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Concept: Aphakia


To describe the differences in treatment costs for infants randomized to contact lens correction versus primary intraocular lens (IOL) implantation after unilateral cataract surgery in the Infant Aphakia Treatment Study (IATS).

Concepts: Cornea, Ophthalmology, Lens, Contact lens, Intraocular lens, Phacoemulsification, Cataract, Aphakia


Background:  To assess outcomes of the iris claw intraocular lens implanted in the retropupillary position for correction of aphakia without adequate capsular support. Design:  Retrospective study of patients consulted at two private practices and a tertiary public hospital clinic in Brisbane, Queensland. Samples:  Thirty-two consecutive patients who underwent posterior chamber insertion of the iris claw intraocular lens alone or in combination with other procedure/s by the same consultant ophthalmologist (GL). Methods:  Lens power was calculated using an A-constant of 117.0. Main Outcome Measures:  Clinical examination. Results:  Thirty-four eyes in 32 patients (23 male, 9 female) were included in the study. Indications for surgery were pseudophakic bullous keratopathy (n = 14), aphakia from previous lens extraction/lensectomy (n = 9), subluxation of intraocular lens (n = 7), cataract extraction (n = 2), explantation of anterior chamber intraocular lens due to uveitis (n = 1) and for Baerveldt tube insertion (n = 1). Follow-up duration ranged from 1 to 68 months. Of the 26 eyes followed for at least 6 months, the final vision improved in 69% (n = 18), remained unchanged in 8% (n = 2) and worsened in 23% (n = 6). Final visual acuity was 6/12 or better in 58% (n = 15). Complications included iris trauma/defect (n = 8), pupil irregularity/ovalization (n = 6), microhyphaema (n = 2) and lens decentration (n = 2). Conclusion:  Implantation of the iris claw intraocular lens in the retropupillary position is a useful technique for correction of aphakic eyes with sufficient iris support, avoiding the corneal complications of an anterior chamber intraocular lens and the surgical challenge of a sutured posterior chamber intraocular lens.

Concepts: Eye, Visual acuity, Cornea, Ophthalmology, Lens, Intraocular lens, Cataract, Aphakia


Objective evaluation of accommodation with a bilateral accommodating intraocular lens (IOL) versus monofocal IOLs.

Concepts: Lens, Presbyopia, Intraocular lens, Aphakia


In recent years new models of intraocular lenses are appearing on the market to reduce requirements for additional optical correction. The purpose of this study is to assess visual outcomes following bilateral cataract surgery and the implant of a FineVision® trifocal intraocular lens (IOL).

Concepts: Ophthalmology, Lens, Presbyopia, Intraocular lens, Eye surgery, Cataract, Aphakia


The ideal intraocular lens in cases of aphakia without capsular support is debated. Choices include anterior chamber lenses, iris- or scleral-sutured lenses, and iris-claw lenses. Our aim was to report our long-term evaluation of the use of retropupillary implantation of the Artisan iris-claw intraocular lens (RPICIOL) in several aphakic conditions without capsular support.

Concepts: Lens, Intraocular lens, Aphakia


Today, patients often expect to achieve spectacle independance after cataract surgery. New trifocal intraocular lenses have been developed to try and fullfill this demand. The purpose of this study is to report the short-term visual outcomes of a new trifocal intraocular lens (AcrySof PanOptix™).

Concepts: Time, Term, Lens, Intraocular lens, Eye surgery, Finance, Cataract, Aphakia


Improvement in surgical devices and intraocular lenses has made modern cataract surgery a safe procedure with decreasing complication rates. Intraocular lens dislocation is a serious complication after cataract surgery. Although most dislocations occur during the first week postoperative period, late intraocular lens dislocation occurring 3 months or later post-surgery has been reported with increasing frequency in recent years as a result of progressive zonular dehiscence. We report the clinical features, management and outcomes of five cases of late in-bag dislocation of intraocular lens in patients with underlying uveitis. This is a retrospective case series and literature review.

Concepts: Function, Surgery, Ophthalmology, Lens, Intraocular lens, Eye surgery, Cataract, Aphakia


Purpose: Although visual impairment is a well recognised consequence of cataract development; little is known about the ability of the melanopsin based photosensitive retinal ganglion cells (pRGC’s) to regulate sleep wake timing in the presence of cataract. In this study we replaced a cataractous natural crystalline lens with two different types of artificial intraocular lenses, a UV-blocking lens or a blue-filtering lens. We investigated the level of sleep disturbance before cataract surgery and any change in sleep due to improved light transmission following surgery and compared this in both types of intraocular lens. Methods: Quality of sleep in 961 patients undergoing cataract surgery was assessed by administering the validated self-reported Pittsburgh Sleep Quality Index (PSQI) questionnaire. The PSQI distinguishes good sleepers from poor sleepers by scoring seven different sleep components over the last month, which are combined to produce an overall score for sleep quality. Patients received either an ultraviolet blocking (UVB) clear intraocular lens (IOL) or a blue-filtering (BF) IOL. Questionnaires were completed four times: 1 month pre-operatively and again 1, 6 (UVB-IOL only) and 12 months post-operatively. Results: Half of the patients reported poor sleep in the presence of cataract. Cataract removal improved overall sleep quality significantly 1 month post-operatively and improved sleep latency, which was sustained at 6 and 12 months. Conclusions: Overall sleep quality and sleep latency improves after removal of cataract irrespective of the type of IOL implanted. These data show that implantation of BF-IOL does not have a negative impact on the sleep-wake cycle.

Concepts: Ultraviolet, Sleep, Ophthalmology, Lens, Intraocular lens, Phacoemulsification, Cataract, Aphakia


Myopia is increasing worldwide. Although the exact etiology of myopia is unknown, outdoor activity is one of the most important environmental factors for myopia control. We previously reported that violet light (VL, 360-400 nm wavelength), which is abundant in the outdoor environment, suppressed myopia progression for individuals under 20 years of age. However, whether VL is also effective for adult high myopia, which can be sight-threatening, has remained unknown. To investigate the influence of VL for adult myopia, we retrospectively compared the myopic progression and the axial length elongation over five years in adult high myopic patients over 25 years of age after two types (non-VL transmitting and VL transmitting) of phakic intraocular lens (pIOL) implantation. We found that high myopic patients with the non-VL transmitting pIOLs implanted are almost two times more myopic in the change of refraction and four times longer in the change of axial length, compared to those implanted with the VL transmitting pIOLs. This result indicated that the VL transmitting pIOL suppressed myopia progression and axial length elongation compared with the non-VL transmitting one. In conclusion, our study showed the VL possibly has an anti-myopia effect for human adults with high myopia.

Concepts: Wavelength, Myopia, Lens, Presbyopia, Contact lens, Intraocular lens, Aphakia


To compare the results between hydroimplantation of a single-piece, acrylic foldable toric intraocular lens (IOLs) and conventional implantation using an ophthalmic viscosurgical device (OVD).

Concepts: Lens, Intraocular lens, Toric lens, Aphakia