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The aspherical diffractive Tecnis multifocal IOL gave better outcomes than the Array multifocal IOL.

The EPCO PCO grade was low 1 year after implantation of CeeOn Edge 911A, PhacoFlex SI-40NB, and AcrySof MA60BM IOLs; there was no statistically significant difference between the IOLs. The impact of IOL material and edge design on PCO development might be relevant in a long-term follow-up of this study.

The melanin pigmentation of 18 subjects was investigated in vivo by measuring light (λ = 675 nm) reflected from an area of 7° × 7° of the fundus incorporating the macula. The mean value for 16 Caucasian fundi was 0.79 ( ± 0.17) extinction units (E). The value for an albino (E = 0.06) and a Negro fundus (E = 1.36) lay well outside the range of Caucasian values. The in vivo results are in good agreement with measurements made on enucleated eyes

We did a follow-up study of 35 patients who had phacoemulsification with implantation of diffractive, multifocal intraocular lenses (IOLs) 2.5 years ago. The patients had an average age of 58.2 +/- 9.6 years. Fifty multifocal IOLs were implanted (3M 815LE, n = 45; 3M 825X, n = 5). Refractive values, visual acuity, depth of focus, and the dependence on corrective glasses were evaluated. Eighty percent of the spherical equivalents ranged from -1 to +1 D (mean 0.25 +/- 0.71). In 76% the cylindric power was not higher than 1 D (mean 0.87 +/- 0.64). With distance correction, 100% of the patients achieved a visual acuity of 20/40 or better. Without correction, 86% achieved 20/40 or better. Near acuity of 20/40 or better with only distance correction was achieved in 98% of patients. Ninety-four percent had a near acuity of 20/40 or better without any correction. The depth of focus was significantly better in the multifocal group than in a control group of patients with monofocal IOLs (P < .01). Although 90% of the patients had good uncorrected visual acuity results of 20/40 or better for near and distance, 58% preferred glasses for distance and/or near.

A new scheme for refractive measurements under atropine cycloplegia was tested in 90 strabismic children aged two to several years. Refraction was determined by an autorefractor (CANON R 10) 90 minutes after application of two drops of atropine (0.5% atropine children < 2 1/2 years; 1.0% atropine children > 2 1/2 years) and compared with the results after 3 days of receiving 1 atropine eyedrop 3 times daily. In 86.5% the spherical equivalents differ not more than 1.0 diopter (p = 0.05); the correlation was 0.99. Astigmatic corrections were in agreement in 95.5%, the axis of cylinders in 93.0% (p = 0.05); the correlations were 0.95 and 0.97. The residual accommodation 90 minutes after 2 drops of atropine was not more than 1 diopter in all children. The additional cycloplegic effect of the three-day-atropinization was only 0.5 diopters. This new type of application allows a more rapid and less toxic assessment of refraction than the usual three-day-atropinization.

Corneal changes are typical for infantile glaucoma. In newborns, Descemet's membrane and the stroma are still soft, and distend when intraocular pressure rises. Cell counts were performed under the reflecting microscope to determine whether the endothelium is affected when corneal diameter increases and changes occur in Descemet's membrane. The mean endothelial cell density of 20 patients with congenital or secondary juvenile glaucoma, aged between 4 and 29 years, was found to be 2780/mm2. Even though increased corneal diameter was the most common primary symptom of buphthalmos, there were no relationships between corneal diameter on the one hand and postoperative endothelial cell density, visual outcome, or postoperative pressure on the other. In children who had had corneal edema followed by ruptures of Descemet's membrane the number of endothelial cells was significantly reduced, visual outcome was worse, and there were more problems with regulation of intraocular pressure. Lower-than-average endothelial cell densities were also found in some patients with secondary glaucoma.

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