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Sample records for cataract surgery review

  1. Barriers to cataract surgery in Africa: A systematic review

    Shaheer Aboobaker

    2016-01-01

    Full Text Available Cataract remains the leading cause of blindness in Africa. We performed a systematic literature search of articles reporting barriers to cataract surgery in Africa. PubMed and Google Scholar databases were searched with the terms "barriers, cataract, Africa, cataract surgery, cataract surgical coverage (CSC, and rapid assessment of avoidable blindness (RAAB." The review covered from 1999 to 2014. In RAAB studies, barriers related to awareness and access were more commonly reported than acceptance. Other type of studies reported cost as the most common barrier. Some qualitative studies tended to report community and family dynamics as barriers to cataract surgery. CSC was lower in females in 88.2% of the studies. The variability in outcomes of studies of barriers to cataract surgery could be due to context and the type of data collection. It is likely that qualitative data will provide a deeper understanding of the complex social, family, community, financial and gender issues relating to barriers to uptake of cataract surgery in Africa.

  2. Small incision cataract surgery: Complications and mini-review

    Gogate Parikshit

    2009-01-01

    Full Text Available This article reviews the literature on manual small incision cataract surgery (MSICS and its complications. Various articles on MSICS published in indexed journals were reviewed, as well as the sections on complications of MSICS. The Pubmed search engine on the Internet was used to find out articles published since 1985 on MSICS in any language in indexed journals. Books published by Indian authors and the website of Indian Journal of Ophthalmology were also referred to. MSICS has become very popular technique of cataract surgery in India, and it is often used as an alternative to phacoemulsification. Studies on its efficacy and safety for cataract surgery show that, being a variant of extracapsular cataract surgery, MSICS also has similar intraoperative and postoperative complications. The considerable handling inside the anterior chamber during nucleus delivery increase the chances of iris injury, striate keratitis, and posterior capsular rupture. The surgeon has to be extra careful in the construction of the scleral tunnel and to achieve a good capsulorrhexis. Postoperative inflammation and corneal edema are rare if surgeons have the expertise and patience. The final astigmatism is less than that in the extracapsular cataract surgery and almost comparable to that in phacoemulsification. There is, however, a concern of posterior capsular opacification in the long term, which needs to be addressed. Although MSICS demands skill and patience from the cataract surgeon, it is a safe, effective, and economical alternative to competing techniques and can be the answer to tackle the large backlog of blindness due to cataract.

  3. Femtosecond laser-assisted cataract surgery: A current review

    Majid Moshirfar

    2011-01-01

    Full Text Available To evaluate the safety, efficacy, advantages, and limitations of femtosecond laser-assisted cataract surgery through a review of the literature. A PubMed search was conducted using topic-appropriate keywords to screen and select articles. Initial research has shown appropriate safety and efficacy of femtosecond laser-assisted cataract surgery, with improvements in anterior capsulotomy, phacofragmentation, and corneal incision. Limitations of these studies include small sample size and short-term follow-up. Cost-benefit analysis has not yet been addressed. Preliminary data for femtosecond laser-assisted cataract surgery shows appropriate safety and efficacy, and possible advantage over conventional cataract surgery. Questions to eventually be answered include comparisons of long-term postoperative complication rates-including infection and visual outcomes-and analysis of contraindications and financial feasibility.

  4. Small incision cataract surgery: Complications and mini-review

    Gogate Parikshit

    2009-01-01

    This article reviews the literature on manual small incision cataract surgery (MSICS) and its complications. Various articles on MSICS published in indexed journals were reviewed, as well as the sections on complications of MSICS. The Pubmed search engine on the Internet was used to find out articles published since 1985 on MSICS in any language in indexed journals. Books published by Indian authors and the website of Indian Journal of Ophthalmology were also referred to. MSICS has become ver...

  5. Cataract surgery - series (image)

    Cataract surgery usually works very well. The operation has few risks, the pain and recovery period are short, ... improved. Ninety-five percent or more of all cataract surgeries result in improved vision.

  6. Diplopia as the Complication of Cataract Surgery.

    Gawęcki, Maciej; Grzybowski, Andrzej

    2016-01-01

    The authors present systematic review of aetiology and treatment of diplopia related to cataract surgery. The problem is set in the modern perspective of changing cataract surgery. Actual incidence is discussed as well as various modalities of therapeutic options. The authors provide the guidance for the contemporary cataract surgeon, when to expect potential problem in ocular motility after cataract surgery. PMID:26998351

  7. Diplopia as the Complication of Cataract Surgery

    Maciej Gawęcki; Andrzej Grzybowski

    2016-01-01

    The authors present systematic review of aetiology and treatment of diplopia related to cataract surgery. The problem is set in the modern perspective of changing cataract surgery. Actual incidence is discussed as well as various modalities of therapeutic options. The authors provide the guidance for the contemporary cataract surgeon, when to expect potential problem in ocular motility after cataract surgery.

  8. Cataract Surgery

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  9. Cataract surgery to lower intraocular pressure

    Berdahl John

    2009-01-01

    Full Text Available Cataract and glaucoma are common co morbidities. Cataract surgery is frequently performed in patients with glaucoma. In this study, a review of literature with search terms of cataract, glaucoma and intraocular pressure is followed by evaluation and synthesis of data to determine the effect of cataract surgery on intraocular pressure. Cataract surgery seems to lower intraocular pressure on a sustained basis, especially in patients with higher preoperative intraocular pressure. The mechanism of action of these finds remains speculative.

  10. An Audit Investigating the Usefulness of a Hospital-Based 4-Week First Postoperative Review Following Routine Cataract Surgery

    Porter, Louise F.; Smith, Amy; Showman, Aaron D.; Sadiq, S. Ahmed

    2011-01-01

    Aim: Timing of postoperative review after routine phacoemulsification cataract surgery in the English National Health Service is not specified in the Royal College of Ophthalmologists Cataract Surgery Guidelines. There are wide variations in when the first postoperative review occurs in routine practice. This audit assesses the usefulness of a 4-week first postoperative review in the hospital setting, in the context of high volume routine cataract surgery. Setting: Manchester Royal Eye Hospit...

  11. Surgery for Congenital Cataract

    David Yorston FRCS FRCOphth

    2004-01-01

    The management of congenital cataract is very different to the treatment of a routine age-related cataract. In adults, surgery may be delayed for years without affecting the visual outcome. In infants, if the cataract is not removed during the first year of life, the vision will never be fully regained after surgery. In adults, if the aphakia is not corrected immediately, it can be corrected later. In young children, if the aphakia is not corrected, the vision will never develop normally.

  12. Cost effectiveness of second eye cataract surgery

    Frampton, Geoff; Harris, Petra; Cooper, Keith; Lotery, Andrew J; Shepherd, Jonathan

    2014-01-01

    Background Elective cataract surgery is the most commonly performed surgical procedure in the NHS. In bilateral cataracts, the eye with greatest vision impairment from cataract is operated on first. First-eye surgery can improve vision and quality of life. However, it is unclear whether or not cataract surgery on the second eye provides enough incremental benefit to be considered clinically effective and cost-effective. Objective To conduct a systematic review of clinical effectiv...

  13. Cataract surgery in uveitis

    Hazari Ajit; Sangwan Virender

    2002-01-01

    Purpose:To study the visual outcome of cataract surgery in eyes with uveitis.Methods: A retrospective analysis of patients with uveitis operated for cataract. Results: 106 eyes of 89 patients with uveitis were operated for cataract. In 62.3% eyes (66/106), post -operative follow-up was at least 6 months. There was significant improvement (P<0.001) in visual acuity after cataract surgery. Provided the uveitis was well controlled for three months pre-operatively, additional pre...

  14. Recovery after cataract surgery.

    Porela-Tiihonen, Susanna; Kokki, Hannu; Kaarniranta, Kai; Kokki, Merja

    2016-04-01

    Cataract surgery is the most common ophthalmological surgical procedure, and it is predicted that the number of surgeries will increase significantly in the future. However, little is known about the recovery after surgery. The first aim of this study was to evaluate the prevalence, severity and duration of pain and other ocular discomfort symptoms experienced after cataract surgery. The other objectives were to identify the factors associated with lower postoperative patient satisfaction and to measure the effect of cataract surgery on patients' health-related quality of life (HRQoL) and visual function in everyday life. The study design was a prospective follow-up study. The course of the recovery and the presence of ocular symptoms were evaluated by interviewing the patients via a questionnaire at 1 day, 1 week, 6 weeks and one year after surgery The visual functioning in everyday life was measured with Visual Functioning Index VF-7 and Catquest-9SF-questionnaires and furthermore the HRQoL was measured with the 15D-instrument before surgery and at 12 months after surgery. The patients returned the questionnaires by mail and were interviewed in the hospital on the day of the surgery. The same patients filled-in all the questionnaires. The patient reports were used to collect the data on medical history. A total of 303 patients were approached at Kuopio University Hospital in 2010-2011 and of these 196 patients were eligible and willing to participate, with postoperative data being available from 186 (95%) patients. A systematic review article was included in the study procedure and it revealed the wide range in the reported incidence of postoperative ocular pain. Some of the identified randomized controlled studies reported no or only minor pain whereas in some studies significant pain or pain lasting for several weeks has been described in more than 50% of the study patients. In the present study setting, pain was reported by 34% during the first

  15. Heavier molecular weight ocular viscoelastic devices and timing of post-operative review following cataract surgery

    Brooker Lucenne; Blamires Trudi L; Thirumalai Balaji; Deeks Jon

    2007-01-01

    Abstract Background To assess the safety of abandoning the next day post-operative review in preference for assessment only 2 hours post-surgery for both phacoemulsification and extracapsular surgery with heavier molecular weight ocular viscoelastic devices (OVD). Methods 475 patients who underwent uncomplicated cataract surgery using heavier molecular weight ocular viscoelastic device (Healon GV) were studied. Of these 415 were phacoemulsification and 60 extracapsular and none received Intra...

  16. Femtosecond laser cataract surgery.

    Nagy, Zoltan Z; McAlinden, Colm

    2015-01-01

    Femtosecond laser (FSL) cataract surgery is in its infancy but is rapidly gaining popularity due to the improved consistency and predictability for corneal incisions and anterior capsulorhexis. It enables subsequently less phacoemulsification energy and time to be employed, which has gains in terms of reduced corneal oedema. In addition, the FSL allows better circularity of the anterior capsulotomy, capsule overlap, intraocular lens (IOL) placement and centration of the IOL. These advantages have resulted in improved visual and refractive outcomes in the short term. Complication rates are low which reduce with surgeon experience. This review article focuses on the Alcon LenSx system. PMID:26605364

  17. Immediate Sequential Bilateral Cataract Surgery

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...

  18. Cataract surgery and intraocular pressure.

    Melancia, Diana; Abegão Pinto, Luis; Marques-Neves, Carlos

    2015-01-01

    Cataract surgery is one of the most performed surgeries in the developed world. In addition to its significant impact on visual acuity, phacoemulsification has been hailed as a potential intraocular pressure (IOP)-lowering procedure. While current evidence suggests an overall significant and sustained decrease in IOP to exist after cataract surgery, the specific ocular characteristics that could help predict which patients are likely to benefit from this IOP-lowering effect remain unclear. This definition is important in glaucoma patients if this surgery is to be used in the treatment for this disease. Our review aims to summarize the literature on the subject, depicting possible mechanisms behind this IOP decrease, which type of patients are more likely to benefit from this surgery for IOP-lowering purposes and ultimately help optimizing disease management for the increasing number of patients with concomitant glaucoma and cataract. PMID:25765255

  19. Viscoless microincision cataract surgery

    Guy Sallet

    2008-06-01

    Full Text Available Guy SalletDepartment of Opthamology, Aalsters Stedelijk Ziekenhuis, BelgiumAbstract: A cataract surgery technique is described in which incisions, continuous circular capsulorhexis and hydrodissection are made without the use of any viscoelastics. Two small incisions are created through which the different parts of the procedure can take place, maintaining a stable anterior chamber under continuous irrigation. Subsequent bimanual phacoemulsification can be done through these microincisions. At the end of the procedure, an intraocular lens can be inserted through the self-sealing incision under continuous irrigation. 50 consecutive cataract patients were operated on without the use of viscoelastics and then compared with a group of 50 patients who had been helped with viscoelastics. No difference in outcome, endothelial cell count or pachymetry was noted between the two groups. No intraoperative complication was encountered. Viscoless cataract surgery was a safe procedure with potential advantages.Keywords: ophthalmic visco-surgical device, viscoless cataract surgery, microincision

  20. First postoperative day review after uneventful phacoemulsification cataract surgery: Is it necessary?

    Chatziralli Irini P; Sergentanis Theodoros N; Kanonidou Evgenia; Papazisis Leonidas

    2012-01-01

    Abstract Background Our purpose was to examine the value of the first postoperative day review after uneventful phacoemulsification cataract surgery. Methods 291 patients who underwent uneventful phacoemulsification were randomized into two groups (ClinicalTrials.gov Identifier: NCT01247155): i) Next day review (NDR group, n = 146) and ii) No next day review (NNDR group, n = 145). The rate of complications, percentage of patients seeking non-scheduled medical consultation up to postoperative ...

  1. Cataract Surgery Tool

    1977-01-01

    The NASA-McGannon cataract surgery tool is a tiny cutter-pump which liquefies and pumps the cataract lens material from the eye. Inserted through a small incision in the cornea, the tool can be used on the hardest cataract lens. The cutter is driven by a turbine which operates at about 200,000 revolutions per minute. Incorporated in the mechanism are two passages for saline solutions, one to maintain constant pressure within the eye, the other for removal of the fragmented lens material and fluids. Three years of effort have produced a design, now being clinically evaluated, with excellent potential for improved cataract surgery. The use of this tool is expected to reduce the patient's hospital stay and recovery period significantly.

  2. Cataract surgery in uveitis

    Hazari Ajit

    2002-01-01

    Full Text Available Purpose:To study the visual outcome of cataract surgery in eyes with uveitis.Methods: A retrospective analysis of patients with uveitis operated for cataract. Results: 106 eyes of 89 patients with uveitis were operated for cataract. In 62.3% eyes (66/106, post -operative follow-up was at least 6 months. There was significant improvement (P<0.001 in visual acuity after cataract surgery. Provided the uveitis was well controlled for three months pre-operatively, additional pre-operative anti-inflammatory medications did not significantly affect (P=0.842 post -operative inflammation. Patients who received extracapsular cataract extraction (ECCE or phacoemulsification with posterior chamber IOL (PCIOL obtained better visual acuity at 6 weeks (P=0.009 and P=0.032 respectively than those with only ECCE without IOL. In 37 eyes vision did not improve due to persistent uveitis (23.9%, 16/67, cystoid macular oedeme (20.9%, 14/67, and posterior capsule opacification (14.9%, 10/67. Conclusion: Cataract extraction and PCIOL implantation is safe in eyes with uveitis. Additional preoperative medications may not alleviate post-operative inflammation if uveitis is well controlled for at least three months before surgery.

  3. Bimanual microincisional cataract surgery technique and clinical outcome

    Al-Muammar, Abdulrahman

    2009-01-01

    Bimanual microincisional cataract surgery has been introduced recently as a technique for cataract surgery and it is gaining interest of many cataract surgeons in the world. Over the last few years many changes were made in the phacoemulsification machines and the intraocular lenses design which allowed bimanual microincisional cataract surgery to be safer and more efficient. The purpose of this review is to introduce the technique of bimanual microincisional cataract surgery and to review al...

  4. Immediate Sequential Bilateral Cataract Surgery: A Systematic Review and Meta-Analysis

    Line Kessel

    2015-01-01

    Full Text Available The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation. We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery on two different dates. The quality of evidence was rated as low to very low. None of the studies reported the prevalence of postoperative anisometropia. In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence. Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient.

  5. Cataract surgery in juvenile xanthogranuloma: Case report and a brief review of literature

    R Muralidhar

    2013-01-01

    Full Text Available There is limited literature on the management of cataracts in juvenile xanthogranuloma (JXG. A 2-month-old girl presented to us with hyphema, secondary glaucoma OU and skin nodules suggestive of JXG. She developed bilateral cataracts during her follow-up and was treated successfully with cataract surgery and aphakic rehabilitation.

  6. Cataract surgery and anticoagulants

    Koopmans, SA; VanRij, G

    1996-01-01

    A questionnaire was sent to 240 members of the Netherlands Intraocular implant Club (NIOIC) to register their policy followed in 1993 with regard to anticoagulant therapy (ACT) and the use of aspirin in patients having cataract surgery. Ninety-one (32%) forms were suitable for analysis. Most eye sur

  7. Paediatric cataract implant surgery outcome

    Istiantoro Istiantoro

    2003-01-01

    This study evaluated the surgical outcome of various surgical technique in paediatric cataract implant surgery, at Jakarta Eye Center, Jakarta, Indonesia. This was a retrospective study of 57 eyes in 44 children who had primary cataract implants surgery. Three surgical techniques used were : 1. Extracapsular cataract extraction with intraocular lens implantation with intact posterior capsule which was performed on 21 eyes (group 1). 2. Extracapsular cataract extraction with intraocular lens i...

  8. Femtosecond laser cataract surgery

    Nagy, Zoltan Z.; McAlinden, Colm

    2015-01-01

    Femtosecond laser (FSL) cataract surgery is in its infancy but is rapidly gaining popularity due to the improved consistency and predictability for corneal incisions and anterior capsulorhexis. It enables subsequently less phacoemulsification energy and time to be employed, which has gains in terms of reduced corneal oedema. In addition, the FSL allows better circularity of the anterior capsulotomy, capsule overlap, intraocular lens (IOL) placement and centration of the IOL. These advantages ...

  9. Astigmatism following cataract surgery.

    Reading, V M

    1984-01-01

    The changes in corneal curvature were determined at regular intervals over a one-year period following intracapsular cataract extraction by microsurgical techniques. During the first postoperative month photokeratometric measurements showed rapid changes in astigmatism associated with large changes in the direction of the axis. Thereafter astigmatism against-the-rule predominated. Data from the small group of patients who underwent surgery in which the technique of phacoemulsification was use...

  10. Cataract Surgery in Eyes with Shallow Anterior Chamber

    Hüseyin Bayramlar; Remzi Karadağ; Ünsal Sarı

    2014-01-01

    Shallow anterior chamber may be encountered in an eye planned for cataract surgery as well as during phacoemulsification. In both situations, cataract surgery is a challenging case. In this article, we tried to review the situations and management of shallow anterior chamber in cataract surgery. (Turk J Ophthalmol 2014; 44: 388-91

  11. Cataract Surgery in Eyes with Shallow Anterior Chamber

    Hüseyin Bayramlar

    2014-10-01

    Full Text Available Shallow anterior chamber may be encountered in an eye planned for cataract surgery as well as during phacoemulsification. In both situations, cataract surgery is a challenging case. In this article, we tried to review the situations and management of shallow anterior chamber in cataract surgery. (Turk J Ophthalmol 2014; 44: 388-91

  12. First postoperative day review after uneventful phacoemulsification cataract surgery: Is it necessary?

    Chatziralli Irini P

    2012-06-01

    Full Text Available Abstract Background Our purpose was to examine the value of the first postoperative day review after uneventful phacoemulsification cataract surgery. Methods 291 patients who underwent uneventful phacoemulsification were randomized into two groups (ClinicalTrials.gov Identifier: NCT01247155: i Next day review (NDR group, n = 146 and ii No next day review (NNDR group, n = 145. The rate of complications, percentage of patients seeking non-scheduled medical consultation up to postoperative day 14, presence of any inflammation-related sign and best corrected visual acuity (BCVA on postoperative day 28 were analyzed. Results In the NDR group, 5.5% of patients developed a postoperative complication, whereas the respective rate was 6.2% in the NNDR group. The difference was not statistically significant (p = 0.791. The most frequent complications were: elevated intraocular pressure, allergy to postoperative treatment, corneal abrasion, punctuate epitheliopathy, iris prolapse and postoperative hyphema, whose rates did not differ between the two groups. The rate of patients seeking non-scheduled medical consultation up to postoperative day 14, presence of any inflammation-related sign, as well as BCVA on day 28 did not exhibit any significant differences between the study groups. Conclusions First postoperative day review could be omitted in cases of uneventful cataract surgery.

  13. Changing indications for cataract surgery.

    Cairns, L.; Sommer, A

    1984-01-01

    Despite the fact that two community-based surgeons switched from routine intracapsular cataract extraction to planned extracapsular cataract surgery and routine implantation of posterior chamber lenses, they did not materially increase the size of their surgical load or change their indications for cataract surgery. In contrast a similar change in surgical technique by two high-referral hospital-based surgeons was associated with a marked increase in operative rates and increased preoperative...

  14. Quality of vision in refractive and cataract surgery, indirect measurers: review article

    Taís Renata Ribeira Parede

    2013-12-01

    Full Text Available Visual acuity is the measurement of an individual's ability to recognize details of an object in a space. Visual function measurements in clinical ophthalmology are limited by factors such as maximum contrast and so it might not adequately reflect the real vision conditions at that moment as well as the subjective aspects of the world perception by the patient. The objective of a successful vision-restoring surgery lies not only in gaining visual acuity lines, but also in vision quality. Therefore, refractive and cataract surgeries have the responsibility of achieving quality results. It is difficult to define quality of vision by a single parameter, and the main functional-vision tests are: contrast sensitivity, disability glare, intraocular stray light and aberrometry. In the current review the different components of the visual function are explained and the several available methods to assess the vision quality are described.

  15. Daily tonometric curves after cataract surgery

    Sacca, S; Marletta, A; Pascotto, A; Barabino, S; Rolando, M.; Giannetti, R.; Calabria, G.

    2001-01-01

    AIM—To evaluate daily tonometric curves after cataract surgery in patients with cataract only and in patients with cataract and glaucoma.
METHODS—108 patients scheduled for cataract surgery were randomly allocated to two groups: 57 patients with cataract only (normal) and 51 with cataract and primary open angle glaucoma (POAG). All patients underwent extracapsular cataract extraction (ECCE) (manual technique with long wound), phacoemulsification (automated technique with short wound), or nucl...

