Purpose: To describe clinical visual outcomes, spectacle independence, and patient satisfaction after cataract surgery with blending implantation of ReSTOR (Alcon laboratories) multifocal intraocular lenses. Material and Methods: A single-arm, non-randomized prospective study assessed patients undergoing cataract surgery with ReSTOR® +2.50 intraocular lens in the dominant eye and +3.00 add in the fellow eye between January 2015 to January 2020. Results: In total, 47 patients (94 eyes) were enrolled, 28 women and 19 men. The average age at surgery time was 64 ±8 years, average postoperative follow-up was 45.4 ±7.0 months, with a minimum of 18.9 months. Postoperative binocular uncorrected distance visual acuity (UDVA) was on average 0.07 logMar (Snellen 20/24), uncorrected binocular intermediate visual acuity at 65 cm was 0.07 logMar (20/24), uncorrected binocular near visual acuity at 40 cm was 0.06 logMar (20/23). Contrast sensitivity under photopic and scotopic conditions, with and without glare, remained at the upper limit of normality. 98% of patients were quite satisfied or very satisfied. 87% did not require glasses for any activities, either at distant vision, nor at near vision. Conclusions: Cataract surgery with ReSTOR® IOL blended vision showed medium-term satisfactory visual results, achieving spectacle independence and a high level of satisfaction.
- MeSH
- citlivost na kontrast MeSH
- extrakce katarakty * metody MeSH
- fakoemulzifikace metody MeSH
- implantace nitrooční čočky metody MeSH
- katarakta komplikace terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nitrooční čočky MeSH
- prospektivní studie MeSH
- senioři MeSH
- spokojenost pacientů MeSH
- vidění binokulární MeSH
- zraková ostrost MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
Ciele: Sivý zákal je hlavnou príčinou slepoty celosvetovo. Dodnes nebol objavený konzervatívny spôsob ako zabrániť vzniku a progresii kalenia šošovky. Fakoemulzifikácia je zlatým štandardom v chirurgickom riešení sivého zákalu. Cieľom práce bolo porovnať pooperačné výsledky techniky fakoemulzifikácie v porovnaní s femtosekundovým laserom asistovanou operáciou katarakty (FLACS). Material a metódy: Práca retrospektívne hodnotí výsledky pacientov po výmene umelej vnútroočnej šošovky pre kataraktu od mája 2017 do marca 2019. V štúdii bolo celkovo hodnotených 80 implantovaných šošoviek u 47 pacientov, operovaných dvomi chirurgami. Zo 47 pacientov bolo 28 žien. Priemerný vek v skupine bol v čase operácie 63,7 rokov, v rozmedzí 34–79 rokov. Pacienti si mohli zvoliť operáciu šošovky FLACS (n = 45) alebo štandardnú fakoemulzifikáciu (n = 35) šošovky. Výsledky: Porovnaním skupiny v nekorigovanom videní do diaľky 12 mesiacov po operácii v skupine FAKO KATARAKTY 0,85 ±0,18 vs. 0,93 ±0,12 v skupine FEMTO KATARAKTY (p = 0,021), porovnateľne nekorigovaný vízus do blízka bol 12 mesiacov po operácii 0,77 ±0,18 vs. 0,84 ±0,17 v skupine FEMTO KATARAKTY (p = 0,034). Rozdiel v použití fakoemulzifikačnej energie (OZIL) u pacientov s fakoemulzifikáciou 3,5 ±3,1 a pri použití femtosekundového lasera 2,2 ±3,1, (p = 0,005). Vo všetkých prípadoch bola implantovaná trifokálna šošovka AT LISA 839 (Carl Zeiss Meditec, Nemecko). Záver: Femtosekundová platforma pomáha chirurgovi pri operácii katarakty s kapsulorexou a prefragmentáciou šošovkového jadra, čo môže byť výhodne najmä u komplikovaných katarákt. V skupine FLACS sme zaznamenali signifikantne vyššiu nekorigovanú zrakovú ostrosť do diaľky aj do blízka a signifikatne nižšiu hodnotu použitej energie pri fakoemulzifikácii.
