Papers by Thomas Neumayer
American Journal of Ophthalmology, 2015
ABSTRACT Background: Kimura disease (KD) is a rare chronic inflammatory disorder characterized by... more ABSTRACT Background: Kimura disease (KD) is a rare chronic inflammatory disorder characterized by angiolymphatic proliferation and eosinophilic infiltration. This condition, which predominantly affects young men of Asian origin, is of unknown etiology. Purpose: To report a case of orbital KD in a non-Asian child. Design: Interventional case report. Case: A 12-year-old Caucasian boy presented with a painless mass in his right upper eyelid, accompanied by ptosis, progressive exopthalmos, reduced eye motility, sicca symptoms, diminished visual acuity, and transient photopsia in the right eye. CT and MRI scans of the right orbit revealed diffuse swelling of the upper eyelid with a distinct nodular mass, enlargement of the lacrimal gland, as well as enlargement of the medial, superior, and lateral recti, and superior oblique muscles, causing proptosis and segmental optic nerve compression along the optic nerve canal. Investigations and Management: Excisional biopsy from the skin lesions along with markedly elevated serum IgE levels and eosinophilia confirmed the diagnosis of KD. Periorbital triamcinolone acetonide and iv methylprednisolone pulse therapy were initiated. There was a prompt clinical improvement and no complications were encountered. Conclusion: To our knowledge, this is the first non-Asian case of pediatric orbital KD presenting with impending compressive optic neuropathy. Abstract book. p 13
Spektrum der Augenheilkunde
Summary OBJECTIVE: Topical anaesthesia has been proven to be safe and effective in controlling p... more Summary OBJECTIVE: Topical anaesthesia has been proven to be safe and effective in controlling pain during routine cataract surgery. However, pain sensations cannot be completely excluded during certain steps of the procedure. The aim of this study was to evaluate the effect of unpreserved lidocaine 1% administered during hydrodissection on intraoperative pain levels. Possible local toxic effects on the corneal endothelium
Background: Kimura disease (KD) is a rare chronic inflammatory disorder characterized by angiolym... more Background: Kimura disease (KD) is a rare chronic inflammatory disorder characterized by angiolymphatic proliferation and eosinophilic infiltration. This condition, which predominantly affects young men of Asian origin, is of unknown etiology. Purpose: To report a case of orbital KD in a non-Asian child. Design: Interventional case report. Case: A 12-year-old Caucasian boy presented with a painless mass in his right upper eyelid, accompanied by ptosis, progressive exopthalmos, reduced eye motility, sicca symptoms, diminished visual acuity, and transient photopsia in the right eye. CT and MRI scans of the right orbit revealed diffuse swelling of the upper eyelid with a distinct nodular mass, enlargement of the lacrimal gland, as well as enlargement of the medial, superior, and lateral recti, and superior oblique muscles, causing proptosis and segmental optic nerve compression along the optic nerve canal. Investigations and Management: Excisional biopsy from the skin lesions along wit...
Purpose: To assess the demographics, risk factors, clinical features and treatment options for pe... more Purpose: To assess the demographics, risk factors, clinical features and treatment options for pediatric Graves orbitopathy (GO) in our tertiary referral centre. Design: Retrospective case series. Methods: In our retrospective case series we analyzed the charts of all pediatric and adolescent patients (aged 18 years and younger) who presented at our GO clinic between January 2008 and December 2013. Results: 48 patients (96 eyes) were identified; 36 females (75.0%) and 12 males (25.0%). Ethnicity: 40 (83.0 %) were Caucasian, 4 (8.0%) were Asian, 3 (6.0%) were African and 1 (2.0%) was of Arabic descent. Mean age at presentation was 12.0 years (range 2.2-18.1). Positive family history was recorded in 8 (17.0 %) cases. Smoking: 16 (33.0 %) were active and 8 (17%) passive smokers. Additional autoimmune disorder was present in 3 patients (6.0%). Mild disease was observed in 49.0%, moderate in 40.0% and 11.0% developed severe pediatric GO. The most frequent ophthalmic symptom was exophthal...
