To compare the visual acuity and satisfaction outcomes of 2 different concepts of extended depth-of-focus intraocular lenses (EDOF IOLs).
University Eye Hospital Bochum, Germany.
Prospective ...randomized comparative clinical trial.
Patients undergoing cataract surgery with the implantation of 2 different concept EDOF IOLs. In the first group (IC-8 Group), a monofocal 1-piece Tecnis Z B00 IOL (Johnson & Johnson Vision Care, Inc.) was implanted in the dominant eye, and an IC-8 IOL (AcuFocus) was implanted in the nondominant eye. In the second group (Symfony Group), a Tecnis Symfony IOL (Johnson & Johnson Vision Care, Inc.) was implanted in both eyes. The target refraction of the dominant eye was emmetropia and slight myopia (mini-monovision, -0.75 diopters) in the nondominant eye. Visual and refractive outcomes and patient satisfaction rates were evaluated 3 months postoperatively.
This study comprised 76 eyes of 38 patients. No intraoperative or postoperative complications occurred in either group. Target refraction was reached in both groups without statistically significant differences. The uncorrected distance visual acuity (UDVA, photopic and mesopic light conditions) was excellent in both groups with statistically significantly better results in the IC-8 goup (logarithm of the minimum angle of resolution; IC-8 Group (0.1 ± 0.07 logarithm of the minimum angle of resolution logMAR; Symfony Group 0.07 ± 0.1 logMAR, P value .02 photopic; IC-8 group 0.12 ± 0.09 logMAR, Symfony group 0.22 ± 0.1 logMAR, P value < .01 mesopic). Binocular uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA) were also good in both groups without statistically significant differences (UIVA: IC-8 Group, 0.01 ± 0.07 logMAR, Symfony Group 0.01 ± 0.08 logMAR, P value .35; UNVA: IC-8 Group 0.14 ± 0.11, Symfony Group 0.09 ± 0.08, P value .14). Subjective satisfaction was high in both groups.
Both EDOF IOLs provided a very good UDVA with superior results in the IC-8 Group, and a good UIVA and UNVA under photopic light conditions. Subjective patient satisfaction was higher in the IC-8 Group.
To determine the long-term safety and effectiveness of a light-adjustable intraocular lens (LAL) over a period that is longer than reported in the literature at the time of the study.
University Eye ...Hospital, Bochum, Germany.
Noninterventional observation.
In 445 patients, cataract surgery with LAL implantation was performed between April 2008 and December 2012. It was possible to contact 171 of these patients or their relatives through letter or telephone; 61 patients (103 eyes) agreed to participate in the long-term study and were examined.
The mean time between the lock-in (final light treatment) and long-term visit was 7.2 years; 61 patients were included and examined. Corrected and uncorrected distance visual acuity was and remained good (n = 93). The refractive outcome was stable with minimal deviation. There were no significant changes in corneal thickness. In 2 patients, there were slight opacities of the IOL material without impact on visual acuity. Other eye diseases were within the normal range of the patients' age.
Seven years after implantation and refractive adjustment, eyes with an LAL had stable refraction, good visual acuity, and no IOL-associated pathologies. The findings suggest that LAL technology is a safe and efficient method to achieve good visual results without long-term complications.
Borderline personality disorder (BPD) is a psychiatric condition which severely affects psychological well-being. Etiological explanations of BPD include the experience of early adversity, but how ...this impacts on risk-taking and impulsivity in relation to sexuality and mating has remained elusive. Here, we tested the hypothesis that people with BPD adopt a “fast” life history strategy which impacts their mate choice and sexual behavior.
Sixty female patients with BPD and 45 controls were given 3 hypothetical vignettes depicting a “Predictably Safe”, an “Unpredictably Safe-Risky”, and a “Predictably Risky” life conditions, requiring the participant to put herself imaginatively into the described situation. Participants also completed questionnaires about their psychosexual development, depressiveness, and childhood experiences.
Patients with BPD were significantly more likely to expect less parental investment from their hypothetical partners in the predictably safe condition, and to consent to sexual affairs at an earlier age than controls. Correlation analyses suggest that subjective depressiveness, childhood trauma, rearing style of patients' parents, and actual psychosexual development impacted on mate choice in the hypothetical scenarios. In addition, findings may also corroborate ideas of nonrandom mating in patients with BPD, which may be taken into consideration when interpersonal difficulties with romantic partners are dealt with in psychotherapy.
