- MeSH
- Capsulorhexis methods MeSH
- Cataract Extraction * methods MeSH
- Glucocorticoids administration & dosage MeSH
- Lens Implantation, Intraocular methods MeSH
- Cataract complications therapy MeSH
- Humans MeSH
- Uveitis, Anterior complications MeSH
- Child, Preschool * MeSH
- Check Tag
- Humans MeSH
- Child, Preschool * MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Cataract Extraction methods MeSH
- Cataract * diagnosis etiology MeSH
- Humans MeSH
- Risk Factors MeSH
- Check Tag
- Humans MeSH
PURPOSE: To compare 3 capsulotomy centration methods. SETTING: Private clinic, Zlin, Czech Republic. DESIGN: Prospective, consecutive case series. METHODS: 180 eyes undergoing cataract surgery had anterior capsule staining with microfiltered 0.4% trypan blue solution before selective laser capsulotomy. The first 60 eyes (Group 1) had mydriatic dilated pupil centered capsulotomies. The next 60 eyes (Group 2) were centered on the trypan blue central landmark (TCL). The final 60 capsulotomies (Group 3) were centered on the patient fixated coaxial Purkinje reflex (CPR). Measurements between key anatomical landmarks and the TCL, CPR capsulotomies, and implanted intraocular lens (IOL) center were made. RESULTS: The TCL, observed in >94% of eyes in the study, coincided with the CPR with a displacement of <0.1 ± 0.1 mm. Group 1 capsulotomies were noticeably decentered on the IOLs by 0.3 ± 0.2 mm. The Group 2 symmetrical IOL relationship was maintained with a decentration of 0.15 ± 0.1 mm. Group 3 had a similar decentration with the IOLs with 0.15 ± 0.1 mm. Verification with IOLMaster 700 data and CALLISTO Eye System showed that the CPR and the TCL were coincident with the measured visual axis. CONCLUSIONS: The clearly visible TCL served as an alternate landmark to the patient fixated CPR, and being on the anterior capsule was not sensitive to tilt. Further patient compliance was not required. Both were superior to dilated pupil centration, to achieve symmetric IOL coverage. This has application for both capsulotomies and capsulorhexes.
- MeSH
- Anatomic Landmarks MeSH
- Coloring Agents * administration & dosage MeSH
- Capsulorhexis * methods MeSH
- Phacoemulsification * MeSH
- Lens Implantation, Intraocular MeSH
- Middle Aged MeSH
- Humans MeSH
- Lens Capsule, Crystalline surgery MeSH
- Anterior Capsule of the Lens surgery MeSH
- Prospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Trypan Blue * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
This is a case report describing the uncommon finding of a cystic-like lesion and its management in the anterior chamber of a male patient after cataract surgery.
- MeSH
- Cataract Extraction * adverse effects MeSH
- Cataract * etiology MeSH
- Hyaluronic Acid MeSH
- Humans MeSH
- Anterior Chamber MeSH
- Sodium MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
PURPOSE: To assess the visual outcome of cataract surgery in patients with retinitis pigmentosa (RP). DESIGN: Retrospective, noncomparative clinical study. METHODS: Preoperative, intraoperative, and postoperative data of patients with RP who were undergoing cataract surgery were collected from several expertise centers across Europe. RESULTS: In total, 295 eyes of 226 patients were included in the study. The mean age at surgery of the first eye was 56.1 ± 17.9 years. Following surgery, best-corrected visual acuity (BCVA) improved significantly from 1.03 to 0.81 logMAR (ie, 20/214 to 20/129 Snellen) in the first treated eye (-0.22 logMAR; 95% CI = -0.31 to -0.13; P < .001) and from 0.80 to 0.56 logMAR (ie, 20/126 to 20/73 Snellen) in the second treated eye (-0.24 logMAR; 95% CI = -0.32 to -0.15; P < .001). Marked BCVA improvements (postoperative change in BCVA of ≥0.3 logMAR) were observed in 87 of 226 patients (39%). Greater odds for marked visual improvements were observed in patients with moderate visual impairment or worse. The most common complications were zonular dialysis (n = 15; 5%) and (exacerbation of) cystoid macular edema (n = 14; 5%), respectively. Postoperative posterior capsular opacifications were present in 111 of 295 eyes (38%). CONCLUSION: Significant improvements in BCVA are observed in most patients with RP following cataract surgery. Baseline BCVA is a predictor of visual outcome. Preoperative evaluation should include the assessment of potential zonular insufficiency and the presence of CME, as they are relatively common and may increase the risk of complications.