  16. Complications of cataract surgery.

    Chan, Elsie; Mahroo, Omar A R; Spalton, David J

    2010-11-01

    Modern cataract surgery is safe in more than 95 per cent of patients. In the small number of cases where a serious complication occurs, the most common is an intra-operative posterior capsular rupture. This can lead to vitreous loss or a dropped nucleus and can increase the risk of post-operative cystoid macular oedema or retinal detachment. Post-operatively, posterior capsular opacification is the most common complication and can be readily treated with a YAG capsulotomy. The most devastating complication is endophthalmitis, the rate of which is now significantly decreased through the use of intracameral antibiotics. As a clinician, the most important step is to assess the patient pre-operatively to predict higher risk individuals and to counsel them appropriately. In these patients, various pre- or intra-operative management steps can be taken in addition to routine phacoemulsification to optimise their visual outcome. PMID:20735786

  17. Long-Term Results of Cataract Surgery in Patients with Unilateral Childhood Cataract

    Suzan Güven Yılmaz; Duygu İnci Bozbıyık; Süheyla Köse; Önder Üretmen

    2012-01-01

    Pur po se: To evaluate the long-term visual outcome and to determine the surgical complications after cataract surgery in patients with unilateral childhood cataract. Ma te ri al and Met hod: We retrospectively reviewed the records of 18 cases with unilateral childhood cataract who had undergone cataract surgery before the age of seven. Primary intraocular lens (IOL) implantation was made in children who were older than 1 year of age. Secondary IOL implantation was made after 18 m...

  18. Immediate versus Delayed Sequential Bilateral Cataract Surgery: A Systematic Review and Meta-Analysis.

    Monali S Malvankar-Mehta

    Full Text Available Immediately sequential bilateral cataract surgery (ISBCS, the cataract surgery that is performed in both eyes simultaneously, is gaining popularity worldwide compared to the traditional treatment paradigm: delayed sequential bilateral cataract surgery (DSBCS, the surgery that is performed in each eye on a different day as a completely separate operation. ISBCS provides advantages to patients and patients' families in the form of fewer hospital visits. Additionally, patients enjoy rapid rehabilitation, lack of anisometropia - potentially reducing accidents and falls, and avoid suboptimal visual function in daily life. The hospital may benefit due to lower cost.To perform a systematic review and meta-analysis to evaluate ISBCS and DSBCS.Databases including MEDLINE, EMBASE, BIOSIS, CINAHL, Health Economic Evaluations Database (HEED, ISI Web of Science (Thomson-Reuters and the Cochrane Library were searched.Not applicable.Literature was systematically reviewed using EPPI-Reviewer 4 gateway. Meta-analysis was conducted using STATA v. 13.0. Standardized mean difference (SMD and 95% confidence intervals (CI were calculated and heterogeneity was assessed using I2 statistics. Fixed-effect and random-effect models were computed based on heterogeneity. Meta-analysis was done by instrument used to calculate utility score.In total, 9,133 records were retrieved from multiple databases and an additional 128 records were identified through grey literature search. Eleven articles with 3,657 subjects were included for analysis. Our meta-analysis results indicated significant improvement in post-operative utility score using TTO, EQ5D, HUI3, VF-7, and VF-14 and a non-significant improvement using Catquest questionnaire for both surgeries. For ISBCS versus DSBCS, utility-specific fixed-effect model provided an overall SMD of the utility score using the TTO method as 0.12 (95% CI: -0.15, 0.40, EQ5D as 0.14 (95% CI: -0.14, 0.41, HUI3 as 0.12 (95% CI: -0.15, 0.40, VF

  19. Heavier molecular weight ocular viscoelastic devices and timing of post-operative review following cataract surgery

    Brooker Lucenne

    2007-02-01

    Full Text Available Abstract Background To assess the safety of abandoning the next day post-operative review in preference for assessment only 2 hours post-surgery for both phacoemulsification and extracapsular surgery with heavier molecular weight ocular viscoelastic devices (OVD. Methods 475 patients who underwent uncomplicated cataract surgery using heavier molecular weight ocular viscoelastic device (Healon GV were studied. Of these 415 were phacoemulsification and 60 extracapsular and none received Intraocular pressure (IOP lowering prophylaxis at the end of surgery. All were examined at 2 hours post-surgery and on the following day. Results were tabulated and analysed assessing wound stability, corneal clarity, anterior chamber reaction and IOP. Results In the time between the two assessments 44 (10.6% patients developed a total of 53 new problems, with a majority being increases in IOP. Based on the lower threshold of IOP of 30 mmHg, the incidence of new problems at the next-day assessment was 9.8% (95% CI: 7.0 to 13.6 in the phacoemulsification group and 16.3% (7.3 to 29.7in the extracapsular surgery group. At the higher threshold of IOP of 35 mmHg the corresponding figures were 6.6% and 16.3%. Conclusion There is a higher incidence of new problems at the next-day assessment than previous studies with conventional OVD. Therefore results from previous studies using standard OVDs cannot be simply extrapolated to heavier molecular weight OVDs. When these agents are used, routine use of an ocular hypotensive agent may be necessary to increase the safety of abandoning the review on the first post-operative day for phacoemulsification patients. This is to be studied.

  20. EARLY COMPLICATIONS OF CATARACT SURGERY

    C. Constantin

    2013-06-01

    Full Text Available BACKGROUND: There are different complications of the cataract surgery described in the literature. The impact of these complications on the visual function is in correlation with many factors, some of them being imprecise and unable to be used as prognostic factors before and after the surgery. The modern technique and the surgeon’s experience lowers the complications incidence to a minimum, but even so, some problems cannot be avoided. AIM: The aim of this study is to analyse the early cataract surgery complications for patients operated in 2012 at the Ophthalmology Unit, Railway Hospital, Iaşi. MATERIAL AND METHOD: We conducted a retrospective analysis of the medical records of the patients who underwent cataract surgery in 2012. There were a total of 480 cataract surgeries, the majority of them (92,7% being age related cataracts in different stages of evolution, of which 31.45% being mature cataracts. In 476 eyes, artificial lens was inserted per-primam (474 eyes with posterior chamber intraocular lens and 2 eyes with anterior chamber intraocular lens, in one case the posterior chamber intraocular lens was sutured to the sclera, in 3 cases the eyes remained without lens. RESULTS: The incidence of severe complications or with potential of severe development was: severe corneal oedema 0.83% (4 cases, remaining lens fragments in the vitreous cavity 0.62% (3 cases, toxic anterior segment syndrome (TASS 0.41% (2 cases. There were no endophthalmitis, expulsive haemorhage or retinal detachment after cataract surgery. CONCLUSIONS: The number of early complications of our patients is the same with numbers shown in other studies. With a better surgical technique, a good examination of the patient, a thorough explanation of the procedure to the patient, the use of high quality substances during surgery and proper technology we can lower even more the incidence of the complications.

  1. Cataract surgery in pseudoexfoliation syndrome.

    Sangal, Neha; Chen, Teresa C

    2014-01-01

    Pseudoexfoliation (PXF) syndrome is characterized by the deposition of distinctive fibrillar material in the anterior segment of the eye. It is an age-related process that is associated with open and narrow angle glaucomas and the formation of cataracts. Not only is PXF associated with the formation of dense nuclear cataracts, it is also well known that those presenting with PXF are at a higher risk of developing complications during, and even after, cataract surgery. Complications associated with cataract surgery in PXF can occur from poor pupillary dilation, zonular weakness leading to intraoperative or postoperative lens dislocation and vitreous loss, postoperative intraocular pressure (IOP) spikes potentiating glaucomatous damage, capsular phimosis, prolonged inflammation, and postoperative corneal decompensation. The surgeon should be prepared to encounter the various potential intraoperative and postoperative complications in eyes with pseudoexfoliation syndrome during cataract surgery. In this way, the surgeon can plan his/her surgical technique to help avoid surprises during cataract surgery and be prepared to manage the potential postoperative complications that can occur in pseudoexfoliation eyes. PMID:25325866

  2. Cataract and Cataract Surgery: Nationwide Prevalence and Clinical Determinants.

    Park, Sang Jun; Lee, Ju Hyun; Kang, Se Woong; Hyon, Joon Young; Park, Kyu Hyung

    2016-06-01

    This study aimed to investigate the prevalence and clinical determinants of cataract and cataract surgery in Korean population. The 2008-2012 Korean National Health and Nutrition Examination Survey was analyzed, which included 20,419 participants aged ≥ 40 years. The survey is a multistage, probability-cluster survey, which can produce nationally representative estimates. Prevalence of cataract and cataract surgery was estimated. Clinical determinants for those were investigated using logistic regression analyses (LRAs). The prevalence of cataract was 42.28% (95% confidence interval [CI], 40.67-43.89); 40.82% (95% CI, 38.97-42.66) for men and 43.62% (95% CI, 41.91-45.33) for women (P = 0.606). The prevalence of cataract surgery was 7.75% (95% CI, 7.30-8.20); 6.38% (95% CI, 5.80-6.96) for men and 9.01% (95% CI, 8.41-9.61) for women (P Cataract was associated with older age (P Cataract surgery was consistently associated with older age, occupation, DM, asthma, and anemia in two LRAs, which compared participants with cataract surgery to those without cataract surgery and those having a cataract but without any cataract surgery, respectively. Hypertension, arthritis, and dyslipidemia were associated with cataract surgery at least in one of these LRAs. These results suggest that there are 9.4 million individuals with cataract and 1.7 million individuals with cataract surgery in Korea. Further studies are warranted to reveal the causality and its possible mechanism of developing/exacerbating cataract in novel determinants (i.e., anemia, asthma, and arthritic conditions) as well as well-known determinants. PMID:27247507

  3. [Keratoplasty combined with cataract surgery].

    Muraine, M; Gueudry, J; Retout, A; Genevois, O

    2012-09-01

    Corneal pathologies leading to keratoplasty are often associated with cataract and combined surgery is therefore mandatory. Triple procedure with penetrating keratoplasty and concurrent cataract extraction followed by intra ocular lens (IOL) implantation is usually the preferential choice because visual rehabilitation is theoretically more rapid. Surgeons have to be aware of surgical conditions during open-sky surgery because vitreous pressure is not counterbalanced by anterior chamber pressure. Today, many surgeons prefer non-simultaneous procedures with cataract surgery performed months after grafting because of the improvement in spherical refractive error. More recently, new triple procedures, Descemet's stripping automated keratoplasty and concurrent cataract surgery have gained popularity, especially in patients with Fuchs dystrophy associated with cataract. Surgery starts with phacoemulsification, followed by endothelium exchange through a 3 to 5 mm incision. Advantages against classic triple procedure are quick visual rehabilitation, fewer induced refractive errors, minimal postoperative discomfort and corneal integrity. Surgeons have to consider an eventual postoperative hyperopic shift secondary to corneal lenticule shape when choosing adequate intraocular lens. PMID:22921023

  4. Risk of Retinal Detachment After Pediatric Cataract Surgery

    Haargaard, Birgitte; Andersen, Elisabeth W; Oudin, Anna; Poulsen, Gry; Wohlfahrt, Jan; la Cour, Morten; Melbye, Mads

    2014-01-01

    PURPOSE: To determine the long-term risk of retinal detachment following pediatric cataract surgery and to identify risk factors for retinal detachment. METHODS: We included all children (aged 0 to 17 years) who during the time period of 1977 to 2005 underwent pediatric cataract surgery in Denmark...... was based on medical chart review. RESULTS: Among 1043 eyes of 656 children undergoing surgery for pediatric cataract, 25 eyes (23 children) developed retinal detachment at a median time of 9.1 years after surgery. The overall 20-year risk of retinal detachment was 7% (95% confidence interval [CI]: 3...... (16% [95% CI: 6%-24%]). CONCLUSIONS: The estimated overall risk of retinal detachment 20 years after pediatric cataract surgery was 7%, but only 3% for isolated cataract. Particularly high risks of retinal detachment after cataract surgery were associated with mental retardation and having other...

  5. The correction of corneal astigmatism of toric intraocular lenses in patients who underwent cataract surgery. Review

    G. A. Fedyashev

    2014-01-01

    The paper presents an overview of the methods of surgical correction of corneal astigmatism in patients who underwent cataract surgery with IOL implantation, gives an idea of toric IOL, their advantages over other methods of the astigmatism correction, the criteria for patient selection, calculation features, preoperative marking. Besides the concept of rotational instability is sanctified position the IOL within the eye, its causes, methods of detecting the position of the IOL, as well as su...

  6. Outcome after surgery of congenital cataract

    Lundvall, Anna

    2002-01-01

    The visual outcome in infants undergoing surgery for bilateral congenital cataract has improved considerably because of improved surgical methods and the realisation that early detection, allowing early cataract extraction and immediate optical correction, can prevent otherwise irreversible deprivation amblyopia. The management of unilateral congenital cataract is still of the most difficult problems in paediatric ophtalmology. In unilateral congenital cataract, interven...

  7. CATARACT SURGERY IN PSEUDOEXFOLIATION SYNDROME

    Abbin George

    2014-10-01

    Full Text Available Pseudoexfoliation (PEX syndrome is an age-related systemic disorder with major ocular manifestations. It is characterized by the production and deposition of fibrillogranular amyloid-like extracellular material within many ocular tissues. Pseudoexfoliation is also a risk factor for glaucoma and also correlated to an increased incidence of cataract formation. Cataract surgery in eyes with pseudoexfoliation is connected with many complications and presents challenges that require careful preoperative planning and intraoperative care to ensure safe surgery and successful postoperative outcome. Zonular weakness and poor pupillary dilation are the two major risk factors for surgical complications and poor visual acuity after surgery. With proper preparation and the use of specialized adjunctive devices, phacoemulsification is the preferred procedure of cataract extraction in this group of patients. Postoperatively, patients require frequent and detailed follow-up to monitor for complications such as intraocular pressure rise, inflammation and intraocular lens dislocation. In conclusion, with appropriate preoperative, intraoperative and postoperative care, the risk of complications can be minimized and favorable outcomes may be achieved in cataract surgery in eyes with pseudoexfoliation syndrome.

  8. Clear corneal incision in cataract surgery

    Ammar M Al Mahmood

    2014-01-01

    Full Text Available Since the introduction of sutureless clear corneal cataract incisions, the procedure has gained increasing popularity worldwide because it offers several advantages over the traditional sutured scleral tunnels and limbal incisions. Some of these benefits include lack of conjunctival trauma, less discomfort and bleeding, absence of suture-induced astigmatism, and faster visual rehabilitation. However, an increasing incidence of postoperative endophthalmitis after clear corneal cataract surgery has been reported. Different authors have shown a significant increase up to 15-fold in the incidence of endophthalmitis following clear corneal incision compared to scleral tunnels. The aim of this report is to review the advantages and disadvantages of clear corneal incisions in cataract surgery, emphasizing on wound construction recommendations based on published literature.

  9. Paediatric cataract implant surgery outcome

    Istiantoro Istiantoro

    2003-03-01

    Full Text Available This study evaluated the surgical outcome of various surgical technique in paediatric cataract implant surgery, at Jakarta Eye Center, Jakarta, Indonesia. This was a retrospective study of 57 eyes in 44 children who had primary cataract implants surgery. Three surgical techniques used were : 1. Extracapsular cataract extraction with intraocular lens implantation with intact posterior capsule which was performed on 21 eyes (group 1. 2. Extracapsular cataract extraction with intraocular lens implantation and posterior capsulorhexis (PCCC and optic capture which was performed on 24 eyes (group 2. 3. Extracapsular cataract extraction with intra­ocular lens implantation, posterior capsulorhexis and anterior vitrectomy which was performed on 24 eyes (group 3. All patients were followed up more than one year. Our results showed that posterior capsule opacity (PCO was developed in 20 eyes with intact capsules in group 1. All eyes had a clear visual axis in group 2. PCO developed only in one eye in group 3. In conclusion,  PCCC and optic capture with or without anterior vitrectomy are effective methods in preventing PCO in infant and children. (Med J Indones 2003; 12: 21-6Keywords: posterior capsule opacification, posterior capsulorhexis, optic capture, anterior vitrectomy

  10. The correction of corneal astigmatism of toric intraocular lenses in patients who underwent cataract surgery. Review

    G. A. Fedyashev

    2014-07-01

    Full Text Available The paper presents an overview of the methods of surgical correction of corneal astigmatism in patients who underwent cataract surgery with IOL implantation, gives an idea of toric IOL, their advantages over other methods of the astigmatism correction, the criteria for patient selection, calculation features, preoperative marking. Besides the concept of rotational instability is sanctified position the IOL within the eye, its causes, methods of detecting the position of the IOL, as well as surgical ways to improve its rotational stability.

  11. Usefulness of Surgical Media Center as a Cataract Surgery Educational Tool

    Tomoichiro Ogawa; Takuya Shiba; Hiroshi Tsuneoka

    2016-01-01

    Purpose. This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC) (Abbott Medical Optics Inc.), a new cataract surgery recording device, for training of cataract surgery. Methods. We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on ...

  12. Femtosecond laser in refractive and cataract surgeries

    Han-Han; Liu; Ying; Hu; Hong-Ping; Cui

    2015-01-01

    In the past few years, 9 unique laser platforms have been brought to the market. As femtosecond(FS) laserassisted ophthalmic surgery potentially improves patient safety and visual outcomes, this new technology indeed provides ophthalmologists a reliable new option. But this new technology also poses a range of new clinical and financial challenges for surgeons. We provide an overview of the evolution of FS laser technology for use in refractive and cataract surgeries. This review describes the available laser platforms and mainly focuses on discussing the development of ophthalmic surgery technologies.

  13. Manual small incision cataract surgery in eyes with white cataracts

    Venkatesh Rengaraj; Das Manoranjan; Prashanth Sadasivam; Muralikrishnan Radhakrishnan

    2005-01-01

    PURPOSE: To assess the safety and efficacy of Manual Small Incision Cataract Surgery (MSICS) in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorthexis (CCC). MATERIALS AND METHODS: Prospective observational study on 100 consecutive eyes of 100 patients with white cataract who had undergone MSICS with trypan blue assisted CCC. The nucleus was prolapsed into anterior chamber by using a sinskey hook and extracted out of the eye u...

  14. Modified Small Incision Cataract Surgery and Intraocular Lens Implantation in HIV Patients

    Kagmeni Giles; Christelle Domngang; Georges Nguefack-Tsague; Ebana Mvogo Come; Peter Wiedemann

    2015-01-01

    AIM To describe a surgical technique suitable for cataract surgery in regions with a high prevalence of HIV infection. METHODS We reviewed the medical records of 20 consecutive AIDS patients with cataract who underwent modified small-incision cataract surgery (mSICS) with posterior chamber lens implantation. Classic extracapsular cataract extraction (ECCE) was compared to mSICS. The number of potentially risky steps for contamination during surgery and duration of surgery were analyzed. A ris...

  15. Indication for cataract surgery. Do we have evidence of who will benefit from surgery? A systematic review and meta-analysis.

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2016-02-01

    The need for cataract surgery is expected to rise dramatically in the future due to the increasing proportion of elderly citizens and increasing demands for optimum visual function. The aim of this study was to provide an evidence-based recommendation for the indication of cataract surgery based on which group of patients are most likely to benefit from surgery. A systematic literature search was performed in the MEDLINE, CINAHL, EMBASE and COCHRANE LIBRARY databases. Studies evaluating the outcome after cataract surgery according to preoperative visual acuity and visual complaints were included in a meta-analysis. We identified eight observational studies comparing outcome after cataract surgery in patients with poor (20/40) preoperative visual acuity. We could not find any studies that compared outcome after cataract surgery in patients with few or many preoperative visual complaints. A meta-analysis showed that the outcome of cataract surgery, evaluated as objective and subjective visual improvement, was independent on preoperative visual acuity. There is a lack of scientific evidence to guide the clinician in deciding which patients are most likely to benefit from surgery. To overcome this shortage of evidence, many systems have been developed internationally to prioritize patients on waiting lists for cataract surgery, but the Swedish NIKE (Nationell Indikationsmodell för Katarakt Ekstraktion) is the only system where an association to the preoperative scoring of a patient has been related to outcome of cataract surgery. We advise that clinicians are inspired by the NIKE system when they decide which patients to operate to ensure that surgery is only offered to patients who are expected to benefit from cataract surgery. PMID:26036605

  16. Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness

    Linertová R

    2014-08-01

    Full Text Available Renata Linertová,1,2 Rodrigo Abreu-González,3 Lidia García-Pérez,1,2 Marta Alonso-Plasencia,3 Luis Mateo Cordovés-Dorta,4 José Augusto Abreu-Reyes,4 Pedro Serrano-Aguilar2,5 1Fundación Canaria de Investigación y Salud (FUNCIS, Santa Cruz de Tenerife, Spain; 2Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC, Madrid, Spain; 3Ophthalmology Service, University Hospital Ntra Sra de La Candelaria, Santa Cruz de Tenerife, Spain; 4Ophthalmology Service, University Hospital of Canary Islands, La Laguna, Spain; 5HTA Unit, Canary Health Service, Santa Cruz de Tenerife, Spain Abstract: Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral

  17. Femtosecond laser cataract surgery: technology and clinical practice.

    Roberts, Timothy V; Lawless, Michael; Chan, Colin Ck; Jacobs, Mark; Ng, David; Bali, Shveta J; Hodge, Chris; Sutton, Gerard

    2013-03-01

    The recent introduction of femtosecond lasers to cataract surgery has generated much interest among ophthalmologists around the world. Laser cataract surgery integrates high-resolution anterior segment imaging systems with a femtosecond laser, allowing key steps of the procedure, including the primary and side-port corneal incisions, the anterior capsulotomy and fragmentation of the lens nucleus, to be performed with computer-guided laser precision. There is emerging evidence of reduced phacoemulsification time, better wound architecture and a more stable refractive result with femtosecond cataract surgery, as well as reports documenting an initial learning curve. This article will review the current state of technology and discuss our clinical experience. PMID:22788831

  18. SMALL INCISION CATARACT SURGERY VERSUS PHACOEMULSIFICATION FOR IMMATURE CATARACT: A SINGLE BLIND RANDOMIZED CONTROLLED TRIAL

    Md. Jawed; Himadri; De, Abhijit; Rathindra; Deshmukh Md Saudmiya

    2014-01-01

    BACKGROUND: Manual small incision cataract surgery (SICS) has given visual results almost equivalent to Phacoemulsification but limited studies are available regarding the efficacy of small incision cataract surgery in phaco suitable immature cataracts. OBJECTIVE: To compare manual small incision cataract surgery and Phacoemulsification in immature cataracts. MATERIALS AND METHODS: A single blind randomized controlled trial was conducted with 105 eyes each for small incisi...

  19. Pseudoexfoliation - A Dreaded Nightmare in Cataract Surgery

    Kar, Sushil Kumar; Bhuyan, Lopamudra; Nanda, Ashok Kumar

    2015-01-01

    Aim: Pseudoexfoliation (PXE) is a common and clinically important systemic condition in elderly people that affects the outcome of cataract surgery. It can cause various complications during cataract surgery due to pupillary rigidity and zonular weakness and instability. The purpose of this study was to evaluate the frequency and types of complications of Phacoemulsification in patients with cataract and PXE.Materials and Methods: This cross sectional, prospective study was carried out on 60 ...

