Abstract
The power of an intraocular lens can be calculated before surgery to make the eye emmetropic or ametropic. The physiological mechanism of accommodation however, cannot be restored with an inelastic lens. An increased depth of focus in the implanted eye can be predicted through optical principles alone, if the postoperative ametropia of the implanted eye is a simple myopic astigmatism. This increased depth of focus without accommodation was tested in artificial ametropia and found to be used in nature by the seal. To increase the precision of intraocular lens calculation the average change in corneal power induced at surgery is used to predict the postoperative corneal power. By controlled suture release in the postoperative phase, the amount of induced corneal astigmatism is adjusted to obtain a simple myopic astigmatism. Patients with an intraocular lens and a simple myopic astigmatism as a residual ametropia, are spectacle independent most of the time. They need their glasses only for driving or prolonged reading. The methods used to calculate the postoperative cornea, the post-operative anterior chamber depth and the intraocular lens are described with the corresponding calculator programs for the HP 41C calculator. Clinical results and measurements of the depth of focus are shown in a series of 50 successive implant cases.
Similar content being viewed by others
References
Anonymous (1952) The adjustment of aphakia. Amer J Ophthal 35: 118
Askowitz SI (1956) The circle of least confusion on Sturm's conoid of astigmatism. AMA Arch Ophthal 56: 321–326
Barron GB, Villasenor RA & Weber M (1977) Correction of induced astigmatism after cataract surgery with introduction of an intraocular lens. Ophthal Surg 8 (3): 110–112
Bigar F (1980) Klinische Mikrophotographie des Hornhautendothels. Thesis, Zürich
Binkhorst CD (1972) Power of the prepupillary pseudophakos. Brit J Ophthal 56: 332–337
Binkhorst CD (1973) Dioptrienzahl künstlicher Augenlinsen. Klin Mbl Augenheilk 162: 354–361
Binkhorst CD & Loones LH (1976) Intraocular lens power. Trans Amer Acad Ophthal Otolaryng 81: 70–79
Binkhorst CD, Loones LH & Nygaard P (1977) Biomicroscopical observations on corneal endothelium in pseudophakia. Trans Ophthal Soc UK 97: 67–73
Binkhorst CD, Loones LH & Nygaard P (1977) The clinical specular microscope. Amer Intraocular Implant Soc J 3: 184–192
Binkhorst RD (1976) Pitfalls in the determination of intraocular lens power without ultrasound. Ophthal Surg 7 (3): 69–82
Binkhorst RD (1979) Intraocular lens power calculation. Int Ophthal Clin 19/4: 83–94
Bonavolonta G & de Simone S (1960) Considerazione sull astigmatismo con sezioni principali molto oblique. Ann ottal clin Ocul 86: 391–415
Böke W, Thiel HJ, Hübner H & Lamcke B (1972) Weitere Erfahrungen mit cornealem Schnitt und fortlaufender Naht bei Karatakt-Operation. Ber Dtsch Ophthal Ges 71: 712–716
Bourne WM & Kaufman HE (1976) Endothelial damage associated with intraocular lenses. Amer J Ophthal 81: 482–485
Brown N (1973) Lens changes with age and cataract; slit image photography. In: The human lens in relation to cataract. Ciba Foundation Symposium 19. Amsterdam, Associated Scientific Publishers
Bruun Laursen A & Fledelius H (1979) Variations of lens thickness in relation to biomicroscopic types of human senile cataract. Acta Ophthal 57: 1–13
Burki E (1979) Zur Ermittlung des Dioptrienwertes der Binkhorst-Linse. Klin Mbl Augenheilk 174: 676–682
Campbell FW (1957) The depth of the human eye. Optica Acta (New York) 4: 157–164
Campbell FW & Westheimer G (1958) Sensitivity of the eye to differences in focus. J Physiol (London) 143: 18
Campbell FW (1959) The accommodative response of the human eye. Brit J Physiol Opt 16: 188–203
Campbell FW & Green DG (1965) Optical and retinal factors affecting visual resolution. J Physiol (London) 181: 576–593
