scholarly journals Cataract Surgery with a New Fluidics Control Phacoemulsification System in Nanophthalmic Eyes

2016 ◽  
Vol 7 (3) ◽  
pp. 496-504 ◽  
Author(s):  
John S.M. Chang ◽  
Jack C.M. Ng ◽  
Vincent K.C. Chan ◽  
Antony K.P. Law
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Vision System ◽  
Case Series ◽  
Research Committee ◽  
Retrospective Case ◽  
Prior Approval ◽  
Line Loss ◽  
Uveal Effusion

Purpose: To report visual outcomes and complications after cataract surgery in nanophthalmic eyes with a phacoemulsification system using the active fluidics control strategy. Methods: This is a retrospective case series. All eyes with an axial length of less than 20 mm that underwent cataract surgery or refractive lens exchange using the Centurion Vision System (Alcon Laboratories Inc.) in Hong Kong Sanatorium and Hospital were evaluated. The visual acuity and intraoperative and postoperative complications were reported. Prior approval from the Hospital Research Committee has been granted. Results: Five eyes of 3 patients were included. The mean follow-up period was 10.2 ± 5.3 months (range, 4–18). Two eyes (40%) had a one-line loss of corrected distance visual acuity. No uveal effusion and posterior capsular tear developed. An optic crack and haptic breakage in the intraocular lens developed in 1 eye (20%) and 2 eyes (40%), respectively. Additional surgeries to treat high postoperative intraocular pressure were required in 1 eye (20%). Conclusion: The use of a new phacoemulsification system, which actively monitors and maintains the intraoperative pressure, facilitated anterior chamber stability during cataract surgery in nanophthalmic eyes. This minimized the risk of major complications related to unstable anterior chambers such as uveal effusion and posterior capsular tear. Development of intraoperative crack/breakage in a high-power intraocular lens was common.

scholarly journals Correction of Pre-Existing Astigmatism with Phacoemulsification Using Spherical Intraocular Lens and Wave front Guided Surface Ablation: A Retrospective Case Series

2021 ◽  
pp. 24-29
Author(s):  
Ahmed El-Shehawy ◽  
Ahmed El-Massry ◽  
Mohamed El- Shorbagy ◽  
Mohamed Atef ◽  
Moataz Sabry
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Case Series ◽  
Corneal Astigmatism ◽  
Retrospective Case ◽  
Astigmatism Correction ◽  
Surface Ablation ◽  
Retrospective Case Series ◽  
Case Series Study ◽  
Significant Difference

Objective: To evaluate safety and efficacy of using spherical intraocular lens followed by wavefront guided surface ablation in correction of preexisting regular corneal astigmatism. Methods: This retrospective case series study included 20 eyes of 16 patients having visually significant cataracts and co-existing regular corneal astigmatism. The patients underwent phacoemulsification with spherical intraocular lens and wavefront guided PRK three months later.  Results: There was a statistically significant difference for Uncorrected Visual Acuity UCVA, Best Corrected Visual Acuity BCVA, Manifest Refraction Spherical Equivalent MRSE, and refractive astigmatism postoperatively regarding all these parameters (P˂0.05). Conclusion: Astigmatism correction during or even after cataract surgery is a safe and effective method to improve visual outcomes. Longer period of follow up are required to evaluate stability of this technique and possibility of regression.

scholarly journals Visual outcomes after vitrectomy for epiretinal membrane in pseudophakic eyes with a diffractive trifocal intraocular lens.