  20. Glaucoma after Congenital Cataract Surgery

    Mahmoodreza Panahi Bazaz

    2014-05-01

    Full Text Available Purpose: To determine the incidence and risk factors associated with glaucoma following congenital cataract surgery (CCS in children under age of 15 Methods: This prospective cohort (since 2006 consisted of children less than 15 years of age who underwent cataract surgery with or without intraocular lens (IOL implantation. The role of the following factors on the development of glaucoma after CCS including age at surgery, gender, laterality of the cataract, IOL implantation, congenital ocular anomalies, intra- and postoperative complications, length of follow-up, central corneal thickness (CCT as well as the effect of the age of onset, time to development of glaucoma, and response to treatment were evaluated. Results: Overall, 161 eyes of 96 patients were included in this study of which 28 eyes developed glaucoma. Incidence of glaucoma was 17.4%. Mean±SD age at surgery was 9.3±6.9 (range, 1-24 months in glaucomatous and 40.4±41.1 (range, 1 m-13.6 year months in non-glaucomatous group (p<0.001. All glaucoma patients had the operation under two years of age. In group 1, 9 (60% and in group 2, 24 (30% patients were female (p=0.001. In group 1, 17 eyes (60.7% and in the group 2, 41 eyes (30.8% were aphakic (p=0.001. Mean time to diagnosis of glaucoma was 111.2 days (range 30-1200 days. Mean follow-up time was 3.1 years (range, 1-6 years. In 22 (78.6% eyes glaucoma was diagnosed within six months after surgery. Glaucoma was controlled with medications in 23 eyes (82% and with surgery in five eyes. Conclusion: In this study the incidence of glaucoma after CCS was 17.4% over a follow-up period of six years. Younger age at the time of lensectomy increases the risk of secondary glaucoma. IOL implantation may protect against glaucoma. Female gender was affected more than male.

  1. Simulation-based certification for cataract surgery

    Thomsen, Ann Sofia Skou; Kiilgaard, Jens Folke; Kjaerbo, Hadi; la Cour, Morten; Konge, Lars

    2015-01-01

    PURPOSE: To evaluate the EyeSi(™) simulator in regard to assessing competence in cataract surgery. The primary objective was to explore all simulator metrics to establish a proficiency-based test with solid evidence. The secondary objective was to evaluate whether the skill assessment was specific...... to cataract surgery. METHODS: We included 26 ophthalmic trainees (no cataract surgery experience), 11 experienced cataract surgeons (>4000 cataract procedures) and five vitreoretinal surgeons. All subjects completed 13 different modules twice. Simulator metrics were used for the assessments. RESULTS......: Total module score on seven of 13 modules showed significant discriminative ability between the novices and experienced cataract surgeons. The intermodule reliability coefficient was 0.76 (p < 0.001). A pass/fail level was defined from the total score on these seven modules using the contrasting...

  2. New technology update: femtosecond laser in cataract surgery

    Nagy ZZ

    2014-01-01

    Zoltan Z NagyDepartment of Ophthalmology, Semmelweis University, Budapest, HungaryAbstract: Femtosecond lasers represent a new frontier in cataract surgery. Since their ­introduction and first human treatment in 2008, a lot of new developments have been achieved. In this review article, the physical principle of femtolasers is discussed, together with the indications and side effects of the method in cataract surgery. The most important clinical results are also presented regarding c...

  3. New technology update: femtosecond laser in cataract surgery

    Nagy, Zoltan

    2014-01-01

    Zoltan Z NagyDepartment of Ophthalmology, Semmelweis University, Budapest, HungaryAbstract: Femtosecond lasers represent a new frontier in cataract surgery. Since their ­introduction and first human treatment in 2008, a lot of new developments have been achieved. In this review article, the physical principle of femtolasers is discussed, together with the indications and side effects of the method in cataract surgery. The most important clinical results are also presented reg...

  4. Benign prostatic hyperplasia: clinical treatment can complicate cataract surgery

    Fernando Facio; Renata Kashiwabuschi; Yutaro Nishi; Ricardo Leao; Peter Mcdonnell; Arthur Burnett

    2010-01-01

    PURPOSE: To investigate the effects of alpha-1 adrenergic receptor antagonists for the treatment of benign prostatic hyperplasia (BPH) regarding potential risks of complications in the setting of cataract surgery. AIM: To address recommendations, optimal control therapy, voiding symptoms and safety within the setting of cataract surgery. MATERIALS AND METHODS: A comprehensive literature review was performed using MEDLINE with MeSH terms and keywords "benign prostatic hyperplasia", "intraopera...

  5. VISUAL OUTCOME AFTER CATARACT SURGERY IN COMPLICATED CATARACT

    Satish

    2014-08-01

    Full Text Available AIMS: To study various factors responsible for visual outcome after cataract surgery in complicated cataract secondary to uveitis. SETTINGS AND STUDY DESIGN: A Retrospective, Clinical study was carried out at tertiary eye care center in central Maharashtra from Jan. 2002 to Jan. 2007 which included 60 eyes of 52 patients. METHODS AND MATERIAL: It was a retrospective study of patients with uveitis undergone cataract surgery between Jan. 2002 to Jan. 2007, at Shri Ganapati Netralaya, Jalna. It included patients of all age groups, both genders, diagnosed of complicated cataract due to uveits subjected to cataract surgery with IOL implantation and detailed preoperative and postoperative -UCVA, BCVA, SLE, and Fundus evaluation with at least 3 months follow up. Follow up was on 1'st post-operative day, 1 week post-operative, 1 month post-operative and 3 months post-operative. We excluded patients with complicated cataract other than uveitic origin, post-operative follow up less than 3 months and patients with ocular diseases other than uveitis. TESTS APPLIED: Paired & Unpaired t-test. RESULTS: 1 Visual acuity: BCVA (>6/12 in 43(71.67 % eyes. 2 TYPE OF SURGERY: ECCE+IOL,(3 SICS+IOL,(5 SICS+AV(1 PE+IOL.(51 3 Type of IOL used: PMMA,(46 HSM,(2 Acrylic.(11 4 Postoperative complications:- CME-1(1.66%, Recurrence of Uveitis-9(15%, PCO:-19(31.66%, Posterior synaechie: 3 (5%, Hyphema:-2 (3.33%, Hypotony:-4 (6.66%, Secondary Glaucoma:-2 (3.33% RD:-1 (1.66%. CONCLUSIONS: 1 Visual outcome after cataract surgery in complicated cataract is statistically significant (P<0.0001 in our study. 2 The best technique of surgery remains Phacoemulsification with in-the-bag IOL implantation of PCIOL. 3 Use of pupil dilating technique's (Iris hook, Sphincterotomy is helpful in making adequate size capsulorrhexis and thereby reducing post-operative complications like anterior capsular opacification & capsular phimosis. 4 The most important predictor of successful cataract

  6. Safety of deferring review after uneventful cataract surgery until 2 weeks postoperatively

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    was gained by reviewing patients on the first postoperative day, and we recommend that routine early postoperative control can be omitted in nonglaucomatous patients after uneventful surgery if symptomatic patients are seen by an ophthalmologist as needed. FINANCIAL DISCLOSURE: No author has a...

  7. Cataract surgery after Descemet stripping endothelial keratoplasty

    Sunita Chaurasia

    2012-01-01

    Full Text Available Management of endothelial dysfunction in phakic patients is sometimes a dilemma for corneal surgeons. Phakic patients with visually significant cataract and endothelial dysfunction are preferably managed by performing combined cataract surgery with endothelial keratoplasty. However, combined surgery may be deferred in eyes with early incipient cataract, younger age and where anterior chamber is poorly visualized. As cataract formation may be accelerated after endothelial keratoplasty, these eyes may need cataract surgery subsequently. Surgical intervention in eyes with endothelial keratoplasty is of concern as this may affect the graft adversely and threaten graft survival. In this report, we describe the intraoperative surgical details and postoperative clinical course of a patient who underwent phacoemulsification with intraocular lens implantation after Descemet stripping automated endothelial keratoplasty (DSAEK.

  8. Cataract Vision Simulator

    ... for Cataracts? Cataract Causes Cataract Diagnosis Cataract Treatment Cataract Surgery IOL Implants: Lens Replacement and Cataract Surgery Cataract Vision Simulator Cataract Vision Simulator Jun. 11, ...

  9. Broken intraocular lens during cataract surgery.

    Kirkpatrick, J N; Cook, S D

    1992-01-01

    A case of planned routine extracapsular cataract extraction is described where surgery was complicated peroperatively by fracture of the posterior chamber lens implant. The technique of lens implantation is discussed.

  10. Manual small incision cataract surgery in eyes with white cataracts

    Venkatesh Rengaraj

    2005-01-01

    Full Text Available PURPOSE: To assess the safety and efficacy of Manual Small Incision Cataract Surgery (MSICS in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorthexis (CCC. MATERIALS AND METHODS: Prospective observational study on 100 consecutive eyes of 100 patients with white cataract who had undergone MSICS with trypan blue assisted CCC. The nucleus was prolapsed into anterior chamber by using a sinskey hook and extracted out of the eye using irrigating vectis. Intraoperative and postoperative findings (according to OCTET classification as well as postoperative visual outcomes were used as main measures to report the safety and efficacy of the surgery. RESULTS: Of the 100 eyes, 16 had intumescent, 67 had mature and 17 had hypermature cataract. Intraoperatively CCC was incomplete in 4 eyes (4% and had to be converted to canopener capsulotomy. None of the eyes had posterior capsular rupture or zonular dialysis and no eyes were converted to conventional Extra Capsular Cataract Extraction (ECCE. Postoperatively, 6 eyes (6% developed corneal oedema with >10 Descemets folds and 7 eyes (7% had corneal oedema with < 10 Descemets folds. Mild iritis was seen in 6 eyes (6% and moderate iritis with fibrin membrane was seen in 3 eyes (3%. Iridodialysis was observed in 1 eye (1%. Of the 99 patients (99% categorised under good visual outcomes category, 94 patients (94% had a best-corrected visual acuity of 6/9 or better on the 40th post-operative day. CONCLUSION: In developing countries like India where phacoemulsification may not be affordable to a majority of those requiring cataract surgery, MSICS proves to be a safe and efficacious alternative for white cataracts especially with the adjunctive use of trypan blue dye.

  11. Cataract

    A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age ... than half of all Americans either have a cataract or have had cataract surgery. A cataract can ...

  12. Impairment of lacrimal drainage after cataract surgery

    Hamid Fesharaki; Hasan Razmjoo; Masoud Aghajani

    2007-01-01

    BACKGROUND: Complaining of tearing was found in some of our patients after phacoemulsification surgery for senile cataract. Secondary acquired lacrimal drainage obstruction has been proposed to happen due to different causes. This study was performed at Feiz hospital in Isfahan, Iran from September to December of 2004 to evaluate the effects of phacoemulsification surgery on tear drainage in eyes with senile cataract. METHODS: This cohort study was performed on 110 patients with senile catara...

  13. Evaluation of Changes of Macular Thickness in Diabetic Retinopathy after Cataract Surgery

    Kwon, Soon Il; Hwang, Duck Jin; Seo, Ji Young; Park, In Won

    2011-01-01

    Purpose To assess the macular thickness changes after cataract surgery in diabetic patients using optical coherence tomography (OCT). Methods We retrospectively reviewed the records of 104 diabetic patients who underwent cataract surgery. We examined the changes of macular thickness using OCT before cataract surgery and 1 week, 1-, 2- and 6-months after surgery. The central subfield mean thickness (CSMT) was used to evaluate macular edema which was defined as an increase of CSMT (ΔCSMT) > 30%...

  14. CORNEAL ASTIGMATISM AFTER MANUAL SMALL INCISION CATARACT SURGERY

    Rajni; Mohd Ayaz; Pallvi; Syed Tariq

    2014-01-01

    INTRODUCTION: Cataract is the leading cause of preventable blindness in India. Manual Small Incision Cataract Surgery is still the preferred method of cataract surgery because of its low cost and non-dependence on costly equipments. Postoperatively astigmatism is an important cause of poor uncorrected visual acuity after cataract surgery. Purpose: The purpose of this study was to assess corneal astigmatism in manual small incision cataract surgery in superior versus temporal ...

  15. Intraocular lens employed for cataract surgery

    Roszkowska, A. M.; Torrisi, L.

    2014-04-01

    The aim of this paper is to illustrate the techniques of cataract surgery with implantation of intraocular lenses and some physical properties of the used materials. The new technology, coupled with extensive experience and the studied cases, permits to increase the standardization and accuracy of the engravings, by reducing the use and handling of surgical instruments inside the eye. At present it is possible to replace the cataract with crystalline lenses based on biopolymers such as PMMA, silicone, acrylic hydrophilic and hydrophobic acrylic. These materials are increasingly able to replace the natural lens and to ensure the fully functional of the eye. The role of femtosecond lasers in cataract surgery, to assist or replace several aspects of the manual cataract surgery, are discussed.

  16. Intraocular lens employed for cataract surgery

    The aim of this paper is to illustrate the techniques of cataract surgery with implantation of intraocular lenses and some physical properties of the used materials. The new technology, coupled with extensive experience and the studied cases, permits to increase the standardization and accuracy of the engravings, by reducing the use and handling of surgical instruments inside the eye. At present it is possible to replace the cataract with crystalline lenses based on biopolymers such as PMMA, silicone, acrylic hydrophilic and hydrophobic acrylic. These materials are increasingly able to replace the natural lens and to ensure the fully functional of the eye. The role of femtosecond lasers in cataract surgery, to assist or replace several aspects of the manual cataract surgery, are discussed.

  17. Recombinant tissue plasminogen activator following paediatric cataract surgery

    Mehta, J; ADAMS, G

    2000-01-01

    BACKGROUND—The use of recombinant tissue plasminogen activator (r-TPA) has been advocated in the treatment of postsurgical fibrinous membrane formation following cataract surgery in adults. Its use in paediatric cases is not well documented.
METHOD—A retrospective review of paediatric cataract extractions performed at Moorfields Eye Hospital between 1 January 1997 and 4 April 1999 was carried out.
RESULTS—Cataract extractions were performed in 37 patients, 22 in males 15 in females. Four (9.2...

  18. Simultaneous pterygium and cataract surgery.

    Gulani A

    1995-01-01

    Full Text Available In our country both pterygium and cataract have a high incidence. Hence in this study, thirty patients with pterygium and cataract were treated with a simultaneous pterygium excision and cataract extraction procedure. These patients after pterygium excision were treated intra-operatively with 500 rads of beta radiation over the pterygium site. Then, the cataract was extracted and the patients were treated post-operatively with topical betamethasone 0.1% for a duration of three months. They were followed up for a duration of 6 months postoperatively. Nineteen patients (63% had visual recovery to 6/12. Twelve of 30 patients (40% had recurrence of pterygium. The combined procedure did not result in any surgical complications following cataract removal. Post-operatively, after 6 months 13 patients had with the rule astigmatism (WRA for a mean WRA of 1.3 D, and 17 had against the rule astigmatism (ARA for a mean ARA of 1.2 D.

  19. Retinal detachment following cataract surgery with capsulorhexis.

    Kelley, J S; Doxanas, M T

    1995-01-01

    PURPOSE: To estimate the incidence of retinal detachment after cataract surgery with capsulorhexis. METHODS: A consecutive series of 2,150 cataract operations were followed for incidence of retinal detachment. A series of 1,000 patients from this group were analyzed for high risk factors: myopia, age, sex, operative complications and capsulotomy. RESULTS: With minimum one year follow up in 90% of patients the incidence of retinal detachment was 0.25% (5 cases). CONCLUSION: The true incidence ...

  20. Cataract surgery in patients with ocular surface disease: An update in clinical diagnosis and treatment

    Afsharkhamseh, Neda; Movahedan, Asadolah; Motahari, Hooman; Ali R Djalilian

    2014-01-01

    In this article we review essentials of diagnosis and management of ocular surface disease in patients who undergo cataract surgery. It is clearly shown that dry eye disease worsens following the cataract surgery in patients with prior history of ocular surface disease, Also new cases of dry eye might appear. Current strategies for the timely diagnosis and proper management of dry eye syndrome in the face of cataract surgery patients are mainly emphasized. To achieve the best outcome in catar...

  1. Cataract Surgery in Eyes with Previous Glaucoma Surgery: Pearls and Pitfalls

    Dada, Tanuj; Bhartiya, Shibal; Begum Baig, Nafees

    2013-01-01

    ABSTRACT The problem of cataract management in the patients of glaucoma who have undergone fltering surgery is a challenging proposition for any surgeon, as the surgery can lead to several complications in the already compromised eye. As glaucoma requires lifelong management, the development of cataract is a significant concern because its treatment may lead to loss of intraocular pressure (IOP) control. This review aims to highlight the intra- and postoperative measures that may increase the...

  2. Evolution of cataract surgery: Smaller incision - less complications

    Draganić Vladimir; Vukosavljević Miroslav; Milivojević Milorad; Resan Mirko; Petrović Nenad

    2012-01-01

    Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. ...

  3. Outsourced cataract surgery and postoperative endophthalmitis

    Solborg Bjerrum, Søren; Kiilgaard, Jens F; Mikkelsen, Kim Lyngby; la Cour, Morten

    2013-01-01

    To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk.......To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk....

  4. Partially coherent interferometric biometry in cataract surgery

    Drexler, Wolfgang; Findl, Oliver; Menapace, Rupert; Hitzenberger, Christoph K.; Fercher, Adolf F.

    1999-02-01

    In an earlier study we showed that precise axial eye length measurement on cataract eyes is possible with the dual beam partial coherence interferometry technique (PCI). A high correlation with the standard ultrasound technique has been obtained. Recently, in a prospective study, partially coherent interferometry and ultrasound biometry were compared in cataract surgery using the SRK II formula based on US applanation biometry. Three months after surgery PCI was repeated and refractive outcome was determined. The use of PCI would have improved refractive outcome by about 30%.

  5. MANUAL SMALL INCISION CATARACT SURGERY (MSICS

    Mishra

    2014-09-01

    Full Text Available : In developing country like India, the primary goal is to provide all the benefits to common man at minimal possible cost in visual rehabilitation of cataract. In achieving this goal, the surgery (MICS described in this article can be extremely helpful. It has almost all the advantages of phacoemulsification, at the same time it is inexpensive. The wound construction, various techniques of nucleus delivery in MSICS are described precisely. This may stimulate the reader towards this surgery, which is the only way to tackle the huge backlog of cataract in developing countries, particularly in India, where 60% of rural people live in less than thirty rupees a day.

  6. Cost-effectiveness analysis of cataract surgery with intraocular lens implantation: extracapsular cataract extraction versus phacoemulsification

    Mohd R.A. Manaf; Aljunid, Syed M; Faridah H. Annuar; Chuah K. Leong; Normalina Mansor

    2007-01-01

    A randomized single blinded clinical trial to compare the cost-effectiveness of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) from March 2000 until August 2001. The cost of a cataract surgery incurred by hospital, patients and households were calculated preoperatively, one week, two months (for both techniques) and six months (for ECCE only). Effectiveness of cataract surgery was ...

  7. New technology update: femtosecond laser in cataract surgery

    Nagy ZZ

    2014-06-01

    Full Text Available Zoltan Z NagyDepartment of Ophthalmology, Semmelweis University, Budapest, HungaryAbstract: Femtosecond lasers represent a new frontier in cataract surgery. Since their ­introduction and first human treatment in 2008, a lot of new developments have been achieved. In this review article, the physical principle of femtolasers is discussed, together with the indications and side effects of the method in cataract surgery. The most important clinical results are also presented regarding capsulotomy, fragmentation of the crystalline lens, corneal wound creation, and refractive results. Safety issues such as endothelial and macular changes are also discussed. The most important advantage of femtolaser cataract technology at present is that all the important surgical steps of cataract surgery can be planned and customized, delivering unparalleled accuracy, repeatability, and consistency in surgical results. The advantages of premium lenses can be maximally used in visual and presbyopia restoration as well. The advantages of ­premium lenses can be maximally used, not only in visual, but in presbyopia restoration as well. Quality of vision can be improved with less posterior chamber lens (PCL tilt, more centralized position of the PCL, possibly less endothelial damage, less macular edema, and less posterior capsule opacification (PCO formation. This technological achievement should be followed by other technical developments in the lens industry. Hopefully this review article will help us to understand the technology and the results to ­demonstrate the differences between the use of femtolasers and phacoemulsification-based cataract surgery. The most important data of the literature are summarized to show ophthalmologists the benefits of the technology in order to provide the best refractive results to the patient.Keywords: femtosecond laser-assisted cataract surgery, capsulotomy, lens fragmentation, corneal wound, arcuate keratotomy, safety

  8. Dropped nucleus following phacoemulsification cataract surgery.

    Tajunisah, I; Reddy, S C

    2007-12-01

    Twenty two cases of dropped nucleus following 1,196 phacoemulsification procedures in cataract surgery were examined retrospectively to determine the incidence, predisposing factors and visual outcomes of this dreaded complication. All the cases underwent pars plana vitrectomy and the lens fragments were removed with phacofragmotome, vitrectomy cutter or delivered through limbus. The incidence of dropped nucleus was 1.84%. The predisposing factors were hard cataracts (13.6%), polar cataracts (9.1%), previously vitrectomized eyes (4.5%) and high myopia (4.5%). The final visual outcome was > or = 6/12 in 10 eyes (45.5%); complications were seen in 5 eyes (22.7%). The interval between initial surgery and vitrectomy, the method of fragment removal and the type of lens implanted, did not influence the final visual outcome. PMID:18705466

  9. [The development of cataract surgery after 1745].

    Pouw, C A M Karin; Zegers, Richard H C

    2013-01-01

    Nowadays, cataract surgery is the most commonly performed surgical procedure in the Netherlands. This is due to the increasing incidence of cataracts, the changing indication for surgery in our society where good vision is becoming increasingly important, and the quality of the operation. How was this modern procedure developed? Cataracts were treated by couching until the middle of the 18th century. Since then, many discoveries by a number of doctors changed the procedure gradually from couching to lens extraction and through extracapsular to intracapsular extraction with the simultaneous implantation of an intraocular lens. This article outlines the development and also discusses some of the many inventions in the field of instrumentation and materials that have brought this intervention to its current high level; these include the cryo-probe, implantation of artificial lenses, the use of hyaluronic acid, phaco-emulsification, smaller incisions without sutures and the development of foldable intraocular lenses. PMID:23548190

  10. Role of sphincterotomy in extracapsular cataract surgery.

    Cole, M D; Brown, R.; Ridgway, A. E.

