These findings verify the results calculated by paraxial vergence equations. A ray-tracing program simulated the optic imagery for various kinds of IOL misalignment and IOL optic properties.

Citation: Mahelková G, Filouš A, Odehnal M, Cendelín J. Corneal changes assessed using confocal microscopy in patients with unilateral buphthalmos. Invest Ophthalmol Vis Sci. 2013;54:4048-4053. DOI:10. 1167/iovs.12-11165 PURPOSE. To compare corneal structures in buphthalmic eyes and healthy eyes in patients with unilateral congenital glaucoma using a corneal confocal microscope.METHODS. Ten patients with unilateral buphthalmos (mean 6 SD age, 14.85 6 5.12 years) were examined using corneal confocal microscopy. The cell density and cell area of endothelial cells and superficial and basal epithelial cells and the number of keratocytes were evaluated.RESULTS. There was no significant difference between the cell density of superficial epithelial cells in buphthalmic eyes relative to healthy eyes (P ¼ 0.1944). The cell density of basal epithelial cells was significantly higher (P ¼ 0.0234) and the cell area was significantly smaller (P ¼ 0.0181) in buphthalmic eyes relative to healthy eyes. There was no difference between the number of keratocytes in buphthalmic eyes and healthy eyes in the anterior stroma (P ¼ 0.273) or in the posterior stroma (P ¼ 0.0799). The cell density of endothelial cells was significantly lower and the cell area was significantly larger in buphthalmic eyes relative to healthy eyes (P ¼ 0.0009). CONCLUSIONS.We demonstrated a lower cell density of endothelial cells in buphthalmic eyes. We found no differences in keratocyte density between the buphthalmic eyes and healthy eyes. The cell density of basal epithelial cells was higher in buphthalmic eyes. These differences could be due to buphthalmos or due to the previous surgical and medical therapies. Monitoring of these changes could help to contribute to accurate assessments regarding future ocular surgical procedures.

Aim of the Study. The aim of this prospective study was to analyse the effect of lateral stromal hydration on the morphology of clear corneal incision architecture using the microscope integrated anterior segment OCT. Methods. The cohort included 65 clear corneal incisions of 49 patients who underwent cataract surgery. Corneal incisions were recorded using a Leica Proveo 8 microscope with an intraoperative OCT EnFocus™ device continuously during the surgery. Corneal incision morphology before and after lateral stromal hydration was analysed. Results. Good adaptation of the corneal incision before hydration was present in 39 cases (60%), in 16 cases (24.6%), the prominence of posterior lip was present, and, in 10 cases (15.4%), the posterior lip tongue was inverted/retracted into the incision. In 38 cases (58.5%), hydration had no effect on the incision architecture; most often, it was primarily a well-adapted corneal incision (46.2%), less often an incision with posterior lip prominence (10.8%), or tongue inversion into the incision (1.6%) prior to hydration. Hydration worsened the incision architecture in 14 cases (21.5%); most often, it induced/worsened posterior lip prominence (15.4%), less often posterior lip retraction (1.6%), tongue inversion into the incision (1.6%), gap development in the peripheral part of the corneal incision (1.6%), or incomplete opening of the corneal incision (1.6%). In 13 cases (20%), hydration improved the incision architecture, especially in cases with inverted or retracted posterior lip tongue (12.3%), less often in cases with posterior lip prominence (7.7%). Conclusion. Lateral stromal hydration seldom affects the condition of the corneal incision. Still, it can cause both deterioration and improvement of the corneal incision architecture. Intraoperative OCT provides real-time monitoring of corneal incision morphology during hydration procedure.

BACKGROUND: Intraocular lens (IOL) deceleration and tilt may affect postoperative refractive errors through spherical aberration of the IOL. METHODS: Through a use of a ray-tracing program and by minimizing algorithm, we calculated theoretical refractive errors for various degrees of IOL decentration and tilt. We compared our results with those obtained by paraxial vergence calculations. RESULTS: IOL decentration and/or tilt shifted postoperative refractive errors toward myopia and astigmatism of oblique origin. For example, a 3millimeter decentration of an IOL resulted in induction of approximately - 2.00 diopters (D) sphere and + 0.70 D cylinder. IOL tilt affected refractive errors to a lesser degree. The change in refractive error caused by a combination of IOL decentration and tilt depended on the relationship between the geometrical axes of decentration and tilt. In the case of the least favorable combination of 12° of tilt and 3 mm of decentration, it can reach - 7.00 D sphere and + 4.00 D cylinder. CONCLUSIONS: IOL decentration and/or tilt increase myopia and astigmatism. They are negligible for small decentrations, but could be sources of substantial postoperative refractive errors if the decentration or tilt is large. [J Refract Corneal Surg. 1994;10:556-564.] RESUME INTRODUCTION: La decentration et l'inclinaison de la lentille intra-oculaire (LIO) ont des effets sur la réfraction post-opératoire à cause de l'aberration sphérique. METHODES: En utilisant un programme à rayons dessinés et un algorithme minimisant nous avons calculé les erreurs réfractives correspondants aux plusieurs décentrations et inclinaisons des LIO. Nous avons comparé les résultats avec ceux des calculs de vergence paraxialle. RESULTATS: La decentration et l'inclinaison des lentilles intra-oculaires changent l'erreur refractive vers la myopie et l'astigmatisme oblique. Par example, une decentration de 3 mm entraîne un changement de -2.0 D sphérique et +0.7 D cylindrique. L'inclinaison des LIO a moins d'effet. Le changement dans l'erreur refractive entraîné par la combinaison d'une decentration et d'une inclinaison d'une LIO dépend du rapport entre les axes de la decentration et de l'inclinaison. Le changement peut atteindre -7.0 D pour le sphérique et +4.0 D pour le cylindrique dans la pire combinaison 12 degrés d'inclinaison et 3 mm de decentration. CONCLUSION: La decentration et l'inclinaison des LIO augmentent la myopie et l'astigmatisme. Elles ont peu d'effets dans les petites positions mauvaises, mais entraînent des erreurs réfractives significatives quand la decentration ou l'inclinaison est plus grande. (Translated by Robert Mack, MD, Kansas City, Mo.) SOMMARIO PREMESSA: Il decentramento e l'obliquità delle lenti intraoculari (IOL) generalmente compromettono, a causa delle aberrazioni sferiche della IOL, la refrazione postoperatoria. METODI: Utilizzando un programma di tracciamento dei raggi e minimizzando l'algoritmo, abbiamo calcolato gli errori refrattivi teorici per vari gradi di decentramento ed obliquità delle IOL. I nostri dati sono stati confrontati con quelli ottenuti tramite il calcolo della vergenza para assiale.

The capsular tension ring (CTR) is a useful aid in cataract surgery involving zonular impairment. In standard implantation with tweezers or injectors, there is limited control of the leading eyelet, and this can cause excessive stress on the zonular fibers and lead to damage of the capsular bag. Several techniques have been investigated with the aim of reducing these risks. In this study, a simple new modification of the suture-guided CTR technique is described. Adding a loop to the suture can facilitate manipulation during implantation and removal of cortex residues at the end of cataract extraction.