scholarly journals Axial Length of the Eyeball Is Important in Secondary Dislocation of the Intraocular Lens, Capsular Bag, and Capsular Tension Ring Complex

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Anna Klysik ◽  
Katarzyna Kaszuba-Bartkowiak ◽  
Piotr Jurowski

Purpose. To analyze the patients with secondary dislocation of CTR and IOL within 5 years from cataract surgery, to determine predisposing factors.Methods. 16 eyes of 15 patients aged66.2±6.7(from 49 to 82) with CTR/IOL complex dislocation within 5 years from cataract surgery were compared with 26 patients aged67.1±7.2(from 53 to 85), implanted with CTR during cataract surgery to manage zonule dehiscence and did not dislocate for at least 5 years, in respect of cause, axial length and IOL power, refraction, coexistent pathology, and trauma.Results. Axial length of the eyeball was23.8±1.3(from 21 to 29) in the group of patients with CTR/IOL dislocation and20.7±1.2(from 19 to 24) in patients with no dislocation present (p=0.008). Crystalline lens dislocation was diagnosed before surgery in 13 of 16 patients with CTR/IOL complex dislocation as opposed to 7 of 26 eyes in the control group (p=0.01). Pseudoexfoliation was present in 50% and 58% in both groups, respectively. Traumatic dislocation was present in 8 patients, none of them with CTR/IOL dislocation (p=0.04).Conclusion. Longer axial length may contribute to the failure of the CTR to prevent in-the-bag IOL dislocation. Traumatic dislocation appears to be well fixed with the CTR.

2020 ◽  
Vol 20 (4) ◽  
pp. 187-190
Author(s):  
N.V. Kutukova ◽  
◽  
A. Yu. Kutukov ◽  
V.V. Brzheskiy ◽  
◽  
...  

im: to assess the clinical course and surgical procedures for contusion cataracts.Patients and Methods: 50 patients with a contusion cataract who underwent surgical treatment in 2008–2018 were included in the study group. 50 patients with a complicated cataract, either along with glaucoma (n=25) or diabetic cataract (n=25), were included in the control group. All patients were examined and treated in the same manner (i.e., eye exam was performed at admission, before the surgery, on postoperative days 1–3, and 1, 3, and 6 months after the surgery).Results: unilateral cataracts were revealed in the study group and bilateral cataracts were revealed in the control group. More than two-third of study group patients and only 14% of controls have the clinical signs of subluxated lens. In the study group, lens opacities were polymorphic. In the control group, nuclear opacities occurred in 30%, cortical opacities in 32%, and mixed opacities in 38%. In the course of surgical procedures, previously undiagnosed mild lens subluxation was identified in 12% of study group patients and less than 6% of controls. The total rate of zonular insufficiency in the study group was twice as much as in the control group. Additional devices (i.e., iris and capsular retractors, capsular tension rings etc.) were used in 46% of study group patients and 20% of control group patients. Visual acuity more than 12/20 was reported in 86% of study group patients and only 32% of control group patients.Conclusions: the clinical course and surgical performance of contusion cataracts should be considered when examining and operating these patients. Occult minimal lens subluxation is also important. Keywords: complicated cataract, traumatic cataract, contusion cataract, lens subluxation, iris capsular retractor, capsular tension ring, surgical specificities.For citation: Kutukova N.V., Kutukov A.Yu., Brzheskiy V.V. Addressing the specificities of contusion cataract surgery in adults. Russian Journal of Clinical Ophthalmology. 2020;20(4):187–190. DOI: 10.32364/2311-7729-2020-20-4-187-190.


2021 ◽  
Vol 12 (9) ◽  
pp. 126-129
Author(s):  
Kabindra Bajracharya ◽  
Anjita Hirachan ◽  
Kriti Joshi ◽  
Bimala Bajracharya

Background: In congenital and developmental cataract primary undercorrection of intraocular lens (IOL) power is a common practice. However, long-term refractive status of these children is largely unknown. Aims and Objective: To analyse refractive status after cataract surgery with undercorrected IOL power implantation in congenital and developmental cataract. Materials and Methods: This study was descriptive, retrospective conducted for three years from 1st January 2013 to 31st December 2015. The children (> 6 months to <=7 years of age) who underwent cataract surgery for congenital and developmental cataract with a primary IOL implantation and had reached the age of 8 years were studied. The data were collected in terms of demography, axial length, biometry, IOL implanted, hyperopic correction and postoperative refractive status at 8 years. Results: Total numbers of children operated were 181 with total eyes 288. Unilateral cases were 74 (40.88%) and bilateral 107 (59.12%). Male were 121 (66.85%) and female were 60 (33.15%) with male is to female ratio of 2:1. Right eye was involved in 152 (52.8%) and left eye 136 (47.2%). The mean axial length at the age of one year was 20.75 mm, and gradually increased as age increased which was 22.47 mm at 6 years. The mean biometry was 27.9 diopter (D) at the age of one year which gradually decreased as age increased. Of the total 288 congenital cataract operated, complete follow-up documents were available for 77 (26.74%) eyes up to 8 years which showed emmetropia achieved in 25.97%, myopia in 28.57% and hypermetropia in 45.45%. Conclusion: Primary IOL implantation with hyperopic correction is accepted practice in congenital and developmental cataract. Emmetropia can be achieved however some hyperopic or myopic refractive status at the age of 8 years is not a surprise. Myopic shift continues as the age increases. Parent awareness for early detection and surgery, optical correction and regular follow-up are essential for good outcome.