    1986-01-01

    Forty patients subjected to extracapsular cataract extraction with posterior chamber intraocular lens implantation in whom a sphincterotomy was required are reported on. This method was used to counter the problems created by a small pupil during surgery. The technique is described and results evaluated.

  11. Intraocular eyelash after uneventful cataract surgery

    Knyazer, Boris

    2010-01-01

    Boris Knyazer, Jaime Levy, Itamar Klemperer, Tova LifshitzDepartment of Ophthalmology, Soroka University Medical Center, Ben-Gurion, University of the Negev, Beer-Sheva, IsraelIntroduction: Intraocular eyelash is an uncommon complication after cataract surgery. We report a very rare case of corneal foreign body after uneventful phacoemulsification surgery. Methods: A 66-year-old man referred to our outpatient ophthalmology clinic for routine examination one week after uneventful phacoemulsifi...

  12. Cataract surgery following KAMRA presbyopic implant

    Tan TE

    2013-09-01

    Full Text Available Tien-En Tan,1,2 Jodhbir S Mehta2–4 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 2Singapore National Eye Centre, Singapore; 3Singapore Eye Research Institute, Singapore; 4Department of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore Abstract: Intrastromal corneal inlays are an emerging treatment for presbyopic patients. The KAMRA™ small aperture inlay was the first such inlay to receive Conformité Européenne (CE marking in 2005. It has been shown to improve uncorrected near and intermediate visual acuity without adversely affecting uncorrected distance visual acuity. Due to the age of presbyopic patients, they may eventually develop cataracts. In two such cases, we found that cataract surgery with the KAMRA implant left in place was not technically more difficult, and that the surgical procedure could be improved by additional ocular rotations to improve visualization. Biometry readings were reliable, and it appeared that the SRK/T formula was accurate for calculation of intraocular lens power. Cataract surgery with the KAMRA implant left in situ is a viable option for patients. Keywords: cataract surgery, KAMRA, corneal inlay, AcuTarget, presbyopia

  13. Small incision cataract surgery: tips for avoiding surgical complications

    Reeta Gurung; Albrecht Hennig

    2008-01-01

    Small incision cataract surgery (SICS) is one of the cataract surgical techniques commonly used in developing countries. This technique usually results in a good visual outcome and is useful for high-volume cataract surgery.1–3This article describes how to minimise surgical complications in SICS.

  14. Tools to fight the cataract epidemic: A review of experimental animal models that mimic age related nuclear cataract.

    Lim, Julie C; Umapathy, Ankita; Donaldson, Paul J

    2016-04-01

    Cataract is the leading cause of blindness worldwide and accounts for approximately half of all forms of vision loss. Currently, the only way to treat cataracts is by surgery. However, with an ageing population, the demand for surgery and the need for cost effective alternative solutions grows exponentially. To reduce the need for cataract surgery, alternative medical therapies to delay cataracts are urgently required. However, given the difficulty in accessing human cataract lenses, investigating the process of cataract formation and testing the efficacy of potential therapies in humans is problematic. Therefore, researchers have looked to create suitable animal models of cataractogenesis to identify therapeutic options. This review will provide an overview of the cataract specific changes previously reported in human cataract lenses, before focussing on the specific changes that occur in age related nuclear (ARN) cataract, the most common form of cataract in humans. This will be followed by a discussion of a range of existing animal cataract models and their respective suitability for mimicking the processes associated with the development of ARN cataract, and therefore their utility as models to test anti-cataract therapies for future use in humans. PMID:26391448

  15. Axial length variability in cataract surgery

    To determine the mean axial length and biometric measures in patients undergoing cataract surgery and further compare the variability of axial length between the gender and with age. Study Design: Cross-sectional observational study. Place and Duration of Study: Eye Unit I, Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan from January 2010 to December 2012. Methodology: All patients referred for cataract surgery were assessed. The study included 886 eyes which were straightforward cataract cases with no other ocular problem. The data was collected for axial length, keratometric values and Intra-Ocular Lens (IOL) power prior to cataract surgery. The collected data was then analyzed using SPSS version 19 for windows software. Results: Gender based comparison showed significant difference in age, axial length, keratometric values and IOL power between the two groups (p=0.000). 86% of the eyes had an axial length between 21.00 mm and 23.99 mm. In univariate analysis there was significant (p=0.000) relation between overall age and axial length. The keratometric values ranged between 36.75 D and 52.50 D. Majority of the IOL powers ranged between 20.00 D and 23.00 D. Conclusion: The mean axial length of patients undergoing cataract surgery was 22.96 +- 1.04 mm, was comparable to Indian and Chinese population but shorter than the Western population. Females had shorter axial lengths, similar to other studies. Axial length was positively associated with age among the females, the cause of which is yet to be determined. (author)

  16. High-Fidelity Cataract Surgery Simulation and Third World Blindness

    Singh, Ajay; Strauss, Glenn H.

    2015-01-01

    The burden of global cataract blindness continues to rise, because the number of surgical ophthalmologists is insufficient, and they are unevenly distributed. There is an urgent need to train surgeons quickly and comprehensively in high-quality, low-cost cataract removal techniques. The authors suggest manual small-incision cataract surgery as a safe alternative to phacoemulsification cataract surgery in the developing world. They discuss the development of a novel, full-immersion, physics-ba...

  17. Quality assessment of cataract surgery in Denmark - risk of retinal detachment and postoperative endophthalmitis

    Bjerrum, Søren Solborg

    The main purpose of this thesis was to examine whether the Danish National Patient Registry (NPR) could be used to monitor and assess the quality of cataract surgery in Denmark by studying the risks of two serious postoperative complications following cataract surgery - retinal detachment (RD) and......-operated fellow eyes up to 10 years after cataract surgery. The epidemiology of RD in the non-operated fellow eyes was different from the epidemiology of RD in the background population as young men had the highest risk of RD in the non-operated fellow eyes. This means that the absolute risk of PRD was highest...... for young men because they had a higher risk of RD before they underwent cataract surgery. In the second study (paper II), we used data from the NPR and reviewed patient charts to assess the risk of PE after cataract surgery performed in public eye departments and private hospitals/clinics in the...

  18. New technology update: femtosecond laser in cataract surgery.

    Nagy, Zoltan Z

    2014-01-01

    Femtosecond lasers represent a new frontier in cataract surgery. Since their introduction and first human treatment in 2008, a lot of new developments have been achieved. In this review article, the physical principle of femtolasers is discussed, together with the indications and side effects of the method in cataract surgery. The most important clinical results are also presented regarding capsulotomy, fragmentation of the crystalline lens, corneal wound creation, and refractive results. Safety issues such as endothelial and macular changes are also discussed. The most important advantage of femtolaser cataract technology at present is that all the important surgical steps of cataract surgery can be planned and customized, delivering unparalleled accuracy, repeatability, and consistency in surgical results. The advantages of premium lenses can be maximally used in visual and presbyopia restoration as well. The advantages of premium lenses can be maximally used, not only in visual, but in presbyopia restoration as well. Quality of vision can be improved with less posterior chamber lens (PCL) tilt, more centralized position of the PCL, possibly less endothelial damage, less macular edema, and less posterior capsule opacification (PCO) formation. This technological achievement should be followed by other technical developments in the lens industry. Hopefully this review article will help us to understand the technology and the results to demonstrate the differences between the use of femtolasers and phacoemulsification-based cataract surgery. The most important data of the literature are summarized to show ophthalmologists the benefits of the technology in order to provide the best refractive results to the patient. PMID:24970994

  19. High-fidelity cataract surgery simulation and third world blindness.

    Singh, Ajay; Strauss, Glenn H

    2015-04-01

    The burden of global cataract blindness continues to rise, because the number of surgical ophthalmologists is insufficient, and they are unevenly distributed. There is an urgent need to train surgeons quickly and comprehensively in high-quality, low-cost cataract removal techniques. The authors suggest manual small-incision cataract surgery as a safe alternative to phacoemulsification cataract surgery in the developing world. They discuss the development of a novel, full-immersion, physics-based surgical training simulator as the centerpiece of a scalable, comprehensive training system for manual small-incision cataract surgery. PMID:24996918

  20. Socioeconomic barriers to cataract surgery in Nepal: the south Asian cataract management study

    Snellingen, T; Shrestha, B.; Gharti, M; Shrestha, J.; Upadhyay, M; Pokhrel, R

    1998-01-01

    BACKGROUND—Previous studies have shown that, despite an increasing availability of cataract surgery, important socioeconomic barriers exist in the acceptance of surgery in many rural areas of south Asia. Nepal has developed a comprehensive national network of eye hospitals but the surgical coverage for the treatment of cataract blind is still low.
AIMS—To determine the utilisation of cataract surgery and the level of physical and psychosocial impairment and the socioeconomic barriers to surge...

  1. The clinical utility of new combination phenylephrine/ketorolac injection in cataract surgery

    Lawuyi LE

    2015-07-01

    Full Text Available Lola Elizabeth Lawuyi, Avinash Gurbaxani Moorfields Eye Hospital Dubai, Dubai, UAE Abstract: The maintenance of mydriasis throughout cataract extraction surgery and the control of ocular inflammation are crucial for successful surgical outcomes. The development of miosis during cataract surgery compromises the visualization of the surgical field and working space for surgeons. This may lead to complications that include posterior capsular tear and associated vitreous loss, longer surgical time, and postoperative inflammation. Postoperative inflammation is often uncomfortable and frustrating for patients. It causes pain, redness, and photophobia. This compromises the best-uncorrected vision following surgery and often leads to multiple clinic visits. This article examines the literature published on the current treatments used to manage mydriasis, pain, and inflammation in cataract extraction surgery. Combination phenylephrine/ketorolac injection offers an exciting new class of medication for use in cataract surgery. With the recent approval of Omidria™ (combination of phenylephrine 1% and ketorolac 0.3% by the US Food and Drug Administration (FDA for intraocular use, we review the clinical utility of this new combination injection in cataract surgery. PubMed, MEDLINE, and conference proceedings were searched for the relevant literature using a combination of the following search terms: cataract extraction surgery, pupil dilation (mydriasis, miosis, phenylephrine, ketorolac, Omidria™, intracameral mydriatic. Relevant articles were reviewed and their references checked for further relevant literature. All abstracts were reviewed and full texts retrieved where available. Keywords: cataract extraction surgery, ketorolac, mydriasis, miosis, Omidria™, phenylephrine

  2. Control of astigmatism in cataract surgery.

    Brown, N. A.; Sparrow, J M

    1988-01-01

    A study is reported on cataract surgery, with intraocular lens implant, with measurement of the preoperative astigmatism and of the postoperative astigmatism over 28 weeks. Nine interrupted 10/0 nylon sutures are used to close a limbal section. Preoperative astigmatism is compensated for in the method of suturing by the placement of additional sutures. Postoperatively sutures are cut in line with the plus cylinder axis in eyes showing excessive astigmatism with the rule. Final postoperative a...

  3. MANUAL SMALL INCISION CATARACT SURGERY (MSICS)

    Mishra,, A.N.; Manavalan; Ramya; Jeevitha; Vinnarasi; Latha; Sridevi; Parth

    2014-01-01

    : In developing country like India, the primary goal is to provide all the benefits to common man at minimal possible cost in visual rehabilitation of cataract. In achieving this goal, the surgery (MICS) described in this article can be extremely helpful. It has almost all the advantages of phacoemulsification, at the same time it is inexpensive. The wound construction, various techniques of nucleus delivery in MSICS are described precisely. This may stimulate the reader towar...

  4. Cataract.

    Lam, Dennis; Rao, Srinivas K; Ratra, Vineet; Liu, Yizhi; Mitchell, Paul; King, Jonathan; Tassignon, Marie-José; Jonas, Jost; Pang, Chi P; Chang, David F

    2015-01-01

    Cataract is the leading cause of reversible blindness and visual impairment globally. Blindness from cataract is more common in populations with low socioeconomic status and in developing countries than in developed countries. The only treatment for cataract is surgery. Phacoemulsification is the gold standard for cataract surgery in the developed world, whereas manual small incision cataract surgery is used frequently in developing countries. In general, the outcomes of surgery are good and complications, such as endophthalmitis, often can be prevented or have good ouctomes if properly managed. Femtosecond laser-assisted cataract surgery, an advanced technology, can automate several steps; initial data show no superiority of this approach over current techniques, but the results of many large clinical trials are pending. The greatest challenge remains the growing 'backlog' of patients with cataract blindness in the developing world because of lack of access to affordable surgery. Efforts aimed at training additional cataract surgeons in these countries do not keep pace with the increasing demand associated with ageing population demographics. In the absence of strategie that can prevent or delay cataract formation, it is important to focus efforts and resources on developing models for efficient delivery of cataract surgical services in underserved regions. For an illustrated summary of this Primer, visit: http://go.nature.com/eQkKll. PMID:27188414

  5. The Tear Osmolarity Changes After Cataract Surgery

    Banu Öncel

    2012-01-01

    Full Text Available Pur po se: To determine the tear osmolarity changes in patients who had undergone phacoemulsification surgery. Ma te ri al and Met hod: Tear osmolarity measurements were performed in 30 eyes of 30 patients who had undergone cataract surgery without any complication. Measurements were performed before surgery and consecutively at 1st month, 3rd month, and 6th month after the surgery. TearLab osmometer (TearLab Corporation, San Diego, CA, USA device was used for the measurements and paired ttest was used for statistical analysis. Re sults: The mean age of the patients was 72.3±3.7 (67-78 years. Thirteen patients were men and 17 patients were women. The mean osmolarity values were 305.8±6.5 mOsm/L before the surgery and 312.3±6.4 mOsm/L at 1st month, 307.5±5.1 mOsm/L at 3rd month and 305.1±5.7 at 6th month after the surgery. The difference between the values before surgery and at 1st month was found statistically significant (p=0.001. Dis cus si on: The tear osmolarity increases at the first month after surgery but decreases to the levels measured before surgery at the 3rd month. The increase at the first month may be due to the corneal incisions and medication used after the surgery. We think that we have to take into account this similarity increase in all cataract patients, especially in those who also have dry eye disease. (Turk J Ophthalmol 2012; 42: 35-7

  6. Effect of cataract surgery on regulation of circadian rhythms

    Erichsen, Jesper Høiberg; Brøndsted, Adam E; Kessel, Line

    2015-01-01

    UNLABELLED: This review looked at the effect of cataract surgery on the regulation of circadian rhythms and compared the effect of blue light-filtering and clear intraocular lenses (IOLs) on circadian rhythms. A systematic review and metaanalysis were performed, and the level of evidence was...... Trials web site. Trials that reported the effect of cataract surgery on circadian rhythms were included. Outcomes were the Pittsburgh Sleep Quality Index (PSQI) global score, number of poor sleepers, Epworth Sleepiness Score, sleep efficiency, and mean concentration of melatonin. Cataract surgery...

  7. Surgical magnification for intracapsular cataract surgery in a rural hospital

    Braganza Andrew; Cheng Arthur; Thomas Ravi; Muliyil Jayaprakash

    1996-01-01

    Intracapsular cataract extraction is still the most common type of operation performed in India, especially in eye camps, and most of these are done without magnification. To assess the surgical outcome of intracapsular cataract surgery in a rural hospital with various magnifying systems, 121 consecutive eyes (121 patients) with uncomplicated cataract were randomly allocated to surgery with the operating microscope, binocular loupe or unaided eye. The surgery was performed by either consultan...

  8. The pattern of cataract surgery in India: 1992

    Gupta A; Ellwein Leon

    1995-01-01

    Surgery for cataract blindness, a major health problem, is undergoing a rapid transition. This study characterizes cataract surgery in India in terms of practice setting and surgical procedure. A survey questionnaire was mailed in December 1992 to 4356 members of the All India Ophthalmological Society, resident in India, requesting data on cataract surgery cases within the past 12 months. Two thousand one hundred thirty-four (49%) ophthalmologists responded to the survey. Of the 1,023,...

  9. Usefulness of Surgical Media Center as a Cataract Surgery Educational Tool.

    Ogawa, Tomoichiro; Shiba, Takuya; Tsuneoka, Hiroshi

    2016-01-01

    Purpose. This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC) (Abbott Medical Optics Inc.), a new cataract surgery recording device, for training of cataract surgery. Methods. We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on the surgical video. We examined whether use of SMC is able to demonstrate the differences in technique between experienced and trainee operators, to identify inappropriate phacoemulsification techniques from analyzing the graphs, and to elucidate the cause of intraoperative complications. Results. Significant differences in the time taken to reach maximum vacuum and the speed of increase in vacuum during irrigation and aspiration were observed between experienced and trainee operators. Analysis of the graphs displayed by SMC detected inappropriate phacoemulsification techniques mostly in cases operated by trainee operators. Conclusions. Using SMC, it was possible to capture details of cataract surgery objectively. This recording device allows surgeons to review cataract surgery techniques and identify the cause of intraoperative complication and is a useful education tool for cataract surgery. PMID:26881060

  10. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

    Tien-En Huang; Hsi-Kung Kuo; Sue-Ann Lin; Po-Chiung Fang; Pei-Chang Wu; Yi-Hao Chen; Yung-Jen Chen

    2007-01-01

    Background: The aim of this study was to evaluate the indications, safety, benefits, disadvantagesand advantages, and the visual outcomes for simultaneous bilateralcataract surgery (SBCS) under general anesthesia.Methods: This retrospective case review pertained to a period spanning from June1998 through June 2005 inclusively, and comprised of 27 consecutivepatients (54 eyes) that underwent simultaneous bilateral cataract surgeryunder general anesthesia at the Kaohsiung Chang Gung Memorial Ho...

  11. Perioperative Modulating Factors on Astigmatism in Sutured Cataract Surgery

    Cho, Yang Kyeung; Kim, Man Soo

    2009-01-01

    Purpose To evaluate the factors that affect postoperative astigmatism and post-suture removal astigmatism, and to evaluate the risk factors associated with astigmatism axis shift. Methods We performed a retrospective chart review of 130 eyes that had undergone uneventful phacoemulsification cataract surgery. Preoperative astigmatism was divided into four groups (Groups I, II, III, and IV) according to the differences between the axis of preoperative astigmatism (flattest axis) and the incisio...

  12. How to prevent endophthalmitis in cataract surgeries?

    Kelkar Aditya

    2008-01-01

    Full Text Available Postoperative endophthalmitis is a very devastating complication and every step should be taken to reduce its occurrence. Unattended air conditioning filter systems are often the culprits and regular maintenance of the filters is of paramount importance. Shedders of pathogenic organisms amongst the theater personnel should be identified by regular screening and should be promptly treated. In addition to the use of Povidone iodine 5% solution in the conjunctival sac few minutes prior to surgery, proper construction of wound, injectable intraocular lenses, use of prophylactic intracameral antibiotics or prophylactic subconjunctival antibiotic injection at the conclusion of cataract surgery, placing a patch after the surgery for at least 4 h and initiating topical antibiotics from the same day of surgery helps to lower the frequency of postoperative endophthalmitis. Intraoperative posterior capsule rupture and anterior vitrectomy are risk factors for acute endophthalmitis, and utmost care to prevent posterior capsular rent should be taken while performing cataract surgery. Also, in case of such complication, these patients should be closely monitored for early signs of endophthalmitis in the postoperative period. In the unfortunate event of endophthalmitis the diagnosis should be prompt and treatment must be initiated as early as possible.

  13. Endothelial trauma in the surgery of cataract

    Đurović Branislav M.

    2004-01-01

    Full Text Available Cataract surgery is most common in human surgery and comprises 80% of eye surgery programs. Owing to sophisticated technologies, it has become a routine surgery with lowered complications rate; hence, the functional outcome is more conditioned by operative trauma. The aim of this study was to demonstrate the significance of specular microscopy in the evaluation of operative trauma during extra-capsular cataract extraction (ECCE and phacoemulsification (P, in a controlled environment. The study included 100 consecutive patients who met the established criteria, and groups were formed according to the type of surgery by the assignment of successive numbers from a random number table. Examination and photographs of the corneal endothelium, as well as pachymetry were performed on Keeler-Konan Poclington Specular Microscope (KSP. The obtained results revealed significant dissimilarity in endothelial cell reduction (9.17% in group E, and 4.72% in group P, which generated statistically significant correlation of pre-operative and post-operative pachymetry in the group E (p=0.0004. On the basis of the results obtained by specular microscopy, it was concluded that under the same conditions phacoemulsification caused reduced operative trauma of the corneal endothelium.

  14. Pregled operacij sive mrene v letih 1998-2001 na Očesnem oddelku Splošne bolnišnice Murska Sobota: Review of cataract surgery from 1998 to 2001 at the Murska Sobota General hospital eye department:

    Šterman, Mitja; Štrumbelj, Vlasta

    2003-01-01

    Background. Cataract is a leading cause of a reversible blindness in a developed world. The number of cataract surgery procedures performed has been increasing. This study describes methods and cataract surgery quatity in Pomurje region, Slovenia from 1998 to 2001, to identify the need for cataract surgical service in this region. Methods. For the purposes of this study, datafrom medical documentation of all 1182 cataract surgery procedures performed in Murska Sobota Eye Depar-tmentfrom 1998 ...

  15. Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

    Jan Teper, Slawomir; Dobrowolski, Dariusz; Wylegala, Edward

    2011-01-01

    The prevalence of benign prostate hyperplasia (BPH) and cataract increases with age. Both diseases may develop concomitantly and may affect almost 50% of elderly men as comorbidities. Cataract is treated surgically and it has been reported that there may be an association between use of alpha-blockers for BPH, particularly alpha1A-adrenergic receptor selective drugs, and complications of cataract surgery known as Intraoperative Floppy Iris Syndrome (IFIS). The article reviews literature publi...

  16. Incidence and Characteristics of Cataract Surgery in France from 2009 to 2012 : Incidence and characteristics of cataract surgery

    Daien, Vincent; Le Pape, Annick; Hève, Didier; Carriere, Isabelle; Villain, Max

    2015-01-01

    Objective: To report age- and sex-specific incidence rates of cataract surgery in France and evaluate the trends of cataract surgery from 2009 to 2012. Design: Cohort study Subjects: Data for all patients who underwent primary cataract surgery in France between January 2009 and December 2012 were collected from the national database. Methods: Annual incidence rates were calculated and adjusted to the corresponding-year national population data from the French national institute of statistics....

  17. PROGNOSIS, PREVENTION, AND TREATMENT OF DIABETIC CATARACT SURGERY POSTOPERATIVE COMPLICATIONS

    M. A. Kovalevskaya; N. V. Vedrintseva; L. A. Filina; T. Yu. Perova

    2015-01-01

    Aim. To study immune and antioxidant status of diabetic cataract patients and to assess the efficacy of preoperative preparation for diabetic cataract surgery to prevent intra- and postoperative complications and the efficacy of cataract treatment in metabolic syndrome patients. Patients and methods. 136 cataract patients (272 eyes) were examined (mean age 62±3.2 years). Among these patients, women predominated (n = 74). Control group included 25 healthy volunteers (10 men and 15 women) aged ...

