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In comparison, log straylight values for the Acrysof lenses were higher than for the Eternity IOLs although there was significant variation with two out of five cases being greater than the year-old CIE standard glare observer. Angular distribution of forward light scatter and its comparison with the year-old and year-old CIE standard glare observers is shown in figure 5.

The log s values for the CIE young and old observer are 0. Angular distribution of forward light scatter. The green line represents the straylight for a young year-old subject while the red line that of a year-old according to the CIE standard glare observer. The results support the hypothesis that differences in the material properties are likely to play a role in glistenings formation.

Forward light scatter for the Acrysof lenses was higher than for the Eternity Natural Uni lenses indicating an association between forward light scatter and increased number of glistenings in agreement with theoretical models. The measured log straylight values for these same two IOLs also exceeded the straylight parameter for a subject with cortical cataract.

Scattering theory tells us that although smaller particles generate a more uniform angular distribution of scattered light, they also produce a lower straylight parameter for equivalent density values compared with larger particles.

Indeed, our measured median glistenings diameters were larger at Careful re-examination of the two Acrysof lenses with higher straylight values indicated the presence of small, out of focus irregularities that were not detected by our glistenings detection software, which could be subsurface nano-glistenings.

It is possible that these degradations could increase the level of straylight. It also remains possible that system scatter could increase measured straylight values and so log straylight parameter values were calculated for clear IOLs and found to be 0. However, this level of straylight has minimal effect on the log s values for the IOLs measured in our study.

In conclusion, we believe our results are valid and explained by the effect of glistenings diameter as well as number and possibly the presence of subsurface nano-glistenings that are not quantified by the glistenings detection programme. This result indicates that not only the number but the size of glistenings differs among materials figures 2 and 3 , as has also been noted by other authors. The wide variation in the number of developed glistenings among Acrysof IOLs may indicate changes in the manufacturing process.

In , Alcon reported a continuous improvement of its manufacturing process, including environmental controls, cast moulding and curing operations. As reported in our methodology, the Acrysof lenses used in this current study were manufactured between February and September However, it is not clear whether the IOLs were manufactured before, during or after the reported manufacturing improvements.

Consequently, our results on the Acrysof IOLs should be interpreted cautiously. The results from this study hint at the role material properties play in the development of glistenings. However, we do not infer a causal relationship because of other potential explanatory variables: the two IOLs evaluated are supplied in different packaging, one dry Acrysof and the other hydrated Eternity.

Dry packaging has been associated with glistenings formation 7—9 although there is no association when the IOL is hydrated. This is because the scatter is more directional so more light is scattered towards the retina. The results are most useful for informing materials development and generating further hypotheses for clinical studies that should lead to an evidence-base for clinical advice and management. The experimental design of our study had several strengths.

These include the objective quantification of glistenings parameters, the before and after design so that differences can be analysed and the systematic way in which all samples were handled reducing variability. However, there are some limitations to our study the most significant of which was the small number of lenses analysed. This was compensated partially by the before and after design allowing the analysis of differences.

More importantly the measured difference between the two materials was large enough even at the sample size used to reach significance. Increasing the sample size would therefore be unlikely to change the main results and conclusions.

A further limitation we noted was that the glistenings detection software reported optical artefacts as glistenings prior to thermal induction.

From analysis of the images, we suspect these are most likely false glistenings, appearing at the edges of the IOL optic although we cannot rule out the possibility that some glistenings may develop in the lens materials during the manufacturing process and while in packaging and storage. Again, analysing the differences from baseline helps to compensate for any artefacts if they are detected as glistenings by the software.

In vitro studies are open to the criticism that their results may not extend to the clinical domain thereby lacking relevance to clinical decision making and management. It is not known for certain if accelerated thermal ageing, widely used in in vitro studies, produces clinically relevant results. We do not therefore infer a clear clinical meaning to our results and further clinical studies should be carried out to support our conclusions.

The findings from this study suggest avenues for future research. Previous studies have demonstrated an increase in light scatter with increased numbers of glistenings. However, the interaction with glistenings size is more complex with larger glistenings producing greater levels of straylight. The possibility of objectively quantifying glistenings in in vivo images coupled with sensitive tests of vision that move away from high contrast acuity in a clinical trial would be advantageous and is currently being pursued by the authors.

Further data on the association of glistenings parameters with visual performance could better inform clinical advice and management in symptomatic cases. In conclusion, this laboratory study has demonstrated that different IOL materials produce varying density and size of glistenings, which both influence straylight.

Our results imply that the threshold at which visual performance is affected could vary. Choice of IOL material should consider the development of glistenings alongside other material properties such as biocompatibility. The authors are grateful to Dr Bunyarit Uyyanonvara and Parisut Jitpakdee at the Sirindhorn International Institute of Technology, Thammasat University, Thailand for their development of the glistenings detection software and also Advanced Vision Science for their support of this project.

Contributors EP: laboratory work, data analysis, manuscript preparation. CH: PI, manuscript preparation. DPO'B: manuscript preparation. Grant from Alcon unrelated to the submitted work CH. Provenance and peer review Not commissioned; externally peer reviewed.