•Borderline Personality Disorder (BPD) is characterized by a “fast” life history strategy.•People with BPD tend to show less parental investment and engage in sexual relationships earlier than controls.•The experience of early adversity seems to predispose to the choice of faster life history strategies.•Depressiveness plays a significant role in mate choice, suggesting nonrandom mating in BPD.
To evaluate the safety and feasibility of a new femtosecond laser-assisted method for posterior capsule opacification (PCO) prevention.
University Eye Hospital Bochum, Bochum, Germany.
Prospective ...randomized intraindividual case series.
Eyes scheduled for bilateral cataract surgery between April 2015 and January 2016 were enrolled in the study. In 1 eye, routine manual cataract surgery with intraocular lens (IOL) implantation was performed with a primary posterior laser capsulotomy as the last step in the procedure. For the laser treatment, the posterior capsule between the anterior hyaloid surface and the posterior optic surface of the IOL was identified with integrated 3-dimensional spectral-domain optical coherence tomography. In the fellow eye, routine manual cataract surgery without posterior capsulotomy was performed. Follow-up examinations were done 1 week, 2 months, and 6 months after surgery. The main outcome measures were feasibility of the procedure and between-group difference in visual acuity, macular thickness, laser flare, intraocular pressure (IOP), and PCO.
Fifty-six eyes were included. No differences in cataract density (P = .2), axial length (P = .8), or amount of ultrasound energy used (P = .55) were found between the groups. In all cases, it was possible to identify and target the posterior capsule. In 1 case, a minimal attachment of a half-hour length was seen. No significant between-group differences in visual acuity, macular thickness, laser flare, or IOP were seen.
The described off-label use of primary posterior laser capsulotomy was a safe, feasible technique in preventing PCO over a 6-month follow-up.
To describe a new technique for implantation of capsule-fixated intraocular lenses (IOLs) (FEMTIS; Oculentis, Berlin, Germany) in patients with small pupils.
In 4 eyes with small pupils, an anterior ...capsule-fixated IOL was implanted into the capsular bag after femtosecond laser treatment. The two large and two small flaps of the IOL were elevated to the front of the iris and the anterior capsule. Finally, the iris was flipped over the flaps to ensure a fixation of the capsule inside of the capsulotomy.
In all cases, the implantation of anterior capsule-fixated IOLs was possible. No complications occurred during surgery or within the first months after surgery.
With the described technique, capsulefixated IOLs can be implanted in eyes with small pupil easily and safely. This type of IOL has great potential to improve the refractive outcome by better prediction of the postoperative IOL position and eliminating IOL rotation after cataract surgery. J Refract Surg. 2017;33(8):568-570..
To compare the clinical outcomes of binocular cataract surgery with and without pinhole corneal inlay implantation.
In the inlay-cataract group, a small aperture corneal inlay was implanted in ...addition to cataract surgery in the non-dominant eye and routine cataract surgery was performed in the dominant eye. In the control group, conventional cataract surgery was performed in both eyes in separate consecutive surgeries 2 weeks apart. The target refraction was emmetropia. Visual acuity, refraction, contrast sensitivity, and visual field were analyzed 1, 4, and 12 weeks after surgery.
Sixteen patients with advanced cataracts underwent cataract surgery on both eyes in separate surgeries. There was no statistically significant difference regarding mean age, Lens Opacities Classification System grading, and refractive outcome. The difference in uncorrected distance visual acuity between the control group and inlay-cataract group was not statistically significant after 12 weeks (P = .59). Mean uncorrected intermediate visual acuity was significantly better in the inlay-cataract group (P = .03). Near visual acuity was better in the inlay-cataract group, but it was not statistically significant (P = .07). There was no statistically significant difference between groups under binocular photopic and mesopic conditions with and without glare. The results of the visual field examination showed no statistically significant difference between both eyes.
The findings demonstrate that implantation of monofocal IOLs in combination with a small aperture corneal inlay in the non-dominant eye helps to increase intermediate and near visual acuity. The implantation of small aperture corneal inlays seems to be an interesting alternative for pseudophakic patients who desire spectacle independence. J Refract Surg. 2018;34(11):746-750..
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