  18. [Objective evaluation the application of femtosecond laser in cataract surgery].

    Liu, Y Z

    2016-02-11

    Femtosecond laser-assisted cataract surgery (FLACS) is a novel technology and the biggest revolution in the field of cataract in the latest several years. However, increasing large-scale population randomized controlled trials (RCT) have demonstrated that FLACS does not provide significant advantages over conventional phacoemulsification cataract surgery (CPCS) for common cataract patients. Furthermore, the cost and space requirement of the femtosecond equipment are another two limitations for the universal application of FSL in cataract surgery. However, FLACS may be beneficial for complex cataract situations, such as lens dislocation, zonular laxity, traumatic cataract, low preoperative endothelial cell values, and significant corneal astigmatism. With the progress of science and technology, FLACS can be expected to achieve integration with phacoemulsification systems, and equipment costs can be reduced, making it more widely used in clinical practice in the future. (Chin J Ophthalmol, 2016, 52: 81-84). PMID:26906700

  19. VISUAL OUTCOME FOLLOWING SURGERY OF TRAUMATIC CATARACT

    Prasad Rao

    2015-04-01

    Full Text Available AIM: To assess the visual outcome following traumatic cataract surgery and to assess the predictors of better visual outcome STUDY SETUP AND DESIGN: This is a prospective case study made on consecutive series of patients with traumatic cataract who underwent surgery between November 2012 to July 2013 at Government Regional eye hospital, Andhra medical college, Visakhapatnam . METHODS: Study was made on 100 eyes of 100 patients. Patient’s detailed history, clinical features, pre - operative examination, surgical intervention, post - operative visual acuity and follow up refraction changes record. RESULTS: In total , 100 eyes of 100 patients were included . Out of 100 cases, 78 cases (78% were males and 22 cases (22% were females. Good visual acuity of 6/6 – 6/18 was achieved by 70 cases, (70% out of which 58 cases (58% are closed globe type and 12 cases ( 12% are open globe type. 4 cases ( 4% achieved visual acuity of 6/24 to 6/609 . ( 1 26 cases ( 26% achieved a poor visual outcome of < 6/60 out of which 22 cases (22% are open globe type and 4 cases 4% are closed globe type . ( 2 CONCLUSIONS: Closed globe injury has a favorable prognosis for a satisfactory better that 6/18 visual recovery after surgical management of traumatic cataract , compared to open globe type. In case of open globe injury . (3 prompt wound repair , proper use of drugs to reduce infection , inflammation followed by timely surgery may improve the visual prognosis if there is no other sight threatening injury.

  20. Cataract Surgery and Falls, Fractures, and Mortality in the United States Population

    Tseng, Victoria Li-Ting

    2016-01-01

    Cataract surgery is the mainstay of treatment for visually significant cataract. Aside from vision improvement, one secondary benefit of cataract surgery that has been reported is the reduction of fracture risk. This dissertation examines associations between cataract surgery and factors related to fracture risk, including the association between cataract surgery and falls and the association between cataract surgery and long-term mortality. The first study of this dissertation uses data from...

  1. Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results

    Chang JS

    2013-04-01

    Full Text Available Jonathan S Chang, Harry W Flynn Jr, Darlene Miller, William E Smiddy Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Background: Stenotrophomonas maltophilia is a Gram-negative organism known to cause opportunistic infections. It is a rare source of endophthalmitis, often in the setting of trauma, but has been reported following cataract extraction. The purpose of this study was to evaluate antimicrobial sensitivities, clinical characteristics, and treatment outcomes in patients with endophthalmitis caused by S. maltophilia following cataract extraction. Methods: A retrospective case review of records from January 1, 1990 to June 30, 2010 was performed at the Bascom Palmer Eye Institute. Results: Eight cases of S. maltophilia endophthalmitis were identified following cataract surgery. Initial visual acuity ranged from 20/200 to light perception. Time to diagnosis with cultures was 2–118 days. Patients received either intravitreal tap and inject (n = 5 or pars plana vitrectomy with intravitreal antibiotic injections (n = 3. All patients had vitreous or anterior chamber cultures positive for S. maltophilia. Seven of seven isolates tested were found to be sensitive to ceftazidime. Seven of eight isolates were sensitive to polymyxin B, six of eight isolates were sensitive to amikacin, and five of the seven isolates tested were sensitive to ciprofloxacin. Two of four tested isolates were sensitive to trimethoprim-sulbactam. All eight isolates were resistant to gentamicin and seven of the seven tested isolates were resistant to imipenem. All patients received intravitreal ceftazidime as part of the initial treatment regimen. Final visual acuity ranged from 20/25 to 4/200. Conclusion: S. maltophilia endophthalmitis is a rare source of endophthalmitis following cataract surgery. A case series of eight independent patients is reported, along with antibiotic resistance profiles and

  2. The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

    Trikha, S; Turnbull, A M J; Morris, R.J.; Anderson, D F; Hossain, P.

    2013-01-01

    Femtosecond laser-assisted cataract surgery (FLACS) represents a potential paradigm shift in cataract surgery, but it is not without controversy. Advocates of the technology herald FLACS as a revolution that promises superior outcomes and an improved safety profile for patients. Conversely, detractors point to the large financial costs involved and claim that similar results are achievable with conventional small-incision phacoemulsification. This review provides a balanced and comprehensive ...

  3. Manual Suture Less Small Incision Cataract Surgery in Patients with Uveitic Cataract

    Rahul Bhargava; Prachi Kumar; Hafsa Bashir; Shiv Kumar Sharma; Anurag Mishra

    2014-01-01

    Purpose: The purpose of this study is to evaluate the outcome of manual small incision cataract surgery (SICS) in eyes with uveitic cataract. Setting: Medical college hospital of the subcontinent. Design: Retrospective case series. Materials and Methods: In this retrospective study, patients who underwent SICS with posterior chamber intraocular lens implantation for uveitic cataract from 2006 to 2009 were evaluated. Patients with less than 3 months follow-up were excluded. Post-opera...

  4. Determinants of Visual Outcomes in Femtosecond Laser Assisted Cataract Surgery and Phacoemulsification: A Nested Case Control Study

    Rajiv Khandekar; Ashley Behrens; Abdul Elah Al. Towerki; William May; Saeed Motowa; Komal Tailor; Ches Souru

    2015-01-01

    Purpose: We present the visual outcomes 6 weeks following Femtosecond laser assisted cataract surgery (FLACS) and conventional phacoemulsification cataract extraction (CE) cataract surgeries in 2013. Materials and Methods: This was a review of health record type of study. Eyes operated by FLACS and an equal number of conventional phacoemulsification (CE) on the same day by same surgeon were included in the study. Demographics, preoperative status, operative details and the best-corrected ...

  5. Convulsions during cataract surgery under peribulbar anesthesia: a case report

    Bensghir, Mustapha; Badou, Najlae; Houba, Abdelhafid; Balkhi, Hicham; Haimeur, Charki; Azendour, Hicham

    2014-01-01

    Introduction Locoregional anesthesia techniques are increasingly used for cataract surgery. From these techniques, peribulbar anesthesia has been very successful over the retrobulbar anesthesia seen its effectiveness and safety. However, peribulbar anesthesia is not without risk. Case presentation A 70-year-old African man was scheduled for cataract surgery and lens implant for his right eye. His medical history included hypertension, diabetes mellitus and gall bladder surgery. There were no ...

  6. [Developments in modern cataract surgery – a critical overview].

    Menapace, Rupert

    2016-01-01

    Cataract surgery has tremendously evolved in recent years. Innovations include micro-incision cataract surgery through incisions smaller than 2mm, high-fluidics phacoaspiration and laser phacoemulsification to minimize or replace the use of ultrasound, the advent of femtolasers for high-precision incisions in the cornea, the lens capsule and the cataractous lens, aspheric intraocular lenses (IOLs) to enhance the quality and contrast of the image, multifocal and enhanced-depth-of-focus IOLs to correct presbyopia, advancements in biometry and IOL power calculation, prevention of secondary capsule opacification by improvements in the design and material of the IOLs and surgical techniques like capsule polishing and posterior capsulorhexis, and pharmacological prophylaxis and possible future treatment of the cataract itself. Finally, cost-effectiveness and future potential of same-session bilateral cataract surgery are discussed. PMID:26982642

  7. Ocular safety limits for 1030nm femtosecond laser cataract surgery

    Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel V.

    2013-03-01

    Application of femtosecond lasers to cataract surgery has added unprecedented precision and reproducibility but ocular safety limits for the procedure are not well-quantified. We present an analysis of safety during laser cataract surgery considering scanned patterns, reduced blood perfusion, and light scattering on residual bubbles formed during laser cutting. Experimental results for continuous-wave 1030 nm irradiation of the retina in rabbits are used to calibrate damage threshold temperatures and perfusion rate for our computational model of ocular heating. Using conservative estimates for each safety factor, we compute the limits of the laser settings for cataract surgery that optimize procedure speed within the limits of retinal safety.

  8. SMALL INCISION CATARACT SURGERY VERSUS PHACOEMULSIFICATION FOR IMMATURE CATARACT: A SINGLE BLIND RANDOMIZED CONTROLLED TRIAL

    Md. Jawed

    2014-08-01

    Full Text Available BACKGROUND: Manual small incision cataract surgery (SICS has given visual results almost equivalent to Phacoemulsification but limited studies are available regarding the efficacy of small incision cataract surgery in phaco suitable immature cataracts. OBJECTIVE: To compare manual small incision cataract surgery and Phacoemulsification in immature cataracts. MATERIALS AND METHODS: A single blind randomized controlled trial was conducted with 105 eyes each for small incision cataract surgery and Phacoemulsification. RESULT: Mean IOL power was similar in both Phacoemulsifications as well as SICS. Four cases of posterior capsular rupture occurred in Phacoemulsification while one case of zonular dialysis occurred in SICS. Uncorrected visual acuity was good (6/6-6/18 in 80.0 % of the phaco and 93.33 % of the SICS group. CONCLUSION: SICS surgical technique resulted in significantly better visual acuity on the 1st postoperative day in comparison with phaco. Hence, SICS with rigid PMMA IOL implantation being a cheaper, faster and easier technique, may be recommended for immature cataract surgery in the developing countries

  9. Simultaneous Penetrating Keratoplasty and Cataract Surgery

    Mohammad-Ali Javadi; Sepehr Feizi; Hamid-Reza Moein

    2013-01-01

    Purpose: To determine the clinical outcomes of simultaneous penetrating keratoplasty (PK), cataract removal and intraocular lens implantation (triple procedure), and to compare the safety and efficacy of two different cataract extraction techniques during the course of PK. Methods: This retrospective comparative study was conducted on patients who had undergone a triple procedure. The technique of cataract extraction was either opensky extracapsular cataract extraction (ECCE) or phacoemul...

  10. Sutureless Non-phaco Cataract Surgery: A Solution to Reduce Worldwide Cataract Blindness?

    Albrecht Hennig

    2003-01-01

    The Search for Appropriate Sutureless Cataract Surgery. During the last decade, in industrialised countries phacoemulsification has largely replaced ab-externo extracapsular cataract extraction with posterior chamber intraocular lenses (ECCE/PC IOL) with sutures. The small self-sealing phaco incision provides rapid visual rehabilitation, and the surgery is increasingly done on an outpatient basis. However, in developing countries phacoemulsification is performed only on selected patients, usu...

  11. Cataract surgery and age-related macular degeneration. An evidence-based update

    Kessel, Line; Erngaard, Ditte; Flesner, Per; Andresen, Jens; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    PURPOSE: Age-related macular degeneration (AMD) and cataract often coexist in patients and concerns that cataract surgery is associated with an increased risk of incidence or progression of existing AMD has been raised. This systematic review and meta-analysis is focused on presenting the evidence...... concerning progression of AMD in patients undergoing cataract surgery. METHODS: We performed a systematic literature search in the PubMed, Medline, Cochrane Library and CINAHL databases. Two randomized trials and two case-control trials were identified. Quality of the studies was assessed using the Cochrane...... risk of bias tool, data were extracted, and meta-analyses were performed. Quality of the available evidence was evaluated using the GRADE system. RESULTS: We found that visual acuity at 6-12 months follow-up was significantly better (6.5-7.5 letters) in eyes that had undergone cataract surgery than in...

  12. Risk of retinal detachment following cataract extraction: results from the International Cataract Surgery Outcomes Study.

    Norregaard, J. C.; Thoning, H.; Andersen, T. F.; Bernth-Petersen, P.; Javitt, J C; Anderson, G F

    1996-01-01

    AIMS: To estimate the risk of retinal detachment (RD) following cataract extraction in Denmark, and to compare the risk with that following cataract extraction in the USA, and with that in a sample of Danish patients who did not have ocular surgery. METHODS: A sample was created from the administrative Danish Hospital Register and included 19,252 patients who underwent first eye cataract surgery between 1985 and 1987, and who were 50 years of age or older. The patients were then followed for ...

  13. Cataract surgery in a case of carotid cavernous fistula

    Akshay Gopinathan Nair

    2014-01-01

    Full Text Available A carotid-cavernous fistula (CCF is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF.

  14. The Effect of Cataract Surgery on Circadian Photoentrainment

    Brøndsted, Adam Elias; Sander, Birgit; Haargaard, Birgitte;

    2015-01-01

    of cataract surgery on circadian photoentrainment and to determine any difference between blue-blocking and neutral intraocular lenses (IOLs). DESIGN: The study was a single-center, investigator-driven, double-masked, block-randomized clinical trial. PARTICIPANTS: One eye in 76 patients with...... bilateral age-related cataract eligible for cataract surgery was included. METHODS: Intervention was cataract surgery by phacoemulsification. Patients were randomized to receive a blue-blocking or neutral IOL. MAIN OUTCOME MEASURES: Primary outcome was activation of intrinsic photosensitive ganglion cells...... (P = 0.004) for actigraphy and a tendency toward an earlier melatonin onset (P = 0.095) were found. Peak salivary melatonin concentration increased after surgery (P = 0.037). No difference was detected between blue-blocking and neutral IOLs, whereas low preoperative blue light transmission was...

  15. Cataract surgery outcomes in a Tertiary Hospital, Riyadh

    Bader Al-Qahtani

    2016-01-01

    Conclusion: Cataract removal is a safe and effective surgery which can improve the quality of life. It has some complications that can be minimised with good pre-operative evaluation and post-operative rehabilitation.

  16. Long-term results, prognostic factors and cataract surgery after diabetic vitrectomy

    Ostri, Christoffer; Lux, Anja; Lund-Andersen, Henrik; la Cour, Morten

    2014-01-01

    PURPOSE: To report long-term results, prognostic factors and cataract surgery after diabetic vitrectomy. METHODS: Retrospective review of patient files from a large diabetes centre between 1996 and 2010. Surgical history was obtained from the Danish National Patient Register. Follow-up intervals...... after 5 and 10 years, respectively. Use of silicone oil increased the risk of cataract surgery (p = 0.009, log-rank test). CONCLUSIONS: Most diabetic vitrectomy patients stand to gain visual acuity ≥0.3 after surgery and a stable long-term visual acuity after 1 year. The only consistent long......-term predictor of low vision after surgery is use of silicone oil for endotamponade. About 2/3 of phakic patients will subsequently have cataract surgery the first 10 years after diabetic vitrectomy....

  17. Visual experience during phacoemulsification cataract surgery under topical anaesthesia

    Newman, D.

    2000-01-01

    BACKGROUND/AIMS—Visual awareness during phacoemulsification cataract surgery is an important determinant of patient satisfaction with any anaesthetic technique. Topical anaesthesia could be associated with significant visual awareness because it does not affect optic nerve function.
METHODS—The visual experience during phacoemulsification cataract surgery under topical anaesthesia (without sedation) was assessed for 106 consecutive unselected patients. Patients were interviewed immediately af...

  18. Cataract surgery without anaesthesia: two descriptions by Arthur Jacob.

    Haridas, R P

    2009-07-01

    Dr Arthur Jacob (1790-1874), of Dublin, Ireland, was one of the leading ophthalmologists of his time. He was the first to describe the membrane that contains the rods and cones in the eye (membrana Jacobi) and basal cell carcinoma (Jacob's ulcer). He made a curved needle for cataract surgery from a sewing needle (Jacob's needle). Two descriptions of cataract surgery without anaesthesia are presented. PMID:19705632

  19. TARGET EMMETROPIA IN MANUAL SMALL INCISION CATARACT SURGERY

    Sathish; Prakash; Kanchana; Uma; Ambika A.; Amar; Mohan; Jafar,, T

    2013-01-01

    INTRODUCTION: Patient dissatisfaction is very common even with go od cataract surgery. Cataract surgery done by phacoemulsification with f oldable IOL implantation results in minimal astigmatism. This results in early rehabilitation t hereby rendering the patient nearly emmetropic for both distant and near work. But the drawbacks of this surgical technique are high cost, steep learning curve and is entirely mach ine dependent. This study has been conducted to ...

  20. Glaucoma in aphakia and pseudophakia after congenital cataract surgery.

    Mandal Anil; Netland Peter

    2004-01-01

    Glaucoma is one of the most common causes of visual loss despite successful congenital cataract surgery. The overall incidence does not appear to have decreased with modern microsurgical techniques. The onset of glaucoma may be acute or insidious and notoriously refractory to treatment. Angle closure glaucoma may occur in the early postoperative period; but the most common type of glaucoma to develop after congenital cataract surgery is open angle glaucoma. Several risk factors have been iden...

  1. Safety of warfarin therapy during cataract surgery under topical anesthesia

    2015-01-01

    ABSTRACT Purpose: To analyze the safety of warfarin therapy during cataract surgery under topical anesthesia. Methods: This was a prospective nonrandomized comparative study of 60 eyes of 60 patients treated with or without concurrent oral warfarin anticoagulant therapy, referred for cataract surgery under topical anesthesia. The sample included a treatment (n=30) and a control (n=30) group. Results: There were no records of intraoperative or postoperative intracameral bleeding complications ...

  2. Role of cataract surgery in lowering intraocular pressure

    To study the effects of cataract surgery in lowering of intraocular pressure (IOP). Study Design: Retrospective study. Place and Duration of Study: The Department of Ophthalmology, Combined Military Hospital, Rawalpindi from January 2011 to December 2013. Patients and Methods: The study included a total of 250 patients; of which 100 cases had simple cataract with no coexisting disease, 100 cases had cataract with primary open angle glaucoma and 50 cases of cataract had accompanying pseudoexfoliation glaucoma. All patients were assessed and recorded preoperatively for their IOP, vision, depth of anterior chamber (ACD), angle of anterior chamber by gonioscopy and glaucoma medications being used. Cataract surgery was performed by phacoemulsification and IOL implantations in all cases. These patients were followed up for a period of six months. Results: The intraocular ressure of all these patients was recorded at monthly interval for six months. The IOP showed a significant decrease in all cases and remained constant till the end of the study. A marked improvement of vision was noted in all cases. The depth of the anterior chamber increased and the angle also widened in all cases. Discussion: Cataract surgery has been found to reduce IOP along with improvement in vision. Patients with glaucoma have a dual benefit of reduced IOP and visual improvement after cataract surgery. (author)

  3. The challenges in improving outcome of cataract surgery in low and middle income countries

    Robert Lindfield; Kalluru Vishwanath; Faustin Ngounou; Rohit C Khanna

    2012-01-01

    Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income ...

  4. IMPROVEMENT IN VISION FOLLOWING CATARACT SURGERY: A COMPARISON OF PHACOEMULSIFICATION AND SMALL INCISION CATARACT SURGERY (SICS TECHNIQUES

    Abraham

    2016-03-01

    Full Text Available INTRODUCTION Phacoemulsification is the method of choice in most of the western nations and tertiary care ophthalmology centres in India, while manual small incision cataract surgery (MSICS is the surgical technique preferred by most of the ophthalmic surgeons working in smaller centres. Many studies have indicated that the MSICS technique is preferable for smaller centres, especially in developing countries, as the duration of surgery and requirement of equipment tends to be much smaller. This study was aimed at comparing the outcomes of MSICS and phacoemulsification surgeries carried out over a period of three months at a tertiary care hospital in South India. MATERIALS AND METHODS Patients diagnosed to have age related cataract and undergoing surgery in this institution were included in the study. The choice of surgical intervention was based on the preference of the operating surgeon and choice of the patient. The patients were followed up at the end of one week on their review visit to the outpatient department of the hospital. The incidence of postoperative complications was enquired, apart from measurement of visual acuity and corneal diameters. RESULTS A total of 106 participants were included in the study. Eighty percent of the patients who underwent phacoemulsification had some improvement in vision, while 81.9% of the participants in the MSICS group showed improvement, (p-0.825, only one participant had a complication related to the surgery, and he belonged to the MSICS group. The changes in K1 (p-0.547 and K2 (p-0.698 corneal diameters during surgery was also not significantly different between the groups. CONCLUSIONS It was observed that MSICS and phacoemulsification procedures have similar outcomes when used at a tertiary care teaching hospital in South India. A large multicentric Randomised Control Trial (RCT is warranted to compare the outcomes of the two surgical procedures and the cost-effectiveness of each, before concrete

  5. Sutureless Cataract Surgery: Principles and Steps

    John Sandford-Smith

    2003-01-01

    Introduction. Cataracts cause about 50% of world blindness. There is little likelihood of effective prevention becoming available in the next few years and so the only treatment will remain surgical. For many of the other major causes of world blindness, like trachoma, xerophthalmia and onchocerciasis, the remedy is community-based, not hospital-based, and requires prevention rather than treatment. The prevalence of blinding cataract will only increase as people live longer, so cataract will ...

