Background To investigate visual outcomes following cataract surgery in patients who were implanted monocularly with an extended range of focus IC-8 IOL. Methods A multicentre, non-randomised, retrospective case series of 126 consecutive patients implanted with the IC-8 IOL. Data were collected and pooled from six centres across Australia. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) at 80 cm and uncorrected near visual acuity (UNVA) at 40 cm were measured in eyes implanted with the IC-8 IOL. Adverse events, spectacle independence, visual symptoms and patient satisfaction were assessed at final follow-up. Results Over 90% of the patients without pre-existing ocular pathology (n = 109) achieved UDVA, UIVA and UNVA of 6/ 12 or better in the IC-8 eye. Binocularly, in this group, 98% achieved UDVA of 6/9, 94% UIVA of 6/12 and 91% UNVA of 6/12 or better. By final follow-up, over 50% of patients reported complete spectacle independence for distance, intermediate and near visual activity, with the remainder only using spectacles for specific tasks such as near-vision hobbies and reading in dim light. Conclusions The IC-8 IOL is capable of providing extended depth of focus following cataract surgery. It allows complete spectacle independence in more than half of the patients implanted with the IC-8 IOL.
Purpose: To assess if post-keratorefractive patients can achieve spectacle independence following cataract surgery with currently available presbyopia correcting intraocular lenses (IOLs). Patients and Methods: Retrospective case series of unilateral implantation of the IC-8 IOL in two patients with history of bilateral myopic radial keratotomy (RK) and one patient with history of bilateral myopic RK and astigmatic keratotomy (AK), and bilateral implantation of AT Lisa 939M multifocal IOLs in one patient with previous history of RK and laser in situ keratomileusis (LASIK). Results: Good uncorrected distance, intermediate and near visual acuity (VA) was achieved for most patients. Stereopsis and contrast sensitivity (CS) were maintained in patients that received the IC-8 IOLs, and two patients achieved full spectacle independence. The patient that received the trifocal lenses expressed satisfaction with their vision, but required long distance correction and experienced reduced CS. Conclusion: The IC-8 and AT Lisa 939M IOLs both offer satisfactory results and reduced spectacle dependence in post-keratorefractive patients. However, it is recommended to properly counsel visual outcomes and patient expectations before commencing surgery.
αA-Crystallin (αA) and αB-crystallin (αB) are small heat shock proteins responsible for the maintenance of transparency in the lens. In non-lenticular tissues, αB is involved in both maintenance of the cytoskeleton and suppression of neurodegeneration amongst other roles. Despite their importance in maintaining cellular health, modifications and mutations to αA and αB appear to play a role in disease states such as cataract and myopathies. The list of modifications that have been reported is extensive and include oxidation, disulphide bond formation, C- and N-terminal truncation, acetylation, carboxymethylation, carboxyethylation, carbamylation, deamidation, phosphorylation and methylation. Such modifications, notably phosphorylation, are alleged to cause changes to chaperone activity by inducing substructural changes and altering subunit exchange dynamics. Although the effect modification has on the activities of αA and αB is contentious, it has been proposed that these changes are responsible for the induction of hyperactivity and are thereby indirectly responsible for protein deposition characteristic of many diseases associated with αA and αB. This review compiles all reported sites of αA and αB modifications, and investigates the role phosphorylation, in particular, plays in cellular processes.
Background: Quality of life may be negatively impacted following cataract surgery if glasses prescription is delayed. This study aims to confirm the refractive stabilisation time in an Australian population to form the basis for suggesting an appropriate timeframe for spectacle prescription. Methods: Participants (51 female and 35 male) were recruited one day after uncomplicated unilateral cataract surgery using a monofocal intraocular lens. Subjective refraction, automated refraction and central corneal thickness were measured at two, four and six weeks post-operatively. A short questionnaire assessing the impact of uncorrected near vision on daily activities was collected at two and four weeks. Results: There was no significant change in the mean automated or subjective spherical equivalent refraction (p eq < 0.001), mean corneal thickness (p eq < 0.001), mean uncorrected distance visual acuity (p eq < 0.001) or mean uncorrected near visual acuity (p eq < 0.001) over the six-week study period. At week two, 59 per cent of patients stated that their uncorrected near vision affected their ability to perform daily tasks 'somewhat' or 'a lot', increasing to 75 per cent by week four. Conclusion: Uncorrected near vision affected quality of life for most participants. All measured visual and ocular parameters were stable from two weeks post-operatively. Patients need not wait longer than this for spectacle prescription following uncomplicated unilateral cataract surgery.
Patients who have had previous refractive procedures often require cataract surgery at an early age; however, postoperative results are compromised by corneal aberrations and difficulties achieving a desired refractive endpoint. We describe the use of the IC-8 small-aperture intraocular lens (IOL) in 3 patients who had previous laser in situ keratomileusis (LASIK). Standard cataract surgery was performed in all cases. The small-aperture IOL was implanted in the patient's nondominant eye, and a clear aspheric monofocal IOL was implanted in the dominant eye. Visual performance was assessed between 1 month and 6 months after surgery. After surgery, all patients had good simultaneous near, intermediate, and distance visual acuities while maintaining stereoacuity and mesopic contrast sensitivity. This technique provided good visual outcomes in these patients who had cataract surgery after previous corneal refractive surgery.
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