A three-dimensional, in vivo method for determining the position of implanted intraocular lenses (IOLs) using an image-processing technique has been developed. Two images of the anterior segment of the eye with an implanted IOL were photographed with a Scheimpflug camera at slit-lamp angles of 90 degrees and 180 degrees. After geometrical correction, the contours of the original images were enhanced using binarization and curve-fitting techniques. These images afforded calculation of the angle of tilt of the IOL optic axis relative to a standard reference line which connected the center of anterior corneal surface curvature with the geometrical center of the pupil. The extent and direction of IOL decentration could also be shown. The IOL image in the posterior chamber was expressed as a wire-frame figure. This method provides several kinds of biometry in pseudophakic eyes.
In order to know the initial lens changes that accompany atopic dermatitis (AD), 99 patients diagnosed dermatologically to have AD without any or with slight external ocular inflammations and with no habit of rubbing the eyelid due to severe itching were examined opthalmologically. Clinically, none of them showed any cataractous changes in their eyes. For the sake of comparison with the above population, 4 AD patients with cataractous eyes, 49 renal transplantation patients who were administered steroids over a long period of time but clinically had no cataractous lenses, and 94 healthy individuals with transparent lenses were also selected as subjects. The crystalline lenses of the subjects were examined using an anterior eye segment analysis system and specular microscopy. From Scheimpflug slit images of the lens, light scattering intensity of different lens layers was measured as an indicator of lens transparency changes. The subcapsular basement membrane and changes in the lens epithelial layers were analyzed from specular images of these areas by image processing. Results and considerations from the investigations were: (1) Initial lens changes in cases with AD which may be occult cataractous findings were often detectable. (2) Cataract associated with AD can be accelerated by steroid administration or the habit of strongly rubbing the eyelid, but this may not be the original cause of cataract formation. (3) Two types of cataract are seen in patients with AD: (a) anterior subcapsular plaque formation and (b) anterior and posterior subcapsular opacity formation. The latter type, however, is also accompanied by epithelial damage from the early stage. (4) Significant numbers of patients with AD who have not yet shown manifest lens changes were found among the subjects.
The small axial movement of the anterior surface of implanted intraocular lenses (IOLs) were examined in pseudophakic eyes with one-piece and three-piece IOLs using an anterior eye segment analysis system. The movement was calculated as the distance between the posterior surface of the cornea and the anterior surface of an IOL under a normal pupil size, following the instillation of 1 % pilocarpine and 1 % cyclopentolate solutions, respectively. The axial movement including movement after instillation of pilocarpine and cyclopentolate was 0.17 ± 0.06, 0.05 ± 0.07 and 0.13 ± 0.06 mm, in phakic eyes and eyes with one-piece and three-piece IOLs, respectively. Image analysis techniques using Scheimpflug images proved its usefulness in the research field of IOL implantation.
Endocapsular phacoemulsification and complete in-the-bag intraocular lens (IOL) fixation was performed on 77 eyes. Specular microscopy of the anterior lens capsule was performed postoperatively, and the process of anterior capsule opacification after endocapsular cataract surgery was classified. Lens epithelial cells on the inner surface of the anterior lens capsule, facing the optical portion of the IOL, underwent a diffuse fibrosis. In more peripheral areas, where the anterior and posterior capsules were tightly adherent, the regularly proliferating lens epithelial cells retained their polygonal shape. These findings suggest the possibility of retaining the transparency of the anterior lens capsule postoperatively by refilling the capsular bag to apply internal pressure.
A Japanese family with 4 members suffering from lattice dystrophy of the cornea is reported. Their central corneas were affected leaving the peripheral zone clear. Corneal lesions were found in the superficial stroma of younger cases and in the deeper stroma of older cases. The proband was a 75 year-old woman who underwent a penetrating keratoplasty. Her corneal specimens revealed amyloid deposits stained with Congo red in the stroma. In specular microscopy, the probands central cornea had a crateriform appearance which had not been reported in the literatures. A few fine short branching lines and crateriform lesions were shown in the superficial stroma of the proband's daughter and only crisscrossing lines could be seen in her granddaughter's cornea.
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