A comparative study on visual and optical performance of Akreos AO and Kontur AB IOLs after phacoemulsification cataract surgery

AbstractPurposeAkreos AO and Kontur AB are two commonly used intraocular lenses (IOLs) in Iran. This study was designed to evaluate the visual performance of these lenses.MethodsIn a comparative interventional study, 35 patients (70 eyes) were recruited, and each IOL was implanted in one eye of the patients, randomly. Best corrected visual acuity (BCVA), contrast sensitivity, aberrometric analysis, and depth of focus were evaluated 1 month and 3 months postoperatively. A visual quality questionnaire was also filled for each eye, and the results were compared.ResultsMean age of the patients was 60.97 ± 7.00 years. BCVA was not significantly different between the two eyes, before, 1 month, and 3 months postoperatively (p > 0.05 for all). Photopic and mesopic contrast sensitivity was not different between the two lenses instead of photopic 18 cycles per degree, 3 months postoperatively and in mesopic 6 cycles per degree 1 month postoperatively (p = 0.034 and p = 0.002, respectively). Aberrometric factors including HoRMS, Total RMS, and Higher order without Z(4,0) were not significantly different between the two lenses (p > 0.05 for all), but they were slightly lower for Akreos AO. Post-operative distance-corrected visual acuity for intermediate and near vision were not different between the two groups (p > 0.05, respectively).ConclusionVisual performance of Akreos AO and Kontur AB is similar. However, contrast sensitivity and aberrometric parameters are slightly better for Akreos AO IOL

Correlation between Corneal Endothelial Cell Loss and Location of Phacoemulsification Incision

Purpose: To assess the relationship between corneal endothelial cell loss after phacoemulsification and the location of the clear corneal incision. Methods: A total of 92 patients (92 eyes) with senile cataracts who met the study criteria were included in this cross sectional study and underwent phacoemulsification. The incision site was determined based on the steep corneal meridian according to preoperative keratometry. Endothelial cell density was measured using specular microscopy in the center and 3 mm from the center of the cornea in the meridian of the incisions (temporal, superior, and superotemporal). Phacoemulsification was performed by a single surgeon using the phaco chop technique through a 3.2 mm clear cornea incision. Endothelial cell loss (ECL) was evaluated 1 week, and 1 and 3 months postoperatively. Results: At all time points during follow-up, ECL was comparable among the 3 incision sites, both in the central cornea and in the meridian of the incision (P > 0.05 for all comparisons). However, 3 months postoperatively, mean central ECL with superior incisions and mean sectoral ECL with temporal incisions were slightly higher. Superotemporal incisions entailed slightly less ECL than the other 2 groups. Overall, one month after surgery, mean central ECL was 10.8% and mean ECL in the sector of the incisions was 14.0%. Axial length and effective phaco time (EFT) were independent predictors of postoperative central ECL (P values 0.005 and < 0.0001, respectively). Conclusion: A superotemporal phacoemulsification incision may entail less ECL as compared to other incisions (although not significantly different). The amount of central ECL may be less marked in patients with longer axial lengths and with procedures utilizing less EFT

Comparing morphologic features and complications of main clear corneal incision between junior and senior residents observed using anterior segment optical coherence tomography

Background: Wound construction is a critical step in phacoemulsification. Using anterior segment optical coherence tomography (AS-OCT), we compared the morphological features and complications of main incisions made by junior or senior residents during phacoemulsification. Methods: This cross-sectional comparative study included eyes with senile cataracts that underwent uneventful phacoemulsification with a clear corneal incision made by seven senior and eight junior ophthalmology residents. All eyes underwent postoperative image acquisition using AS-OCT on day one and at three months, examining for morphological features and potential complications of the main incision. Results: We included 50 eyes of 50 patients with a male-to-female ratio of 22 (44%) to 28 (56%); 26 (52%) were operated on by junior residents and 24 (48%) by seniors. The mean geometric features of the main incisions and the frequency of early and late wound complications were comparable between the two groups (all&nbsp;P&nbsp;&gt; 0.05). A significant correlation was found between the incision length and angle with the superior (r = + 0.80;&nbsp;P&nbsp;&lt; 0.001 and r = - 0.63;&nbsp;P&nbsp;&lt; 0.001, respectively) and inferior (r = + 0.84;&nbsp;P&nbsp;&lt; 0.001 and r = - 0.68;&nbsp;P&nbsp;&lt; 0.001, respectively) areas of the incision, as well as between the length and angle of incision (r = - 0.74;&nbsp;P&nbsp;&lt; 0.001). The number of planes in the wound architecture was not significantly different according to senior or junior resident status (P&nbsp;&gt; 0.05). Although the number of eyes with stromal hydration was significantly greater for junior residents than for seniors (P&nbsp;&lt; 0.001), the corneal thickness at the entrance to the cornea or the anterior chamber, presence of endothelial wound gaping, and Descemet’s membrane detachment were comparable between eyes with and without stromal hydration (all&nbsp;P&nbsp;&gt; 0.05). At three months, 29 (58%) patients returned for examination, in whom seven (24%) had late wound complications. Conclusions: This study found no significant differences in the performances of junior and senior residents in terms of wound construction or its associated complications. However, considering the overall rate of some observed wound-related complications, we recommended revision of the resident educational curriculum concerning the structure and complications of the main incision

