Search Results (70)

Objectives: To assess the anatomical lens position (ALP) predictability for a capsulotomy-fixated intraocular lens (IOL; FEMTIS FB-313, Teleon Surgical B.V) versus an intracapsular IOL (TECNIS 1-Piece, ZCB00V, Johnson & Johnson) implanted for age-related cataracts. Methods: Pre- and 3-month postoperative measurements from optical biometry and swept-source anterior segment OCT were analyzed. The lens position (i.e., postoperatively, ALP) was defined as the distance between the corneal endothelium and the lens equator. Multivariate linear mixed-effects models assessed the influence of preoperative biometric parameters on ALP, prediction error (PE), and absolute PE (AbsPE). Results: A total of 45 FEMTIS eyes from 32 patients and 26 TECNIS eyes from 18 patients were included. Postoperatively, the anterior chamber depth (ACD) increased by 1.10 mm in FEMTIS eyes and 1.66 mm in TECNIS eyes, while the lens position decreased by 0.59 mm and 0.34 mm, respectively. ACD and lens thickness (LT) were the strongest ALP predictors (ACD: β = +0.70, p < 0.0001; LT: β = +0.37, p < 0.0001). Separate multivariate models demonstrated strong predictive performance, with the FEMTIS achieving R² = 0.92 and the TECNIS IOL performing even better with R² = 0.97. In the FEMTIS group, LT influenced the PE (p = 0.006) and ACD the AbsPE (p = 0.005). In the TECNIS group, ACD influenced the PE (p < 0.0001), while AbsPE was not significantly affected by biometric parameters or formulas. Conclusions: ALP can be reliably predicted from standard biometric data, although less accurately for the FEMTIS IOL. Its anterior capsulotomy fixation likely compromises refractive accuracy with formulas inherently designed and optimized for in-the-bag IOLs, emphasizing the need for fixation-specific formula adjustments and dedicated optimization in capsulotomy-fixated IOLs. Full article

Refractive error affects people’s vision and may be the cause of a variety of fundus diseases. Early detection of refractive error and its location are very important to protect vision and prevent the occurrence of pathological symptoms. In this paper, a dual-focus SS-OCT system was developed to obtain whole-eye imaging and eight biometry parameters, which include corneal center thickness, lens center thickness, anterior chamber depth, vitreous chamber depth, corneal anterior and posterior surface curvature, lens anterior and posterior surface curvature. The diopter of each refractive component and the whole eye can be calculated from these parameters. Healthy subjects were measured under different accommodative stimuli using the proposed system and compared with the refractometer. The results show that there is a high consistency between the two in the overall diopter. The advantage of our system is that it cannot only measure the overall refractive deviation, it can also find the location of the deviation, which will be critical for the prevention and treatment of refractive system diseases in humans. Full article

This study describes and validates a novel method for assessing anterior crystalline lens curvature along vertical and horizontal meridians using radial measurements derived from Scheimpflug imaging. The aim was to evaluate whether pupil diameter (PD), anterior lens curvature, and anterior chamber depth (ACD) change during accommodation and whether these changes are age-dependent. A cross-sectional study was conducted on 104 right eyes from healthy participants aged 21–62 years. Sixteen radial images per eye were acquired using the Galilei Dual Scheimpflug Placido Disk Topographer under four accommodative demands (0, 1, 3, and 5 dioptres (D)). Custom software analysed lens curvature by calculating eccentricity in both meridians. Participants were analysed as a total group and by age subgroups. Accommodative amplitude and monocular accommodative facility were inversely correlated with age. Both PD and ACD significantly decreased with higher accommodative demands and age. Relative eccentricity decreased under accommodation, indicating increased lens curvature, especially in younger participants. Significant curvature changes were detected in the horizontal meridian only, although no statistically significant differences between meridians were found overall. The vertical meridian showed slightly higher eccentricity values, suggesting that it remained less curved. By enabling detailed, meridionally stratified in vivo assessment of anterior lens curvature, this novel method provides a valuable non-invasive approach for characterizing age-related biomechanical changes during accommodation. The resulting insights enhance our understanding of presbyopia progression, particularly regarding the spatial remodelling of the anterior lens surface. Full article