Ophthalmic research, 2012
To observe changes in posterior capsule opacification (PCO) after Nd:YAG treatment with and witho... more To observe changes in posterior capsule opacification (PCO) after Nd:YAG treatment with and without opening the posterior lens capsule. This prospective randomized study included patients with regeneratory PCO. In substudy 1, a small low-energy Nd:YAG capsulotomy was performed (MiniYAG). In substudy 2, a low-energy Nd:YAG laser treatment without opening the lens capsule was performed (GentleYAG). Concerning analysis, in both substudies, the posterior capsule was divided into 4 quadrants and the quadrant where the Nd:YAG laser treatment was performed was randomly allocated. Change in PCO was analyzed using retroillumination images objectively (AQUA score: 0-10). In total, 27 eyes of 25 patients were used for this study. In substudy 1, the mean amount of PCO (AQUA score) for the entire posterior capsule decreased significantly (p < 0.05, ANOVA) from 5.2 (SD: 1.6) before to 4.0 (SD: 1.9) immediately after the MiniYAG. In substudy 2, the mean amount of PCO (AQUA score) for the entire...
Ophthalmology, 2007
To compare the intensity of posterior capsule opacification (PCO) between the 1-piece and 3-piece... more To compare the intensity of posterior capsule opacification (PCO) between the 1-piece and 3-piece haptic designs of the foldable hydrophobic acrylic AcrySof intraocular lens (IOL) over a 5-year period. Randomized, prospective, patient- and examiner-masked clinical trial with intraindividual comparison. Fifty-two patients with bilateral age-related cataract (104 eyes). Each study patient had cataract surgery in both eyes and received a 1-piece AcrySof IOL in 1 eye and a 3-piece AcrySof IOL in the other eye. Follow-up examinations were performed at 1 week, 1 month, 6 months, and 1, 2, and 5 years. Digital retroillumination images were obtained of each eye. The amount of posterior capsule opacification (score range, 0-10) was assessed subjectively at the slit lamp and objectively using automated image analysis software 1, 2, and 5 years after surgery. Posterior capsule opacification score (scale, 0-10). There was no significant difference between the 1-piece and 3-piece AcrySof IOL in ...
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie, 2015
The objective of this study was to evaluate the correlation between twin-twin transfusion syndrom... more The objective of this study was to evaluate the correlation between twin-twin transfusion syndrome (TTTS) and the development of retinopathy of prematurity (ROP) in premature infants. Fifty-one infants who were less than 32 postmenstrual gestational weeks at birth or with a birth weight less than 1,501grams were included in this longitudinal observational study. The infants were matched by gestational age and birth weight, and divided into three groups: multiples with TTTS, multiples without TTTS, and singletons. The primary outcome variable was the incidence of ROP in infants affected by TTTS versus infants not affected by TTTS. Secondary outcome variables were multiple pregnancy, gestational age, and birth weight. Infants affected by TTTS showed a significantly higher incidence of ROP than infants not affected by TTTS (p < 0.01). TTTS donors and TTTS recipients were both at greater risk of developing ROP. ROP occurred in infants with TTTS whose gestational age at birth was sign...
Klinische Monatsblätter für Augenheilkunde, 2008
Journal of Cataract & Refractive Surgery, 2012
To assess intraocular lens (IOL) shift along the visual axis induced by ciliary muscle contractio... more To assess intraocular lens (IOL) shift along the visual axis induced by ciliary muscle contraction with pilocarpine after cataract surgery and to compare primary posterior continuous curvilinear capsulorrhexis (CCC) and posterior optic buttonholing with IOLs implanted in the bag. Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. Clinical trial. Eyes with age-related cataract had cataract surgery with implantation of a nonaccommodating IOL (AF-1 YA-60BB). Surgery was performed with primary posterior CCC and posterior buttonholing in 1 eye (study eyes) and with conventional in-the-bag implantation in the contralateral eye (control eyes). After a minimum of 6 months postoperatively, the anterior chamber depth was assessed with partial coherence interferometry before and after application of pilocarpine 2.0% and, after a washout interval of 1 week, before and after the application of cyclopentolate 1.0%. Forty eyes of 20 patients were enrolled. A slight backward shift of the IOL (+78 μm) in study eyes and in control eyes (+118 μm) was detected after pilocarpine application (both P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.05). No significant difference in IOL shift was found between study eyes and control eyes (P=.19). Combined primary posterior CCC and posterior optic buttonholing did not affect IOL shift during pharmacologically stimulated ciliary muscle contraction compared with in-the-bag implanted IOLs. Capsule fibrosis diminished with primary posterior CCC but did not seem to be the only limiting factor in the accommodative IOL shift. No author has a financial or proprietary interest in any material or method mentioned.