Campbell FW & Gubisch RW (1966) Optical quality of the human eye. J Physiol (London) 186: 558–578
Campbell FW, Kulikowski JJ & Levinson J (1966) The effect of orientation on the visual resolution of gratings. J Physiol (London) 187: 427–436
Charmann W & Jennings J (1976) Objective measurements of the longitudinal chromatic aberration of the human eye. Vision Res 16: 999–1005
Chibret (1886) Loi des déformations astigmatiques consécutives à l'opération de la cataracte. CR Soc Franç Ophtal p 66
Clevenger CE (1978) Clinical prediction versus ultrasound measurement of IOL power. Amer Intraocular Implant Soc J 4: 222–224
Coleman DJ, Lizzi FL, Franzen LA & Abramson DH (1975) A determination of the velocity of ultrasound in cataractous lenses. In: Ultrasonography in ophthalmology. Bibl Ophthal 83: 246–251
Colenbrander MC (1973) Calculation of the power of an iris clip lens for distant vision. Brit J Ophthal 57: 735–740
Cramer A (1851) Over den stand der iris. Tijdschrift der Maatschappij voor geneeskunde 11: 99–119
Cravy T (1979) The calculation of the change in corneal astigmatism following cararact surgery. Ophthal Surg 10: 38–49
Chung-Kuo, Liao (1978) Bilateral cataract extraction in one session. A series of 106 additional cases. In: Current concepts in cataract surgery. Selected proceedings of the Vth Biennial Cataract Surgical Congress, ed: JM Emery. St Louis Mosby p. 506–509
Dabezies OH Jr (1979) Defects of vision through aphakic spectacle lenses. Ophthalmology (Rochester) 86: 352–379
Davenport D & Foley BM (1979) Fringe benefits of cataract surgery. Science 204: 454–457
Delmarcelle Y & Luyckx-Bacus J (1971) Biométrie du segment antérieur de la cataracte sénile. Acta Ophthal 49: 454–456
Descartes R (1637) La dioptrique, discours troisième in Descartes oeuvres et lettres. Paris Ed Gallimard nrf p 200–201
Diepes H (1978) Akkomodationserfolg und Abbildungstiefe. DOZ 7: 4–15
Drews RC (1977) Programs for the HP 25C Calculator for lens implant power. Amer Intraocular Implant Soc J 3: 48–49
Drews RC (1977) Refractive error for intraocular lens of known power. Amer Intraocular Implant Soc J 3: 109–110
Drews RC (1977) A practical approach to lens implant power. Amer Intraocular Implant Soc J 3: 170–176
Drews RC (1978) Inflammatory response, endophthalmitis, corneal dystrophy, glaucoma, retinal detachment, dislocation, refractive error, lens removal and enucleation. Ophthalmology (Rochester) 85: 164–175
Duke-Elder S (1958) System of ophthalmology, Vol I: The eye in evolution. London, Kimpton p 336
Duke-Elder S (1961) System of ophthalmology, Vol III: The anatomy of the visual system. London, Kimpton p 311
Epstein I & Geeraets W (1977) On the determination of the power of a lens implant. Amer Intraocular Implant Soc J 3: 87–90
Eberle H (1967) Cone length and chromatic aberration in the eye of Lebistes reticulatus. Z vergl Physiol 57: 172–173
Fyodorov SN, Galin, MA & Linksz A (1975) Calculation of the optical power of intraocular lenses. Invest Ophthal 14: 625–628
Gernet H, Ostholt H & Werner H (1978) Intraokulare Optik in Klinik und Praxis. Rothacker Buchhandlung für Medizin (Berlin, Köln, München). Wien, Urban & Schwarzenberg
Gibson Moore J (1977) Incidence of astigmatism after cataract surgery. Trans Ophthal Soc UK 97: 104–108
Gullstrand A (1890) Beitrag zur Theorie des Astigmatismus. Skand Arch Physiol 2: 269–359
Harrison A (1979) Personal experience of aphakia. Aust J Ophthal 7: 91–93
Heijde van der GL (1976) The optical correction of unilateral aphakia. Trans Amer Acad Ophthal Otolaryng 81: 80–88
Helmholtz H van (1855) Ueber die Accommodation des Auges. Archiv für Ophthalmologie 1: 1–74
Hirst LW, Snip RC, Stark WJ & Maumenee AE (1977) Quantitative corneal endothelial evaluation in intraocular lens implantation and cataract surgery. Amer J Ophthal 84: 755–780