This study proposes a deep learning-based, non-contact method for detecting elevated intraocular pressure (IOP) by integrating Scheimpflug images with corneal biomechanical features. Glaucoma, the leading cause of irreversible blindness worldwide, requires accurate IOP monitoring for early diagnosis and effective treatment. Traditional IOP measurements are often influenced by corneal biomechanical variability, leading to inaccurate readings. To address these limitations, we present a multi-modal framework incorporating CycleGAN for data augmentation, Swin Transformer for visual feature extraction, and the Kolmogorov–Arnold Network (KAN) for efficient fusion of heterogeneous data. KAN approximates complex nonlinear relationships with fewer parameters, making it effective in small-sample scenarios with intricate variable dependencies. A diverse dataset was constructed and augmented to alleviate data scarcity and class imbalance. By combining Scheimpflug imaging with clinical parameters, the model effectively integrates multi-source information to improve high IOP prediction accuracy. Experiments on a real-world private hospital dataset show that the model achieves a diagnostic accuracy of 0.91, outperforming traditional approaches. Grad-CAM visualizations identify critical anatomical regions, such as corneal thickness and anterior chamber depth, that correlate with IOP changes. These findings underscore the role of corneal structure in IOP regulation and suggest new directions for non-invasive, biomechanics-informed IOP screening. Full article

Background/Objectives: This study assessed the reliability of the Barrett True-K formula in patients who had undergone laser-based corneal refractive surgery by comparing outcomes using measured vs. predicted posterior corneal astigmatism (PCA) within the Barrett True-K No History formula. Methods: We selected 49 eyes out of 41 patients with a history of uncomplicated laser visual correction (LVC) that underwent cataract surgery between 2020 and 2024. The Front K1 and K2, the Back K1 and K2, the anterior chamber depth, the lens thickness, the horizontal white-to-white, and the central corneal thickness were measured using Pentacam. The axial length was measured using the IOL Master 500 or NIDEK AL-Scan. These data were then imported into the freely available online Barrett True-K calculator for post-LVC eyes, and the postoperative results were compared with the predicted IOL target. The cumulative distribution of the refractive prediction error, absolute refractive prediction error, and refractive prediction error were calculated as the difference between the postoperative spherical equivalent and the expected spherical equivalent for both the predicted and measured PCA calculations. Results: The results suggest improved accuracy with the Barrett True-K formula when incorporating measured PCA values, supporting the use of corneal tomography for optimized refractive outcomes in post-LVC cataract patients. Conclusions: It is always advisable to measure the posterior corneal surface using corneal tomography in all patients who have undergone LVC to achieve better refractive outcomes after cataract surgery. Full article

Background/Objectives: The role of the vitreous in the effective lens position (ELP) is controversial in patients undergoing phacovitrectomy. The aim of this study was to compare the change in aqueous depth (AD), a surrogate of the ELP, in non-vitrectomized and vitrectomized fellow eyes. Methods: Post-hoc analysis of a prospective study conducted in OMIQ facilities (Barcelona, Spain) between 2021 and 2023. Patients with bilateral cataracts and a unilateral grade 2/3 epiretinal membrane underwent phacoemulsification in one eye and phacovitrectomy without endotamponade in the fellow eye. All eyes were implanted with an extended depth-of-focus intraocular lens after power calculation using the same biometer, technicians, formula, and surgeon. We compared the change in AD (mm and percentage) from baseline, and the role of vitrectomy without endotamponade on AD with a mixed-effects models. Results: We included 40 eyes (20 patients) with a mean age of 71.6 years, with 55% females. The mean change in AD was +1.51 (vitrectomized) and +1.42 mm (non-vitrectomized eyes), p = 0.33. The percent of change in AD was not different between groups (p ≥ 0.38) and phacovitrectomy had no effect on the change in AD on mixed-effects models (p > 0.10). Conclusions: The absence of the vitreous had a minimal influence on AD in these patients undergoing standard phacoemulsification or phacovitrectomy. Full article