Aims: Cataracts continue to be the leading cause of blindness worldwide. Phacoemulsification is the gold standard in the treatment of cataracts. The aim of the study was to compare the postoperative results of the phacoemulsification technique in comparison with femtosecond laser-assisted cataract surgery (FLACS). Material and Methods: Our work retrospectively evaluates the results of patients after implantation of an artificial intraocular lens for cataract from May 2017 to March 2019. The study evaluated a total of 80 implanted lenses in 47 patients operated on by two surgeons. Of the 47 patients, 28 were women. The mean age in the group at the time of surgery was 63.7 years, ranging from 34–79 years. Patients could choose FLACS (n = 45) surgery or standard phacoemulsification procedure (n = 35). Results: Upon a comparison of the group regarding uncorrected distal visual acuity (UCDVA) up to 12 months after surgery, the group FAKO CATARACTS recorded 0.85 ±0.18 vs. 0.93 ±0.12 in the FEMTO CATARACTS group (p = 0.021), comparably uncorrected near visual acuity (UCNVA) was 0.77 ±0.18 vs. 0.84 ±0.17 (p = 0.034) respectively. A difference in the use of phacoemulsification energy (OZIL) was measured in patients with phacoemulsification 3.5 ±3.1 and in the use of femtosecond laser 2.2 ±3.1, (p = 0.005). In all cases, an AT LISA 839 trifocal lens (Carl Zeiss Meditec, Germany) was implanted. Conclusion: The femtosecond platform assists the surgeon in cataract surgery with capsulorhexis and pre-fragmentation of the lens nucleus, which can be advantageous especially for complicated cataracts. We recorded significantly higher uncorrected distance and near visual acuity in the FLACS group, and also a significantly lower value of the phacoemulsification energy used.
Cíl: Porovnat parametry fakoemulzifikace při použití koncovek Active Sentry a Centurion Ozil. Metodika: Prezentovaný soubor zahrnuje 200 očí 129 pacientů, kteří byli operováni na Oční klinice pro kataraktu jedním chirurgem (NJ). U 100 očí byla použita koncovka Active Sentry a u 100 očí koncovka Centurion Ozil. Hlavními sledovanými parametry byly nitrooční tlak v průběhu operace, celková kumulativní energie (CDE – cumulative dissipated energy), celkový čas fakoemulzifikace (U/S čas) a spotřebovaná tekutina během zákroku. Výsledky: Při použití koncovky Centurion Ozil byl průměrný nitrooční tlak během operace 65 mmHg, při použití koncovky Active Sentry bylo možné snížit bezpečný nitrooční tlak v průběhu operace na 46 mmHg aniž by docházelo ke zvýšení fluktuace či k poklesu stability přední komory. Průměrné hodnoty CDE a U/S čas byly ve skupině Active Sentry statisticky signifikantně menší než ve skupině Centurion Ozil. Rozdíl v množství spotřebované tekutiny naopak nebyl statistický signifikantní. Závěr: Naše výsledky potvrdily, že při použití koncovky Active Sentry lze bezpečně významně snížit nitrooční tlak v průběhu fakoemulzifikace a výrazně eliminovat postokluzní vlny. Toto snížení přináší více výhod: pro pacienta např. nižší bolestivost, pro chirurga mnohem komfortnější průběh fakoemulzifikace zejména u rizikových pacientů (syndrom vlající duhovky, těžká myopie).
Aim: To compare parameters of phacoemulsification using handpiece Active Sentry and Centurion Ozil. Methods: We have evaluated results of 200 eyes of 129 patients that were operated for cataract at the Department of Ophthalmology. All surgeries were performed by one surgeon (NJ). In 100 eyes handpiece Active Sentry was used and in 100 eyes handpiece Centurion Ozil was used. The intraocular pressure during surgery (IOP), cumulative dissipated energy (CDE), ultrasound time (U/S time) and estimated consumption of balanced salt solution (BSS) were evaluated. Results: Using handpiece Ozil Centurion the IOP was 65 mmHg, use handpiece Active Sentry enabled decrease safely peroperative IOP to 46 mm Hg withouth increase of fluctuation or declension of stability of the anterior chamber. The mean CDE a U/S time were significantly statistically decreased using Active Sentry versus Centurion Ozil handpieces. Difference in estimated consumption of balanced salt solution was not statistically significant. Conclusion: Our results proved that using handpiece Active Sentry enabled statistically significantly decrease IOP during phacoemulsification and eliminated post-occlusion surge. This brings several advantages: more painless surgery for patients and more user-friendly procedure for surgeon especially in challenging cases (intraoperative floppy iris syndrome or severe myopia).
