Archive 2013Archive 2014
Lectures at scientific congresses in 2014
Publication of a scientific study in the Journal of Refractive Surgery
In August a study lead by a team of specialists at the Lexum Eye Clinic on implantation of phakic Visian Implantable Collamer Lenses (ICL) in patients with high hyperopia was published in the prestigious international ophthalmological Journal of Refractive Surgery. Very few similar studies have been published to date globally (and most included only a small group of patients with short follow-up period). Based on long-term monitoring of patients, the authors, František Benda, MD, Lenka Filipová, PhD and professor Martin Filipec, MD, PhD, demonstrated that implantation of posterior chamber phakic lens is a safe, effective, predictable and stable method for correction of medium and high hyperopia (More information can be found here)
Contributions at the 22nd Annual Meeting of the Czech Ophthalmological Society of the Czech Medical Association of J.E. Purkyně – Prague, June 2014
First results of trifocal toric lens implantation for a correction of presbyopia
The study evaluated the first results of implantation of AT LISA tri toric 939MP (Zeiss) trifocal toric intraocular lens for correction of presbyopia in patients after refractive lens exchange (RLE). The authors focused on the functional outcomes of postoperative vision and lens rotation stability and monitored the effectiveness and safety of the surgery. These first results showed that implantation of trifocal toric lenses for a correction of presbyopia in eyes with high astigmatism is a suitable and effective method. Patients are satisfied with their postoperative vision. (Poster in Czech available here)
Outcomes of trifocal lens implantation in patients after previous laser refractive surgery
Filipová L., Hlinomazová Z., Filipec M., Holubová A.
This study evaluates outcomes of PhysIOL FineVision Micro F trifocal lens implantation in eyes after previous laser surgery in patients with presbyopia who did not want to be dependent on spectacles. Our results showed that implantation of PhysIOL FineVision Micro F trifocal lenses in patients after previous laser refractive surgery contributes to their improved vision, leads to spectacle independency and thus to patients’ general satisfaction. It is necessary to inform the patient about the difficulty in lens power calculation and of the possibility of potential residual refractive error correction. (Poster in Czech available here)
Comparison of outcomes of refractive error correction in presbyopic patients with implantation of two types of trifocal intraocular lenses
Holubová A., Filipová L., Filipec M., Hlinomazová Z.
The aim of the study was to compare outcomes in presbyopic patients that have undergone refractive lens exchange (RLE) with implantation of PhysIOL FineVision Micro F or Zeiss AT LISA tri 839MP trifocal intraocular lens. Our short-term results for both currently available models of trifocal lenses were comparable and their implantation proved to be a suitable approach for a correction of presbyopia. The study demonstrated that both types of lenses provide patients with very good distance, intermediate and near vision. Patients’ subjective satisfaction with vision after the surgery was also very high. (Poster in Czech available here)
The poster outlines the case of a 59-year-old patient visiting our clinic with problems of eye discomfort, describing heavy eyelids and turning out of the eyelids during sleep, together with restless and interrupted sleep. After learning about his personal anamnesis and detailed examination, including smear and PCR testing for the presence of chlamydia, a diagnosis of chronic conjunctivitis was established. Negative result smear and PCR excluded chlamydia infection as the cause. Further examination revealed excessive laxity of upper eyelids in both eyes and thus floppy eyelid syndrome was diagnosed, with suspicion of the obstructive sleep apnoea (OSA) syndrome, which was confirmed by examination at a pulmonary and sleep clinic. The author discusses the symptoms and diagnostics of OSA and possible treatment that, with the proper diagnosis, lead to the disappearance of the optical problems.