Background/Objectives: Swept-Source Optical Coherence Tomography (SS-OCT) is a novel optical biometry technology with limited published data on its reliability compared to the gold standard, partial coherence interferometry (PCI). This study aims to assess the agreement between an SS-OCT biometer (Argos) and a PCI device (IOLMaster 500) in terms of biometry values, intraocular lens (IOL) power calculation and mean prediction error (ME). Methods: In this prospective comparative study, axial length (AL), anterior chamber depth (ACD), flat (K1), steep (K2) and mean (Km) keratometry values, astigmatism power, J0, and J45 vector components, white-to-white distance (WTW), and IOL power calculations for nine IOL models using four formulas were compared in cataract patients. Refractive outcomes were assessed in eyes implanted with SN60WF and Panoptix IOLs, with ME calculated for each module and formula for both IOLs postoperatively. Results: This study included 133 eyes (mean age: 66.0 ± 10.95 years). Argos measured significantly higher ACD and steeper keratometry values than IOLMaster, albeit without significant differences in AL, astigmatism power, WTW, J0, and J45. Mean IOL power differences were within the clinically acceptable threshold (0.50 D), except for SN6ATx with Hoffer Q and Haigis, and Clareon with Haigis. For Panoptix and SN60WF, IOLMaster demonstrated a more hyperopic ME than Argos with SRK/T, Holladay 1, and Hoffer Q; however, this was without clinically significant differences. Conclusions: Argos and IOLMaster 500 presented differences in ACD, keratometry values, and IOL power calculation. However, both devices showed non-clinically significant differences in IOL power calculation and ME in the majority of formulas. Full article

Purpose: This study aimed to refine the criteria for EndoART implantation regarding posterior corneal irregularity; to improve the selection of candidates for this synthetic alternative to endothelial keratoplasty. Methods: This study analyzed the impact of posterior corneal surface elevation differences; anterior chamber depth (ACD); and preoperative corneal pachymetry on the success of EndoART implant adhesion. Patients undergoing EndoART implantation at the Medical University of Vienna were assessed using OCT to measure corneal irregularities. Postoperative outcomes, including re-bubbling rates; implant adhesion; and visual acuity changes, were monitored. Results: EndoART successfully adhered in eyes with moderate posterior irregularities (elevation differences up to 204 µm). Severe irregularities (elevation differences > 200 µm) resulted in implant detachment. No significant correlation was found between corneal pachymetry or ACD and adhesion failure. Glaucoma devices and prior penetrating keratoplasty did not significantly affect adhesion. Some cases required re-bubbling, and patients reported pain reduction and moderate improvements in visual acuity. Conclusions: This study found that EndoART implantation can be successful despite posterior corneal irregularity. EndoART represents a viable solution for patients with poor biological graft survival prognosis, including those with glaucoma or prior surgeries, expanding its potential use and addressing the global donor cornea shortage. Full article

Objectives: Intraocular lens dislocation is a well-recognized complication of cataract surgery, necessitating secondary interventions such as retropupillary iris-claw IOL implantation. While effective, this procedure requires larger incisions that may induce significant astigmatism. This study aimed to (1) evaluate anterior chamber changes following retropupillary ICIOL implantation and (2) compare surgically induced astigmatism between corneal and scleral incision techniques. Methods: In this prospective cohort study, patients with IOL dislocation underwent 25-gauge pars plana vitrectomy with ICIOL implantation. Anterior chamber depth, volume, and angle configuration were measured across 12 meridians preoperatively, at 1–1.5 months (short-term), and 5–6 months (long-term). Surgically induced astigmatism was compared between the corneal and scleral incision groups. Statistical analysis included Shapiro–Wilk, Mann–Whitney U, and repeated-measures ANOVA tests. Results: This prospective study included 40 patients (22 females, 18 males) with a mean age of 76.3 ± 5.38 years (range 65–86). Significant reductions in ACD and ACV occurred postoperatively (p < 0.05), with partial recovery at long-term follow up. Surgically induced astigmatism was markedly higher with corneal incisions versus scleral approaches (p < 0.01 short term; p < 0.05 long term). Anterior chamber angle changes varied by meridian but stabilized by 6 months. Conclusions: Retropupillary ICIOL implantation induces predictable anterior segment remodeling, with scleral incisions offering superior refractive stability. Surgical planning should prioritize scleral techniques to minimize surgically induced astigmatism while maintaining anatomical efficacy. Future innovations in IOL design may further reduce incision-related complications. Full article

