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Accommodation after implantation of an accommodating PC IOL should be assessed with several techniques, including subjective and objective, to differentiate true pseudophakic accommodation from pseudoaccommodation. Researchers should be aware of the different variability and consistency of measurements with each technique over time.

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ABSTRACT.Purpose: Age-related macular degeneration (AMD) is the most common cause of severe visual impairment, including loss of reading ability, among elderly persons in developed countries. The aim of the present study was to evaluate reading ability before and after providing of appropriate low vision aids. Methods: Five hundred and thirty patients with different stages of AMD (age 82 ± 8 years) were included in this retrospective study. All patients underwent a standardized ophthalmological examination including evaluation of magnification requirement and careful providing of low vision aids. Before and after the provision of low vision aids, reading speed [words per minute (wpm)] was evaluated using standardized reading texts. Results: For the whole group, the average best-corrected distance visual acuity of the better eye was 0.18 ± 0.15, with 69% of patients having visual acuity of 0.1 (20 ⁄ 200) or better. The mean magnification requirement was 7.4 ± 6.3-fold (range 2-25). Visual rehabilitation was achieved with optical visual aids in 58% of patients, whereas 42% of patients needed electronically closed-circuit TV systems. Mean reading speed was 20 ± 33 wpm before and increased significantly to 72 ± 35 (p < 0.0001) after the provision of low vision aids for the whole group. Between patients with visual acuity < 0.1 and patients with visual acuity of 0.1 or better, there are highly significant differences in reading speed before (0.4 ± 3.8 versus 20 ± 28 wpm, p £ 0.0001) and after providing of visual aids (40 ± 13 versus 84 ± 30 wpm, p £ 0.0001). Patients with severe visual impairment (visual acuity £ 0.1) showed significantly lower improvement of reading speed compared to patients with visual acuity of 0.1 or better following rehabilitation (p £ 0.0001). Before providing of low vision aids, only 16% of patients were able to read; in contrast, reading ability was achieved in 94% of patients after the provision of low vision aids for the whole group. Conclusion: Our results indicate the great value of low vision rehabilitation through adequate providing of vision aids for the improvement of reading ability, with a highly significant increase of reading speed without training of eccentric viewing in patients with retained central fixation. The prompt implementation of low vision aids in patients with macular degeneration will help them to maintain and regain their reading ability, which can lead to an increase in independence, communication, mental agility and quality of life.

Eyes with pseudoexfoliation syndrome (PEX) frequently show clinical signs of impairment of the blood-aqueous barrier. Herein we give an overview of recent studies that analyzed the blood-aqueous barrier in eyes with PEX. Methods: The authors review and summarize recent studies including quantification of aqueous flare in eyes with PEX using the laser flare cell meter (LFCM; Kowa FC-1000) in comparison with normal eyes and eyes with primary open-angle glaucoma (POAG), quantification of aqueous flare in eyes with PEX with and without secondary open-angle glaucoma (SOAG), and quantitative biochemical determination of total aqueous protein concentration in PEX eyes. In addition, studies of noninvasive quantification of the blood-aqueous barrier breakdown following trabeculectomy and following phacoemulsification with intraocular lens implantation in eyes with and without PEX are reviewed. Results: In eyes with manifest PEX, both aqueous flare and aqueous protein concentration were significantly increased in comparison with normal control eyes and eyes with POAG. Flare values in PEX eyes with SOAG were not significantly different from flare values in PEX eyes without SOAG. Following trabeculectomy as well as following cataract surgery, breakdown of the blood-aqueous barrier as determined by quantification of aqueous flare was significantly higher in eyes with PEX than in eyes without PEX. Conclusions: Impairment of the blood-aqueous barrier with increase in aqueous protein concentration is a feature of PEX and may be quantified both by flare measurement and by biochemical protein determination. The extensive blood-aqueous barrier breakdown in eyes with PEX following intraocular surgery is an important risk factor for early or late postoperative complications. The alterations of the blood-aqueous barrier should be considered in the medical and surgical treatment of eyes with PEX.