- MeSH
- Adult MeSH
- Phacoemulsification * MeSH
- Lens Implantation, Intraocular MeSH
- Cataract * complications MeSH
- Middle Aged MeSH
- Humans MeSH
- Retinitis Pigmentosa * complications diagnosis surgery MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Capsule Opacification * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Intraoperative floppy iris syndrome (IFIS) is a cataract surgery complication that remains a challenge for eye surgeons. It is caused by the antagonism of alfa-1-adrenergic receptors within the dilator muscle of the iris, thus preventing the iris from dilation during a cataract surgery. The long-term blocking alfa-1 adrenergic receptors by the chronic use of a number of systemic medications may lead to permanent anatomical atrophy of the dilator muscle of the iris. The most common drugs associated with the development of IFIS are tamsulosin and other alpha-1 adrenergic receptor antagonists prescribed to patients with low urinary tract symptoms (LUTS). There are other systemic medications that have been reported to have increased risk for IFIS. It is crucial for the ophthalmologist to identify the high-risk patients prone to develop IFIS. Its presence may complicate the course of cataract surgery, ultimately negatively affecting visual outcome. Cataract surgery should be performed by an experienced eye surgeon using alternative pharmacological and surgical techniques. Interdisciplinary cooperation is essential to mitigate potential complications. Patients should be informed by their physicians about the need to report a medication history to their eye specialists, especially before cataract surgery.
- MeSH
- Receptors, Adrenergic MeSH
- Adrenergic alpha-Antagonists adverse effects MeSH
- Phacoemulsification * MeSH
- Iris MeSH
- Cataract * chemically induced MeSH
- Humans MeSH
- Iris Diseases * chemically induced diagnosis MeSH
- Intraoperative Complications chemically induced MeSH
- Sulfonamides adverse effects MeSH
- Syndrome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
PURPOSE: The study evaluates the rate of postoperative formation of a pupillary membrane (PM) and posterior visual axis opacification (PVAO) in infants with and without primary IOL implantation during the first 4 months of infancy. METHODS: Medical records for 144 eyes (101 infants) operated between 2005 and 2014 were evaluated. A posterior capsulectomy and anterior vitrectomy were performed. Primary IOL implantation was performed in 68 eyes, while 76 eyes were left aphakic. There were 16 bilateral cases in the pseudophakic group and 27 in the aphakic group. The follow-up period was 54.3 ± 21.05 months and 49.1 ± 18.60 months, respectively. Fisher's exact test was used for statistical analysis. The two-sample t-test with equal variance was used to compare surgery age, follow-up period and time intervals of complications. RESULTS: The mean age of surgery was 2.1 ± 0.85 months in the pseudophakic and 2.2 ± 1.01 months in the aphakic group. PM was diagnosed in 40% pseudophakic and 7% aphakic eyes. A second surgery for PVAO was performed in 72% pseudophakic and 16% aphakic eyes. Both were significantly higher in the pseudophakic group. In the pseudophakic group, the number of PVAO was significantly higher in infants operated before 8 weeks of age compared to surgery age 9-16 weeks. The frequency of PM was not age-dependent. CONCLUSION: Although it remains feasible to implant an IOL during the primary surgery, even in very young infants, there should always be solid arguments for this decision since it puts the child at higher risk of repeated surgeries under general anaesthesia.
- MeSH
- Aphakia * complications MeSH
- Child MeSH
- Cataract Extraction * adverse effects MeSH
- Lens Implantation, Intraocular adverse effects MeSH
- Cataract * congenital MeSH
- Infant MeSH
- Humans MeSH
- Follow-Up Studies MeSH
- Lenses, Intraocular * adverse effects MeSH
- Postoperative Complications epidemiology MeSH
- Retrospective Studies MeSH
- Visual Acuity MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
Aims: To compare the changes of central corneal thickness (CCT) and intraocular pressure (IOP) post-phacoemulsification between cataract patients with and without pre-existing glaucoma. Materials and methods: A prospective cohort study of 86 patients with visually significant cataract: 43 with pre-existing glaucoma (GC group) and 43 without pre-existing glaucoma (CO group). CCT and IOP were evaluated at baseline (pre-phacoemulsification), as well as at 2 hours, 1 day, 1 week and 6 weeks post-phacoemulsification. Results: The GC group have significantly thinner CCT pre-operatively (p = 0.003). There was a steady increase of CCT with the highest peak at 1 day post-phacoemulsification, followed by a steady decline of CCT and back to baseline at 6 weeks post-phacoemulsification in both groups. The GC group demonstrated a significant difference in CCT at 2 hours (mean difference 60.2 μm, p = 0.003) and 1 day (mean difference 70.6 μm, p = 0.002) post-phacoemulsification, compared to the CO group. There was a sudden increase in IOP at 2 hours post-phacoemulsification measured by GAT and DCT in both groups. This was followed by a gradual reduction of IOP, with significant reduction at 6 weeks post-phacoemulsification in both groups. However, there was no significant difference in IOP between the two groups. IOP measured by GAT and DCT showed strong correlation (r > 0.75, p < 0.001) in both groups. There was no significant correlation between GAT-IOP and CCT changes; nor between DCT-IOP and CCT changes in both groups. Conclusions: CCT changes post-phacoemulsification in patients with pre-existing glaucoma were similar, in spite of having thinner CCT pre-operatively. IOP measurement was not affected by CCT changes in glaucoma patients post-phacoemulsification. IOP measurement using GAT is comparable with DCT post-phacoemulsification.
