Letteratura scientifica selezionata sul tema "Intraocular lens industry"

Adjustable intraocular lenses (IOLs) are uniquely poised to disrupt the refractive IOL arena for both cataract and refractive lens exchange patients. This is because they will not only improve refractive outcomes, but will dramatically enhance the patient experience as well. Patients will be able to postpone confusing decisions about refractive targets and objectives until they can preview them postoperatively. The unique benefit of being able to customize and “choose” their pseudophakic vision after the surgery will be understandable, desirable, and easily explained to family and friends.

Purpose. To compare two calculators for toric intraocular lens (IOL) calculation and to evaluate the prediction of refractive outcome. Methods. Sixty-four eyes of forty-five patients underwent cataract surgery followed by implantation of a toric intraocular lens (Zeiss Torbi 709 M) calculated by a standard industry calculator using front keratometry values. Prediction error, median absolute error, and refractive astigmatism error were evaluated for the standard calculator. The predicted postoperative refraction and toric lens power values were evaluated and compared after postoperative recalculation using the Barrett calculator. Results. We observed a significant undercorrection in the spherical equivalent (0.19 D) by using a standard calculator (p≤0.05). According to the Baylor nomogram and the refractive influence of posterior corneal astigmatism (PCA), undercorrection of the cylinder was lower for patients with WTR astigmatism, because of the tendency of overcorrection. An advantage of less residual postoperative SE, sphere, and cylinder for the Barrett calculator was observed when retrospectively comparing the calculated predicted postoperative refraction between calculators (p≤0.01). Conclusion. Consideration of only corneal front keratometric values for toric lens calculation may lead to postoperative undercorrection of astigmatism. The prediction of postoperative refractive outcome can be improved by using appropriate methods of adjustment in order to take PCA into account.

The purpose of this review is to aggregate technical information on existent optomechanical eye models (OME) described in the literature, for image quality assessment in different applications. Several physical eye models have been reviewed from peer-reviewed papers and patent applications. A typical eye model includes an artificial cornea, an intraocular lens or other lens to simulate the crystalline lens, an aperture as the pupil, and a posterior retinal surface, which may be connected to a light sensor. The interior of the eye model may be filled with a fluid to better emulate physiological conditions. The main focus of this review is the materials and physical characteristics used and the dimensional aspects of the main components including lenses, apertures, chambers, imaging sensors and filling medium. Various devices are described with their applications and technical details, which are systematically tabulated highlighting their main characteristics and applications. The models presented are detailed and discussed individually, and the features of different models are compared when applicable, highlighting strengths and limitations. In the end there is a brief discussion about the potential use of artificial eye models for industrial applications.

Cataract surgery is the commonest ophthalmic surgery worldwide. The replacement of the diseased lens with a synthetic one (intraocular lens—IOL) remains the treatment of choice, despite its potential complications that include infection, inflammation and posterior capsule opacification. The potential for drug delivery via the IOL has been researched extensively over a period of twenty-five years, yet there is very limited progress in transferring the findings from research to everyday practice. The objective of this review is to assess the progress made in the field of IOL lens modifications and drug delivery systems over the past five years. Thirty-six studies that were conducted during the past five years were identified and deemed suitable for inclusion. They were grouped in three broad categories, studies that described new methods for loading a drug onto the IOL, assessment of the effects of drugs that were loaded to the IOL and studies that assessed the effects of non-pharmaceutical modifications of IOLs. While considerable progress is continually being made with regard to methods and materials, there is still little capitalization upon these research studies, with no commercially available IOL-based drug delivery system being available. Close cooperation between researchers in basic sciences (chemistry, physics, materials science and pharmacy), clinical researchers, IOL manufacturers and the pharmaceutical industry is an important prerequisite for further development.

Visual impairment resulting from advanced dry age-related macular degeneration (AMD) limits the ability to perform activities required for independent living and adversely affects quality of life. We aimed to determine changes in these parameters in patients with AMD-related geographic atrophy who underwent magnifying cataract surgery (MAGS) using a foldable, bifocal high-add intraocular lens (IOL). The high-add IOL (LENTIS® MAX LS-313 MF 80, Oculentis) was implanted in the better seeing or dominant eye of eligible patients with clinically significant cataract, best corrected distance visual acuity 1.3–0.5 logMAR (20/400–20/63), best corrected near visual acuity >0.8 logMAR (20/125), and stable advanced dry AMD. Self-reported feasibility of performing routine activities and change in quality of life were the main outcome measures. Eleven of 15 operated patients had complete follow-up to 48 months. There were no significant intraoperative or postoperative complications. AMD converted from dry to wet in 2 patients. All patients reported functional gains in the first 3–6 months after surgery, and 10/11 patients reported improved quality of life. From baseline to 48 months, functional performance remained improved in all patients, and quality of life remained improved in the 9 patients with stable AMD. Best corrected distance visual acuity and uncorrected near visual acuity improved in all cases after surgery. Conclusion: Implantation of the high-add IOL was safe and resulted in durable functional and quality of life benefits. To our knowledge, our report describes the longest prospective follow-up (4 years) of a series of patients undergoing MAGS for rehabilitation of low vision related to advanced AMD. Data are needed from larger cohorts, but our experience supports giving consideration to MAGS in appropriately selected patients with low vision related to advanced dry AMD. We encourage further industry development of this technology and additional clinical research to collect more outcomes data to determine its potential to help patients maintain highly valued autonomy and quality of life.