Journal of Cataract & Refractive Surgery, 2005
To observe and document posterior capsule opacification (PCO) growth in vivo over a short period ... more To observe and document posterior capsule opacification (PCO) growth in vivo over a short period of time (4 weeks). Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. Fifteen eyes of pseudophakic patients with PCO of varying degrees were included in this prospective study. Digital retroillumination images were taken in a standardized fashion at 3 time points: 1 baseline image, a second image after 2 weeks, and a third image after 4 weeks. Thus, a 3-image series could be created for each eye. Additionally, sections of the posterior capsule with interesting structures were photographed with higher magnification and compared in supplementary image series. Morphologic changes in the PCO structure (eg, number and size of Elschnig pearls, total PCO area) were analyzed in the image series. In all cases, significant changes could be observed between the 3 time points. In 71% of cases, some Elschnig pearls increased in size during the first 2 weeks and during weeks 3 and 4. In 73% of cases, however, there was a reduction a pearl size or even disappearance of some Elschnig pearls. The total PCO area did not change significantly during the 4-week period. Development of (regeneratory) PCO is a very dynamic process that includes not only growth of preexisting structures and occurrence of new Elschnig pearls, but also reorganization and even disappearance of pearls within a short time period (2-4 weeks). The latter in particular is not well known but could be observed in the majority of cases in this study.
Journal of Cataract & Refractive Surgery, 2006
To compare preoperative and postoperative measurements of the axial length (AL) performed with th... more To compare preoperative and postoperative measurements of the axial length (AL) performed with the IOLMaster (Carl Zeiss Meditec) to evaluate the effect of nuclear cataract on the optical biometry. Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. In 245 consecutive eyes of 162 patients scheduled for cataract surgery, type and severity of cataract was evaluated using the Lens Opacities Classification System III. Preoperative and postoperative axial length measurements were performed with the IOLMaster. The postoperative readings of AL were corrected for the IOL optic material implanted. The preoperative AL measurements were 0.07 mm +/- 0.05 (SD) (range -0.18 to 0.11 mm) longer than the postoperative measurements (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). These differences in AL were only weakly correlated (r = -0.28, P = .01) with the nuclear cataract grade, mean 3.5 +/- 0.9. In this study, AL measurements with optical biometry using the IOLMaster were not influenced by the severity of nuclear cataract to a clinically relevant degree. Furthermore, it was found that AL in the phakic eye was overestimated by about 0.07 mm because of a slightly too low value of the group refractive index used for the crystalline lens.
Journal of Cataract & Refractive Surgery, 2008
To compare axial position changes of the intraocular lens (IOL) by measuring anterior chamber dep... more To compare axial position changes of the intraocular lens (IOL) by measuring anterior chamber depth (ACD) after small-incision cataract surgery with primary posterior continuous curvilinear capsulorhexis (PPCCC) and posterior optic buttonholing (POBH) of the IOL and after conventional cataract surgery with phacoemulsification and in-the-bag IOL implantation. Department of Ophthalmology, Medical University of Vienna, Austria. This prospective comparative study comprised 23 patients (46 eyes) with age-related cataract who had bilateral cataract surgery and implantation of an acrylic IOL (YA-60BB, Hoya). In randomized order, cataract surgery with PPCCC and POBH of the IOL was performed in 1 eye of each patient. In the fellow eyes, conventional phacoemulsification cataract surgery with in-the-bag IOL implantation was performed. The ACD was measured 1 to 2, 6, and 24 hours as well as 7 and 30 days postoperatively using high-resolution partial coherence laser interferometry. A baseline measurement was taken preoperatively in all patients. Ten patients completed 10 to 12 months of follow-up. Postoperatively, the axial IOL position was stable in eyes with PPCCC-POBH (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;.05). In contrast, a significant axial shift of the IOL in the anterior direction was observed in control eyes with in-the-bag IOL implantation (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). The resulting refractive shift was significantly higher in control eyes than in eyes with PPCCC-POBH (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). Combined PPCCC and POBH for cataract surgery significantly reduced postoperative anterior movement of the IOL.