2021 ◽  
Author(s):  
Luis Arrevola-Velasco ◽  
Jaime Beltrán ◽  
Maria Jesus Gimeno ◽  
Julio Ortega-Usobiaga ◽  
Vasyl Druchkiv ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Epiretinal Membrane ◽  
Case Series ◽  
Primary Outcome Measure ◽  
Retrospective Case ◽  
Visual Outcomes ◽  
Case Series Study ◽  
Trifocal Iol ◽  
Corrected Distance Visual Acuity

Abstract Purpose: To evaluate the effect on visual outcomes of a diffractive trifocal intraocular lens (IOL) in pars plana vitrectomy (PPV) for removal of epiretinal membrane (ERM) in pseudophakic eyes. Methods: This is retrospective case-series study on 20 eyes with a single model of trifocal IOL that underwent PPV for removal of ERM between January 2015 and September 2018 in our clinics. Follow up was at least 1 year. Primary outcome measure was mean change in visual acuity. Other outcome measures were mean change in central macular thickness (CMT), recovery of the external retinal layers, and change in spherical equivalent (SE). Results: Mean corrected distance visual acuity (CDVA) was 0.03±0.03 logMAR after phacoemulsification; this worsened to 0.23±0.10 logMAR with ERM, improving to 0.10±0.04 log MAR 12 months after PPV (p=0.001). Mean uncorrected near visual acuity (UNVA) was Jaeger 2.62±0.51 after lensectomy. This worsened to Jaeger 5.46±1.67 with ERM and improved to the initial Jaeger 2.69±0.84 after PPV (p=0.005). CMT decreased significantly, from 380.15 ±60.50 µm with the ERM to 313.70 ±36.98 µm after PPV. Mean SE after lensectomy was -0.18 ±0.38 D, which minimally changed to – 0.18±0.47 D after PPV (p=0.99). The only complication recorded after PPV was a case of cystoid macular edema. No difficulties in visualization due to IOL design were reported during PPV. Conclusion: PPV for ERM in eyes with this trifocal IOL is safe and effective, and allows recovery of the loss of UNVA.

scholarly journals Monocular Clinical Outcomes and Range of Near Vision following Cataract Surgery with Implantation of an Extended Depth of Focus Intraocular Lens

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Rahul T. Pandit
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Focal Length ◽  
Full Range ◽  
Case Series ◽  
Depth Of Focus ◽  
Retrospective Case ◽  
Distance Visual Acuity ◽  
Extended Depth Of Focus ◽  
Near Visual Acuity

Importance. A full range of near and intermediate vision has not been clinically evaluated for the Symfony extended depth of focus intraocular lens (EDOF IOL). Background. To evaluate the monocular range of near visual acuity with an EDOF IOL. Design. Retrospective case series. Participants. Consecutive patients of a single surgeon from January 2017 through March 2018. Methods. Phacoemulsification with implantation of an EDOF IOL. Main Outcome Measures. Uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), distance-corrected near visual acuity (DCNVA), range of DCNVA, and optimal near focal length. Results. Seventy-six eyes of 48 patients (34 or 71% female, mean age: 68 years) were included with a mean follow-up of 68 days. Mean values were as follows: logarithm of the minimum angle of resolution (logMAR) UDVA 0.02 ± 0.09, logMAR UNVA 0.12 ± 0.09 at a mean distance of 51 cm, logMAR CDVA −0.05 ± 0.07, logMAR DCNVA 0.08 ± 0.07 at a mean distance of 51 cm, and a spherical equivalent of −0.16 diopters ±0.35. Percentage of eyes achieving DCNVA of 20/30 were 84% at 36 cm, 92% at 41 cm, 99% at 51 cm, 93% at 61 cm, and 74% at 71 cm. DCNVA of 20/40 or better was achieved in nearly 100% of eyes over a range of 35 cm. Conclusions and Relevance. The Symfony EDOF IOL achieved excellent distance visual acuity while providing a 35 cm range of near visual acuity at levels useful for many tasks in nearly all patients.

scholarly journals Outcome of paediatric cataract surgery in Northwest Ethiopia: a retrospective case series

2018 ◽  
Vol 103 (1) ◽  
pp. 112-118 ◽  
Author(s):  
Mulusew Asferaw ◽  
Sisay Yoseph Mekonen ◽  
Geoffrey Woodruff ◽  
Clare E Gilbert ◽  
Samson Tesfaye
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Case Series ◽  
Northwest Ethiopia ◽  
Retrospective Case ◽  
Postoperative Rehabilitation ◽  
Bilateral Cataract ◽  
Eye Health ◽  
Paediatric Cataract