INTRODUCTION: To evaluate the results of the fluctuations of intraocular pressure (IOP) and calculated mean ocular perfusion pressure (MOPP) during the usual steps of standard phacoemulsification. METHODS: Nine human eyes were evaluated. The IOP was measured indirectly by electronic applanation tonometer. The MOPP was calculated using the systolic blood pressure (SBP), the diastolic blood pressure (DBP) and the IOP: MOPP = 2/3x[DBP + 1/3x(SBP - DBP)] - IOP. The operations were performed with the INFINITI® Vision System: main incision 2.2 mm, coaxial handpiece, 2 paracenteses 1.1 mm, bimanual irrigation/aspiration, bottle height 100 cm. As ocular viscoelastic device (OVD) Hypromel 2.5% (UNIMED) was used. RESULTS: The initial and final IOPs were 17-30 Torr (median 18) and 6-16 Torr (median 8), respectively. The IOP values oscillated between 4 and 63 Torr during the procedure. The highest values of the IOP were achieved at the beginning of phacoemulsification (from 42 to 63 Torr). The maximum pressure higher than 50 mmHg and 60 mmHg was found in 89% and 30% of cases, respectively. The mean ocular perfusion pressure (MOPP) at the beginning of the procedure was 46.4-67.0 (median 53.3) and 0.4-42.0 (median 19.3) during the maximum intraocular pressure. CONCLUSIONS: Measured IOP as well as MOPP varied in all normal steps of real phacoemulsification. High values of intraoperative IOL induced by irrigation may compromise the intraocular perfusion. These fluctuations may induce impairment of the optic nerve perfusion, as well as retina, or choroid.
- MeSH
- fakoemulzifikace škodlivé účinky metody MeSH
- glaukom chirurgie MeSH
- krevní tlak fyziologie MeSH
- lidé MeSH
- nitrooční tlak fyziologie MeSH
- reprodukovatelnost výsledků MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- tonometrie oční metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: To compare the visual and refractive outcomes obtained with the implantation of a rotationally asymmetric refractive multifocal IOL after femtosecond laser-assisted cataract surgery (FLACS) and conventional lens extraction (CLE). METHODS: A total of 78 eyes of 58 patients that had undergone conventional phacoemulsification (36 eyes, CLE group) or FLACS (37 eyes, FLACS group) with the implantation of the toric multifocal IOL LU-313 MF30T (Oculentis, Germany) were enrolled in this retrospective study. Mean age was 57.0 years at the time of surgery, ranging from 44 to 69 years. Visual and refractive outcomes were evaluated during a 12-month follow-up. Likewise, contrast sensitivity was assessed at the end of the follow-up. RESULTS: Significant improvements were observed in both groups in uncorrected distance (UDVA) and near visual acuity (UNVA) at 1 month postoperatively (p < 0.001). Differences between groups in these parameters as well as in sphere and cylinder did not reach statistical significance during the whole follow-up (p ≥ 0.079), except for UNVA only at 12 months postoperatively (p = 0.018). Concerning corrected near visual acuity, only significant differences between groups were found preoperatively (p = 0.020). Furthermore, only a minimal but significant difference between groups was found at 12 months postoperatively in contrast sensitivity for the spatial frequency of 18 cycles/° (p = 0.029). CONCLUSIONS: The rotationally asymmetric toric multifocal IOL LU-313 MF 30T provides good visual rehabilitation for near and distance vision after presbyopic lens extraction in eyes with preexisting astigmatism, independently whether the cataract surgery is performed with the FLACS or conventional technique.
- MeSH
- citlivost na kontrast MeSH
- dospělí MeSH
- fakoemulzifikace * metody MeSH
- implantace nitrooční čočky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- multifokální intraokulární čočky * MeSH
- refrakce oka * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- zraková ostrost MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: To compare the efficacy and safety of anterior capsulotomy creation with a new selective laser device (CAPSULaser) with those of manual capsulotomies. SETTING: GEMINI Eye Clinic, Zlin, Czech Republic. DESIGN: Prospective case series. METHODS: Patients were placed in cohorts based on age and cataract grade and randomly allocated to have laser capsulotomy or manual continuous curvilinear capsulorhexis (CCC). The anterior capsule was stained with microfiltered trypan blue 0.4%. The anterior capsulotomy was created with the laser device focused on the anterior capsule through a custom patient interface lens. Intraoperative video analysis with the use of an intraocular ruler and postoperative examinations were used to assess safety and efficacy (accuracy of capsulotomy size, circularity, centration). RESULTS: No intraoperative complications occurred in the laser group or the manual group. All capsulotomies in the laser group were free-floating with no tags or tears. The mean capsulotomy diameter was 5.03 mm overall (range 4.8 to 5.2 mm, laser group; 4.4 to 5.8 mm, manual group). In the laser group, all the capsulotomies were within 0.1 mm ± 0.1 (SD) of the target. The circularity accuracy was greater than 99.0% ± 1.0%; the mean centration of the capsulotomy in relation to the intraocular lens (IOL) was 0.1 ± 0.1 mm. All parameters were statistically significant (P < .01). The IOL-capsulotomy overlap was 360 degrees in all laser cases. CONCLUSIONS: Selective laser capsulotomy using a new proprietary trypan blue formulation was safe and effective in cataract surgery. The sizing, circularity, and centration of the laser capsulotomy were more accurate than those of the manual CCC, resulting in consistent 360-degree IOL coverage.