  6. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

    Tien-En Huang

    2007-04-01

    Full Text Available Background: The aim of this study was to evaluate the indications, safety, benefits, disadvantagesand advantages, and the visual outcomes for simultaneous bilateralcataract surgery (SBCS under general anesthesia.Methods: This retrospective case review pertained to a period spanning from June1998 through June 2005 inclusively, and comprised of 27 consecutivepatients (54 eyes that underwent simultaneous bilateral cataract surgeryunder general anesthesia at the Kaohsiung Chang Gung Memorial Hospital,Taiwan. Surgery modalities included phacoemulsification, extracapsularcataract extraction, lens aspiration and intraocular lens implantation.Outcome measures included postoperative best correct visual acuity (BCVAas well as intraoperative and postoperative complication rates. Due to thebipolas distribution of the age, we arbitrarily divided our cases into youngergroup (Group Y, younger than 20 years old and older group (Group O, equalto or older than 20 years old.Results: Thirty-eight of the 54 eyes (60% in the younger group and 76.5% in theolder group, featuring measured preoperative and postoperative BSCVA,achieved improved visual acuity following SBCS. Two eyes (5.9% in theolder group demonstrated poorer visual acuity postoperatively than preoperatively.Seven patients (40% in the younger group and 17.6% in the oldergroup were not able to express VA due to their particular medical conditionssuch as mental disease and young age. Intraoperative and postoperative complicationrates were similar to those cited in previous reports of analogousbut unilateral extracapsular surgery and simultaneous bilateral cataractsurgery. Endophthalmitis did not arise in any of the eyes operated upon andreported on herein, and no examples of bilateral complications that resultedin visual loss occurred in our patients.Conclusion: SBCS could be a good choice when cataract surgery needs to be performedunder general anesthesia. The relative benefits of SBCS under general

  7. CORNEAL ASTIGMATISM AFTER MANUAL SMALL INCISION CATARACT SURGERY

    Rajni

    2014-11-01

    Full Text Available INTRODUCTION: Cataract is the leading cause of preventable blindness in India. Manual Small Incision Cataract Surgery is still the preferred method of cataract surgery because of its low cost and non-dependence on costly equipments. Postoperatively astigmatism is an important cause of poor uncorrected visual acuity after cataract surgery. Purpose: The purpose of this study was to assess corneal astigmatism in manual small incision cataract surgery in superior versus temporal incision. MATERIALS AND METHODS: A total of 100 patients were included in our study. 50 patients received superior incision and 50 patients received temporal incision. Surgically induced astigmatism was calculated in these patients postoperatively. RESULTS: We observed mean 1.16 D of surgically induced astigmatism in patients with superior incision and mean 0.62 D of astigmatism in patients with temporal incision at the end of 12th postoperative week. CONCLUSION: The results of the present study showed a favourable influence of temporal incision over superior incision in manual incision cataract surgery in terms of surgically induced astigmatism.

  8. The effects of blunt trauma and cataract surgery on corneal endothelial cell density

    Yeniad Baris; Corum Isik; Ozgun Cahit

    2010-01-01

    Purpose: This study was designed to investigate the effects of trauma and cataract surgery on corneal endothelial cell density (ECD) in patients with a traumatic cataract due to blunt trauma without globe laceration. Materials and Methods: In this prospective study, 31 subjects with traumatic cataract (traumatic cataract group) and 30 subjects with a senile cataract (control group) were enrolled. The subjects with traumatic cataract were subdivided into two groups: uncomplicated surgery subg...

  9. The incidence and rate of rhegmatogenous retinal detachment seven years after cataract surgery in patients with high myopia

    Williams, Michael A.; McGimpsey, Stuart; Abugreen, Salwa; Chan, Wing,; Sharkey, James A; Best, Richard M; Johnston, Patrick B.

    2009-01-01

    Background Cataract extraction is the most commonly performed surgery in the National Health Service. Myopia increases the risk of postoperative rhegmatogenous retinal detachment (RRD). The aim of this study was to determine the incidence and rate of RRD seven years after cataract extraction in highly myopic eyes. Methods Retrospective review was performed of notes of all high myopes (axial length 26.0 mm or more) who underwent cataract extraction during the study period in one centre. Result...

  10. Cost-effectiveness analysis of cataract surgery with intraocular lens implantation: extracapsular cataract extraction versus phacoemulsification

    Mohd R.A. Manaf

    2007-03-01

    Full Text Available A randomized single blinded clinical trial to compare the cost-effectiveness of cataract surgery between extracapsular cataract extraction (ECCE and phacoemulsification (PEA was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM from March 2000 until August 2001. The cost of a cataract surgery incurred by hospital, patients and households were calculated preoperatively, one week, two months (for both techniques and six months (for ECCE only. Effectiveness of cataract surgery was assessed using Visual Function 14 (VF-14, quality of life measurement specifically for vision. The cost analysis results from each 50 subjects of ECCE and PEA group showed that average cost for one ECCE after six months post-operation is USD 458 (± USD 72 and for PEA is USD 528 (± USD 125. VF-14 score showed a significant increased after a week, two months and six months post-operation compared to the score before operation for both techniques (p<0.001. However, there was no significant difference between them (p = 0.225. This study indicated that ECCE is more cost effective compared to PEA with cost per one unit increment of VF-14 score of USD 14 compared to USD 20 for PEA. (Med J Indones 2007; 16:25-31 Keywords: cataract, cost-effectiveness, extracapsular cataract extraction, phacoemulsification, visual function 14

  11. Indication for cataract surgery. Do we have evidence of who will benefit from surgery?

    Kessel, Line; Andresen, Jens; Erngaard, Ditte;

    2015-01-01

    surgery. To overcome this shortage of evidence, many systems have been developed internationally to prioritize patients on waiting lists for cataract surgery, but the Swedish NIKE (Nationell Indikationsmodell för Katarakt Ekstraktion) is the only system where an association to the preoperative scoring of...... a patient has been related to outcome of cataract surgery. We advise that clinicians are inspired by the NIKE system when they decide which patients to operate to ensure that surgery is only offered to patients who are expected to benefit from cataract surgery....

  12. Is there overutilisation of cataract surgery in England?

    Black, N.; Browne, J.; van der Meulen, J.H.; Jamison, L.; Copley, L.P.; Lewsey, J.

    2009-01-01

    Objectives: Following a 3.7-fold increase in the rate of cataract surgery in the UK between 1989 and 2004, concern has been raised as to whether this has been accompanied by an excessive decline in the threshold such that some operations are inappropriate. The objective was to measure the impact of surgery on a representative sample of patients so as to determine whether or not overutilisation of surgery is occurring. Design: Prospective cohort assessed before and 3 months after surgery. ...

  13. Conjunctival inclusion cysts following small incision cataract surgery

    Narayanappa Shylaja; Dayananda S; Dakshayini M; Gangasagara Suresh; Prabhakaran Venkatesh

    2010-01-01

    The occurrence of acquired conjunctival inclusion cysts following various ophthalmic surgeries such as strabismus surgery, scleral buckling, pars plana vitrectomy, ptosis surgery and phacoemulsification has been reported. We report two cases of conjunctival inclusion cysts following manual Small Incision Cataract Surgery (SICS) in two male patients aged 65 and 67 years. The cysts originated from the scleral tunnel used for manual SICS. Both were treated by excision and confirmed histopatholog...

  14. Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery

    Kang, Kui Dong; Yim, Hye Bin; Biglan, Albert W.

    2006-01-01

    Purpose To investigate the causes and characteristics of glaucoma in children following cataract surgery. Methods Twenty-four patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma after cataract surgery were studied retrospectively. Variables included cataract morphology, surgical techniques, post-operative complications, time to the onset of glaucoma, gonioscopic findings, presence of microcornea and the histopathologic characteristics of the filtration angle (in ...

  15. TARGET EMMETROPIA IN MANUAL SMALL INCISION CATARACT SURGERY

    Sathish

    2013-04-01

    Full Text Available INTRODUCTION: Patient dissatisfaction is very common even with go od cataract surgery. Cataract surgery done by phacoemulsification with f oldable IOL implantation results in minimal astigmatism. This results in early rehabilitation t hereby rendering the patient nearly emmetropic for both distant and near work. But the drawbacks of this surgical technique are high cost, steep learning curve and is entirely mach ine dependent. This study has been conducted to know if it is possi ble to achieve minimal astigmatism with MSICS with rigid PMMA IOL in selected cases th us achieving cost effectiveness and reducing the duration of surgery.

  16. [Simultaneous bilateral cataract surgery--advantages and disadvantages].

    Obuchowska, Iwona; Mariak, Zofia

    2006-01-01

    During the past decade, advances in techniques and technology led to major changes in cataract surgical practice patterns. In this progression towards ever faster eye rehabilitation after surgery, simultaneous bilateral cataract surgery (SBCS) may be the next and ultimate step. It is not routinely performed: however, there are certain situations in which SBCS might be beneficial to the patients. It has been considered a good option in patients who have significant cataract in both eyes and are not good candidates for having anesthesia and surgery twice. The question is, if the benefits by bilateral surgery justify the risk of simultaneous complications, in particular endophthalmitis. In this perspective we present the clinical, social and economic advantages and disadvantages of such surgical procedures. PMID:17290841

  17. Outcomes of Surgery for Posterior Polar Cataract Using Torsional Ultrasound

    Selçuk Sızmaz

    2013-10-01

    Full Text Available Purpose: The aim of this study is to report outcomes of surgery for posterior polar cataract using torsional ultrasound. Material and Method: Medical records of 26 eyes of 21 consecutive patients with posterior polar cataract who had cataract surgery using the torsional phacoemulsification were evaluated retrospectively. The surgical procedure used, phacoemulsification parameters, intraoperative complications, and postoperative visual outcome were recorded. Results: Of the 26 eyes, 24 (92.3% had small to medium posterior polar opacity. Two eyes had large opacity. All surgeries were performed using the torsional handpiece. Posterior capsule rupture occurred in 4 (15.3% eyes. The mean visual acuity improved significantly after surgery (p<0.001. The postoperative visual acuity was worse than 20/20 in 5 eyes. The cause of the low acuity was amblyopia. Discussion: Successful surgical results and good visual outcome can be achieved with phacoemulsification using the torsional handpiece. (Turk J Ophthalmol 2013; 43: 345-7

  18. Evolution of cataract surgery: Smaller incision - less complications

    Draganić Vladimir

    2012-01-01

    Full Text Available Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/ forceps IOL implantation, phacoemulsification/ injector IOL implantation, microincision cataract surgery (MICS. Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Results. Uncorrected visual aquity 30 days postoperatively was ≥ 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Conclusion. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

  19. Complicated extracapsular cataract surgery in pseudoexfoliation syndrome: a case report.

    Kirkpatrick, J N; Harrad, R A

    1992-01-01

    Crystalline lens dislocation and zonular dialysis during intraocular surgery are recognised features of the pseudoexfoliation syndrome (PES). A case is reported in which zonular dialysis occurred in both eyes during extracapsular cataract extraction. In particular surgery was complicated by difficulty in performing anterior capsulotomy. Careful preoperative assessment and peroperative technique may help to reduce the risk of surgical complication in PES.

  20. Topical Anesthesia for Cataract Surgery: The Patients' Perspective

    Aytekin Apil; Baki Kartal; Metin Ekinci; Halil Huseyin Cagatay; Sadullah Keles; Erdinc Ceylan; Ozgur Cakici

    2014-01-01

    Purpose. To evaluate the analgesic efficacy of 0.5% propacaine hydrochloride as topical anesthesia during phacoemulsification surgery. Methods. Intraoperative pain intensity was assessed using a 5-category verbal rating scale during each of three surgical stages. Pain scores from each surgical stage and total pain scores were compared for the factors of patient age, gender, cataract laterality, and type. Results. In comparison of cataract type subgroups, the mean total pain scores and mean st...

  1. Effect of Cataract Surgery With Phacoemulsification on Diabetic Retinopathy

    BİRİNCİ, H.; SEZGİN, S.; OGE, I.

    2009-01-01

    To asses the influence of cataract surgery and posterior chamber intraocular lens implantation on retinopathy progression, and visual acuity in patients with different stages of diabetic retinopathy (DR). Ninety-three eyes of 76 patients with or without diabetic retinopathy were evaluated prospectively following cataract extraction with posterior chamber intraocular lens implantation between January 1995 and December 2000. The ocular findings were recorded on each follow-up visits for at l...

  2. MRSA and cataract surgery – reflections for practice

    Porter, LF; Khan, RU; Hannan, A.; Kelly, SP

    2010-01-01

    Introduction Postoperative bacterial endophthalmitis is a devastating complication of cataract surgery. Methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis is rare. Recent debate over MRSA screening in United Kingdom (UK) National Health Service (NHS) hospital services has implications for cataract patients and ophthalmology services. Aims To discuss issues for clinical practice as based on reflective experience at a UK district general NHS hospital in relation to care of MRSA-...

  3. Efficacy comparison between manual small incision cataract surgery and phacoemulsification in cataract patients: a meta-analysis

    Ye, Zi; He, Shou-Zhi; Li, Zhao-Hui

    2015-01-01

    Objective: Systematic review of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) on the postoperative visual quality and surgical complications. Methods: Relevant literatures on clinical efficacy of PHACO and MSICS were included by retrieving in Medline, PubMed, Chinese Biomedical Literature Database (CBM) and Chinese Academic Journal (CNKI) databases. Meta-analysis was conducted by RevMan5.0 software with OR and its 95% CI for the effect size. Results: A total o...

  4. Sutureless Cataract Surgery: Principles and Steps

    John Sandford-Smith

    2003-01-01

    Full Text Available Introduction. Cataracts cause about 50% of world blindness. There is little likelihood of effective prevention becoming available in the next few years and so the only treatment will remain surgical. For many of the other major causes of world blindness, like trachoma, xerophthalmia and onchocerciasis, the remedy is community-based, not hospital-based, and requires prevention rather than treatment. The prevalence of blinding cataract will only increase as people live longer, so cataract will continue to be, by far, the most important treatable cause of blindness.

  5. Laser-assisted cataract surgery and other emerging technologies for cataract removal

    Aasuri Murali

    1999-01-01

    Full Text Available As we near the end of this century, refractive cataract surgery has become a reality through concerted contributions from ultrasonic phacoemulsification, foldable intraocular lens (IOL implantation technology and keratorefractive surgery. As we enter the new millennium, our sights are set on realizing another dream: accommodative IOL surgery. Towards achieving this goal, many advances have been made in both techniques and technology of cataract removal. Lasers in particular have been under investigation for cataract removal for nearly two decades. The technology has now reached a stage where cataract can indeed be removed entirely with laser alone. Neodymium:YAG and erbium:YAG are the laser sources currently utilized by manufacturers of laser phaco systems. Initial clinical experience reported in the literature has served to highlight the capabilities of lasers and the need for further refinement. Despite the excitement associated with the availability of this alluring new technology for cataract removal, it is necessary to develop more effective laser systems and innovative surgical techniques that optimize its capabilities if laser phaco surgery is to be a genuine improvement over current techniques.

  6. The pattern of cataract surgery in India: 1992

    Gupta A

    1995-01-01

    Full Text Available Surgery for cataract blindness, a major health problem, is undergoing a rapid transition. This study characterizes cataract surgery in India in terms of practice setting and surgical procedure. A survey questionnaire was mailed in December 1992 to 4356 members of the All India Ophthalmological Society, resident in India, requesting data on cataract surgery cases within the past 12 months. Two thousand one hundred thirty-four (49% ophthalmologists responded to the survey. Of the 1,023,070 cataract cases reported, two-thirds were private patients. Among private patients, 26.0% received extracapsular cataract extraction (ECCE with intraocular lens (IOL implantation and 20.7% received ECCE without an IOL. Among patients operated under government auspices, 9.1% received ECCE with IOL and 22.4% received ECCE without IOL. Overall, 82.8% of active surgeons reported experience with the ECCE procedure. The cataract case load in the private sector and the frequency of ECCE, with or without IOL implantation, among both private and government-operated cases is greater than previously recognized.

  7. Reduction of intraocular pressure and improvement of vision after cataract surgeries in angle closure glaucoma with concomitant cataract patients

    Zhang, Zong-Mei; Niu, Qing; Nie, Yan; Zhang, Jin

    2015-01-01

    Objective: This study is to compare the efficacy of three different cataract surgeries in eyes with angle closure glaucoma (ACG) with concomitant cataract. Methods: A retrospective comparative analysis of 106 ACG patients (112 eyes) with concomitant cataract was conducted between February, 2012 and February, 2014. Clinical outcomes of ACG patients with concomitant cataract underwent phacoemulsification and intraocular lens implantation (group A, n = 34, 36 eyes, angle closure < 180°); combine...

  8. Safety of warfarin therapy during cataract surgery under topical anesthesia

    Newton Kara-Junior

    2015-06-01

    Full Text Available ABSTRACT Purpose: To analyze the safety of warfarin therapy during cataract surgery under topical anesthesia. Methods: This was a prospective nonrandomized comparative study of 60 eyes of 60 patients treated with or without concurrent oral warfarin anticoagulant therapy, referred for cataract surgery under topical anesthesia. The sample included a treatment (n=30 and a control (n=30 group. Results: There were no records of intraoperative or postoperative intracameral bleeding complications in both the groups. At 1-month postoperative follow-up, 90.0% of patients presented spectacle-corrected visual acuity of at least 20/40. Conclusion: Cataract surgery by phacoemulsification with topical anesthesia can be successfully conducted without discontinuing warfarin.

  9. [Incisions for biaxial and coaxial microincision cataract surgery].

    Müller, M; Kohnen, T

    2010-02-01

    Microincision cataract surgery (MICS) represents a new level in the development of cataract surgery. Phacoemulsification with intraocular lens (IOL) implantation via incisions of biaxial approach, with separation of the phaco tip and irrigation (B-MICS). Compared with standard small-incision cataract surgery, the advantages of MICS are less corneal astigmatism and fewer corneal surface irregularities, with favorable implications for visual quality and early rehabilitation. In the effort toward smaller incisions, special interest should be given to wound integrity, especially regarding the risk of endophthalmitis. With limited corneal elastic capacity, irreversible expansion of the incision with tissue laceration may occur. Smaller incisions are superior only if they cause less trauma. This requires an optimized relationship between incision size and manipulation during IOL implantation as well as attention to safety issues. MICS offers a platform for new benchmarks in phacoemulsification. PMID:20107810

  10. Sutureless Non-phaco Cataract Surgery: A Solution to Reduce Worldwide Cataract Blindness?

    Albrecht Hennig

    2003-01-01

    Full Text Available The Search for Appropriate Sutureless Cataract Surgery. During the last decade, in industrialised countries phacoemulsification has largely replaced ab-externo extracapsular cataract extraction with posterior chamber intraocular lenses (ECCE/PC IOL with sutures. The small self-sealing phaco incision provides rapid visual rehabilitation, and the surgery is increasingly done on an outpatient basis. However, in developing countries phacoemulsification is performed only on selected patients, usually those able to pay high treatment charges. The reasons for this include the cost of a phaco machine and consumables such as foldable IOLs. Until now, phacoemulsification has played a very limited role in the reduction of cataract blindness in low income countries. Therefore, eye surgeons in developing countries are searching for alternatives to phacoemulsification. We need a surgical technique which is easy to learn, provides an immediate good uncorrected visual outcome, and is affordable to most cataract patients. Such a technique would advance cataract surgery in low income countries and contribute to reaching the goal of VISION 2020: The Right to Sight.

  11. STUDY OF ASTIGMATISM IN SMALL INCISSION CATARACT SURGERY BETWEEN TEMPORAL AND SUPERIOR INCISSIONS

    Sivacharan; Hanumantharao

    2014-01-01

    Surgically induced astigmatism is a part of cataract surgery. Surgically induced astigmatism varies with distance the incision is made from limbus and site of incision. Small incision cataract surgery a suturless technique of cataract surgery can be done through both temporal and superior sclerocorneal incisions. Since majority of patients undergoing cataract surgery have an against the rule astigmatism, a temporal sclerocorneal incision is better than superior sclera incision...

  12. STUDY OF ASTIGMATISM IN SMALL INCISSION CATARACT SURGERY BETWEEN TEMPORAL AND SUPERIOR INCISSIONS

    Sivacharan

    2014-10-01

    Full Text Available Surgically induced astigmatism is a part of cataract surgery. Surgically induced astigmatism varies with distance the incision is made from limbus and site of incision. Small incision cataract surgery a suturless technique of cataract surgery can be done through both temporal and superior sclerocorneal incisions. Since majority of patients undergoing cataract surgery have an against the rule astigmatism, a temporal sclerocorneal incision is better than superior sclera incisions in respect to astigmatism.

  13. Clinical-epidemiological behaviour of patients after cataract surgery

    Leydi E. Jacomino Hernández; Idalia Triana Casado; Juan C. Medina Perdomo

    2010-01-01

    Background: Cataract is the leading cause of blindness in the world. Its only effective treatment is surgery, with a high rate of efficiency, but it is not always practiced due to several reasons that limit access to health services.Objective: To identify clinical and epidemiological behaviour of patients after cataract surgery. Methods: An observational, descriptive and cross-sectional study conducted in the "José Joaquín Palma" Ophthalmology Center in the town of San Cristóbal, Guatemala. W...

  14. Combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery in cases with cataract and posterior segment diseases

    Yazici Ahmet; Kara Necip; Bozkurt Ercument; Cakir Mehmet; Goker Hasan; Demirok Ahmet; Yilmaz Omer

    2010-01-01

    Background: Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. Aim: To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery. Settings and Design: A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital. Materials and Methods: In this study, 28 eyes of 28 patients underwent combine...

  15. Do patients with age related maculopathy and cataract benefit from cataract surgery?

    Shuttleworth, G.; Luhishi, E; Harrad, R

    1998-01-01

    AIMS—To assess the benefits of cataract extraction in patients with age related maculopathy (ARM).
METHODS—1073 randomly selected cataract operations were reviewed and 99 cases of preoperatively recognised ARM were identified for investigation. Data relating to visual function were retrieved from case notes, and patient responses to a questionnaire were analysed.
RESULTS—98% had dry or unspecified ARM. Only 2% had exudative maculopathy. 81% of cases had an improvement in best distance acuity;...

  16. Vitrectorhexis versus forceps posterior capsulorhexis in pediatric cataract surgery

    Lav Kochgaway

    2013-01-01

    Full Text Available This study was done to compare the results of posterior continuous curvilinear capsulorhexis created using forceps with those created using vitrector in eyes suffering from congenital cataract. Vitrectorhexis term was first used by Wilson et al in 1999. [1] Fifty eyes with congenital and developmental cataract were included in this study. The posterior capsulorhexis was created using utrata forceps in 17 eyes or through a vitrector in 33 eyes. Forceps capsulorhexis was performed before IOL implantation, while vitrectorhexis was performed after IOL implantation in the bag. The results of both the surgery were compared using the following criteria: incidence of extension of rhexis, ability to achieve posterior rhexis of appropriate size, ability to implant the IOL in the bag, the surgical time, and learning curve. Vitrectorhexis after IOL implantation was an easy to learn alternative to manual posterior continuous curvilinear capsulorhexis in pediatric cataract surgery. It was more predictable and reproducible, with a short learning curve and lesser surgical time.

