Abstract：
PURPOSE:To understand, demonstrate, and further research the mechanisms of accommodation and presbyopia. SETTING:Private practice, Little Silver, New Jersey, USA. DESIGN:Experimental study. METHODS:The CAMA 2.0 computer-animated model of accommodation and presbyopia was produced in collaboration with an experienced medical animator using Autodesk Maya animation software and Adobe After Effects. RESULTS:The computer-animated model demonstrates the configuration and synchronous movements of all accommodative elements. A new classification of the zonular apparatus based on structure and function is proposed. There are 3 divisions of zonular fibers; that is, anterior, crossing, and posterior. The crossing zonular fibers form a scaffolding to support the lens; the anterior and posterior zonular fibers work reciprocally to achieve focused vision. The model demonstrates the important support function of Weiger ligament. Dynamic movement of the ora serrata demonstrates that the forces of ciliary muscle contraction store energy for disaccommodation in the elastic choroid. The flow of aqueous and vitreous provides strong evidence for our understanding of the hydrodynamic interactions during the accommodative cycle. The interaction may result from the elastic stretch in the choroid transmitted to the vitreous rather than from vitreous pressue. The model supports the concept that presbyopia results from loss of elasticity and increasing ocular rigidity in both the lenticular and extralenticular structures. CONCLUSION:The computer-animated model demonstrates the structures of accommodation moving in synchrony and might enhance understanding of the mechanisms of accommodation and presbyopia. FINANCIAL DISCLOSURE:Dr. Goldberg is a consultant to Acevision, Inc., and Bausch & Lomb.
journal_name
J Cataract Refract Surgjournal_title
Journal of cataract and refractive surgeryauthors
Goldberg DBdoi
10.1016/j.jcrs.2014.07.028subject
Has Abstractpub_date
2015-02-01 00:00:00pages
437-45issue
2eissn
0886-3350issn
1873-4502pii
S0886-3350(15)00003-6journal_volume
41pub_type
杂志文章abstract：PURPOSE:To devise a comprehensive cataract surgery complexity score system for the selection of appropriate cases for trainees using evidence-based, validated risk factors for posterior capsule rupture, patient-specific factors, and complexity stratification recommendations to minimize complications, optimize outcomes,...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2018.04.036
更新日期：2018-06-01 00:00:00
abstract：PURPOSE:To study the effect of glistenings on the optical quality of a hydrophobic acrylic intraocular lens (IOL). SETTING:David J. Apple Laboratory, Heidelberg, Germany. DESIGN:An in vitro laboratory study. METHODS:An accelerated aging protocol was used to induce glistenings (microvacuoles) in 38 hydrophobic acryli...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2019.01.025
更新日期：2019-07-01 00:00:00
abstract：PURPOSE:To measure the relative difficulty of each stage of phacoemulsification surgery performed by basic surgical trainees. SETTING:Mater Misericordiae University Hospital, Dublin, Ireland. METHODS:This prospective study comprised 100 consecutive cases of phacoemulsification performed by 8 trainee surgeons over an ...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2006.01.045
更新日期：2006-04-01 00:00:00
abstract：PURPOSE:To investigate changes in corneal higher-order aberrations (HOAs) associated with the incision location in cataract surgery. SETTING:Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. DESIGN:Observational case series. METHODS:Eyes were divided into 3 groups according to the different...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2015.10.052
更新日期：2015-10-01 00:00:00
abstract：:Over a nine-year period, our practice removed 1,091 intraocular lenses. The most common type of lens requiring explantation was the closed-loop anterior chamber lens (58.6%). The Stableflex lens represented the largest percentage of all removed lens types (28.8%). The number of closed-loop anterior chamber lenses requ...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(13)80100-9
更新日期：1992-09-01 00:00:00
abstract：UNLABELLED:We report a case in which toric intraocular Collamer lenses (ICLs) effectively corrected the refractive errors of pellucid marginal degeneration (PMD). Preoperatively, in the patient's right eye, the manifest refraction was -10.5 -3.5 x 55, the uncorrected distance visual acuity (UDVA) was 20/1000, and the c...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2009.08.021
更新日期：2010-01-01 00:00:00
abstract：PURPOSE:To evaluate the contribution of Fourier analysis of videokeratographic data in the diagnosis of subclinical keratoconus and keratoconus. SETTING:Eye Institute of Thrace, Democritus University, Alexandroupolis, Greece. DESIGN:Observational case series. METHODS:The following Pentacam-derived parameters, result...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2016.01.049