White-to-white corneal diameter:normal values in healthy Iranian population obtained with the Orbscan II

AIM:To determine the normative values of white-to-white corneal diameter with Orbscan II Topography System and to compare right and left eyes data in the normal young population.Methods:A total of 1001 healthy participants aged 18-45y participated in this observational cross-sectional study. The study population consisted of 616 female and 385 male subjects. The corneal diameter was measured with the Orbscan II. The differences between genders, between right and left eyes and age-related changes were evaluated. Statistical analyses were performed using Student’s t-test.RESULTS:The average white-to-white distance in our study population was recorded as 11.65±0.36 mm (median:11.60 mm, mode:11.70 mm, minimum:10.50 mm and maximum:13.60 mm). The white-to-white distance was 11.60±0.35 mm in males and 11.71±0.36 mm in females which was statistically different between genders (P&lt;0.01). However, white-to-white distance was not statistically different between right and left eyes. In addition, this parameter decreased with increasing age. Considering 95% confidence interval, corneal diameter less than 10.93 mm and greater than 12.34 mm would be considered as microcornea and megalocornea, respectively based on this study population, using the Orbscan II topography.CONCLUSION:Detailed description and analysis of corneal diameter with Orbscan demonstrate that the obtained average value of horizontal white-to-white is higher in male than female and decreases slightly with increasing age. Our data also suggests the cut off values for definition of microcornea and megalocornea, which can be employed with this population

Evaluation of transforming growth factor-beta1 gene expression in pterygium tissue of atopic patients

Background: The exact pathogenesis of pterygium is still not fully understood. Growth factors are considered to play an important role in the formation of pterygium. Transforming growth factor (TGF)-β1 is considered to be one of the main mediators of fibroblast stimulation and tissue remodeling in allergic conditions. The objective of the present study was to investigate the association between TGF-β1 gene expression and pterygium in atopic and nonatopic participants. Methods: We used questionnaires to record demographic and clinical information from patients who underwent pterygium excision surgery. Skin prick examination was done to confirm or rule out atopy in 30 patients with atopy (Case Group) and 30 individuals without atopy (Control Group). Additionally, measurement of serum immunoglobulin E, cytokines, including interleukin-4 and interferon-γ, and peripheral blood eosinophil count was performed to confirm atopy in 30 consecutive patients (Case Group). A semiquantitative reverse transcription polymerase chain reaction was performed to determine TGF-β1 gene expression in all individuals. Results: TGF-β1 mRNA gene expression was significantly higher (p = 0.0001) in atopic patients 2.50 ± 1.11 compared to nonatopic individuals 1.40 ± 0.46. Eosinophil count and serum immunoglobulin E were significantly higher (p = 0.031 and p = 0.001, respectively) in atopic patients compared to the Control Group. Serum interleukin-4 was also significantly higher (p = 0.01) in atopic patients compared with nonatopic individuals. Conclusion: Excess expression of TGF-β1 gene in pterygium tissue of atopic individuals suggests that growth factors play a role in the pathogenesis of pterygium

Properties and Immune Function of Cardiac Fibroblasts.

This chapter will discuss the role of cardiac fibroblasts as a target of various immunological inputs as well as an immunomodulatory hub of the heart through interaction with immune cell types and chemokine or cytokine signaling. While the purpose of this chapter is to explore the immunomodulatory properties of cardiac fibroblasts, it is important to note that cardiac fibroblasts are not a homogeneous cell type, but have a unique embryological origin and molecular identity. Specific properties of cardiac fibroblasts may influence the way they interact with the heart microenvironment to promote healthy homeostatic function or respond to pathological insults. Therefore, we will briefly discuss these aspects of cardiac fibroblast biology and then focus on their immunomodulatory role in the heart. Adv Exp Med Biol 2017; 1003:35-70