2021 ◽  
Vol 7 (3) ◽  
pp. 477-481
Author(s):  
Harish R Trivedi ◽  
Bhavik C Zala ◽  
Nitesh S Pancholi

The higher cost of IOL master is an issue in developing countries and hence it cannot be widely used for calculation of IOL power in such countries. Thus, the aim of the current study is to evaluate a cheaper alternative for the calculation of IOL power by comparing the axial length measurement obtained using applanation A-scan with that of IOL Master for accuracy of predicting postoperative refraction.A prospective, randomized, comparative study was done with 100 patients who were posted for cataract surgery. The patients were randomly divided into two groups of 50 patients each using computerized random number method. In Group A (n=50) axial length was measured with applanation A-scan and in Group B (n=50) axial length was measured with IOL Master. Before cataract surgery keratometry reading was taken with auto keratometer and intraocular lens (IOL) power calculation was done using SRK 2 formula in all patients. All patients were operated for cataract surgery by phacoemulsification and foldable intraocular lens were implanted in the bag. Postoperatively, best accepted refraction at 8th week was taken and mean spherical equivalent was calculated. 100 patients of cataract were subjected for cataract surgery by phacoemulsification.Corrected spherical equivalent on 8th postoperative week showed: 88% patients in Group A and 96% patients of Group B were within ± 1.00 D.56% patients of Group A and 76% patients of Group B were within ± 0.50 D.There was no statistically significant difference (p &#62; 0.05) in axial length and corrected spherical equivalent between the two groups. There is no extra advantage of IOL Master over applanation A-scan for measuring Axial Length between 21 and 24.50 and predicting post-operative refractive outcome.


2014 ◽  
Vol 6 (2) ◽  
pp. 192-196
Author(s):  
Pawan Baral ◽  
Nabin Baral ◽  
Indra Man Maharjan ◽  
Bhoj Raj Gautam ◽  
Madhavendra Bhandari

Introduction: The biometric parameters of the eye are measured for the calculation of the intra ocular lens power to be used in cataract surgery. Objective: To report the keratometry reading, axial length and intra ocular lens power used for eyes operated for cataract in Karnali Zone, Nepal, and to compare these findings with those reported in other similar studies. Subjects and methods: The data for the study were retrospectively collected from the case files of patients who had undergone cataract surgery between January 2011 and July 2012 in Karnali Zone, Nepal. These surgeries were performed in an outreach surgical camp organized by the Himalaya Eye Hospital, Nepal, as a part of its annual program. The SPSS 16.0 and Microsoft Excel 2007 software were used for the data analysis.Results: The total number of patients taken for the study was 1055 and the total number of eyes was 1055. There were 530 (50.23%) males and 525 (49.77%) females, with the mean age of 64.34±11.25, ranging from 8 to 98 years.The mean keratometry reading for the total sample was 44.11±1.6 (range, 34.00D to 49.00D). The mean axial length for the total sample was 22.68±0.88 (range, 17.75 to 26.17). The mean IOL power for the total sample was 21.60±1.74 (range, +15.00 to +30.00).Conclusion: The biometric eye parameters of keratometry, axial length and IOL power of this study required for cataract surgery in a Karnali population are similar to those presented in other similar studies from Nepal and abroad.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11690Nepal J Ophthalmol 2014; 6(12): 192-196


2020 ◽  
Author(s):  
Pengcheng Zhang ◽  
Yuhuan Yang ◽  
Hong Yan ◽  
Jie Zhang ◽  
Weijia Yan