Skip to main content. Log In More Log in via Institution. Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts.

Forgot your log in details? Register a new account? Forgot your user name or password? Search for this keyword. Advanced search. Latest content Archive Authors About. Log in via Institution. Email alerts. Article Text. Article menu. Original research. Statistics from Altmetric. What are the new findings? How might these results change the focus of research or clinical practice? Different materials produce glistenings of different size and density.

Introduction Glistenings have been observed in all types of intraocular lens IOL materials, 1 although hydrophobic acrylic polymers, the most commonly used IOL material, 2 appear to be more susceptible to their formation.

Light scatter measurements The laboratory set-up for measuring the forward light scatter of IOLs is shown in figure 1. Figure 1 Experimental setup. Induction of lens glistenings To induce lens glistenings, all IOLs were immersed in 0. Statistical analysis Due to the small sample sizes, non-parametric statistics were used. Patient and public partnership No patients or members of the public were involved in this study.

Results The total number of glistenings developed by each IOL group following thermal induction is shown in figure 2. Figure 2 Number of developed glistenings, post-treatment, for each intraocular lens material.

Figure 3 Distribution of the diameters of all detected glistenings for the two different materials data pooled from all lenses within each intraocular lens group ; a Acrysof and b Eternity Natural Uni. Figure 5 Angular distribution of forward light scatter.

Acknowledgments The authors are grateful to Dr Bunyarit Uyyanonvara and Parisut Jitpakdee at the Sirindhorn International Institute of Technology, Thammasat University, Thailand for their development of the glistenings detection software and also Advanced Vision Science for their support of this project.

Glistenings and surface light scattering in intraocular lenses. J Cataract Refract Surg ; 36 : — OpenUrl PubMed. Leaming DV. J Cataract Refract Surg ; 30 : — Comparison of glistenings in intraocular lenses with three different materials: year follow-up.

Acta Ophthalmol ; 91 : 66 — Uveal and capsular biocompatibility of hydrophilic acrylic, hydrophobic acrylic, and silicone intraocular lenses.

J Cataract Refract Surg ; 28 : 50 — Glistenings in lathe-cut acrylic intraocular lens. Ganka Shujutsu ; 13 : — A prospective clinical study to quantify glistenings in a new hydrophobic acrylic IOL. J Cataract Refract Surg ; 24 : — J Cataract Refract Surg ; 27 : — To limit positive dysphotopsia, IOL designs have introduced frosted or curved edges to prevent the reflection of light back onto the IOL.

The etiology of negative dysphotopsia is less understood but is postulated to be caused by the bending of incoming light resulting in a gap forming between the retinal images produced by light bypassing the lens and light being refracted by the optic [ 2 ]. Methods to objectively measure dysphotopsia have traditionally been elusive.

However, kinetic perimetry has been used to objectively measure negative dysphotopsia symptoms [ 8 ]. Briefly, Goldmann kinetic perimetry was used to measure the visual field of pseudophakic patients, and temporal field restrictions and temporal scotomas were detected that corresponded with the location of subjectively reported shadows [ 8 ].

When measured subjectively, 5. However, when measured using kinetic perimetry, there was no difference in visual fields between the groups, with both groups lying within the population norm Fig. This may suggest discrepancies between visual field defects and symptoms perceived by the patient or may suggest that temporal field restriction as measured by kinetic perimetry is not sensitive enough to reliably predict dysphotopsia symptoms in a sample group of this size.

Despite differences in photic symptoms, both groups reported similar rates of satisfaction 8. According to the surgeon, during this study, the delivery system appears to be precise and predictable with few minor complications. The carbon dioxide pump failed in one case and the trailing haptic was found to be stuck to the optic in a few cases.

The haptic could be easily removed from the optic and no further intra- or postoperative complications were encountered for any patient. All IOLs appeared well centered in the eye following surgery and remained stable at follow-up. Some complications, such as glistenings, which can reduce contrast sensitivity, can take years to develop while clinically significant PCO may take years.

Therefore, a long-term comparative study will be required to effectively compare CS and the incidence of PCO. Additionally, the inclusion of eyes with toric IOLs may have skewed photic phenomena resulted as toric IOLs are implanted along the steep axis while monofocal IOLs are implanted inferotemporally to minimise photic phenomena as previously reported and as per surgeon preference [ 4 ].

Due to the small size of this study, larger long-term prospective studies will be required to help elucidate, as well as to determine differences in the long-term incidence of glistenings and PCO between the lens platforms. Ethics approval was not required according to the applicable HREC committee due to the retrospective nature of the study. This research was carried out according to the tenets of the declaration of helsinki. Informed written consent to participate and consent for publication were obtained from all participants.

No financial support was received for this study. Erin thornell has no conflicts of interest to disclose. Smita agarwal is a member of the advisory board for alcon, the manufacturer of both of the lenses used for this study.

Mimura received his PhD from Tokyo University in Currently, he is working as an associate professor at Teikyo University. He has successfully completed his Administrative responsibilities as a reviewer, editor and research scholar for many journals. His research has included investigations of corneal transplantation.

