estudios Retrospectivos , Incidencia , Antibacterianos/uso terapéutico , Antibacterianos/administración & dosificación , Povidona Yodada/administración & dosificación , Povidona Yodada/uso terapéutico , Anciano , Masculino , Infecciones Bacterianas del Ojo/prevención & control , Infecciones Bacterianas del Ojo/epidemiología , Infecciones Bacterianas del Ojo/microbiología , Femenino , Cámara Anterior/efectos de los fármacos , Complicaciones Posoperatorias/prevención & control , Antiinfecciosos Locales/uso terapéutico , Antiinfecciosos Locales/administración & dosificación , Facoemulsificación/efectos adversos , Anciano de 80 o más Años , Extracción de Catarata/efectos adversos , Persona de Mediana Edad , Países Bajos/epidemiología

Asunto(s)

Cámara Anterior , Antibacterianos , Extracción de Catarata , Endoftalmitis , Humanos , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Cámara Anterior/efectos de los fármacos , Endoftalmitis/prevención & control , Infecciones Bacterianas del Ojo/prevención & control , Infecciones Bacterianas del Ojo/microbiología

RESUMEN

Intracameral injection is a standard administration routine in ophthalmology. The application of intracameral injection in rodents for research is challenging due to the limiting dimensions and anatomy of the eye, including the small aqueous humor volume, the lens curvature, and lens thickness. Potential damage during intracameral injections introduces adverse effects and experimental variability. This protocol describes a procedure for intracameral injection in rats, allowing precision and reproducibility. Sprague-Dawley rats were used as experimental models. Since the lens position in rats protrudes into the anterior chamber, injecting from the periphery, as done in humans, is unfavorable. Therefore, an incision is created in the central corneal region using a 31 gauge 0.8 mm stiletto blade to form a self-sealing tunnel into the anterior chamber. An incision at an angle close to the flat allows to create a long tunnel, which minimizes the loss of aqueous humor and shallowing of the anterior chamber. A 34 gauge nanoneedle is inserted into the tunnel for injection. This enables penetration with minimal friction resistance and avoids touching the lens. Injection of trypan-blue allows visualization by slit microscopy the presence of the dye in the anterior chamber and exclude leakage. Bioavailability to the corneal endothelial layer is demonstrated by injection of Hoechst dye, which stained the nuclei of corneal endothelial cells after injection. In conclusion, this protocol implements a procedure for accurate intracameral injection in rats. This procedure may be used for intracameral delivery of various drugs and compounds in experimental rat models, increasing the efficiency and reproducibility of ophthalmic research.

Asunto(s)

Cámara Anterior , Inyecciones Intraoculares , Ratas Sprague-Dawley , Animales , Ratas , Inyecciones Intraoculares/métodos , Cámara Anterior/efectos de los fármacos , Inyección Intracameral