Development of Algorithm of Surgical Treatment Choice in Patients with Cataract and Asteroid Hyalosis

The method of phacovitrectomy can be used for surgical treatment of patients with cataract and asteroid hyalosis. However, there is still a topical question in the choice of surgical treatment taking into account the completeness of the posterior hyaloid membrane (PHM) detachment.Patients and methods: the study involved 24 patients (24 eyes) with cataract and asteroid hyalosis. The average age of patients was 72.9 years, out of the total number of men — 11, women — 13. Pre-and postoperative diagnosis of all patients included standard methods of investigation, as well as optical coherence tomography performed on the Cirrus HD-OCT 400, Carl Zeiss, Germany. Pre-and postoperative subjective satisfaction was assessed using a validated visual Function Qusetionnaire 14 ophthalmological questionnaire. Patients were divided into 3 groups. In the first group of patients, cataract phacoemulsification with posterior chamber lens implantation and total three-port vitrectomy through a flat part of the ciliary body were performed. In the second patients’ group, cataract phacoemulsification with posterior chamber lens implantation and subtotal vitrectomy through posterior capsulorexis were performed. In the third group of patients, cataract phacoemulsification with posterior chamber lens implantation was performed. All operations were performed with the help of ophthalmic systems Infinity Vision System (Alcon, USA) and Constellation Vision System (Alcon, USA).Results: in the first day after the operation, all patients noted improvement in visual acuity and quality of life, but more significant improvement was noted in patients of the first and second groups.Conclusion: analysis of the results of surgical treatment, questionnaire survey, preoperative diagnosis allowed to develop an algorithm for choosing the method of surgical treatment in patients with cataract and asteroid hyalosis, taking into account the state of PHM.

Indications for intraoperative anterior segment optical coherence tomography in corneal surgery

Purpose Recently, intraoperative optical coherence tomography (iOCT) has evolved in the field of ophthalmic surgery. So far, the use of iOCT was mainly focused to lamellar keratoplasty, especially deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK). The aim of this study was to report our experiences with iOCT to introduce new possibilities of this application. Methods We used iOCT in 18 patients who underwent the following surgeries: DALK, DMEK, penetrating keratoplasty, autologous limbal transplantation, transscleral suture fixation of a posterior chamber lens, pannus removal on corneal surface and newborn investigation in Peters’ anomaly. We obtained qualitative video data for all procedures. Results With the iOCT, the cannula placement during DALK preparation of the recipient cornea and bubble formation could be visualized to improve the success rate of the big bubble injection. In DMEK, the iOCT enables the visualization of Descemet’s membrane removal in the recipient and graft orientation as well as better control of graft attachment. The iOCT enables intraoperative visualization of the graft–host interface during penetrating keratoplasty. During autologous limbal transplantation, transscleral suture fixation of a posterior chamber lens and removal of corneal surface pannus the iOCT is capable of showing the thickness of lamellar preparations to avoid penetrations and to save healthy recipient’s tissue. Conclusion The iOCT is a helpful device for intraoperative anterior segment imaging not only for DALK and DMEK. It is also beneficial in penetrating keratoplasty and every other form of lamellar preparation during corneoscleral surgery.

Small Incision Sutureless Cataract Extraction with and without Posterior Chamber Lens

A total of 27 cases were operated at LGH durmg the December 1992 to June 1996, over a period of 4 years With a few complications. the procedure was encouraging. Good visual results were observed in 85% of the cases. Males were 19 and females were 8. The preferred choice of the patients was of younger age group. Posterior capsular rent occurred in 4 patients 3 patients did not like the PCL. And 24 underwent PECCE with PCL

EVALUATE THE CHANGES IN INTRAOCULAR PRESSURE AFTER PHACOEMULSIFICATION WITH POSTERIOR CHAMBER LENS IMPLANTATION

Purpose: To evaluate IOP reduction effect of phaco surgery in senile cataract patients, and to assess the correlation between the changes of IOP and the some affects. Methods: Prospective correlation study. Phaco surgery was performed on 107 senile cataracts of 102 patients in Ophthalmology Department of Hue Central Hospital from January 2014 to July 2014. IOP was measured preoperatively, 4 – 8 hours, 1 day, 10 days, 1 month, and 3 months postoperatively. Some related factors were also analyzed. Results: Mean preoperative IOP declined from 17.27 ± 2.42 mmHg to 14.71 ± 2.20 mmHg at 1 month after the surgery and remained stable until the last follow-up (3 months). The IOP decreased correlated proportionally to the morphology of cataract, the firmness and thickness of lens, anterior chamber depth, anterior chamber angle. Conclusion: IOP was significantly reduced after phacoemulsification. This effect sustained through out the study time. Key words: Cataract, post-operative IOP reduction, phacoemulsification.