AimTo assess visual acuity outcomes, and factors associated with the outcome, of paediatric cataract surgery at the Child Eye Health Tertiary Facility, Gondar, Northwest Ethiopia.MethodsThe medical records of children aged below 16 years who underwent cataract surgery between September 2010 and August 2014 were reviewed for preoperative, surgical and postoperative data.ResultsOne hundred and seventy-six eyes of 142 children (mean age 7.9 years±4.2 SD, 66% male) who had cataract surgery were included. Twenty-five per cent (35/142) of children had bilateral cataract, 18 (13%) had unilateral non-traumatic cataracts and 89 (63%) had unilateral traumatic cataracts. An intraocular lens was implanted in 93% of eyes. Visual acuities at last follow-up: bilateral cases in the better eye: good (≥6/18 or fix and follow) in 21/34 eyes (62%), borderline (<6/18–6/60) in 4 eyes (12%) and poor (<6/60) in 9 eyes (26%). In unilateral non-traumatic cases: good in 6 eyes (33%), borderline in 3 eyes (17%) and poor in 9 eyes (50%). In unilateral traumatic cases: good in 36 eyes (40%), borderline in 20 eyes (23%) and poor in 33 eyes (37%). In bilateral cataract, worse outcomes were associated with preoperative nystagmus/strabismus. In traumatic cases, worse outcomes were associated with the preoperative trauma-related complications.ConclusionsVisual acuity improved significantly after surgery, with better outcomes in bilateral cases. Early detection and surgery by a trained surgeon with good follow-up and postoperative rehabilitation can lead to better visual outcomes.

Clinical characteristics and treatment of secondary glaucoma, glaucoma suspects and ocular hypertension after congenital cataract surgery

2021 ◽  
pp. 112067212199135
Author(s):  
Katharina Eibenberger ◽  
Barbara Kiss ◽  
Ursula Schmidt-Erfurth ◽  
Eva Stifter
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Ocular Hypertension ◽  
Congenital Cataract ◽  
Case Series ◽  
Secondary Glaucoma ◽  
Visual Axis ◽  
Retrospective Case ◽  
Pediatric Cataract ◽  
Congenital Cataract Surgery

Objective: To evaluate changes in intraocular pressure after congenital cataract surgery in a real-world setting. Methods: This retrospective case series included all children aged 0–2 years undergoing lens extraction due to congenital cataract. Development of an elevated intraocular pressure was divided into three groups: secG, suspG and OHT. Further, risk factors for IOP changes, the therapeutic approach and functional outcome were assessed during follow-up. Results: One hundred and sixty-one eyes of 110 patients aged 0–2 years were included, whereof 29 eyes of 17 children developed secondary glaucoma (secG; 11 eyes/8 patients), glaucoma suspect (suspG; three eyes/three patients) or ocular hypertension (OHT; 15 eyes/10 patients). No difference in surgrical procedure ( p = 0.62) was found, but age at cataract surgery differed significantly ( p = 0.048), with the secG group (1.74 ± 1.01 months) being the youngest (suspG: 3.93 ± 1.80 months; OHT group: 5.91 ± 5.36 months). Secondary surgical intervention was significantly higher in the secG (4.64 ± 3.41) followed by the suspG (2.00 ± 2.65) and OHT groups (0.40 ± 0.74; p < 0.001). Postoperative complications including nystagmus ( p = 0.81), strabismus ( p = 0.98) and amblyopia ( p = 0.73) showed no difference, in contrast to visual axis obscuration which was more common in the secG group ( p = 0.036). Conclusion: Initial lensectomy and anterior vitrectomy procedure together with or without IOL implantation seems to have no influence for the development of IOP changes after pediatric cataract surgery. However, children who developed secondary glaucoma had cataract surgery significantly earlier, within the first 2–3 months of life. Glaucoma surgery was required to achieve final IOP control in most eyes. The development of secondary glaucoma was also associated with a significant increase in surgical re-treatments.