  17. Simultaneous Penetrating Keratoplasty and Cataract Surgery

    Mohammad-Ali Javadi

    2013-01-01

    Full Text Available Purpose: To determine the clinical outcomes of simultaneous penetrating keratoplasty (PK, cataract removal and intraocular lens implantation (triple procedure, and to compare the safety and efficacy of two different cataract extraction techniques during the course of PK. Methods: This retrospective comparative study was conducted on patients who had undergone a triple procedure. The technique of cataract extraction was either opensky extracapsular cataract extraction (ECCE or phacoemulsification (PE. In the ECCE group, the posterior chamber intraocular lens (PCIOL was implanted in the ciliary sulcus, while in the PE group PCIOLs were fixated within the capsular bag. Outcome measures included best spectacle corrected visual acuity (BSCVA, refractive results, graft clarity and complications. Results: Seventy-six eyes of 69 consecutive patients with mean age of 61.4±14.2 years were enrolled. Mean follow-up period was 61.4±37.2 months over which mean BSCVA was significantly improved from 1.40±0.68 to 0.44±0.33 LogMAR (P<0.001. Mean postoperative spherical equivalent refractive error was -2.13±3.02 D, which significantly differed from the target refraction (-0.73±0.29 D, P=0.004. At final follow-up, 89.5% of the corneal grafts remained clear. Conclusion: The triple procedure is a safe and effective approach to restore vision in patients with coexisting corneal pathologies and cataracts. However, unacceptable postoperative refractive error can be anticipated.

  18. Clinical-epidemiological behaviour of patients after cataract surgery

    Leydi E. Jacomino Hernández

    2010-12-01

    Full Text Available Background: Cataract is the leading cause of blindness in the world. Its only effective treatment is surgery, with a high rate of efficiency, but it is not always practiced due to several reasons that limit access to health services.Objective: To identify clinical and epidemiological behaviour of patients after cataract surgery. Methods: An observational, descriptive and cross-sectional study conducted in the "José Joaquín Palma" Ophthalmology Center in the town of San Cristóbal, Guatemala. We included all patients over 18 years old meeting the inclusion criteria who had had a cataract surgery between July and December 2007. The following variables were analyzed: age, sex, skin color, place of origin, ocular and systemic personal medical history, etiologic type of cataract and intra and immediate postoperative complications. Results: 63.3% of the patients are in the 60 years on age group, with a slight predominance of females (51.89% and most of them come from the rural areas (66.66%. Among personal medical histories myopia was detected (14.17% and among systemic medical histories there were arterial hypertension (25.98% and diabetes mellitus (22.04%. Senile cataract was more frequent (52.75%. The most frequent intraoperative complications were posterior capsule ruptures with or without vitreous loss (29.548% and 3.37% respectively and corneal edema in the immediate postoperative (5.48%. Conclusions: The results of clinical and epidemiological characterization of patients after cataract surgery included in this series do not differ from those of similar studies, except for the personal glaucoma history.

  19. Endothelial cell loss and refractive predictability in femtosecond laser-assisted cataract surgery compared with conventional cataract surgery

    Krarup, Therese; Holm, Lars Morten; la Cour, Morten;

    2014-01-01

    PURPOSE: To investigate the amount of endothelial cell loss (ECL) and refractive predictability by femtosecond laser-assisted cataract surgery (FLACS) compared to conventional phacoemulsification cataract surgery (CPS). METHODS: Forty-seven patients had one eye operated by FLACS and the contralat......PURPOSE: To investigate the amount of endothelial cell loss (ECL) and refractive predictability by femtosecond laser-assisted cataract surgery (FLACS) compared to conventional phacoemulsification cataract surgery (CPS). METHODS: Forty-seven patients had one eye operated by FLACS...... and the contralateral eye operated by CPS (stop and chop technique). Both eyes had intraocular aspheric lenses implanted. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), central corneal endothelial cell count and hexagonality with a non-contact specular microscope were assessed...... ± 0.42) by CPS (p = 0.56). Mean CDVA was 0.89 (0.3; 1.25) by FLACS and 0.93 (0.4; 1.25) by CPS at 3 months postoperatively (p = 0.36). Within both groups, 70% gained a CDVA of 6/6. Mean surgery time was 9.3 min (SD ± 1.9) by FLACS and 8.0 min (SD ± 1.9) by CPS, (p = 0.0018). Mean phaco energy was 3...

  20. Cost-effectiveness of cataract surgery in a public health eye care programme in Nepal.

    Marseille, E.

    1996-01-01

    Presented is an assessment of the cost-effectiveness of cataract surgery using cost and services data from the Lumbini Zonal Eye Care Programme in Nepal. The analysis suggests that cataract surgery may be even more cost-effective than previously reported. Under a "best estimate" scenario, cataract surgery had a cost of US$5.06 per disability-adjusted life year (DALY). This places it among the most cost-effective of public health interventions. Sensitivity analysis indicates that cataract surg...

  1. Cataract surgery in Southern Ethiopia: distribution, rates and determinants of service provision.

    Habtamu, E.; Eshete, Z; Burton, MJ

    2013-01-01

    BACKGROUND Cataract is the leading cause of blindness worldwide, with the greatest burden found in low-income countries. Cataract surgery is a curative and cost-effective intervention. Despite major non-governmental organization (NGO) support, the cataract surgery performed in Southern Region, Ethiopia is currently insufficient to address the need. We analyzed the distribution, productivity, cost and determinants of cataract surgery services. METHODS Confidential interviews were conducte...

  2. Risk of endophthalmitis after cataract extraction: results from the International Cataract Surgery Outcomes study

    Norregaard, J. C.; Thoning, H.; Bernth-Petersen, P.; Andersen, T. F.; Javitt, J.; G. Anderson

    1997-01-01

    AIM—To estimate risk of infectious endophthalmitis after cataract extraction in Denmark and to compare results with the risk of this complication in the USA
METHODS—In the national Danish administrative hospital register, 19 426 patients were identified who underwent first eye cataract surgery from 1985 to 1987 and who were 50 years of age or older. Of these, 61 patients had postoperative endophthalmitis.
RESULTS—A 12 month cumulative risk of rehospitalisation for endophthalmitis was estimate...

  3. Cataract surgery audit at a private hospital in Saudi Arabia

    Tariq Alasbali

    2015-01-01

    Conclusion: The recent trend of intentional overcorrection in one eye following modern cataract surgery in order to provide some functional near vision indicates that benchmark for success in getting “good visual outcomes” postoperatively (vision of ≥6/18 may need to be revised.

  4. Morphological features in eyes with endophthalmitis after cataract surgery

    Solborg Bjerrum, Søren; Prause, Jan Ulrik; Fuchs, Helle Josefine; la Cour, Morten; Kiilgaard, Jens F

    2016-01-01

    PURPOSE: To assess the ocular damage that occurs in eyes with postoperative endophthalmitis after cataract surgery (PE) based on optical coherence tomography (OCT) retinal scans of PE eyes and histological specimens of eyes removed due to PE. METHODS: Case-control study and case series. Fifty...

  5. A Comparison of Different Operating Systems for Femtosecond Lasers in Cataract Surgery.

    Wu, B M; Williams, G P; Tan, A; Mehta, J S

    2015-01-01

    The introduction of femtosecond lasers is potentially a major shift in the way we approach cataract surgery. The development of increasingly sophisticated intraocular lenses (IOLs), coupled with heightened patient expectation of high quality postsurgical visual outcomes, has generated the need for a more precise, highly reproducible and standardized method to carry out cataract operations. As femtosecond laser-assisted cataract surgery (FLACS) becomes more commonplace in surgical centers, further evaluation of the potential risks and benefits needs to be established, particularly in the medium/long term effects. Healthcare administrators will also have to weigh and balance out the financial costs of these lasers relative to the advantages they put forth. In this review, we provide an operational overview of three of five femtosecond laser platforms that are currently commercially available: the Catalys (USA), the Victus (USA), and the LDV Z8 (Switzerland). PMID:26483973

  6. A Comparison of Different Operating Systems for Femtosecond Lasers in Cataract Surgery

    B. M. Wu

    2015-01-01

    Full Text Available The introduction of femtosecond lasers is potentially a major shift in the way we approach cataract surgery. The development of increasingly sophisticated intraocular lenses (IOLs, coupled with heightened patient expectation of high quality postsurgical visual outcomes, has generated the need for a more precise, highly reproducible and standardized method to carry out cataract operations. As femtosecond laser-assisted cataract surgery (FLACS becomes more commonplace in surgical centers, further evaluation of the potential risks and benefits needs to be established, particularly in the medium/long term effects. Healthcare administrators will also have to weigh and balance out the financial costs of these lasers relative to the advantages they put forth. In this review, we provide an operational overview of three of five femtosecond laser platforms that are currently commercially available: the Catalys (USA, the Victus (USA, and the LDV Z8 (Switzerland.

  7. Instruments for cataract surgery: results from our survey

    Daksha Patel; Phil Hoare

    2011-01-01

    For any operation, including cataract surgery, the appropriate instruments must be available and in good working order. If instruments are not available, or are blunt, or do not function properly, it may be necessary to delay or postpone surgery. Using such instruments in an operation can result in a poor outcome, or even pose a risk to surgeons and their assistants.The impact is therefore considerable, and can damage the reputation of the hospital in the community.

  8. PSYCHOLOGICAL REACTIONS TO CATARACT SURGERY WITH INTRAOCULAR LENS IMPLANTATION

    Chaudhury, S.; Chakraborty, P.K.; Gurunadh, V.S.; Ratha, P.

    1995-01-01

    A prospective study of fifty patients who underwent cataract surgery with intraocular lens (IOL) implantation was undertaken. Factors aggravating and allaying pre-operative, intra-operative and post-operative anxiety were studied A good doctor-patient relations/lip, confidence in the ophthalmologist, and knowledge of successful surgery with IOL implantation in an acquaintance were the major anxiety relieving factors. The main anxiety provoking factors were concerns about the success of surger...

  9. Cataract surgery: ensuring equal access for boys and girls

    Sylvia Shirima

    2009-06-01

    Full Text Available In Tanzania, many children are not brought for surgery in a timely fashion and follow up is often poor. Research at Kilimanjaro Christian Medical Centre (KCMC has shown that girls are more likely than boys to be negatively affected: * Only half as many girls as boys received cataract surgery. * Girls tended to be brought for surgery later than boys. * Girls who did receive surgery were less likely than boys to be brought for the appropriate two-week follow-up visit (36 per cent of girls vs 64 per cent of boys.

  10. Conjunctival inclusion cysts following small incision cataract surgery

    Narayanappa Shylaja

    2010-01-01

    Full Text Available The occurrence of acquired conjunctival inclusion cysts following various ophthalmic surgeries such as strabismus surgery, scleral buckling, pars plana vitrectomy, ptosis surgery and phacoemulsification has been reported. We report two cases of conjunctival inclusion cysts following manual Small Incision Cataract Surgery (SICS in two male patients aged 65 and 67 years. The cysts originated from the scleral tunnel used for manual SICS. Both were treated by excision and confirmed histopathologically. No recurrence was noted at three months follow-up. To our knowledge, conjunctival inclusion cysts following SICS have not been reported previously. Careful reflection of conjunctiva during tunnel construction and posterior chamber intraocular lens implantation may prevent their occurrence.

  11. Retrospective comparison of lens implant surgery and cataract surgery in a provincial unit.

    Watts, J

    1986-01-01

    Evidence is presented which shows that the extracapsular cataract extraction technique combined with a Sinsky type posterior chamber implant is as safe a procedure as routine intracapsular surgery. Its results as reflected in the patient's satisfaction are superior.

  12. Maximal mydriasis evaluation in cataract surgery

    Ho Tony

    1992-01-01

    Full Text Available We propose the Maximal Mydriasis Test (MMT as a simple and safe means to provide the cataract surgeon with objective and dependable pre-operative information on the idiosyncratic mydriatic response of the pupil. The MMT results of a consecutive series of 165 eyes from 100 adults referred for cataract evaluation are presented to illustrate its practical applications and value. The results of the MMT allows the surgeon to anticipate problem eyes pre-operatively so that he can plan his surgical strategy more appropriately and effectively. Conversely, the surgeon can also appropriately and confidently plan surgical procedures where wide pupillary dilation is important. The MMT has also helped improve our cost-effectiveness by cutting down unnecessary delays in the operating room and enabling better utilisation of restricted costly resources.

  13. Focussing both eyes on health outcomes: revisiting cataract surgery

    Davis Jennifer C

    2012-09-01

    Full Text Available Abstract Background The appropriateness of cataract surgery procedures has been questioned, the suggestion being that the surgery is sometimes undertaken too early in the disease progression. Our three study questions were: What is the level of visual impairment in patients scheduled for cataract surgery? What is the improvement following surgery? Given the thresholds for a minimal detectable change (MDC and a minimal clinically important difference (MCID, do gains in visual function reach the MDC and MCID thresholds? Methods The sample included a prospective cohort of cataract surgery patients from four Fraser Health Authority ophthalmologists. Visual function (VF-14 was assessed pre-operatively and at seven weeks post-operatively. Two groups from this cohort were included in this analysis: ‘all first eyes’ (cataract extraction on first eye and ‘both eyes’ (cataract removed from both eyes. Descriptive statistics, change scores for VF-14 for each eye group and proportion of patients who reach the MDC and MCID are reported. Results One hundred and forty-two patients are included in the ‘all first eyes’ analyses and 55 in the ‘both eyes’ analyses. The mean pre-operative VF-14 score for the ‘all first eyes’ group was 86.7 (on a 0–100 scale where 100 is full visual function. The mean change in VF-14 for the 'both eyes' group was 7.5. Twenty-three percent of patients achieved improvements in visual function beyond the MCID threshold and 35% saw improvement beyond the MDC. Conclusions Neither threshold level for MDC or MCID for the VF-14 scale was achieved for a majority of patients. A plausible explanation for this is the very high levels of pre-operative visual functioning.

  14. Cataract surgery in Fuchs' heterochromic iridocyclitis.

    Sherwood, D. R.; Rosenthal, A R

    1992-01-01

    Eighteen eyes in 17 patients with Fuchs' heterochromic iridocyclitis underwent cataract extraction with or without intraocular lens implantation (17 extracapsular and one intracapsular). Intraoperative complications included hyphaema, poor pupillary dilatations, and localised zonule dehiscence with vitreous loss. Only four eyes developed a marked anterior uveitus (two pseudophakic and two aphakic) which resolved within 2 weeks with topical steroids. Three eyes developed a rise in intraocular ...

  15. Visco chop-a new technique for nucleus separation for soft cataracts in femtolaser assisted cataract surgery

    Sri; Ganesh; Sheetal; Brar

    2015-01-01

    <正>INTRODUCTION Femtosecond laser technology,introduced clinically for ophthalmic surgery as a technique for creating lamellar flaps in laser in situ keratomileusis(LASIK),has recently been developed into a tool for cataract surgery.Preliminary experience for femtosecond laser-assisted cataract surgery show appropriate safety and efficacy,and possible advantage over conventional cataract surgery[1-4].The ability of the femtosecond laser to fragment the lens results in the need for less ultrasound energy to be expended inside the eye.Several studies indicate that less effective phacoemulsification time is needed to emulsify the lens

  16. Prevalence of myopic shifts among patients seeking cataract surgery

    Rafael Iribarren

    2013-06-01

    Full Text Available Modern cataract surgery by phacoemulsification is a widely accepted procedure with a rapid recovery time. The prescription of specific intraocular lens, implanted during surgery, makes it possible to anticipate whether the patient will need reading glasses after the procedure. The present study analyses a sample of cataract surgery patients to show the frequency of myopic shifts related to nuclear opacity, which can result in clear near vision before surgery. A non-selected sample of consecutive patients who underwent elective cataract surgery in a private clinic was studied retrospectively. The myopic shift in refraction was assessed by comparing the old prescription with the spectacle correction at the time of interviewing.The mean age of the 229 subjects studied was 71.5 ± 10.4 years (109, 47.6%, males. A myopic shift in refraction, defined as at least - 0.5 diopters, was present in 37.1% of subjects (95% CI: 30.8%-43.4%. The mean change in refraction in these subjects was -2.52 ± 1.52 diopters. The percentage of subjects who had developed a myopic shift was significantly greater in those who presented greater nuclear opalescence. There were also differences in the mean myopic shift by refractive group, with the emmetropes having the greatest myopic shift. In this study of patients seeking cataract surgery in a clinical setting, more than one third had myopic shifts in refraction. This must be taken into account in order that patients maintain the benefit of clear near vision after surgery.

  17. DEPLOYMENT OF SIX SIGMA METHODOLOGY IN PHACOEMULSIFICATION CATARACT SURGERY

    Ibrahim SAHBAZ

    2014-04-01

    Full Text Available The purpose of this study is to show how a public eye care center in Turkey initiated Six Sigma principles to reduce the number of complications encountered during and after phacoemulsification cataract surgeries. To analyze the 3-year data, main tools of Six Sigma’s Define-Measure-Analyze-Improve-Control (DMAIC improvement cycle such as SIPOC table, Fishbone Diagram and, Failure, Mode and Effect Analysis were implemented. Experience of the ophthalmic surgeon, patient’s anatomy, cooperation of patient during the surgery, sterilization and hygiene, attention of assistant surgeon, calibration of equipment and quality/chemical composition of intraocular material were identified to be Critical-to-Quality (CTQ factors for a successful phacoemulsification cataract surgery. The most frequently occurring complication was found to be iris atrophy. The process sigma level for the process was found to be 3.958.

  18. Results of cataract surgery in the very elderly population

    Michalska-Małecka K

    2013-08-01

    Full Text Available Katarzyna Michalska-Małecka,1 Mariusz Nowak,2 Piotr Gościniewicz,1 Jacek Karpe,3 Ludmiła Słowińska-Łożyńska,4 Agnieszka Łypaczewska,1 Dorota Romaniuk11Department of Ophthalmology, University Hospital No 5, Medical University of Silesia, Katowice, 2Pathophysiology Division, Department of Pathophysiology and Endocrinology, Medical University of Silesia, Zabrze, 3Department of Anesthesiology and Intensive Therapy, Medical University of Silesia, Zabrze, 4Department of Biophysics, Faculty of Medicine in Zabrze, Medical University of Silesia, Katowice, Silesia, PolandAim: The aim of our study was to retrospectively evaluate the effectiveness and safety of cataract surgery and intraocular lens implantation (IOL for patients aged 90 years or older, whom we define as “very elderly.”Methods: The study involved a total number of 122 patients (122 eyes with senile cataracts. The mean age of patients was 91.2 ± 2.3 years (range 90–100 years old. Phacoemulsification (phaco was done on 113 of 122 eyes, and 9 of 122 eyes had extracapsular cataract extraction (ECCE. Postoperative visual acuity and intraocular pressure (IOP were analyzed on the first postoperative day, 3 months after surgery, and 6 months after surgery.Results: Best corrected visual acuity (BCVA improved in 100 of 122 eyes (82.0%. BCVA remained the same in 20 of 122 eyes (16.4% and decreased in 2 of 122 eyes (1.6%, mainly because of coexisting age-related macular degeneration (AMD. The BCVA 3 months after surgery was ≥0.8 in 23 of 122 eyes (18.9%, between 0.5 and 0.7 in 28 of 122 eyes (22.3%, and between 0.2 and 0.4 in 33 of 122 eyes (27.1%. We found significant implications of cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma compared to the patients without glaucoma.Conclusion: Advanced age is not a contraindication for cataract surgery. The results of the study showed that when systemic conditions are stable, both phaco and ECCE with

  19. Predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia

    Guber I.; Rémont L.; Bergin C.

    2015-01-01

    Abstract Background: To evaluate the predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia. Methods: This is a retrospective review of all ISBCS performed at Kantonsspital Winterthur, Switzerland, between April 2000 and September 2013. The case notes of 250 patients were reviewed. Patients having full refraction reported (110 patients/220 eyes) were included. 210 (95 %) eyes had a straight forward phacoemulsification...

  20. 42 CFR 1001.1701 - Billing for services of assistant at surgery during cataract operations.

    2010-10-01

    ... PROGRAMS Permissive Exclusions § 1001.1701 Billing for services of assistant at surgery during cataract... surgery during a cataract operation, or (ii) Charges that include a charge for an assistant at surgery... 42 Public Health 5 2010-10-01 2010-10-01 false Billing for services of assistant at surgery...

  1. Feasibility and Complications between Phacoemulsification and Manual Small Incision Surgery in Subluxated Cataract

    Ruchi Goel; Saurabh Kamal; Sushil Kumar; Jugal Kishore; Malik, K. P. S.; Sonam Angmo Bodh; Smriti Bansal; Madhu Singh

    2012-01-01

    Purpose. To compare the feasibility of cataract surgery with implantation of endocapsular supporting devices and intraocular lens (IOL) in subluxated cataract in phacoemulsification and manual small incision cataract surgery (MSICS). Design. Prospective randomized intervention case series consisting of 60 eyes with visually significant subluxated cataract. Method. The patients were randomly distributed between the two groups equally. The main outcome measure was implantation of in-the-bag IOL...

  2. CORTICAL CLEANUP WITHOUT SIDE PORT IN SMALL INCISION CATARACT SURGERY

    Udaya Kumar

    2015-11-01

    Full Text Available The aim of study was to achieve complete cortical cleanup and avoid problems related with sideport during Small Incision Cataract Surgery (SICS so as to have a good visual out come with minimal recovery period, and a better quality of life. After nucleus delivery, cortical cleanup is an important step in any cataract surgical procedure. Cortex especially subincisional area (11 to 1 o’clock is difficult to manage intraoperatively. Bimanual irrigation aspiration through two side ports, aspiration by J cannula, iris massage manoeuver, ice cream scoop manoeuver are various techniques of cortical matter aspiration. We acquired the technique of aspiration of subincisional cortex without using side port in all cases by paying attention on type of cataract, status of pupil, use of Adrenalin mixed BSS intraoperatively, Tunnel construction, Capsulorhexis size and capsular rim size at 12 o’clock. MATERIAL AND METHODS In this retrospective study of 1 year from 2013 to 2014, 60 patients (60 eyes aged 40 years or older attending the General Ophthalmic Department were included in the study group with another group of 60 patients (60 eyes as controls. The study was on age related cataracts which are basically. 1 Cortical cataract 2 Nuclear cataract 3 Subcapsular cataract. Proper assessment of cortical cataract based on its maturity such as a Immature b Mature c Hyper mature and d Morgagnian cataract, nucleus for its opalescence and color, size of posterior subcapsular opacity and pupillary status (Dilating well or not with mydriatics were taken into consideration. Eyes with pseudoexfoliation having poor pupillary dilation were also included. Eyes with congenital anomalies, congenital cataract, gross corneal and retinal pathologies, and glaucoma were excluded. RESULTS Among 60 study eyes in the study group 35 presented with cortical, 20 with nuclear cataract and 5 with posterior subcapsular cataracts. In 58(96.6% cases, sideport was not required; 3(5% eyes

  3. Retinal safety of near-infrared lasers in cataract surgery

    Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel

    2012-09-01

    Femtosecond lasers have added unprecedented precision and reproducibility to cataract surgery. However, retinal safety limits for the near-infrared lasers employed in surgery are not well quantified. We determined retinal injury thresholds for scanning patterns while considering the effects of reduced blood perfusion from rising intraocular pressure and retinal protection from light scattering on bubbles and tissue fragments produced by laser cutting. We measured retinal damage thresholds of a stationary, 1030-nm, continuous-wave laser with 2.6-mm retinal spot size for 10- and 100-s exposures in rabbits to be 1.35 W (1.26 to 1.42) and 0.78 W (0.73 to 0.83), respectively, and 1.08 W (0.96 to 1.11) and 0.36 W (0.33 to 0.41) when retinal perfusion is blocked. These thresholds were input into a computational model of ocular heating to calculate damage threshold temperatures. By requiring the tissue temperature to remain below the damage threshold temperatures determined in stationary beam experiments, one can calculate conservative damage thresholds for cataract surgery patterns. Light scattering on microbubbles and tissue fragments decreased the transmitted power by 88% within a 12 deg angle, adding a significant margin for retinal safety. These results can be used for assessment of the maximum permissible exposure during laser cataract surgery under various assumptions of blood perfusion, treatment duration, and scanning patterns.