Hoffer KB (1979) Use of ultrasound in intraocular lens calculation in the United States. AIOIS Survey Results. Ophthal Surg 10/9: 57–58
Hubel DH & Wiesel TN (1968) Receptive fields and functional architecture of monkey striate cortex. J Physiol (London) 195: 215–243
Huber Ch (1979) Indikation und Resultate der extrakapsulären Linsenimplantation beim Patientengut von Dr CD Binkhorst im Jahre 1976. Klin Mbl Augenheilk 174: 876–881
Huber Ch & Binkhorst CD (1979) Iseikonic lens implantation in anisometropia. Amer Intraocular Implant Soc J 5: 195–202
Irvine AR, Kratz RP & O'Donnell JJ (1978) Endothelial damage with phacoemulsification and intraocular lens implantation. Arch Ophthal 96: 1023–1026
Jaffe NS & Claymann HM (1974) The pathophysiology of corneal astigmatism after cataract extraction. Trans Amer Acad Ophthal Otolaryng 97: 615–630
Jaffe NS (1976) Postoperative corneal astigmatism. In: Cataract surgery and its complications, 2nd ed, Chap IV. St Louis, Mosby
Jaffe NS (1978) A scan calculation of exact desired intraocular lens. In: Current concepts of cataract surgery. Selected Proceeding of the Vth Biennial Cataract Surgical Congress, ed: JM Emery. St Louis, Mosby
Jansson F & Koch E (1963) Determination of the velocity of ultrasound in the human lens and vitreous. Acta Ophthal 41: 25–61
Johns GE (1979) Clinical evaluation of the DBR A-scan unit. Amer Intraocular Implant Soc J 5: 213–216
Johnson GL (1893) Observation on the refraction and vision of the seal's eye. Proc Zool Soc Lond: 719–723
Kollarits CR, Little J & Kollarits FJ (1978) Calculation of intraocular lens power using the Texas Instrument Ti 59 programmable calculator. J Amer Intraocular Implant Soc J 4: 90–98
Kraff MC, Sanders DR & Liebermann HL (1978) Determination of intraocular lens power, a comparison with and without ultrasound. Ophthal Surg 9: 81–89
Kraff MC, Sanders DR & Liebermann HL (1978) Biometric analysis of intraocular lens power required to produce emmetropia, results of 450 implants. Amer Intraocular Implant Soc J 4: 45–47
Leonard P (1975) Ultrasonography and lens implantation. Ophthalmologica (Basel) 171: 276–277
Loyd T, Montgomery D & Gills JP (1979) Deviation from labeled dioptric power for 400 lenses. Amer Intraocular Implant Soc J 5: 229
Lühl C (1909) Ueber die Häufigkeit des Astigmatismus und seine Beziehung zur Sehschärfe. Inaug Diss, Marburg
Luntz MH & Livingston DG (1977) Astigmatism in cataract surgery. Brit J Ophthal 61: 360–365
Maumenee A & Meredith TA (1974) A survey of 500 cases of cataract extraction. In: Current concepts of cataract surgery. Selected Proceedings of the 3rd Biennial Cataract Surgical Congress, eds JM Emery & D Paton. St Louis, Mosby, p 423–426
Mauthner L (1876) Vorlesungen über die optischen Fehler des Auges. Wien, Ed. Wilhelm Braumüller
Michaels DD (1975) Visual optics and refraction. A clinical approach. St Louis, Mosby, p 66
Mitchell DE, Freeman RD & Westheimer G (1967) Effect of orientation on the modulation sensitivity for interference fringes on the retina. J Opt Soc Amer 57: 246–249
Mügge F (1908) Ueber die Häufigkeit des Astigmatismus und seine Beziehungen zur Sehschärfe. Klin Mbl Augenheilk 46/I: 474–489
Ogle KN (1968) Optics, 2nd ed. Springfield, Illinois, Thomas
Oguchi Y & van Balen AThM (1974) Ultrasonic study of the refraction of patients with pseudophakos. Ultrasound Med Biol 1: 267–273
Pallikaris I & Gruber H (1980) Determination of sound velocity in different forms of cataract. 8 Siduo Meeting, Nijmegen 1980. Ophthalmologica (in press)
Peters HB (1961) The relationship between refractive error and visual acuity at three age levels. Amer J Optom 38/4: 194–198
Phillips LB, Lightholder PA & Hurite FG (1978) Evaluation of 225 consecutive intraocular lens implants. Amer J Optom Physiol Opt 55/1: 36–42
Pouliquen Y, Andrianjafy H & Giraud JP (1978) Astigmatisme et incision cornéenne dans l'opération de la cataracte (déductions statistiques). J Fr Ophtal 1: 597–602