更新日期：2016-05-01 00:00:00
abstract：PURPOSE:To investigate the effect of surface modification of poly(methyl methacrylate) (PMMA) by poly(ethylene glycol) (PEG) grafting on cell adhesion. SETTING:Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea. METHODS:The PMMA surface was oxidized with ozone, and PEG acrylate was then gra...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(00)00701-x
更新日期：2001-05-01 00:00:00
abstract：PURPOSE:To evaluate the role of intravitreal bevacizumab, an anti-vascular endothelial growth factor agent, injected at the time of cataract surgery on the postoperative progression of diabetic retinopathy (DR) and diabetic maculopathy. SETTING:Tertiary-care eye specialty hospital, Dhahran, Kingdom of Saudi Arabia. M...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrs.2008.09.019
更新日期：2009-01-01 00:00:00
abstract：:A 48-year-old man had simultaneous bilateral photorefractive keratectomy (PRK). The surgeon who performed the PRK did not see the patient in follow-up, and there was confusion regarding the comanaging doctor. Therefore, the patient was not examined immediately postoperatively. Several days later, he was hospitalized f...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(99)00336-3
更新日期：2000-01-01 00:00:00
abstract：PURPOSE:To evaluate long-term intraocular pressure (IOP) control after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (IOL) implantation in patients with primary angle-closure glaucoma. SETTING:Ophthalmology Department, Groote Schuur Hospital, Cape Town, South Africa. METHODS:This re...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(97)80255-6
更新日期：1997-07-01 00:00:00
abstract：PURPOSE:To assess the effect of folding procedures on modulation transfer function (MTF) and resolving power (RP) in soft acrylic intraocular lenses (IOLs). SETTING:Faculty of Engineering, Chiba University, Chiba, Japan. METHODS:Folding procedures and other manipulations were performed on +18.0 diopter soft acrylic l...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(96)80098-8
更新日期：1996-01-01 00:00:00
abstract：PURPOSE:To evaluate changes in anterior chamber depth (ACD) and intraocular pressure (IOP) after phacoemulsification in eyes with occludable angles and compare the results with those in eyes with normal open angles. SETTING:Eye Clinic, Ipoh General Hospital, Ipoh, Perak, Malaysia. METHODS:Patients with nonglaucomatou...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2010.02.024
更新日期：2010-08-01 00:00:00
abstract：PURPOSE:To determine predictors of long-term intraocular pressure (IOP) after cataract surgery. SETTING:Hunter Holmes McGuire Veterans Administration Hospital, Richmond, Virginia, USA. DESIGN:Case series. METHODS:Clinical variables, IOP by applanation tonometry, anatomic features on anterior segment optical coherenc...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2011.07.033
更新日期：2012-01-01 00:00:00
abstract：PURPOSE:To evaluate the results of ab externo 4-point scleral fixation of posterior chamber intraocular lenses (PC IOLs) as a primary or secondary procedure. SETTING:Aravind Eye Hospital, Madurai, India. METHODS:This retrospective study comprised 25 patients: 17 aphakic and 8 with traumatic subluxated lenses. The sub...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(99)80093-5
更新日期：1999-03-01 00:00:00
abstract：PURPOSE:To assess whether iris-claw intraocular lenses (IOLs) undergo gravitation-dependent changes in position and refraction. SETTING:Tertiary referral center, Bern, Switzerland. DESIGN:Observational case study. METHODS:Patients with a history of pars plana vitrectomy and IOL exchange with implantation of an aphak...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2016.07.033
更新日期：2016-10-01 00:00:00
abstract：:We describe a technique to simplify the retrieval process of an intraocular lens (IOL) that has fallen into the posterior segment of the eye. A high-vacuum level setting is used to achieve fixation of the IOL to the vitrectomy tip, permitting the IOL to be elevated into the anterior segment. The clothesline technique ...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2017.12.018
更新日期：2018-03-01 00:00:00
abstract：PURPOSE:To compare the effect of topical dexamethasone versus ketorolac versus combined dexamethasone-ketorolac after phacoemulsification on choroidal thickness (CT). SETTING:A tertiary university-based hospital Design: Prospective non-randomized comparative case series METHODS:: Ninety-two eyes of 92 patients were as...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1097/j.jcrs.0000000000000477
更新日期：2020-11-12 00:00:00
