scholarly journals Continuation of Aspirin Therapy before Cataract Surgery with Different Incisions: Safe or Not?

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Qingjian Li ◽  
Yiwen Qian ◽  
Yu Zhang ◽  
Gaoyuan Sun ◽  
Xian Zhou ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Aspirin Therapy ◽  
Topical Anesthesia ◽  
Control Group ◽  
Corneal Incision ◽  
Subconjunctival Hemorrhage ◽  
Clear Corneal Incision ◽  
Scleral Tunnel ◽  
Significant Difference ◽  
Phacoemulsification Cataract Surgery

Purpose. To assess whether to continue aspirin therapy while having uncomplicated phacoemulsification cataract surgery with different incisions. Methods. Consecutive patients having cataract surgery under topical anesthesia with different incisions between May 2016 and August 2017 were followed. 236 eyes of 166 patients on routine aspirin therapy were randomized into 2 groups: continuation group, 112 eyes; discontinuation group, 124 eyes. 121 eyes of 94 patients on no routine anticoagulant therapy were used as the control group. Patients were examined 1 day preoperatively and 1 day and 7 days postoperatively. Intraoperative and postoperative complications were recorded. Results. Statistically, there was no significant difference about postoperative BCVA among three groups. A higher incidence of subconjunctival hemorrhage was shown in the continuation group than in the discontinuation group and the control group (17.0% versus 8.1%, p=0.038; 17.0% versus 7.4%, p=0.025, resp.). Although corneal edema was greater in clear corneal incision cases than that of scleral tunnel incision cases (22.5% versus 12.0%, p=0.009), subconjunctival hemorrhage was greater in scleral tunnel incision cases (14.9% versus 6.6%, p=0.011). Subgroup analyses revealed that patients of scleral tunnel incision who continued taking aspirin had a higher incidence of subconjunctival hemorrhage compared with those who discontinued (25.5% versus 10.9%, p=0.038), but no same conclusion in clear corneal incision cases (8.8% versus 5.0%, p=0.483). Conclusions. The outcomes indicated that phacoemulsification cataract surgery under topical anesthesia could be safely performed without ceasing systemic aspirin therapy. Clear corneal incision could be a better choice in patients treated with aspirin.

scholarly journals A Comparative Study of 5.5mm Temporal Sclerocorneal Manual Small Incision Cataract Surgery Versus 5.5mm Temporal Clear Corneal Extended-incision Phacoemulsification with Implantation of a 5.25mm Rigid pmma Intraocular lens in the Bag

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Cataract Surgery ◽  
Controlled Study ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Corneal Incision ◽  
Small Incision ◽  
Clear Corneal Incision ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: Aim of the study is to Compare the astigmatism induced by a reduced temporal sclerocorneal tunnel incision manual small incision cataract surgery with an extended temporal clear corneal Phacoemulsification of similar width . Methods: A Prospective, randomised controlled study was carried out in 224 selected patients who were again divided into two groups - Group A (112 patients) and Group B (112 patients). Group A patients underwent temporal manual small incision cataract surgery with a 5.5 mm sclerocorneal incision and Group B underwent phacoemulsification by a 2.8 mm clear corneal temporal incision which was extended to 5.5 mm before IOL implantation. In both groups, a 5.25 mm rigid PMMA IOL was implanted in the bag. UCVA and BCVA of both group of patients was quantified and analyzed at 1 week and at 6 weeks Observation: It was seen that the mean surgically Induced astigmatism in group A (N=112) was 0.5625D , which was slightly lesser than that in Group B (N=112) which was 0.65D, although the p-value of 0.26 indicated that there was statistically no significant difference in visual outcomes between the two groups of patients. Here, a p-value of < 0.05 was considered statistically significant. Conclusion: In Skilled and Safe hands, refractive outcomes following performing a 5.5mm temporal sclerocorneal frown-incision manual small incision cataract surgery and a phacoemulsification procedure by a 2.8mm temporal clear corneal incision extended to 5.5mm for implanting a 5.25mm rigid PMMA IOL , are comparable.

scholarly journals Scleral tunnel based sutureless extracapsular cataract extraction: An approach to astigmatic correction in soft cataracts of nuclear sclerosis grade 1