Cataract is a disease in which the lens becomes cloudy due to aging and causes loss of vision. It is treated with surgery to remove the cloudy lens and insert an artificial lens. There are single vision lenses and multifocal lenses as types of intraocular lenses, which are the treatment materials used at this time. Monofocal lenses have the disadvantage of requiring separate corrective glasses for near vision even after insertion, but they are inexpensive and require medical treatment under the National Health Insurance Act. On the other hand, multifocal lenses have the advantage of correcting both near and far vision, but they are expensive and do not qualify for medical care benefits under the National Health Insurance Act. In this case, while the state determines the price of the salary, the non-insurance price is set by the medical institution, so the medical institution has an incentive to make a profit by arbitrarily setting the cost of treatment for non-insured items. In particular, in the case of non-insured items covered by medical insurance for indemnity insurance, the patient can claim most of the medical expenses from the insurance company as insurance money. There may be cases in which overpayment or overtreatment may occur. In relation to cataract surgery, some eye clinics, mainly in the Gangnam area of Seoul, arbitrarily adjust the cost of examination or multifocal lenses, which are representative non-covered items, according to changes in the health insurance benefit system or medical insurance policy, without reasonable standards. It is confirmed that they are taking advantage of the business by misusing them. For example, in September 2020, when health insurance was applied to the examination fee, it was no longer possible to claim high medical expenses for the examination fee. Excessive indemnity payments are being made in the medical insurance for loss by processing hospitalization and issuing a confirmation of hospitalization, and the damage is being passed on to good medical consumers and insurance organizations. However, in the recent judgment of 2021 na 2013354 of the Seoul High Court on January 20, 2022, the scope of claims for medical insurance for medical loss for insured persons who underwent cataract surgery was limited to the amount of out-of-patient insurance, not hospitalization. Based on the Supreme Court’s general definition, it was emphasized that ‘the substance of hospitalization’ should be provided in addition to the standards of the Ministry of Health and Welfare notification. He also pointed out that the fact that the comprehensive fee-for-service system is applied in cataract surgery is completely different from judging whether or not the patients were actually ‘hospitalized’. As such, it can be said that the above judgment on the criteria for ‘hospitalization’ for cataract surgery is not limited to the clinic in this case, but is also applied to general ophthalmology clinics performing cataract surgery. Although there is regret in the interpretation of the terms and conditions related to the exemption, I hope that the judgment of the subject judgment regarding hospitalization will be an opportunity to suppress unnecessary and reckless cataract surgery. It seems to be a very desirable direction for government ministries, financial supervisory authorities, and the industry to take an interest in the recent cataract surgery and other problems of the surge in medical expenses and to make various efforts and attempts. As a member of society, the court also expects effective and rational judgments that can effectively suppress turmoil in the medical market and protect the rights and interests of good medical care and insurance consumers.

Background Age-related macular degeneration (AMD) is the leading cause of visual loss in older people. Advanced AMD takes two forms, neovascular (wet) and atrophic (dry). Stargardt disease (STGD) is the commonest form of inherited macular dystrophy. Objective To carry out a systematic review of treatments for dry AMD and STGD, and to identify emerging treatments where future NIHR research might be commissioned. Design Systematic review. Methods We searched MEDLINE, EMBASE, Web of Science and The Cochrane Library from 2005 to 13 July 2017 for reviews, journal articles and meeting abstracts. We looked for studies of interventions that aim to preserve or restore vision in people with dry AMD or STGD. The most important outcomes are those that matter to patients: visual acuity (VA), contrast sensitivity, reading speed, ability to drive, adverse effects of treatment, quality of life, progression of disease and patient preference. However, visual loss is a late event and intermediate predictors of future decline were accepted if there was good evidence that they are strong predictors of subsequent visual outcomes. These include changes detectable by investigation, but not necessarily noticed by people with AMD or STGD. ClinicalTrials.gov, the World Health Organization search portal and the UK Clinical Trials gateway were searched for ongoing and recently completed clinical trials. Results The titles and abstracts of 7948 articles were screened for inclusion. The full text of 398 articles were obtained for further screening and checking of references and 112 articles were included in the final report. Overall, there were disappointingly few good-quality studies (including of sufficient size and duration) reporting useful outcomes, particularly in STGD. However we did identify a number of promising research topics, including drug treatments, stem cells, new forms of laser treatment, and implantable intraocular lens telescopes. In many cases, research is already under way, funded by industry or governments. Limitations In AMD, the main limitation came from the poor quality of much of the evidence. Many studies used VA as their main outcome despite not having sufficient duration to observe changes. The evidence on treatments for STGD is sparse. Most studies tested interventions with no comparison group, were far too short term, and the quality of some studies was poor. Future work We think that the topics on which the Health Technology Assessment (HTA) and Efficacy Mechanism and Evaluation (EME) programmes might consider commissioning primary research are in STGD, a HTA trial of fenretinide (ReVision Therapeutics, San Diego, CA, USA), a visual cycle inhibitor, and EME research into the value of lutein and zeaxanthin supplements, using short-term measures of retinal function. In AMD, we suggest trials of fenretinide and of a potent statin. There is epidemiological evidence from the USA that the drug, levodopa, used for treating Parkinson’s disease, may reduce the incidence of AMD. We suggest that similar research should be carried out using the large general practice databases in the UK. Ideally, future research should be at earlier stages in both diseases, before vision is impaired, using sensitive measures of macular function. This may require early detection of AMD by screening. Study registration This study is registered as PROSPERO CRD42016038708. Funding The National Institute for Health Research HTA programme.