scholarly journals Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK

2021 ◽  
Vol 10 (11) ◽  
pp. 2478
Author(s):  
Majid Moshirfar ◽  
David G. West ◽  
Chase M Miller ◽  
William B. West ◽  
Shannon E. McCabe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
High Myopia ◽  
Case Series ◽  
Retrospective Case ◽  
Visual Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Incidence Risk ◽  
Mechanical Devices

Although the use of femtosecond lasers instead of mechanical devices has decreased the incidence of flap complications following laser-assisted in situ keratomileusis (LASIK), dislocations and striae still occur. Flap repositioning is an effective intervention to improve visual outcomes after acute flap complications in both microkeratome-assisted and femtosecond-assisted LASIK. This retrospective case series included patients undergoing flap repositioning secondary to acute flap dislocation and/or visually significant striae within the first two weeks following femtosecond LASIK (FS-LASIK) from 2015 to 2020 at a single institution. Preoperative, intraoperative, and postoperative de-identified data were analyzed for incidence, risk factors, and visual acuity outcomes. The incidence of flap repositioning was 0.35% in 21,536 eyes (n = 70). Indications for repositioning included acute flap dislocation (35.7%) and visually significant striae (64.3%). High myopia (OR = 3.04, p = 0.001) and patient age over 50 years (OR = 3.69, p = 0.001) were the strongest risk factors for these complications. Prior to flap repositioning, uncorrected distance visual acuity (UDVA) of 20/20 or better and 20/40 or better occurred in 19% and 57% of eyes, respectively. After repositioning, a final UDVA of 20/20 or better and 20/40 or better occurred in 78% and 98% of eyes, respectively. After repositioning, one line of UDVA was lost in two eyes (2.8%) and two lines were lost in one eye (1.4%). Risk factors for acute flap dislocation included high myopia and age over 50 years. Flap repositioning was effective in salvaging visual outcomes.

scholarly journals Frequency of Complications Following Cataract Surgery in Diabetic Patients at Tertiary Care Hospital

2022 ◽  
Vol 9 (1) ◽  
pp. 75-81
Author(s):  
Muhammad Bilal ◽  
Shafqat Ali Shah ◽  
Marina Murad ◽  
Saad Ali ◽  
Ammad Ali ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Tertiary Care ◽  
Case Series ◽  
Female Gender ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Case Series Study

OBJECTIVES: To determine the frequency of complications following cataract surgery in diabetic patients admitted in the ophthalmology unit. METHODOLOGY: A prospective descriptive interventional case series study was conducted after approval of the ethical committee, from June 2017-June 2020 at the Ophthalmology department MTI-MMC. A total of 129 patients from either gender were enrolled in study. All the study patients went through detailed history and complete ocular examination. After necessary investigations, surgical procedure was carried out. Results were analyzed through the SPSS-24 version. RESULTS: Out of the total 129 eyes of the diabetic patients, fifty-nine (45.7%) were males and seventy (54.3%) were females with a ratio of 1:1.2. Uveitis leads the chart in complications found in twenty (15.50%) eyes while PODR being the least common found in only ten (7.75%) eyes. Worse visual acuity was observed in fourteen (10.85%) eyes. Striate keratopathy and posterior capsule opacification were found in sixteen (12.40%) and fifteen (11.62%) eyes respectively. Among the patients, 15.7% were having more than one complication during follow-up visits and eighty-eight (68.2%) eyes were found to have none complication. The age group 51-60 years observed frequent complications as compared to other groups. Similarly female gender (38.57%) has frequent complications as compared to males (2.7%). CONCLUSION: The study concludes Uveitis as the most common complication observed in 15.50% 0f the eyes while worse visual acuity (10.85%) and progression of diabetic retinopathy (7.75%) being the least common. Striate keratopathy was found in 12.40% while posterior capsule opacification in 11.62% of the eyes.

scholarly journals Safety and efficacy of posterior iris claw intraocular lens fixation in aphakic patients

