methylcellulose and Astigmatism

To compare surgically induced astigmatism (SIA) after coaxial 1.8 mm microincision cataract surgery (MICS) and bimanual 1.7 mm MICS calculated with 3 mathematical methods.. Department of Ophthalmology, Medical University of Lodz, Lodz, Poland.. Study comprised a nonrandomized prospective consecutive series of 58 eyes of 58 patients who had uneventful coaxial MICS with implantation of an Akreos MI60 foldable intraocular lens (IOL) using a 1.8 mm temporal clear corneal incision. Fifty eyes of 50 patients who had uneventful bimanual MICS through a 1.7 mm clear corneal incision for a sleeveless phaco tip and a 1.5 mm side port for an irrigating chopper with implantation of an Acri.Smart 48S foldable IOL served as a comparison group. All surgery was performed by 2 experienced surgeons. Surgically induced astigmatism was calculated using 3 methods.. The patients were examined preoperatively and 2 weeks to 1 month postoperatively. No intraoperative or postoperative complications were seen in any patient. The corrected distance visual acuity improved significantly in both groups after surgery (P<.01); the visual outcomes were not significantly different (P>.05). In vector analysis, the mean SIA was 0.42 +/- 0.29 in the coaxial MICS group and 0.50 +/- 0.24 in the bimanual group; the difference was not statistically significant (P>.05). In vector decomposition, the mean SIA (C90) coaxial MICS group was 0.23 +/- 0.29 in the coaxial MICS group and 0.23 +/- 0.22 in the bimanual MICS group; the difference was not significant. Using the Naeser method, DeltaKP-90 was calculated, amounting to 0.05 +/- 0.44 in the coaxial MICS group and -0.04 +/- 0.42 in the bimanual MICS group; the difference was not significant.. The amount of SIA induced by bimanual MICS and coaxial MICS phacoemulsification was very small. The bimanual MICS induced a slightly higher degree of SIA; however, according to all methods of SIA analysis, there was no significant difference in the mean SIA induced by both techniques.

Topics: Adult; Aged; Aged, 80 and over; Astigmatism; Cataract; Cornea; Female; Humans; Hypromellose Derivatives; Lens Implantation, Intraocular; Male; Methylcellulose; Microsurgery; Middle Aged; Phacoemulsification; Prospective Studies; Refraction, Ocular; Viscosupplements; Visual Acuity

Ciliary muscle function in patients with Adie's syndrome was studied retrospectively in 122 patients and prospectively in 17 patients. When a careful history was taken, two thirds of the patients had ciliary muscle-related symptoms. Most of the patients with Adie's syndrome had a moderate accomodative paresis, but there was a strong tendency for the ciliary muscle to recover with time. Many patients showed a tonicity of accommodation, especially those who had had the condition for several years. Astigmatism could be induced with accommodation in one third of patients. This may be related to segmental paralysis of the ciliary muscle. Seventy-three percent of the patients showed supersensitivity of the ciliary muscle in the involved eye, when both eyes were treated with a mixture of 0.25% pilocarpine hydrochloride and hydroxypropyl methylcellulose (Isopto Carpine). This may be a clinical aid in diagnosing Adie's syndrome. Two patients were found to have bilateral ciliary muscle dysfunction but only unilateral pupillary abnormalities. These two patients may have had a "pupil-sparing" Adie's syndrome.

Topics: Accommodation, Ocular; Adie Syndrome; Adolescent; Adult; Astigmatism; Child; Ciliary Body; Female; Humans; Male; Methylcellulose; Myopia; Pilocarpine; Prospective Studies; Pupil; Retrospective Studies