From the cornea to the retina – there’s something to be found everywhere
The poster describes the case of a 62-year-old woman who was sent for a cataract operation. Preoperative examination revealed bilateral drusen papillae, causing visual field defects. OCT of the optic nerve papillae revealed a reduction in the thickness of nerve fibres with atypical distribution of reduction in the sector of the optic nerve. The patient was also found to be suffering from Cogan corneal dystrophy, which was treated by lubrication. The patient underwent cataract surgery with intraocular lens implantation. Two months after the surgery cystoid macular edema (CME) was observed in both eyes. Treatment led to a reduction of macular edema and improvement in visual acuity. It is not clear whether the CME was related to the presence of the drusen of papilla because both eyes were affected in the postoperative period. The poster also discusses the circumstances of all eye diseases from which this patient was suffering. (Poster in Czech available here)
FemtoLASIK and trifocal IOL
This case study shows an improvement of cooperation of a phakic eye over time, after femtoLASIK surgery, with a pseudophakic eye after implantation of a trifocal lens. The cooperation led to an improvement in far, intermediate and near vision. Nonetheless, subjective satisfaction with vision is higher with the eye after femtoLASIK surgery. (Poster in Czech available here)
Contributions at the 12th International Congress of the Czech Society of Refractive and Cataract Surgery (ČSRKCH) – Ostrava, May 2014
Evaluation of macular changes after refractive lens exchange
Skorkovská Š., Ventruba J.
This study evaluated the extent of morphological macular changes after refractive lens exchange (RLE) with implantation of multifocal or trifocal intraocular lens. The authors used optical coherent tomography (OCT) to assess the impact of these changes on postoperative visual acuity and to find possible correlation between biometric and surgical parameters and macular changes in the postoperative period. This study showed that changes in the macular area detected by OCT were induced even after refractive lens exchange. Thickening of the retina attained maximum values during the first month after the surgery. Three months after refractive lens exchange the thickness of the macular area returned to initial preoperative values. Subclinical changes in the macula following refractive lens exchange can be successfully affected by local application of corticoids and nonsteroid antiphlogistics in the postoperative period.
Artephakia and photic phenomena
Choleva M., Filipová L.
The authors compared subjective satisfaction and perception of secondary visual phenomena in 4 groups of patients, differing in the means of dealing with the loss of accommodation following intraocular lens surgery: hybrid monovision (unilateral implantation of multifocal IOL), both lenses multifocal, monovision (unilaterally induced myopia of -1.5 to -2.5 D) and emmetropia (both lenses monofocal). The occurrence of positive dysphotopsia (halo, glare) was higher in the group of patients after bilateral implantation of multifocal lenses and in patients with hybrid monovision. The presence of negative dysphotopsia (shadow) did not reveal statistically significant differences in the compared groups. Subjective satisfaction was not related to the perception of secondary visual phenomena – patients in the group with mono- or bilateral multifocal IOL were most satisfied, followed by the monovision group and the lowest satisfaction was expressed by the group of patients with emmetropia. The differences were not statistically significant. Hybrid monovision seems to be a suitable alternative for dealing with a loss on accommodation after intraocular lens surgery.
Stability of enVista toric intraocular lenses ─ first experience
Zemanová M., Birndtová E., Filipová L., Santarová M., Holubová A.
The authors evaluated the rotational stability, functional results and occurrence of complications following implantation of enVista toric MX60T IOL in patients with high astigmatism. The first results demonstrated that enVista toric intraocular lens has a very good rotational stability in a sulcus and that refractive result was stable during the follow-up period.
Offer a multifocal IOL?
Implantation of multifocal IOL is currently considered to be the best approach to solve the loss of accommodation following lens surgery. The frequency multifocal implants use is primarily limited by their relative financial inaccessibility and persisting low confidence level, especially amongst out-patient ophthalmologists, together with very strict exclusion criteria. On the example of case study (high hyperopia, extremely shallow anterior chamber, partial pupil seclusion following a glaucoma attack and thirty-year history of application of miotics), the author discusses the relativity of these indication schemes. He also emphasizes an individual approach taking into account both the parameters of the patient and the experience of ophthalmologists at the clinic.