scholarly journals Comparison of Femtosecond Laser-Assisted Cataract Surgery and Conventional Phacoemulsification in Shallow Anterior Chambers and Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Zhou Zhou ◽  
Li Li ◽  
Siming Zeng ◽  
Wenjing He ◽  
Min Li

Purpose. To compare femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification in shallow anterior chamber cataract patients with glaucoma or zonulysis. Methods. This was a single-center retrospective review of cataract surgeries in shallow anterior chamber and glaucoma patients between January 2016 and December 2018 in which a LenSx femtosecond laser was used. The outcome measures included pre- and postoperative uncorrected and corrected distance visual acuity (UDVA and CDVA), intraocular pressure (IOP), endothelial cell density (ECD), endothelial cell loss (ECL), and object scatter index (OSI). Results. One hundred and six eyes of 106 patients with a mean anterior chamber depth of 1.54 ± 0.51 mm were included in this study. Among them, 26 (23.2%) had zonulysis and 18 eyes had capsular tension ring implantation in general. The percentage of capsular tension ring implantation was statistically significantly lower in the FLACS group ( P  = 0.027). The UDVA, CDVA, ECD, and IOP were not statistically significant between the two groups at all time points. The postoperative ECL and OSI of the FLACS group was better than those of the conventional group ( P  < 0.01). Conclusions. FLACS can reduce ECL and improve visual quality compared to the conventional phacoemulsification in shallow anterior chamber patients. Also, it has the trend of reducing the use of capsular tension rings in subluxated cataracts. It is an ideal choice for patients with complicated cataract such as with shallow anterior chambers, glaucoma, and zonulysis.

2021 ◽  
pp. 30-31
Author(s):  
Gargi Verma ◽  
Kishor Kumar

Purpose: To assess the association between anterior chamber depth and endothelial cell loss after phacoemulsication Material and Methods: Ninety patients were recruited for this comparative type of observational study who were further divided into 3 groups according to anterior chamber depth (ACD). All patients underwent phacoemulsication procedure and intraocular implantation. Postoperatively endothelial cell loss (ECL) was calculated by measuring percentage decrease in endothelial cell density of central cornea and regression coefcient between ACD and ECLwas assessed in each group. Results: Endothelial cell loss was signicantly higher in shallow anterior chambers to other groups and the association between ACD and ECLwas signicant only in shallow anterior chamber depth group. Conclusion: Eyes with shallow anterior chamber depth are at higher risk for endothelial cell damage and shows an association between ACD and ECLwhen compared to deep anterior chamber depth.


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Rita Mencucci ◽  
Chiara De Vitto ◽  
Michela Cennamo ◽  
Roberto Vignapiano ◽  
Matilde Buzzi ◽  
...  

2019 ◽  
Author(s):  
Man Hu ◽  
Qian Zheng ◽  
Zhangliang Li ◽  
Pingjun Chang ◽  
Yun-e Zhao

Abstract Background To assess the changes of anterior chamber angle in patients with shallow anterior chamber and normal anterior chamber after phacoemulsification and intraocular lens implantation (IOL) using anterior segment swept-source optical coherence tomography (AS-SS-OCT). Methods This was a prospective case control study; 60 eyes of 60 patients who underwent cataract surgery. Based on anterior chamber depth (ACD) and gonioscopy findings, the eyes were classified into two groups, shallow anterior chamber group (30 eyes) and normal anterior chamber group (30 eyes). AS-SS-OCT was used to measure ACD and angle parameters angle opening distance (AOD), angle recess area (ARA), trabecular iris space area(TISA), and trabecular iris angle (TIA). Serial changes in each group were measured before and 3 months after phacoemulsification and IOL, and the differences between the two groups were compared. Results All angle parameters including ACD, AOD, ARA, TISA, and TIA in both groups at 3 months after cataract surgery were significantly different from the preoperative values (p<0.01). In addition, we found significant differences of all angle parameters between groups of shallow anterior chamber (SAC) and normal anterior chamber (NAC) (All P< 0.05). Besides, the TISA750 in superior quadrant and anterior chamber volume (ACV) were significantly smaller in the group of SAC than those in the group of NAC (P = 0.041 and 0.002, respectively). Conclusions The parameters of anterior chamber increased significantly in both two groups but not increase to the same extent 3 months after phacoemulsification. Iris thickening may also be one of the narrow angle factors,not just age-related lens thickening.


2019 ◽  
Vol 4 (1) ◽  
pp. e000280
Author(s):  
Gaspare Monaco ◽  
Mariangela Gari ◽  
Silvia Pelizzari ◽  
Arianna Lanfranchi ◽  
Giada Ruggi ◽  
...  