2020 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Narendra Kumar Keisham ◽  
Anil Sharma
Keyword(s):  
Cataract Extraction ◽  
Corneal Astigmatism ◽  
Control Group ◽  
Extracapsular Cataract Extraction ◽  
Structural Protein ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Scleral Tunnel ◽  
Younger Age ◽  
Age Profile

Objectives: A study to see if scleral tunnel based sutureless extracapsular cataract extraction with superior quadrant approach can correct pre-existing corneal astigmatism in soft cataracts of non-structural protein 1 (NS1) grade nuclear sclerosis in patients of younger age profile having “with-the-rule” pattern of corneal astigmatism. Material and Methods: 47 eyes of 41 patients who underwent scleral tunnel based sutureless extracapsular cataract extraction were taken as the study group and a second group of 44 eyes of 38 patients who underwent clear corneal incision based phacoemulsification surgery formed the control group. Soft cataracts of NS1 grade nucleus having “with-the-rule” corneal astigmatism were included in the study. Keratometry measurements were done preoperatively and at 6 weeks post-operative follow-up by Zeiss IOLMaster. Results: Sutureless scleral tunnel based extracapsular cataract extraction was found to neutralize pre-existing corneal astigmatism if it was in range of 1.0–1.5 D. It was also found to change the pattern of astigmatism from “with-the-rule” to “against-the-rule” if the pre-operative astigmatism was in the range of 0.5–1.0 D with little change in the absolute value of the astigmatism. Conclusion: Patients with pre-existing with-the-rule corneal astigmatism undergoing scleral tunnel based sutureless extracapsular cataract extraction had reduced corneal astigmatism. Phacoemulsification, on the other hand, was found to be an astigmatically neutral surgery.

Prophylaxis of Postoperative Endophthalmitis Following Cataract Surgery

2020 ◽  
pp. 51-56
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Clinical Trial ◽  
Cataract Surgery ◽  
Antibiotic Prophylaxis ◽  
Factorial Design ◽  
Intraocular Lens ◽  
European Society ◽  
Postoperative Endophthalmitis ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Scleral Tunnel

The European Society of Cataract and Refractive Surgeons (ESCRS) multicenter endophthalmitis study, a randomized, partially masked, clinical trial using a 2 × 2 factorial design, examined the question of whether antibiotic prophylaxis (intracameral cefuroxime and topical perioperative levofloxacin) reduces the incidence of postoperative endophthalmitis after cataract surgery. The study showed that use of intracameral cefuroxime at the end of surgery reduced the occurrence of postoperative endophthalmitis to a level below 0.08%. The authors also recommended that to reduce the risk further, consideration should be given to avoiding the use of silicone intraocular lens optic material and using a scleral tunnel incision rather than a clear corneal incision.

scholarly journals A Systematic Review of Phacoemulsification Cataract Surgery in Virtual Reality Simulators

Medicina ◽  
2013 ◽  
Vol 49 (1) ◽  
pp. 1 ◽  
Author(s):  
Chee Lam ◽  
Kenneth Sundaraj ◽  
Mohd Sulaiman
Keyword(s):  
Virtual Reality ◽  
Cataract Surgery ◽  
Surgical Instruments ◽  
Scientific Publications ◽  
Corneal Incision ◽  
Surgery Training ◽  
Significant Difference ◽  
Before And After ◽  
Visual Realism ◽  
Phacoemulsification Cataract Surgery

The aim of this study was to review the capability of virtual reality simulators in the application of phacoemulsification cataract surgery training. Our review included the scientific publications on cataract surgery simulators that had been developed by different groups of researchers along with commercialized surgical training products, such as EYESI® and PhacoVision®. The review covers the simulation of the main cataract surgery procedures, i.e., corneal incision, capsulorrhexis, phacosculpting, and intraocular lens implantation in various virtual reality surgery simulators. Haptics realism and visual realism of the procedures are the main elements in imitating the actual surgical environment. The involvement of ophthalmology in research on virtual reality since the early 1990s has made a great impact on the development of surgical simulators. Most of the latest cataract surgery training systems are able to offer high fidelity in visual feedback and haptics feedback, but visual realism, such as the rotational movements of an eyeball with response to the force applied by surgical instruments, is still lacking in some of them. The assessment of the surgical tasks carried out on the simulators showed a significant difference in the performance before and after the training.