Journal of Cataract & Refractive Surgery, 2008
To compare the corneal protective and intraocular pressure (IOP) effects of a new cohesive ophtha... more To compare the corneal protective and intraocular pressure (IOP) effects of a new cohesive ophthalmic viscosurgical (OVD), Neocrom Cohesive (sodium hyaluronate 1.4%), with those of Healon (sodium hyaluronate 1.0%) in cataract surgery. Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. This randomized patient-masked examiner-masked study with fellow-eye comparison comprised 29 cataract surgery patients. Surgery was performed with Neocrom Cohesive in 1 eye and Healon in the other eye. Central corneal thickness (CCT) was measured preoperatively and 1 day and 3 months postoperatively; endothelial cell density (ECD), preoperatively and 3 months postoperatively; and IOP, preoperatively and 6 hours and 1 day postoperatively. The mean CCT change from preoperatively to postoperatively in the Neocrom Cohesive, respectively, group and Healon group was +16.0 microm +/- 25.7 (SD) (P&amp;amp;amp;amp;lt;.01) and +7.0 +/- 17.1 microm (P&amp;amp;amp;amp;lt;.05), respectively, at 1 day and -5.7 +/- 10.8 microm (P&amp;amp;amp;amp;lt;.01) and -4.7 microm +/- 9.5 microm) (P&amp;amp;amp;amp;lt;.01), respectively, at 3 months. The mean ECD change at 3 months was 8 +/- 155 cells/mm(2) in the Neocrom Cohesive group (P = .8) and -46 +/- 139 cells/mm(2) in the Healon group (P = .08). The mean IOP increase was +2.2 +/- 3.5 mm Hg (P&amp;amp;amp;amp;lt;.01) and +1.4 +/- 4.2 mm Hg (P = .14), respectively, 6 hours postoperatively and +0.9 +/- 4.3 mm Hg (P = .37) and 0.0 +/- 3.5 mm Hg (P = .77), respectively, at 1 day. There was no significant difference between Neocrom Cohesive and Healon in the changes in CCT, ECD, and IOP after cataract surgery.
Journal of Cataract & Refractive Surgery, 2008
To evaluate the effect of posterior capsule opacification (PCO) on macular sensitivity. Departmen... more To evaluate the effect of posterior capsule opacification (PCO) on macular sensitivity. Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. Macular sensitivity, best corrected visual acuity (BCVA), and PCO intensity were evaluated before and after neodymium:YAG (Nd:YAG) laser capsulotomy in pseudophakic eyes with clinically significant PCO that had a healthy macula or dry age-related macular degeneration (ARMD). Macular sensitivity was determined using the fundus-related Microperimeter 1 (Nidek) in a central field of 10 degrees. The intensity of the PCO was assessed objectively in the central 3.0 mm area (score 0 to 10) using quantification software. After Nd:YAG capsulotomy, both groups had a significant improvement in BCVA and mean macular sensitivity; the change in the mean logMAR value was -0.26 in the healthy macula group and -0.23 in the dry ARMD group and the change in mean macular sensitivity, 2.5 dB and 2.0 dB, respectively. Before Nd:YAG capsulotomy, significant correlations were observed between PCO values, BCVA, and macular sensitivity in the healthy macula group only (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.01). Neodymium:YAG laser capsulotomy improved BCVA and macular sensitivity. The PCO scores correlated well with the PCO-induced decrease in BCVA and with PCO-induced loss of macular sensitivity. Functional macular mapping indicated an overall loss of macular sensitivity in patients with dry ARMD. There was no significant association between PCO values and macular sensitivity in eyes with dry ARMD.