Based on this research and fellowship training he has received 25 awards and honours, such as the infamous Rohto Award. He is currently serving as an editorial member of 42 reputed journals. The partnership allows the researchers from the university to publish their research under an Open Access license with specified fee discounts.

Bentham Open welcomes institutions and organizations from world over to join as Institutional Member and avail a host of benefits for their researchers. It is known as one of the oldest universities in Malaysia. UPSI was later upgraded to a full university institution on 1 May, , an upgrade from their previous college status. Their aim to provide exceptional leadership in the field of education continues until today and has produced quality graduates to act as future educators to students in the primary and secondary level.

Bentham Open publishes a number of peer-reviewed, open access journals. These free-to-view online journals cover all major disciplines of science, medicine, technology and social sciences. Bentham Open provides researchers a platform to rapidly publish their research in a good-quality peer-reviewed journal. All peer-reviewed accepted submissions meeting high research and ethical standards are published with free access to all. The partnership provides the opportunity to the researchers, from the university, to publish their research under an Open Access license with specified fee concessions.

Bentham Open welcomes institutions and organizations from the world over to join as Institutional Member and avail a host of benefits for their researchers. The first Ministry of Health in Jordan was established in The Ministry began its duties in , the beginning of the health development boom in Jordan.

The first accomplishment was the establishment of six departments in the districts headed by a physician and under the central administration of the Ministry. All peer-reviewed, accepted submissions meeting high research and ethical standards are published with free access to all. The Porto University was founded in Porto University create scientific, cultural and artistic knowledge, higher education training strongly anchored in research, the social and economic valorization of knowledge and active participation in the progress of the communities in which it operates.

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The Open Ophthalmology Journal is committed to ensuring high quality of research published. We believe that a dedicated and committed team of editors and reviewers make it possible to ensure the quality of the research papers. The overall standing of a journal is in a way, reflective of the quality of its Editor s and Editorial Board and its members.

The Open Ophthalmology Journal is seeking energetic and qualified researchers to join its editorial board team as Editorial Board Members or reviewers. The essential criteria to become Editorial Board Members of The Open Ophthalmology Journal are as follows: Experience in experimental and clinical research in ophthalmology with an academic degree. Proficiency in English language. Submit or solicit at least one article for the journal annually.

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Guidelines for Guest Editors. Article Information. Methods: A total of 20 patients 40 eyes; 12 female, average age Table 1. Table 2. Mean preoperative patient demographics. Table 3. Mean postoperative measurements at weeks following the second surgery. Photic Phenomena and Subjective Vision Average satisfaction was similar for both groups; 8.

A Deviation in postoperative spherical equivalent from the plano target refraction in contralateral eyes that received Clareon or IQ monofocal IOLs 1 month after the final surgery. In vitro and schematic model eye assessment of glare or positive dysphotopsia-type photic phenomena: Comparison of a new material IOL to other monofocal IOLs. J Cataract Refract Surg ; 45 2 : CrossRef PubMed.

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Contact Us. Diabetes Type 1 Type 2 Prevention. All Communities ». Why my dr. I have use bifocals for more than 12 years even though I dont have much difficulty seen at a distance My problem is reading o seen closely even with my last glasses les than 6 months old Ive been told that it is because i have cataracts And durin the discusion of lenses it came that the ones Medicare pays for wont be good for me. Answer Question. Read Responses 5. Related Questions. Planning for cataract surgeries with myopia and macular pucker hogwell.

I have been diagnosed with moderate cataract cloudiness in both eyes and I am trying to determine the best options as far as IOL choice Iol exchange PeTrolium I underwent cataract surgery with multifocals last fall and I am scheduled for an exchange with two monofocals into minimonovision i Cataracts vision changes bunnings. Hi l was diagnosed with cataracts PSC in both eyes a year ago, l think they said its still early stage. The vision in my left eye stil Astigmatism and cataract surgery Barb I'm in the process of arranging for cataract surgery and I have, what they tell me is large amount of astigmatism.

My regular optometris Recently doctor use SN60WF in my mother's right eye. But after 26 days her vision was not stable and things are not looking well. Helpful - 0. Thank you very much for your time and expert opinion.

I'll look for another doctor. See another doctor! And you'd almost certainly have fewer problems post-surgery. Medicare pays for a variety of high quality monofocal IOLs. If you don't mind wearing glasses after cataract surgery then there is no reason to pay extra for the extra cost of multifocal IOL. And I would suggest getting a second opinion about the need for surgery and the type of IOL. The nighttime city driving scene employs a variety of street lights, car lights, store lights and signs to recreate the high level of ambient lighting typical under Your most recent searches Delete.

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How to load a single-piece Acrylic IOL into the injector for cataract surgery

Jun 21,  · About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators. ALCAINE® (proparacaine hydrochloride ophthalmic solution, USP) % Product Information Anterior Chamber Lenses - KELMAN™ MULTIFLEX™ III PMMA Single-Piece IOL MODEL . Nov 9,  · The optimized design allows predictable delivery of the IOL in just three simple preparation steps. The new design features a longer 3 mm nozzle tip with a proprietary depth .