Effect of phacoemulsification on intraocular pressure and bleb function in eyes with previous trabeculectomy

2021 ◽  
Vol 2 (2) ◽  
pp. 88-94
Author(s):  
Jia Cherng Chong ◽  
◽  
Haireen Kamaruddin ◽  
Poh Yan Ong ◽  
Tajunisah Iqbal ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Previous History ◽  
Glaucoma Surgery ◽  
Study Data ◽  
Control Group ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Visual Improvement

AIM: To observe the intraocular pressure (IOP) control and bleb function after phacoemulsification in patients with previous history of successful/qualified success mitomycin-C augmented trabeculectomy. METHODS: This was a retrospective cohort study. Data of patients who had undergone trabeculectomy with subsequent cataract surgery were extracted from server. All patients had previous either success/qualified success trabeculectomy done. They went through uncomplicated phacoemulsification via clear corneal incision. Postoperative follow-up, review of bleb and IOP readings using Goldmann tonometer were taken. Details that were investigated include postoperative IOP control, visual improvement, number of anti-glaucoma medications, as well as the timing from trabeculectomy to phacoemulsification. Comparison with control group was made. RESULTS: Fifteen eyes from thirteen patients fulfilled the criteria for study and had undergone uncomplicated phacoemulsification between January 2014 to June 2016 on a post-trabeculectomy eye. Two of the eyes had secondary glaucoma while the other thirteen had primary glaucoma. All phacoemulsifications were done at least 6mo after trabeculectomy (mean 14.7±4.3mo). There was only 1 eye (6.7%) requiring anti-glaucoma medications before the cataract surgery. This number increased to 4 (26.7%) at 1-year post phacoemulsification. The number further increased to eight (53.3%) at 2y post-phacoemulsification. The number of anti-glaucoma drops needed after surgery at 2y ranged from 2-4. In all the 15 eyes, there was no statistically significant change in IOP control between pre-cataract surgery (mean 13.4±2.9 mm Hg) compared to 1y (mean 14.1±3.2 mm Hg, P=0.357) and 2y (mean 15.1±3.3 mm Hg, P=0.212) post phacoemulsification. Visual improvement after phacoemulsification however is significant, from a preoperative average visual acuity of logMAR 1.52±1.00 to a postoperative average visual acuity of 0.53±0.54 (P=0.000, paired t-test). CONCLUSION: This analysis shows significant visual improvement following cataract surgery in post-trabeculectomy patients without compromising IOP control. However, a reduced bleb function is noted following the surgery evidenced by the increase in number of anti-glaucoma drops used after surgery especially two years after the cataract surgery. Patients should be counselled regarding the possibility of restarting on anti-glaucoma medications post-phacoemulsification. The timing and sequence of cataract and glaucoma surgery should be optimized for best outcome.

scholarly journals Surgically induced astigmatism and coupling effect-mediated keratometric changes after conventional phacoemulsification cataract surgery

2021 ◽  
Author(s):  
Reinhard Angermann ◽  
Christoph Palme ◽  
Philipp Segnitz ◽  
Andreas Dimmer ◽  
Eduard Schmid ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Coupling Effect ◽  
Case Series ◽  
Corneal Incision ◽  
Surgically Induced Astigmatism ◽  
Incision Size ◽  
Case Series Study ◽  
Induced Astigmatism ◽  
Surgically Induced ◽  
Phacoemulsification Cataract Surgery

Summary Background The aim of the present study was to describe surgically induced astigmatism (SIA) and the coupling effect after conventional phacoemulsification cataract surgery (CPS) in relation to the incisional axis. Material and methods A total of 42 patients were included in the retrospective case series study. Corneal topography was obtained for patients with significant cataract before and 6 weeks after CPS with a main clear corneal incision size of 2.4 mm. Patients were grouped according to the relationship of the incisional axis to the position of the steep axis into a steep incisional group and a flat incisional group. Results In total, 46 eyes were included in the study. While the steep incisional group showed an SIA of −0.15 D (± 0.35), the flat incisional group had a significantly higher SIA of 0.20 D (± 0.51) (p = 0.03). The coupling ratio (CR) in the steep incisional group was −0.38 (± 1.41) and in the flat incisional group it was 0.16 (± 0.97). Correspondingly, a coupling constant (CC) of −0.25 was found for group 1 and a CC of 0.0 for group 2. Conclusion Our results suggest that the location of the main incision should be decided with consideration of the corneal astigmatism in order to minimize the SIA. The CR helps to understand the effect of induced astigmatism and the change in spherical equivalent.

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