- MeSH
- barvicí látky aplikace a dávkování MeSH
- capsulorhexis metody MeSH
- dospělí MeSH
- fakoemulzifikace * metody MeSH
- implantace nitrooční čočky * MeSH
- katarakta komplikace MeSH
- laserová terapie škodlivé účinky přístrojové vybavení MeSH
- lidé středního věku MeSH
- lidé MeSH
- přední pouzdro oční čočky chirurgie MeSH
- prospektivní studie MeSH
- pseudofakie patofyziologie MeSH
- senioři MeSH
- trypanová modř aplikace a dávkování MeSH
- výsledek terapie MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Klíčová slova
- kapsulotomie, femtosekundový laser,
- MeSH
- extrakce katarakty * MeSH
- fakoemulzifikace metody MeSH
- katarakta * terapie MeSH
- kontraindikace léčebného výkonu MeSH
- laserová chirurgie rohovky metody MeSH
- laserová terapie * ekonomika metody škodlivé účinky MeSH
- lidé MeSH
- refrakční chirurgické výkony MeSH
- Check Tag
- lidé MeSH
AIM: To compare the degree of posterior capsule opacification (PCO) after AquaLase and NeoSoniX phacoemulsification methods during an 8-year follow-up period using two types of software. DESIGN: Prospective, randomized clinical trial. METHODS: AquaLase was used in the right eye and NeoSoniX in the left eye of each patient with bilateral cataract. RESULTS: Fifty patients were analyzed 1 year, 46 patients 3 years, and 37 patients 8 years after cataract surgery. Mean EPCO 2000 values were for the AquaLase group 0.324 ± 0.305 and for the NeoSoniX group 0.298 ± 0.341 (P = 0.53) 1 year after surgery, for the AquaLase group 0.582 ± 0.506 and for the NeoSoniX group 0.594 ± 0.515 (P = 0.87) 3 years after surgery, and for the AquaLase group 0.648 ± 0.567 and for the NeoSoniX group 0.673 ± 0.542 (P = 0.30) 8 years after surgery. The OSCA results were for the AquaLase group 0.7097 ± 0.3778 and for the NeoSoniX group 0.8584 ± 0.4323 (P = 0.046) 1 year after surgery, for the AquaLase group 0.9667 ± 0.736 and for the NeoSoniX group 0.9540 ± 0.5250 (P = 0.91) 3 years after surgery, and for the AquaLase group 1,035 ± 0,952 and for the NeoSoniX group 1,103 ± 0,741 (P = 0.44) 8 years after surgery. CONCLUSION: There was minimal PCO difference between these 2 approaches, AquaLase and NeoSoniX. Neither AquaLase nor NeoSoniX technique was able to prevent a natural progression of PCO.
- MeSH
- časové faktory MeSH
- fakoemulzifikace škodlivé účinky metody MeSH
- lidé MeSH
- následné studie MeSH
- pooperační komplikace etiologie MeSH
- prospektivní studie MeSH
- zkalení zadního pouzdra čočky etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
- MeSH
- astigmatismus * etiologie prevence a kontrola MeSH
- extrakce katarakty * metody přístrojové vybavení MeSH
- fakoemulzifikace metody přístrojové vybavení MeSH
- laserová terapie metody přístrojové vybavení MeSH
- lidé MeSH
- optická koherentní tomografie MeSH
- rohovková topografie MeSH
- Check Tag
- lidé MeSH
- Klíčová slova
- femtosekundové lasery, multifokální nitrooční čočka,
- MeSH
- extrakce katarakty * metody MeSH
- fakoemulzifikace * metody přístrojové vybavení trendy využití MeSH
- katarakta * diagnóza terapie MeSH
- lidé MeSH
- nitrooční čočky * klasifikace trendy využití MeSH
- předoperační péče * MeSH
- slepota MeSH
- vzdělávání pacientů jako téma MeSH
- zraková ostrost * fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