Journal of Cataract & Refractive Surgery, 2005
To classify the morphologic appearance of posterior capsule opacification (PCO) and to observe an... more To classify the morphologic appearance of posterior capsule opacification (PCO) and to observe and document the changes over longer periods of time. Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. Eighty-one pseudophakic eyes of 53 patients with PCO of varying degrees were included in this prospective study. Digital retroillumination images of the posterior capsule were taken in a standardized fashion 1, 2, and 3 years after cataract surgery. The PCO morphology was classified, and changes among the 3 follow-up images were analyzed. At 1, 2, and 3 years, pearls occurred in 16 (20%), 41 (51%), and 57 (63%) eyes. Pearls increased in size and number. Cases with thin layers of PCO decreased from 53 to 33 to 16 eyes. Conversely, cases with thick layers increased from 18 to 45 and 64 eyes. &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Cheese holes&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; appeared most frequently as the predominant structure (range 47% to 51%), followed by plates (range 28% to 31%), islands (range 15% to 20%), and traces of PCO (range 1% to 5%). Changes in expansion of the PCO area were observed in 61 eyes (75%) during period 1 (1 to 2 years) and period 2 (2 to 3 years). Regions of expansion and regression in the same eye occurred in periods 1 and 2 in 11 eyes (14%) and 9 eyes (11%), respectively. The phenomenon of thinning bridges, a regression of syncytial extensions of PCO, occurred in 22 eyes (27%) and 32 eyes (40%), respectively. An overlapping growth of 2 layers was observed in 18 eyes (22%). The morphology of PCO is multifaceted. Apart from the Elschnig pearls, categories such as cheese holes, plates, islands, and traces of PCO were distinguished. Over the years, pearls increased in frequency, size, and number. Expansion and regression occurred simultaneously in some cases. Two or more layers grew on top of each other in some eyes.
Journal of Cataract & Refractive Surgery, 2011
To compare the rotational stability and posterior capsule opacification (PCO) rate in eyes with a... more To compare the rotational stability and posterior capsule opacification (PCO) rate in eyes with a 1-piece or 3-piece acrylic intraocular lens (IOL). Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. Prospective randomized masked clinical trial. Patients with age-related cataract received a plate-haptic acrylic IOL (Acri.Smart 46S) in 1 eye and a 3-piece loop-haptic acrylic IOL (Acri.Lyc 53N) in the other eye. Retroillumination images were taken 1 hour, 1 week, and 1, 6, and 12 months postoperatively. Intraocular lens rotation was measured using standard software (Adobe Photoshop). The amount of PCO was assessed subjectively at the slitlamp and objectively using an automated image-analysis software (AQUA). The study enrolled 80 eyes of 40 patients. The IOL rotation measurements showed excellent reproducibility, with a deviation of less than 0.8 degrees. Both IOLs had comparable and good rotational stability; rotation was less than 4 degrees in 71% of eyes 1 year postoperatively. The mean absolute rotation was 2.6 degrees ± 1.9 (SD) in the plate-haptic IOL group and 3.1 ± 2.4 degrees in the loop-haptic IOL group. The mean AQUA PCO score (scale 0 to 10) was 0.4 in both IOL groups (P = .7). The 2 IOL models had comparable, excellent rotational stability and low PCO intensity 1 year postoperatively. Thus, the plate-haptic IOL may be a good platform for a toric model.
Investigative Ophthalmology & Visual Science, 2010
To observe and analyze the daily and weekly changes in morphology and size of Elschnig pearls in ... more To observe and analyze the daily and weekly changes in morphology and size of Elschnig pearls in eyes with after-cataract. Pseudophakic eyes with pronounced regeneratory posterior capsule opacification (PCO) were included in this prospective study. High-resolution retroillumination images were taken, and the changes in size and shape of Elschnig pearls were analyzed at baseline and at 2, 7, and 14 days later using dedicated imaging software. In total, 6309 Elschnig pearls in 85 eyes of 77 patients were analyzed. On average, four pearls were found per square millimeter (range, 0.2-9.7/mm(2); CV, 49.5%) with a mean cumulative area of 0.66 mm(2) (range, 0.03-2.18 mm(2); CV, 66.7%) of all marked pearls per eye and follow-up, which was 3.8% of the analyzed area. The mean pearl size was 9630 microm(2) (range, 2390-33,745 microm(2); CV, 61.0%) at baseline, which corresponded to a diameter of 174 microm. The mean change of a pearl per day was 583 microm(2) (range, 175-1631 microm(2); CV, 55.4%) or a 6% change in area. In total, 36% (CV, 5.5%) of all pearls increased in size, 7% (CV, 8.6%) did not change, and 35% (CV, 6.7%) decreased in size during 1 week. Furthermore, 11% (CV, 6,3%) of all pearls newly appeared, and the same number disappeared (CV, 5.7%) within 1 week. Elschnig pearls disappear and appear within days. The degree of progression and regression varies greatly between eyes. Knowledge about Elschnig pearl turnover may be of importance for attempts to modulate lens epithelial regeneration or lens regrowth and for lens-refilling procedures.