Abstract Background: How to reduce the refractive error has always been a tricky problem. The aim of this study was to verify the correlation between binocular refractive errors (RE) after sequential cataract surgery and explore the individualized calculation method of intraocular lens (IOL) for the second eye.Methods: This is a prospective study. One hundred eighty-eight affected eyes of 94 age-related cataract patients with sequential cataract surgery from the Department of Ophthalmology, Tangdu Hospital, china, were recruited. Complete case data of 94 patients were included for correlation analysis of binocular RE. Thereafter, data of patients with RE values greater than 0.50 diopter (D) in the first eyes were extracted and divided randomly into two groups- Group A and B. As the adjustment group, in group A we modified the IOL power for the second eyes according to 50% of the RE of the first eye, and group B was the control group without modify. The mean absolute refractive error (MARE) values of the second eyes were evaluated one month after surgery.Results: The correlation coefficient of binocular RE after sequential cataract surgery was 0.760 (P < 0.001). After the IOL power of the second eyes were adjusted, the MARE of the second eyes was 0.57±0.41 D while MARE of the first eyes was 1.18±0.85 D, and the difference was statistically significant (P<0.001).Conclusions: Binocular REs were correlated positively after sequential cataract surgery. The RE of the second eye can be reduced by adjusting the IOL power based on 50% of the postoperative RE of the first eye.


Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 414
Author(s):  
Je-Sang Lee ◽  
Dong-Ju Yeom ◽  
Seung-Kwan Nah ◽  
Bo-Yeon Kim ◽  
Sun-Young Jang

Background and Objectives: To find the differences in ocular axial length, keratometric measurements, and intraocular lens (IOL) power in patients with Graves’ disease (GD) after treatment with a thionamide antithyroid drug (ATD), methimazole. Materials and Methods: The medical charts of 28 patients (4 males and 24 females; mean age: 47.2 ± 21.2 years) were studied. Each patient was examined twice using an IOL Master Device and keratometry at the first visit (before ATD treatment) and after 1 month of ATD treatment. The IOL power was calculated for each patient using the Hoffer Q, SRK-2, and SRK/T formulas according to axial length. Results: After 1 month, the axial length increased (right and left eyes: p < 0.001 and p = 0.05, respectively). Based on keratometry, changes in the horizontal and vertical optical power [in diopters (D)] were not statistically significant. However, the IOL power changed after 1 month of ATD treatment in 64.3% of the patients. In 14 patients (50%), there was a 0.5–1.0 D IOL power decrease in single eyes; in two patients (7.1%), an IOL power decrease of 0.5–1.0 D in both eyes; and in two patients (7.1%), a 0.5 D IOL power increase in single eyes. The calculated IOL power values were lower after ATD treatment (right and left eyes, p = 0.010 and p = 0.018, respectively). Conclusions: The IOL power changed in 64.3% of GD patients after ATD treatment. Therefore, avoiding cataract surgery at the early stage of ATD treatment would be appropriate for selecting a more accurate IOL power.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Qi Fan ◽  
Xiaoyan Han ◽  
Xiangjia Zhu ◽  
Lei Cai ◽  
Xiaodi Qiu ◽  
...  

Purpose. To investigate the clinical characteristics of patients with intraocular lens (IOL) dislocation after IOL implantation in Chinese Han populations. Methods. The medical records of patients with IOL dislocation were retrospectively reviewed from January 2007 to December 2017, and a total of 312 patients (male: 231, female: 97) (328 eyes) were included in this study. The axial length (AL), IOL power, and the time interval between cataract surgery and IOL dislocation as well as the ocular conditions associated with IOL dislocation were recorded. The IOL dislocation was classified and graded based on its relationship with the capsule and the position of the dislocated IOL. Results. The mean time between original cataract surgery and IOL dislocation was 5.63 ± 5.13 years; IOL dislocation occurred in up to 56.1% (184 eyes) of the eyes within 5 years. Trauma was found in 136 eyes (41.5%); pars plana vitrectomies were performed in 61 eyes (18.6%), and high myopia was detected in 108 eyes (32.9%). A total of 243 eyes (74.1%) had out-of-the-bag IOL dislocations, while 85 eyes (25.9%) had in-the-bag IOL dislocations. There was a statistically significant difference in the constituent ratio of trauma between in-the-bag dislocation and out-of-the-bag dislocation (Pearson’s chi2 = 33.3992, P<0.001); ocular blunt traumas were significantly higher in in-the-bag dislocations, while open-globe injuries were significantly higher in out-of-the-bag dislocations. A statistically significant difference was found for the ratio of patients with AL longer than 30 mm between in-the-bag dislocation and out-of-the-bag dislocation (Pearson’s chi2 = 9.7355, P<0.002). Conclusions. In Chinese Han populations, the most common IOL dislocation is out-of-the-bag dislocation; the most common risk factors were trauma, long axial length, and eyes undergoing pars plana vitrectomy; a minimum follow-up of 5 years is suggested for IOL dislocation-predisposed eyes undergoing cataract surgery.


