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Bhogal, Gurpreet
Languages: English
Types: Doctoral thesis
Subjects:

Classified by OpenAIRE into

mesheuropmc: eye diseases, genetic structures, sense organs
Premium intraocular lenses (IOLs) aim to surgically correct astigmatism and presbyopia following cataract extraction, optimising vision and eliminating the need for cataract surgery in later years. It is usual to fully correct astigmatism and to provide visual correction for distance and near when prescribing spectacles and contact lenses, however for correction with the lens implanted during cataract surgery, patients are required to purchase the premium IOLs and pay surgery fees outside the National Health Service in the UK. The benefit of using toric IOLs was thus demonstrated, both in standard visual tests and real-world situations. Orientation of toric IOLs during implantation is critical and the benefit of using conjunctival blood vessels for alignment was shown. The issue of centration of IOLs relative to the pupil was also investigated, showing changes with the amount of dilation and repeat dilation evaluation, which must be considered during surgery to optimize the visual performance of premium IOLs. Presbyopia is a global issue, of growing importance as life expectancy increases, with no real long-term cure. Despite enhanced lifestyles, changes in diet and improved medical care, presbyopia still presents in modern life as a significant visual impairment. The onset of presbyopia was found to vary with risk factors including alcohol consumption, smoking, UV exposure and even weight as well as age. A new technique to make measurement of accommodation more objective and robust was explored, although needs for further design modifications were identified. Due to dysphotopsia and lack of intermediate vision through most multifocal IOL designs, the development of a trifocal IOL was shown to minimize these aspects. The current thesis, therefore, emphasises the challenges of premium IOL surgery and need for refinement for optimum visual outcome in addition to outlining how premium IOLs may provide long-term and successful correction of astigmatism and presbyopia.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1.8.2.3. Curvature Change IOLs………………………………………….. 59
    • 1.8.3. Toric IOLs………………………………………………………..... 61
    • 1.8.4. Blue-Light Filtering IOLs………………………………………..... 65
    • 1.8.5. Light-Adjustable Lens (LALs)……………………………………. 69
    • 1.8.6. Phakic IOLs………………………………………………………... 71 1.9. Conclusion…………………………………………………………………...... 73 4.2. Methods……………………………………………………………………...... 135 4.3. Statistical Analysis......…………………………………………………......... 138 5.1. Introduction………………………………………………………................... 148 5.2. Methods............……………………………………………………………..... 154 5.3. Statistical Analysis.................................................................................... 157 CHAPTER 6: Validity and Repeatability of a Digital
    • Accommodometer…............................................................... 199 6.1. Introduction…………………………………………………………………..... 200 6.3. Statistical Analysis………………......……………………………………...... 214 6.4. Results....................………………………………………………………...... 215 7.1. Introduction.......………………………………………………………............ 235 7.2. Methods............……………………………………………………………..... 243
    • 7.2.1. Intraocular Lens Characteristics……………………………....... 243
    • 7.2.2. Experimental Design................................................................ 246 7.3. Statistical Analysis……………………………………………………………. 251 8.1. Introduction…………………………………………………………………..... 264 8.2. Summary..…………………………………………………………………...... 266 8.3. Conclusion………………......…………………………………………........... 276 Table 1.1 Categories of aetiological classification of
    • cataracts………………................................................................. 32 Table 2.1 Trial lens combinations used to simulate uncorrected
    • astigmatism……................................................................................... 84 Table 5.1 Average amplitude of accommodation (dioptres, D) measured
    • presbyopes………………............................................................. 171 Crystalline lens……………………………………………………. 18 Internal view of crystalline lens…………………........................ 21 Cortical Cataract…………………………………………………... 34 Nuclear Cataract…………………………………………….......... 35 Posterior Subcapsular Cataract………………………………..... 36 Diagram of IOL.......……………………………………………….. 41 Fully diffractive multifocal optic …………………………………. 48 Refractive multifocal optic......................................................... 49 Single-Optic accommodating IOL mechanism……………….... 56 Synchrony dual-optic accommodating IOL…………………….. 58 NuLens accommodating IOL……………………………………. 60 Toric IOL................................................................................... 62 Blue-Filtering IOL...................................................................... 67 Mechanism of adjusting power of LAL………………………….. 70 Phakic IOL................................................................................ 72 Foci with corneal astigmatism................................................... 76 Cquant straylight meter…………………………………………... 81 Driving Simulator ……......…………………………………......... 82 Web page used for subjective rating of clarity........................................................................................ 82 Distance visual acuity with uncorrected astigmatism power and axis …................................................................................ 88
    • 11 Figure 2.6 Figure 2.7 Figure 2.8 Figure 2.9 Figure 2.10 Figure 3.1 Figure 3.2 Figure 3.4 Figure 3.5 Figure 3.6 Figure 3.7 Figure 4.1 Figure 4.2 Figure 4.3 Figure 5.1 Figure 3.3.A
    • p o 4 t a ed ce h
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