British Journal of Ophthalmology, 2007
Aim: Combining primary posterior capsulorhexis (PPC) and posterior optic buttonholing (POBH) in c... more Aim: Combining primary posterior capsulorhexis (PPC) and posterior optic buttonholing (POBH) in cataract surgery is an innovative approach to prevent after-cataract formation effectively and to increase postoperative stability of the intraocular lens (IOL). The present study was designed to compare the postoperative intraocular flare after cataract surgery with combined PPC and POBH to conventional in-thebag implantation of the IOL. Methods: Fifty consecutive age-related cataract patients with cataract surgery under topical anaesthesia in both eyes were enrolled prospectively into a prospective, randomised clinical trial. In randomised order, cataract surgery with combined PPC and POBH was performed in one eye; in the other eye cataract surgery was performed conventionally with in-the-bag IOL implantation keeping the posterior lens capsule intact. Intraocular flare was measured 1, 2, 4, 6, 12 and 24 h postoperatively, as well as 1 week and 1 month postoperatively, using a KOWA FC-1000 laser flare cell meter. Results: The peak of intraocular flare was observed in POBH eyes and eyes with in-the-bag IOL implantation 1 h postoperatively. In both groups, the response was steadily decreasing thereafter. During measurements at day 1, small though statistically significant higher flare measurements were observed in eyes with in-the-bag IOL implantation (p,0.05). At 1 week and 1 month postoperatively, intraocular flare measurements were comparable again (p.0.05). Conclusion: Cataract surgery with combined PPC/POBH showed slightly lower postoperative anterior chamber reaction compared to conventional in-the-bag implantation during 4-week follow-up, indicating that POBH might trigger somewhat less inflammatory response. This could be explained by the posterior capsule sandwiching between the optic and the anterior capsule, preventing direct contact-mediated myofibroblastic trans-differentiation of anterior lens epithelial cells with consecutive cytokine depletion.
British Journal of Ophthalmology, 2007
To evaluate the influence of hydrophilic and hydrophobic acrylic material and haptic angulation o... more To evaluate the influence of hydrophilic and hydrophobic acrylic material and haptic angulation on anterior capsule opacification (ACO). Prospective study on 53 patients with bilateral age-related cataract. Patients underwent standard cataract surgery by the same surgeon and randomly received a hydrophilic acrylic intraocular lens (IOL) in one eye and a hydrophobic acrylic IOL in the other eye. Forty five of these patients completed the one-year follow-up. The following parameters were assessed: decentration, buttonholing, anterolenticular gap (ALG), ACO, outgrowth and refractive outcome. At the one-year follow-up, ACO was seen in 80% of the hydrophilic and 100% of the hydrophobic IOLs. ACO was more intense in the hydrophobic IOLs (p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Outgrowth was seen in 42% of the hydrophilic and 2% of the hydrophobic IOLs (p = 0.0003). No case of persisting ALG was seen in the hydrophobic IOLs, but in 42% of the hydrophilic IOLs. The refractive outcome was -0.29 (SD 0.56) dioptres for the hydrophilic and 0.003 (SD 0.44) dioptres for the hydrophobic IOLs (p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). These results suggest that there is less ACO in hydrophilic acrylic than in hydrophobic acrylic IOLs. Although material properties might play a role, the angulated haptics of the hydrophilic IOLs exert an additional effect by the persisting ALG and a lack of contact between the IOL and the anterior capsule.
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Papers by Thomas Neumayer