1969 ◽  
Vol 4 (2) ◽  
pp. 497-502
Author(s):  
ASIF IQBAL ◽  
FAKHAR UL ISLAM ◽  
BILAL BASHIR ◽  
MOHAMMAD IDRIS ◽  
OMER KHAN ORAKZAI

OBJECTIVES: To determine the single optimal intraocular lens power based on average biometricassessment for adult cataract surgery in free eye camps.MATERIALS AND METHODS: Prospective observational study of 4 years duration from 1stFebruary 2010 to 31st January 2014.SETTING: Community based Trust eye hospital in Tarakai village of District Swabi.METHODS: All adult patients, undergoing cataract surgery with intraocular lens (IOL) implantationwere included in the study after informed consent and fulfilling the inclusion and exclusion criteria. Allpatients were operated by manual small incision cataract surgery by the same surgeon (AI). Preoperative and Post- operative best spectacle corrected visual acuity (BSCVA) at two months follow upwas noted. Keratometric readings (K1 & K2), axial length and IOL power were calculated and dataanalyzed by using SPSS version 20 software database.RESULTS: Out of 1500 patients with cataract 668 (44.5%) were males and 832 (55.5%) were females.Right eye was involved in 826 (55.1%) patients whereas; left eye was involved in 674 (44.9%) patients.Mean K1 reading was 44.82± 1.80 D. Mean K2 reading was 44.94± 1.80 D. Mean axial length readingwas 23.11± 1.28 mm. 36.6 ifc(n=403) patients had axial length between 23-23.99 mm. Mean IOL powerin dioptres for males was 20.06± 2.53 D with minimum power of 2.00 D, maximum was 27 D and modewas 20.00 D. Mean IOL power in dioptres for females was 20.12 ± 3.43 D with minimum power of -2.00 D, maximum was 36.50 D and mode was 20.00 D. Mean IOL power was 20.10 ± 3.06 D. In 798patients (53.2 %) IOL used was in the range of 20.00 D to 22.00 D. Pre-operative best spectaclecorrected visual acuity was <6/60 in 58.4% (n=877) patients. Post operative best corrected visual acuity6/18 or better was present in 90.5% (n= 1357) patients at two months follow up.CONCLUSION: In community eye care centers located in far-flung areas with no facilities for properbiometric assessment of cataract patients, using an IOL power in the range of 20.00 D to 22.00 D wouldgive optimal visual results.KEY WORDS: Biometry, Keratometric readings, Axial Length, Intraocular lens.


2020 ◽  
Author(s):  
Pengcheng Zhang ◽  
Yuhuan Yang ◽  
Hong Yan ◽  
Jie Zhang ◽  
Weijia Yan

Abstract Background How to reduce the refractive error has always been a tricky problem. The aim of this study was to verify the correlation between binocular refractive errors (RE) after sequential cataract surgery and explore the individualized calculation method of intraocular lens (IOL) for the second eye. Methods This is a prospective study. One hundred eighty-eight affected eyes of 94 age-related cataract patients with sequential cataract surgery from the Department of Ophthalmology, Tangdu Hospital, china, were recruited. Complete case data of 94 patients were included for correlation analysis of binocular RE. Thereafter, data of patients with RE values greater than 0.50 diopter (D) in the first eyes were extracted and divided randomly into two groups- Group A and B. As the adjustment group, in group A we modified the IOL power for the second eyes according to 50% of the RE of the first eye, and group B was the control group without modify. The mean absolute refractive error (MARE) values of the second eyes were evaluated one month after surgery. Results The correlation coefficient of binocular RE after sequential cataract surgery was 0.760 ( P < 0.001). After the IOL power of the second eyes were adjusted, the MARE of the second eyes was 0.57±0.41 D while MARE of the first eyes was 1.18±0.85 D, and the difference was statistically significant ( P <0.001). Conclusions Binocular REs were correlated positively after sequential cataract surgery. The RE of the second eye can be reduced by adjusting the IOL power based on 50% of the postoperative RE of the first eye.


2003 ◽  
Vol 13 (2) ◽  
pp. 151-154 ◽  
Author(s):  
D. D'Eliseo ◽  
B. Pastena ◽  
L. Longanesi ◽  
F. Grisanti ◽  
V. Negrini

Purpose To evaluate the incidence of secondary cataract in phacoemulsification and intraocular lens implantation using a capsular tension ring in case of zonular dehiscence. Methods Phacoemulsification using a double capsular tension ring and intraocular lens implantation was done in 65 eyes with cataract and severe zonular weakness. One year after surgery capsular opacities and fibrosis were detected in a double-blind examination. The results were compared with a control group of 36 eyes that did not have a capsular tension ring but had similar surgery. Results In the group with the capsular tension ring and implantation 7.7% of patients had moderate or severe posterior capsule opacification, compared with 36.1% in the control group. Conclusions Capsular tension rings may influence the formation of capsule opacification.


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