Objectives: In this study, the correlation between anterior chamber depth (ACD) and corneal endothelial cell density (CECD) loss was evaluated, and an assessment was made of the safety and efficacy of the eight-chop technique in cataract surgery for patients with shallow anterior chamber (SAC) depth. Methods: The technique was applied to patients with SAC and normal ACD, defined as <3 mm and ≥3 mm, respectively. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), CECD, coefficient of variation, percentage of hexagonal cells, and central corneal thickness were assessed pre- and postoperatively. Operative time, phaco time, aspiration time, cumulative dissipated energy (CDE), and volume of fluid used were recorded intraoperatively. Results: A total of 180 eyes from 99 patients (mean age, 74.8 ± 5.1 years; 28 men, 71 women) were analyzed. In the SAC group, the mean operative time, phaco time, aspiration time, CDE, and volume of fluid used were 4.7 min, 15.4 s, 65.6 s, 5.87, and 26.6 mL, respectively, demonstrating favorable surgical metrics. CECD loss was 1.3% at 7 weeks, 1.1% at 19 weeks, and 0.9% at 1 year, with no significant decrease after surgery in the SAC group. No correlation was observed between CECD loss and ACD in either group. Conclusions: These findings suggest that the eight-chop technique is a minimally invasive and effective approach that preserves corneal endothelial integrity, even in patients with SAC depth. Full article

Objective: This research seeks to investigate the effects of preoperative intense pulsed light with manual meibomian expression (IPL-MGX) on the refractive accuracy of cataract surgery on dry eyes with meibomian gland dysfunction (MGD-related dry eyes). Methods: Fifty-six MGD-related dry eye cases planned for cataract surgery were analyzed. IPL-MGX (four times at 2-week intervals) was performed before preoperative examination. Axial length (AL), anterior chamber depth (ACD), corneal curvature (mean-K), tear break-up time (TBUT), superficial punctate keratopathy in the central cornea (C-SPK), corneal higher-order aberrations (HOAs), and predicted postoperative spherical equivalent (P-SE) were evaluated pre- and post-IPL-MGX. The postoperative subjective spherical equivalent (S-SE) was evaluated after one month. The absolute difference between the S-SE and P-SE was considered an indication of P-SE accuracy. Changes in all the variables were assessed before and after IPL-MGX treatment. Results: No significant differences were observed in AL or ACD (p = 0.85, 0.56). The differences in mean-K, TBUT, C-SPK, and HOAs were significant (p < 0.01). P-SE accuracy based on post-IPL-MGX data was significantly higher than that based on pre-IPL-MGX data (p < 0.01). P-SE accuracy was within 0.25 diopters (D) in 14.3% of pre- and 55.4% of post-IPL-MGX, within 0.5D in 55.4% of pre- and 92.9% of post-IPL-MGX, within 0.75D in 98.2% of pre- and post-IPL-MGX, and within 1.0D in 98.2% of pre- and 100% of post-IPL-MGX. In the range of 0.25 and 0.5 D, the accuracy of P-SE was significantly higher in post-IPL-MGX (p < 0.01). Conclusions: Preoperative IPL-MGX considerably improved the predicted postoperative refraction accuracy in patients with MGD-related dry eye undergoing cataract surgery. Full article

Background and Objectives: The objective was to assess ocular biometric measurements in relation to age and gender among patients scheduled for cataract surgery, utilizing an optical biometry device. Materials and Methods: The optical biometric parameters evaluated included axial length (AL), central corneal thickness (CCT), anterior chamber depth (AD), lens thickness (LT), horizontal corneal diameter (WTW), and keratometry values in the flat (K1) and steep (K2) meridians. Astigmatism (AST) was also measured as the difference between these keratometry values. Results: A total of 14,183 optical biometric measurements were included in the study. The average age of the participants was determined to be 56 (3–110) years. The average AL was 23.57 ± 1.45 mm, the average AD was 2.76 ± 0.42 mm, the average CCT was 518.13 ± 37.81 μm, the average WTW distance was 11.88 ± 0.59 mm, and the average LT was 4.19 ± 0.51 mm. The keratometry measurements were recorded as K1 = 43.39 ± 1.96 diopters (D), K2 = 44.51 ± 2.31 D, and AST = 1.12 ± 1.15 D. The average values for male eyes in terms of the AL, AD, WTW, and LT measurements were significantly higher than those for female eyes (p = 0.001). The average K1 and K2 values were flatter in males than in females, while the AST value was found to be higher in females (p = 0.001). As age progressed, the mean AL decreased, the CCT decreased, the AD narrowed, the WTW distance decreased, the LT increased, and the keratometric values K1, K2, and AST decreased until the age of 60, after which they increased again. Conclusions: Research indicates that the measurements of the bulbus oculi are generally larger in males than in females. Furthermore, each of the optical biometric measurements is interrelated. Over time, these measurements may change. Full article