ObjectiveTo compare the performance and safety in cataract surgery of two ophthalmic viscoelastic devices (OVDs), each having separate dispersive and cohesive characteristics and different concentrations.Methods and analysisIn this prospective, randomised, controlled clinical study, one eye of each patient was injected with OVD1 (Viscopack14) or OVD2 (DuoVisc) during phacoemulsification and intraocular lens implantation. Endothelial cell count, intraocular pressure (IOP), central corneal thickness (CCT), intraocular inflammation and corrected distance visual acuity (CDVA) were compared 3 months postoperatively.ResultsThe study enrolled 127 patients. Randomisation assigned 50 eyes of as many patients to each arm of the study. The postoperative mean endothelial cell loss was 14.4% and 7.1% from baseline in the OVD1 and OVD2 groups, respectively (p=0.08). The incidence of IOP spikes at 2 hours was 0% and 8%, respectively (p=0.02). There were intergroup differences in postoperative IOP values, the OVD2 group showed significantly higher values at all of the follow-up visits starting from the 24 hours examination (p<0.05). There was no statistically significant difference in the CCT, intraocular inflammation and CDVA at the end of follow-up.ConclusionBoth OVDs showed similar clinical performances and were equally effective during cataract surgery. Viscopack14 showed more corneal endothelial cell reduction, while DuoVisc had more occurrences of IOP values and spikes. Future studies are mandatory to support these preliminary results.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Zi Ye ◽  
Zhaohui Li ◽  
Shouzhi He

Objective. This meta-analysis aimed to compare the outcomes and postoperative complications between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS). Methods. Bibliographic databases, including PubMed, Embase, and Cochrane library, were systematically searched for references on or before September 2015 regarding the outcomes and complications by FLACS or CPCS. Data on corneal endothelial cell loss, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive outcomes, and postoperative complications were retrieved. Results. A total of 9 trials were included in this analysis. Refractive outcomes (MD = −0.21, 95% CI: −0.39~0.03, P=0.02) were significantly improved after FLACS. Although corneal endothelial cell loss was not significantly reduced after FLACS, there was a trend towards lower corneal endothelial cell loss (mean difference (MD) = 197.82, 95% confidence interval (CI): 2.66~392.97, P=0.05) after FLACS. There was no significant difference in UDVA (MD = −0.01, 95% CI: −0.13~0.10, P=0.80) or CDVA (MD = −0.03, 95% CI: 0.07~0.00, P=0.09) between the two surgeries. Elevated intraocular pressure and macular edema were most commonly developed complications after cataract surgery, and the incidence of these complications associated with the two surgeries was similar. Conclusion. Compared with CPCS, FLACS might achieve higher refractive stability and corneal endothelial cell count. Nevertheless, further study is needed to validate our findings.


2021 ◽  
Vol 14 (10) ◽  
pp. 1527-1532
Author(s):  
Qian Zheng ◽  
◽  
Zhang-Liang Li ◽  
Ping-Jun Chang ◽  
Yun-E Zhao ◽  
...  

AIM: To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens (IOL) implantation, based on anterior segment swept-source optical coherence tomography (AS-SS-OCT) measurements. METHODS: This was a prospective case control study; sixty eyes of sixty case were scheduled for cataract surgery with normal intraocular pressure (IOP). Based on anterior chamber depth (ACD) and gonioscopy findings, the eyes were divided into two groups: group of shallow anterior chamber and narrow angle (SAC group, 30 eyes); and group of normal anterior chamber group with wide angle (NAC group, 30 eyes). Measurements of ACD, anterior chamber volume (ACV), iris volume (IV), lens vault (LV), angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), and trabecular iris angle (TIA) were conducted in each group before and 3mo after surgery. RESULTS: There was no significant difference in age, axial length (AL), corneal curvature, corneal diameter, intraocular pressure, and IV between two groups before surgery, except for the LV (P=0.000). ACD and ACV were prominently larger in the NAC group than the SAC group 3mo after operation (3.69±0.38 vs 3.85±0.39 mm, P=0.025; 161.37±19.47 vs 178.26±20.30 mm3, P=0.002). AOD750, ARA750 in nasal and inferior quadrants, TISA750 in all quadrants except temporal, and TIA750 in all quadrants in SAC group were significantly smaller than those in NAC group after operation (all P<0.05). CONCLUSION: Cataract surgery can deepen anterior chamber and increase the width of anterior chamber angle in Chinese subjects, but the angle related parameters including AOD750, ARA750, TISA750, TIA, TISA750, and ACV in patients with shallow anterior chamber and narrow angle do not reach the normal level.


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