abstract：PURPOSE:To compare the visual and refractive outcomes with a diffractive toric extended depth-of-focus (EDOF) intraocular lens (IOL) when both eyes are targeted for emmetropia and the nondominant eye is targeted for slight myopia. SETTING:Three clinical practices, United States. DESIGN:Prospective case series. METHO...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jcrs.2019.05.019
更新日期：2019-10-01 00:00:00
abstract：PURPOSE:To determine whether frozen cultured sheets of human allogeneic epidermal keratinocytes (CEAK) improved wound repair after experimental corneal ablation by photorefractive keratectomy (PRK). SETTING:Hospital "Luis Sanchez Bulnes" de la Asociación para Evitar la Ceguera en Mexico, I.A.P, and Department of Cell ...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(01)01349-9
更新日期：2002-09-01 00:00:00
abstract：PURPOSE:To evaluate the clinical outcomes of laser in situ keratomileusis (LASIK) to correct myopia or myopic astigmatism using the Amaris 750S 750 Hz excimer laser. SETTING:Private LASIK center, Tokyo, Japan. DESIGN:Case series. METHODS:Patients with myopia or myopic astigmatism (spherical equivalent -0.50 to -11.6...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2013.07.043
更新日期：2014-02-01 00:00:00
abstract：PURPOSE:To formulate and test an algorithm using minimal topographic criteria for accurately diagnosing clinical keratoconus. SETTING:Subspecialty cornea practice and Keratoconus Genetic Research Project. METHODS:Both eyes of 86 keratoconic patients who had never worn contact lenses and 195 normal participants were s...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(99)00195-9
更新日期：1999-10-01 00:00:00
abstract：PURPOSE:To compare visual outcomes in patients with cataract surgery and bilateral implantation of a trifocal or bifocal intraocular lens (IOL). SETTING:University Eye Clinic Maastricht, the Netherlands. DESIGN:Prospective randomized clinical trial. METHODS:Eyes with cataract and less than 1.0 diopter (D) of corneal...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrs.2015.08.011
更新日期：2015-08-01 00:00:00
abstract：PURPOSE:To characterize the mean topographic shape of the limbus of a normal human eye and determine whether it depends on age or refractive power. SETTING:University of Manchester, Manchester, United Kingdom. DESIGN:Prospective case series. METHODS:Participants with no previous ocular surgeries were included in thi...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2017.02.027
更新日期：2017-05-01 00:00:00
abstract：:The excimer laser is potentially capable of achieving wide area central corneal reprofiling because of its extreme precision and limited penetration into adjacent tissues. A beam modifying system designed for this application is described. Initial clinical studies in monkeys and in ten human patients with blind eyes w...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(89)80055-0
更新日期：1989-07-01 00:00:00
abstract：PURPOSE:To evaluate the safety and complication rates of excimer laser photorefractive keratectomy (PRK). SETTING:Assutah Laser Center, Tel-Aviv, Israel. METHODS:This retrospective study evaluated the complication rate after PRK in 825 consecutive patients who had PRK for myopia and had a follow-up of at least 12 mon...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(97)80311-2
更新日期：1997-10-01 00:00:00
abstract：PURPOSE:To compare ocular performance and quality of vision in pseudophakic eyes with an aspherical intraocular lens (IOL) or a conventional spherical IOL. SETTING:Bretonneau University Hospital, Tours, France. METHODS:Twenty patients (40 eyes) were randomly divided in 2 equal groups to bilaterally receive the aspher...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrs.2006.10.035
更新日期：2007-02-01 00:00:00
abstract：:A simple technique for the accurate surgical alignment of toric phakic and aphakic intraocular lenses (IOLs) is described. The mathematical relationship between toric misalignment and cylinder error is reviewed to demonstrate the importance of toric lens alignment in the setting of increased rotational stability with ...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2008.04.041
更新日期：2008-10-01 00:00:00
abstract：PURPOSE:To compare measured and calculated postoperative anterior chamber depths (ACDs). SETTING:Department of Ophthalmology and Institute of Medical Physics, University of Vienna, Vienna, Austria, and Department of Ophthalmology, University of Mainz, Mainz, Germany. METHODS:The postoperative ACD was measured in 189 ...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/s0886-3350(03)00414-0
更新日期：2003-11-01 00:00:00
abstract：PURPOSE:To evaluate the change in higher-order aberrations (HOAs) after implantation of a foldable iris-claw phakic intraocular lens (pIOL) in myopic eyes. SETTING:Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. METHODS:This prospective nonrandomized comparative self-controlled trial inclu...
journal_title：Journal of cataract and refractive surgery
pub_type： 杂志文章
doi：10.1016/j.jcrs.2005.12.036
更新日期：2006-02-01 00:00:00