Oksala A & Lehtinen A (1958) Measurement of the velocity of sound in some parts of the eye. Acta Ophthal 36: 633–639
Rähle D (1979) Subjektive Sehstörungen aufgrund von Brillen- oder Kontaktschalenkorrekturen bei linsenextrahierten Kataraktpatienten. Dis. Zürich
Rowan PJ (1978) Corneal astigmatism following cataract surgery. Amer J Ophthal 10: 231–234
Rubin M (1974) Optics for clinicians 2nd ed. Gainesville, Florida, Triad Scientific Publishers
Schley (1905) Ueber Häufigkeit und Sehschärfe des Astigmatismus. Deutsch Militärztliche Zeitschrift 34 (Heft 6): 353–374
Schönebeck W (1912) Ueber operative Behandlung des regelmässigen Astigmatismus. Inaug Diss, Berlin
Schusterman RJ (1972) Visual acuity in pinnipeds. In: Behaviour of marine animals. Vol 2: Vertebrates. Eds: HE Winn & BL Olla. New York-London, Plenum
Söllner F (1972) Vergleich von postoperativen Komplikationen und Astigmatismus bei verschiedenen Starschnittformen. Ber Dtsch Ophthal Ges 71: 717–721
Søren SB (1977) Surgical induction of corneal astigmatism. An experimental study. Graefes Arch Klin Exp Ophthal 201: 213–220
Southall BPC (1933) Mirrors prism and lenses. A textbook of geometric optics. Dover reprint 1964 of the 1933 Edition. London, Constable
Steiger A (1902) Sehschärfe und Astigmatismus. Arch Augenheilk 44: 15–30
Stenström S (1946) Untersuchungen über die Variation und Kovariation der optischen Elemente des menschlichen Auges. Acta Ophthal Suppl 26: 1–103
Stock W (1916) Schiessbrillen und andere optischen Korrektionen. Bericht über die 40. Versammlung der Ophthal Ges, Heidelberg, p 281–286
Strow WF (1974) A review of 10 years of cataract surgery. In: Current concepts in cataract surgery. Selected Proceedings of the 3rd Biennial Cataract Surgical Congress, eds: Emery JM & D Paton. St Louis, Mosby, p 427–429
Sturm M (1845) Mémoire sur la théorie de la vision. Compte-rendu des séances de l'Académie des Sciences T 20: 555–560, 761–767, 1238–1257
Sugar J, Mitchelson J & Kraff M (1978) Endothelial trauma and cell loss from intraocular lens insertion. Arch Ophthal 96: 449–450
Sugar J, Mitchelson J & Kraff M (1978) The effect of phacoemulsification on corneal endothelial cell density. Arch Ophthal 96: 446–448
Terry C (1980) Surgical keratometry and optics of corneal alteration. In: Keratorefraction, ed: L Schachar. Dennison, Texas, LAL Publishing, p 15–25
Thijssen BM (1980) Computation of emmetropizing and iseikonizing implant lenses by means of a pocket calculator. Int Ophthal 2: 39–44
Thygesen J, Reersted P, Fledelius H & Corydon L (1979) Corneal astigmatism after cataract extraction. A comparison of corneal and corneoscleral incisions. Acta Ophthal 57: 243–251
Tucker J & Charmann WN (1975) The depth of focus of the human eye for snellen letters. Amer J Optom Physiol Opt 52: 3–21
Walls GL (1942) The vertebrate eye and its adaptive radiation. New York-London, Hafner 1967 (Facsimile of the 1942 Edition)
Weber A (1900) Operative Beseitigung des Astigmatismus. IXè Congrès d'Ophthalmologie, Utrecht, 1899. Amsterdam
Weekers R, Delmarcelle Y, Luyckx-Bacus J & Collignon J (1973) Morphological changes of the lens with age and cataract. In: The human lens in relation to cataract. Ciba Foundation Symposium 19. Amsterdam, Associated Scientific Publishers
Westheimer G (1964) Pupil size and visual resolution. Vision Res 4: 39–45
Worthen DM, Boucher JA, Buxton JN, Hayreh SS, Lowther G, Reinecke RD, Spencer WH, Talbott M & Weeks DF (1980) Interim DFA report on intraocular lenses. Ophthalmology 87: 267–271
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Huber, C. Myopic astigmatism a substitute for accommodation in pseudophakia. Doc Ophthalmol 52, 123–178 (1981). https://doi.org/10.1007/BF01675203
Issue Date:
DOI: https://doi.org/10.1007/BF01675203