Background/Objectives: The prevalence of myopia is increasing globally, including in Spain. The early detection of ocular biometric parameters associated with myopia development is crucial for implementing control strategies. This study aims to describe the normative biometric values in a Spanish school-aged population and compare them with previously established reference data. Methods: A cross-sectional, observational, and analytical study was conducted on 558 students aged 6 to 12 years from the Educare Valdefuentes School in Madrid. Ocular biometric parameters, including axial length (AL), corneal curvature (CR), anterior chamber depth (ACD), crystalline lens thickness (LT), corneal thickness (CCT), and posterior vitreous depth (PVD), were measured using IOLMaster 700. The axial length/corneal radius (AL/CR) ratio was calculated. Percentile growth curves were generated, and the results were statistically analyzed using IBM SPSS 29. Results: AL significantly increased with age (p < 0.001), and boys had longer AL than girls. The AL/CR ratio showed a moderate correlation with myopia risk (ρ = 0.647, p < 0.001). Compared to previous European studies, no significant differences were found, except for minor variations in AL and CR. Conclusions: These percentile-based biometric values provide a useful reference for monitoring ocular growth and assessing myopia risk in Spanish children. The AL/CR ratio remains a strong predictor of myopia development, supporting its role in early detection strategies. Full article

Background/Objectives: The aim of this study was to evaluate computed tomography (CT) findings in penetrating globe injuries and their relationship with ocular trauma scores (OTSs). Methods: Patients with penetrating globe injuries who had orbital CT images were included in this study. Demographics, injury zone, and ophthalmologic exam data were collected retrospectively. OTSs and categories were determined. Orbital CT images were evaluated by a radiologist to determine decreased globe volume, globe wall irregularity, chorioretinal layer thickening, lens dislocation, asymmetric anterior chamber depth (ACD), abnormal vitreous density, and intraocular air presence. Results: This study included 30 eyes of 30 patients. The majority of patients (n = 20, 66.7%) had Zone I injuries. The most common CT findings were globe wall irregularity (53.3%) and asymmetric ACD (53.3%). No CT findings were observed in 10 patients (33.3%). Globe wall irregularity was the most frequent CT finding in the OTS II category, while asymmetric ACD was most frequent in the OTS IV category. All patients with decreased globe volume, lens dislocation, abnormal vitreous density, and ≥3 CT findings were in the OTS II category. A significant negative correlation was found between the number of CT findings and OTS (r = −0.644, p < 0.001), and a significant positive correlation was found between the number of CT findings and clinically measured wound size (r = 0.600, p < 0.001). Conclusions: CT findings help assess ocular trauma severity, but clinical examination remains essential for accurate diagnosis. Full article

Background: This study aimed to compare the anterior segment characteristics of patients with central serous chorioretinopathy (CSCR) to those with diabetic retinopathy (DR) and healthy controls. Additionally, it explored the possible associations between quality of life and anxiety with CSCR. Methods: A single-center, cross-sectional study involving patients aged 23–61 years diagnosed with CSCR or DR, and healthy patients. Comprehensive ophthalmic examinations included best-corrected visual acuity (BCVA, LogMAR), objective and subjective refraction, and anterior and posterior segments optical coherence tomography (OCT) imaging. Participants completed the Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Beck Anxiety Inventory (BAI). Statistical analysis included Kruskal–Wallis, Tukey post-hoc, Chi-square, and Spearman correlation tests to compare the three groups. Results: A total of 53 patients were recruited (16 CSCR, 8 DR, 29 controls; 52.8% males), with an additional 16 CSCR patients completed only the questionnaires. CSCR and DR patients were the same age as the controls (43.8 ± 9.0, 42.7 ± 9.9, 37.06 ± 13.61 years, respectively, p = 0.19). CSCR and DR patients had similar BCVA, lower than controls (0.19 ± 0.30, 0.15 ± 0.13, 0.01 ± 0.02 LogMAR, respectively, p < 0.01). CSCR patients exhibited more hyperopic refraction compared to healthy controls (p < 0.01) and reported significantly lower life enjoyment and satisfaction than DR and healthy individuals (51.56 ± 9.17, 53.75 ± 7.81, 60.03 ± 7.32, respectively, p < 0.01). No significant correlations were found between anxiety levels and pupil size, anterior chamber depth (ACD), amplitude of accommodation (AA), and intraocular pressure (IOP) among study groups (p > 0.05). Conclusions: CSCR patients demonstrated lower life enjoyment and satisfaction, reduced BCVA, and hyperopic refraction compared to healthy patients. They also tended to have higher stress and anxiety levels. Both CSCR and DR patients shared similar anterior segment characteristics. Full article