2018 ◽  
Vol 16 (2) ◽  
pp. 124-133
Author(s):  
Rosemary Tomy ◽  
Rajkumar Maheshwari ◽  
Ansa Parveen Kunhu Muhammed ◽  
Venkataramana Kalikivayi ◽  
Sajeev Cherian Jacob
Keyword(s):  
Intraocular Lens ◽  
Anterior Segment ◽  
Case Series ◽  
Visual Outcome ◽  
Applanation Tonometry ◽  
Long Term Results ◽  
Retrospective Case ◽  
Case Series Study ◽  
Wide Range

Purpose: To assess the indications and visual outcome of eyes undergoing posterior iris fixated intraocular lens (IFIOL) implantation for aphakia, to identify reasons for poor visual outcome, and report occurrence of complications. Methods: In this retrospective case series study, all cases of posterior IFIOL fixation performed over a 30-month period were identified retrospectively. Preoperative and postoperative evaluations comprised objective and subjective refraction, best corrected visual acuity (BCVA), slit lamp biomicroscopy, applanation tonometry, and dilated fundus examination. Results: Fifty-six eyes of 56 patients were analyzed. Mean age was 60.55 ± 17.2 years. The most common indication for IFIOL implantation was surgical aphakia following complicated cataract surgery (n = 33; 58.9%) followed by trauma (n = 10; 17.9%), dropped nucleus/IOL during primary surgery (n = 6; 10.7%), and subluxated/dislocated lens-induced glaucomas (n = 5; 8.9%). BCVA better than or equal to their preoperative BCVA was achieved in 96.43% patients. The surgical aphakia and paediatric/adolescent groups had the best visual results while the dropped nucleus/IOL group and subluxated lens-induced glaucoma groups fared poorly. On the long-term follow-up visit, the most common complication noted was pigment dusting on the corneal endothelium (65.7%). Conclusion: The long-term results suggest that posterior IFIOL implantation is a safe and effective method for correction of aphakia and can be used for a wide range of indications in eyes without adequate capsule support. It may be considered an easier and faster alternative with minimal manipulation to anterior segment structures in paediatric and post-traumatic aphakic eyes.

scholarly journals A COMPARISION OF POSTERIOR CAPSULAR OPACITY FORMATION UPTO 1 YEAR IN PATIENTS WITH SMALL INCISION CATARACT SURGERY WITH FOLDABLE INTRAOCULAR LENS AND PHACOEMULSIFICATION WITH THE SAME INTRAOCULAR LENS

2020 ◽  
pp. 173-176
Author(s):  
Kinjal Rathod ◽  
Kinjal Trivedi ◽  
Snehal Nayi ◽  
Somesh Aggarwal
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Nd:Yag Laser ◽  
Visual Outcome ◽  
Posterior Capsular Opacification ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Common Procedure ◽  
Age Related

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.

scholarly journals Combined Pars Plana Glaucoma Drainage Device Placement and Vitrectomy Using a Vitrectomy Sclerotomy Site for Tube Placement: A Case Series

2020 ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Tests ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Retrospective Case ◽  
Tube Obstruction ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Background: The purpose of this study is to report the safety and efficacy of pars plana (PP) glaucoma drainage devices (GDDs) with pars plana vitrectomy (PPV) using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma.Methods: Retrospective case series of 28 eyes of 28 patients who underwent combined PP GDD and PPV between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity (BCVA), and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests.Results: Mean IOP decreased from 22.8 mmHg to 11.4 mmHg at 1.5 years (p = 0.009), and mean medication burden decreased from 4.3 to 1.7 at 1.5 years (p = 0.009). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 ≤ IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 77.7% at 1 year and 45.8% at 1.5 years. At their last visit, four eyes (14.3%) achieved complete success with IOP reduction as above without medications, and 13 eyes (46.2%) achieved qualified success with medications. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of >2 lines. Two eyes required subsequent PPV for tube obstruction, and one eye had transient hypotony.Conclusions: The results of pars plana GDD and vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting GDDs into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

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