  4. Impact of tamsulosin exposure on late complications following cataract surgery: retrospective cohort study.

    González-Martín-Moro, Julio; González-López, Julio José; Gómez-Sanz, Fernando; Zarallo-Gallardo, Jesús; Cobo-Soriano, Rosario

    2014-08-01

    The purpose of this study is to measure the impact of tamsulosin intake on five postoperative cataract surgery complications (toxic anterior segment syndrome, rebound uveitis, retinal detachment, macular edema, and postoperative endophthalmitis). This retrospective cohort study was conducted at University Hospital of Henares. The study included 660-eyes of 660 patients submitted to cataract surgery at the ophthalmology unit of Hospital del Henares (Madrid) between 2 March 2009 and 28 February 2010. Extracapsular cataract extraction, combined glaucoma and cataract surgery phacovitrectomy, posterior capsule rupture and zonular damage were considered exclusion criteria. Clinical charts were reviewed during July 2012. Patients were divided in two groups (exposed and non-exposed to tamsulosin). Cumulative incidence of toxic anterior segment syndrome, rebound uveitis, retinal detachment, macular edema and postoperative endophthalmitis were compared in both groups. Rebound uveitis (relative risk [RR] 3.39; confidence interval [CI] 1.63-7.08) and macular edema (RR 4.15; CI 1.06-16.22) were more common in the tamsulosin-exposed group. Retinal detachment had a similar incidence in both groups. We observed no cases of endophthalmitis or toxic anterior segment syndrome in either of the two groups. Tamsulosin exposure in this cohort was associated with a higher risk of rebound uveitis and macular edema but the other three studied postoperative complications had a similar incidence in both groups. PMID:24158613

  5. Cataract Surgery in Eyes with Filtered Primary Angle Closure Glaucoma

    Sasan Moghimi

    2013-01-01

    Full Text Available Purpose: To evaluate the effect of cataract surgery on intraocular pressure (IOP in filtered eyes with primary angle closure glaucoma (PACG. Methods: In this prospective interventional case series, 37 previously filtered eyes from 37 PACG patients with mean age of 62.1±10.4 years were consecutively enrolled. All patients had visually significant cataracts and phacoemulsification was performed at least 12 months after trabeculectomy. Visual acuity, IOP and the number of glaucoma medications were recorded preoperatively, and 1, 3, 6 and 12 months after surgery. Anterior chamber (AC depth was measured preoperatively and 3 months after cataract surgery with A-scan ultrasonography. The main outcome measure was IOP at 12 months. Results: IOP was decreased significantly from 18.16±5.91 mmHg at baseline to 15.37±2.90 mmHg at final follow-up (P<0.01. The mean number of glaucoma medications was significantly decreased from 1.81±0.24 to 0.86±1.00 (P=0.001 at 1 year postoperatively. At final follow up, 36 (97.2% eyes and 32 (86.4% eyes had IOP≤21 and IOP≤18 mmHg, respectively; 14 (37.8% eyes and 9 (24.3% eyes had IOP≤21 and IOP≤18 mmHg without medications, respectively. The magnitude of IOP reduction was correlated with higher preoperative IOP (r=0.85, P<0.001, shallower preoperative AC depth (r=-0.38, P=0.01 and greater changes in AC depth (r=-0.39, P=0.01. Conclusion: Cataract surgery reduces IOP and the number of glaucoma medications in previously filtered PACG eyes. This reduction seems to be greater in patients with higher preoperative IOP and shallower anterior chambers.

  6. Argon laser photocoagulation of cyclodialysis clefts after cataract surgery

    Three patients with cyclodialysis clefts, hypotony and hypotonic retinopathy subsequent to cataract surgery were treated with argon laser photocoagulation. The hypotony was reversed in each patient and their visual acuity was normalized. Laser photocoagulation is a noninvasive treatment that can be repeated easily and safely. The complications of the treatment are minor. A hypertensive episode commonly occurs in the early postoperative period. (au) 8 refs

  7. Nucleus management in manual small incision cataract surgery by phacosection

    Ravindra M

    2009-01-01

    Nucleus management is critical in manual small incision cataract surgery (MSICS), as the integrity of the tunnel, endothelium and posterior capsule needs to be respected. Several techniques of nucleus management are in vogue, depending upon the specific technique of MSICS. Nucleus can be removed in toto or bisected or trisected into smaller segments. The pressure in the eye can be maintained at the desired level with the use of an anterior chamber maintainer or kept at atmospheric levels. In ...

  8. MRSA and cataract surgery – reflections for practice

    LF, Porter; RU Khan2; Hannan, A.; et al.

    2010-01-01

    LF Porter1, RU Khan2, A Hannan3, SP Kelly11Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 2Departments of Microbiology, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 3Haughton Thornley Medical Centers, NHS Tameside and Glossop, UKIntroduction: Postoperative bacterial endophthalmitis is a devastating complication of cataract surgery. Methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis is rare. Recent debate over MRSA screening in United Kingdom (UK) National H...

  9. Safety and efficacy of the transition from extracapsular cataract extraction to manual small incision cataract surgery in prevention of blindness campaigns

    Isabel Signes-Soler; Jaime Javaloy; Gonzalo Munoz; Tomas Moya; Raul Montalban; Cesar Albarran

    2016-01-01

    Purpose: To compare the safety and the visual outcomes of two experienced cataract surgeons who converted from extracapsular cataract extraction (ECCE) to manual small incision cataract surgery (MSICS) during a campaign for the prevention of blindness. Methods: Two surgeons used the ECCE technique (ECCE group) during a campaign in Burkina Faso on 93 consecutive cataract patients with a corrected distance visual acuity (CDVA)

  10. Influence of cataract surgery in biopsychosocial adaptation in the elderly

    Leonor Rosario Diaz Alfonso

    2010-11-01

    Full Text Available Background: The twenty-first century is characterized by a progressive aging in the population, with the subsequent demand of medical care it implies due to the polimorbility rates typical of this stage of life. Objective: to prove the positive influence of cataract surgery in biopsychosocial adaptation of elderlies. Methods: a descriptive study conducted from January to June 2008 in the General University Hospital "Dr. Aldereguía Gustavo Lima’’ in Cienfuegos. The 60 elder patients who underwent surgery cataract in that period were included. Geriatric evaluation was used as assessment instrument. It was applied before and 3 months after cataract surgery and included the Yesavage Geriatric Depression Rating Scale to measure emotional function and the Katz index for functional evaluation. The variables used are part of the preoperative geriatric assessment. Among them we can find biomedical, social, functional and psychological aspects as well as-risk benefit and anesthetic risks analysis. Results: the largest amount of patients was between 70 and 74 years old, predominantly males and white skinned. Most frequent personal pathological records were arthropathies, diabetes mellitus and hypertension. A significant relationship between initial visual acuity levels and depression rates was found; as well as limitations in performing basic daily life activities. Conclusions: with surgical intervention an improved visual acuity was achieved and a number of functional capacities were reestablished to allow a better biopsychosocial adaptation in elderlies.

  11. Randomised, single-masked non-inferiority trial of femtosecond laser-assisted versus manual phacoemulsification cataract surgery for adults with visually significant cataract: the FACT trial protocol.

    Day, A. C.; Burr, J.M.; Bunce, C; Doré, C J; Sylvestre, Y.; Wormald, R. P.; Round, J.; McCudden, V.; Rubin, G; Wilkins, M R

    2015-01-01

    INTRODUCTION: Cataract is one of the leading causes of low vision in the westernised world, and cataract surgery is one of the most commonly performed operations. Laser platforms for cataract surgery are now available, the anticipated advantages of which are broad and may include better visual outcomes through greater precision and reproducibility, and improved safety. FACT is a randomised single masked non-inferiority trial to establish whether laser-assisted cataract surgery is as good as o...

  12. Application of intracameral moxifloxacin to prevent endophthalmitis in cataract surgery

    Servet Cetinkaya

    2015-10-01

    Full Text Available AIM: To evaluate the safety and efficacy of intracameral moxifloxacin in preventing endophthalmitis after cataract surgery.METHODS:Sixty-five eyes of 65 patients underwent cataract surgery between January and June 2012. Some patients received intracameral moxifloxacin at the end of surgery, while others did not(controls. Pre- and postperative logarithm of the minimum angle of resolution(logMARbest corrected visual acuity(BCVA, intraocular pressure(IOP, corneal edema, and anterior chamber(ACstatus were examined.RESULTS: Thirty-three patients(19 males, 14 females; average age, 64.81±11.61y(range: 41-82yreceived moxifloxacin and 32 patients(15 males, 17 females; average age, 65.43±11.10y(range: 42-81ydid not. The differences in patient age(P=0.827and sex(P=0.396were insignificant. Preoperative BCVA was approximately 20/130 in both groups. After surgery, moxifloxacin and control patients had a BCVA of 20/25 and 20/23, respectively(P=0.160. Preoperative IOP was 14.93±2.77mmHg(range: 11-21mmHgin moxifloxacin patients and 15.06±2.42mm Hg(range: 12-21mmHgin controls(P=0.850. After surgery, IOP was not statistically different between two groups(moxifloxacin: 14.06±2.31(range: 10-19mmHg, controls: 14.03±2.36mmHg(range: 10-19mmHg, P=0.960. Slight differences in corneal edema(P=0.623and anterior chamber cell(P=0.726incidences between two groups were not statistically significant. CONCLUSION: Intracameral moxifloxacin is safe and effective in preventing endophtalmitis after cataract surgery.

  13. Postoperative Endophthalmitis Caused by Staphylococcus haemolyticus following Femtosecond Cataract Surgery

    Wong, Margaret; Baumrind, Benjamin R.; Frank, James H.; Halpern, Robert L.

    2015-01-01

    A 53-year-old Caucasian man underwent femtosecond cataract surgery and then presented with pain and hand motions vision 1 day following surgery. Anterior segment examination showed a 2-mm-layered hypopyon, a well-centered intraocular lens in the sulcus, and an obscured view to the fundus. B-scan ultrasonography showed significant vitritis and that the retina was attached. A tap and an injection of vancomycin 1 mg per 0.1 ml and of ceftazidime 2.25 mg per 0.1 ml were performed. The tap eventua...

  14. Bilateral photic maculopathy after extracapsular cataract surgery: a case report

    Chalfin, Steven

    1997-05-01

    A 42 year old Caucasian female underwent uncomplicated extracapsular cataract extraction with posterior chamber lens implantation in the left eye, using a Zeiss model OpMi-6 operating microscope. Her postoperative course was unremarkable and she achieved a corrected visual acuity of 20/15+3. A lesion consistent with a photoretinal injury was noted inferior to the fovea. Seven months later the patient underwent cataract extraction in the right eye. Special care was taken to minimize light exposure during the procedure, including reducing the microscope illumination, minimizing operating time, intraoperative pharmacologic miosis, and using a corneal light shield. Despite these precautions, the patient developed a photoretinal injury almost identical to that in the contralateral eye. Postoperative corrected visual acuity was 20/15+3. Recent studies have reported incidences of retinal photic injuries from operating microscopes between 0 and 28 percent of patients. Several risk factors have been identified, including light intensity, intensity of the blue light component, and exposure time. The occurrence of a retinal photic injury in this patient despite precautions, development of bilateral cataracts at a young age, and a strong family history of early cataracts may indicate an inherited susceptibility to light induced damage. The American National Standards Institute is developing a product performance standard which will be applicable to operating microscopes used in ophthalmic surgery. The as yet undetermined role of individual susceptibility to retinal photic injury should be considered in the formulation of this standard.

  15. Comparison of Morphological and Functional Endothelial Cell Changes after Cataract Surgery: Phacoemulsification Versus Manual Small-Incision Cataract Surgery

    Sunil Ganekal; Ashwini Nagarajappa

    2014-01-01

    Purpose: To compare the morphological (cell density, coefficient of variation and standard deviation) and functional (central corneal thickness) endothelial changes after phacoemulsification versus manual small-incision cataract surgery (MSICS). Design: Prospective randomized control study. Materials and Methods: In this prospective randomized control study, patients were randomly allocated to undergo phacoemulsification (Group 1, n = 100) or MSICS (Group 2, n = 100) using a random nu...

  16. A VidEo-Based Intelligent Recognition and Decision System for the Phacoemulsification Cataract Surgery

    Shu Tian; Xu-Cheng Yin; Zhi-Bin Wang; Fang Zhou; Hong-Wei Hao

    2015-01-01

    The phacoemulsification surgery is one of the most advanced surgeries to treat cataract. However, the conventional surgeries are always with low automatic level of operation and over reliance on the ability of surgeons. Alternatively, one imaginative scene is to use video processing and pattern recognition technologies to automatically detect the cataract grade and intelligently control the release of the ultrasonic energy while operating. Unlike cataract grading in the diagnosis system with ...

  17. Perbandingan Kejadian Astigmatisma Pasca Operasi Katarak Dengan Menggunakan Tehnik Fakoemulsifikasi Dan Small Incision Cataract Surgery

    Marlinda, Sri

    2013-01-01

    Backgraund : Astigmatism change after cataract surgery is common, but if the astigmatism is too high it can effect the visual acuity. The astigmatism change depends on the incision methods, sclera rigidity, and age Objective : To compare the astigmatism change between scleral on the SICS and clearcorneal incision methods on facoemulsification after cataract surgery and intraocular lens implantation. Method : Sixty patients after cataract surgery with IOL implantation were evaluated....

  18. Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracamaral use of cefuroxime

    Cakir, Burcin

    2015-01-01

    Burçin Çakir, Erkan Celik, Nilgün Özkan Aksoy, Özlem Bursali, Turgay Uçak, Erdinç Bozkurt, Gursoy AlagozSakarya University Education and Research Hospital, Sakarya, TurkeyPurpose: To report toxic anterior segment syndrome (TASS) after cataract surgery possibly associated with intracameral use of cefuroxime.Methods: We conducted a retrospective chart review and analysis on the pre- and postoperative conditions of the subjec...

  19. Critical appraisal of ophthalmic ketorolac in treatment of pain and inflammation following cataract surgery

    Reddy RK; Kim SJ

    2011-01-01

    Rahul Reddy, Stephen Jae KimDepartment of Ophthalmology, Vanderbilt University, Nashville, TN, USABackground: The purpose of this review was to provide a critical appraisal of the literature supporting the efficacy of ophthalmic ketorolac (Acuvail®) in the treatment of pain and inflammation after cataract surgery.Methods: Literature search and expert opinion of the authors.Results: Recent studies indicate greater intraocular drug levels in the anterior chamber and iris-ciliary body af...

  20. Cataracts

    ... Training and Jobs Home > Statistics and Data > Cataracts Cataracts Listen Language English Cataracts Defined A cataract is a clouding of the ... 2010 2010 U.S. Age-Specific Prevalence Rates for Cataract by Age, and Race/Ethnicity The risk of ...

  1. Cataract in leprosy patients: cataract surgical coverage, barriers to acceptance of surgery, and outcome of surgery in a population based survey in Korea

    Courtright, P.; Lewallen, S; Tungpakorn, N.; Cho, B; Lim, Y; Lee, H.; S. Kim

    2001-01-01

    BACKGROUND/AIMS—Cataract is the leading cause of blindness in leprosy patients. There is no population based information on the cataract surgical coverage, barriers to use of surgical services, and outcome of surgery in these patients. We sought to determine these measures of cataract programme effectiveness in a cured leprosy population in South Korea.
METHODS—The population consisted of residents of six leprosy resettlement villages in central South Korea. All residents were invited to part...

  2. Iris recognition as a biometric method after cataract surgery

    Roizenblatt Jaime

    2004-01-01

    Full Text Available Abstract Background Biometric methods are security technologies, which use human characteristics for personal identification. Iris recognition systems use iris textures as unique identifiers. This paper presents an analysis of the verification of iris identities after intra-ocular procedures, when individuals were enrolled before the surgery. Methods Fifty-five eyes from fifty-five patients had their irises enrolled before a cataract surgery was performed. They had their irises verified three times before and three times after the procedure, and the Hamming (mathematical distance of each identification trial was determined, in a controlled ideal biometric environment. The mathematical difference between the iris code before and after the surgery was also compared to a subjective evaluation of the iris anatomy alteration by an experienced surgeon. Results A correlation between visible subjective iris texture alteration and mathematical difference was verified. We found only six cases in which the eye was no more recognizable, but these eyes were later reenrolled. The main anatomical changes that were found in the new impostor eyes are described. Conclusions Cataract surgeries change iris textures in such a way that iris recognition systems, which perform mathematical comparisons of textural biometric features, are able to detect these changes and sometimes even discard a pre-enrolled iris considering it an impostor. In our study, re-enrollment proved to be a feasible procedure.

  3. Femtosecond laser-assisted cataract surgery-current status and future directions.

    Grewal, Dilraj S; Schultz, Tim; Basti, Surendra; Dick, H Burkhard

    2016-01-01

    Femtosecond laser-assisted cataract surgery (FLACS) putatively offers several advantages over conventional phacoemulsification. We review the current status of FLACS and discuss the evolution of femtosecond lasers in cataract surgery and the currently available femtosecond laser platforms. We summarize the outcomes of FLACS for corneal wound creation, limbal relaxing incisions, capsulotomy, and lens fragmentation. We discuss surgical planning, preoperative considerations, clinical experiences including the learning curve and postoperative outcomes with FLACS, and also the cost effectiveness of FLACS. We present the intraoperative complications and management of challenging cases where FLACS offers an advantage and also speculate on the future directions with FLACS. Further advancements in laser technology to refine its efficacy, advancement in intraocular lens design to harness the potential benefits of FLACS, and a reduction in cost are needed to establish a clear superiority over conventional phacoemulsification. PMID:26409902

  4. The combination of intravitreal triamcinolone and phacoemulsification surgery in patients with diabeticfoveal oedema and cataract

    Cannon Paul S

    2005-06-01

    Full Text Available Abstract Background The management of diabetic patients with refractory macular oedema or patients with no adequate pre-operative view to administer laser treatment provide a challenge to the ophthalmologist. We wished to assess the use, safety and effect of intravitreal triamcinolone injection at the time of cataract surgery in patients with diabetic foveal oedema and sight limiting lens opacities. Method This was a longitudinal non-randomised prospective pilot study in 18 eyes (12 patients. All patients had visually significant lens opacities and either persistent diabetic foveal oedema unresponsive to laser treatment-group A, or foveal oedema with no adequate pre-operative view for laser treatment- group B. The cataract surgery was carried out under full aseptic technique using a self-sealing temporal incision and a foldable acrylic lens. Intravitreal triamcinolone was given infratemporally pars plana at the completion of the cataract surgery. The patients were reviewed at day 5, 2 weeks, 2 months and then every 3 months as required. The Wilcoxin matched-pairs test was used to assess the significance of the improvement in visual acuity at 2 months. Results Twelve patients with a total of 18 eyes were included in the study. There were 10 patients (15 eyes in group A and 3 patients (3 eyes in group B. Preoperatively 16 of the 18 eyes had a visual acuity of 6/24 or worse. Postoperatively 83% of patients had completely dry foveae at 2 weeks. Best-corrected visual acuities at two months review ranged from 6/6 to CF with 9 eyes (50% achieving 6/12 or better (7 eyes (47% in group A and 2 eyes (67% in group B. Three eyes had no recorded improvement in visual acuity, but no eyes had deterioration in acuity. The improvement in visual acuity was significant at p = 0.001. There were no significant sight threatening complications. Conclusion Intravitreal triamcinolone has been shown to lead to an improvement in macular oedema and visual improvement in

  5. Safety of undiluted intracameral moxifloxacin without postoperative topical antibiotics in cataract surgery.

    Zhou, Andrew Xingyu; Messenger, Wyatt Boyer; Sargent, Steven; Ambati, Balamurali Krishna

    2016-08-01

    The objective of this study is to evaluate the safety of undiluted 0.5 % intracameral moxifloxacin for postoperative endophthalmitis prophylaxis in cataract surgery patients without the use of additional postoperative topical antibiotics. All phacoemulsification cataract surgeries performed by a single surgeon (B.A.) at the John A. Moran Eye Center from June 2012 to May 2015 were reviewed retrospectively. From June 2012 to April 2014, patients were given topical 0.5 % moxifloxacin postoperatively. From May 2014 to May 2015, all patients were given moxifloxacin intracamerally with no antibiotics postoperatively. The follow-up period was 1 month after surgery. Preoperative visual acuity and postoperative visual acuity, corneal edema, and anterior chamber reaction were recorded and compared between the two groups. 384 cataract surgeries were performed during the study period. None of the 384 eyes in the study developed endophthalmitis. Of those 384 eyes, 222 were included in the study for analysis based on the inclusion and exclusion criteria. 131 were part of the topical antibiotic group and 91 were part of the intracameral group. The differences in uncorrected visual acuity at 1 day postoperatively (p = 0.595) and best corrected visual acuity at 1 month postoperatively (p = 0.099) were not statistically significant. Differences in corneal edema (p = 0.370) and anterior chamber reaction (p = 0.069) at 1 day postoperatively and corneal edema (p = 0.512) and anterior chamber reaction (p = 0.512) at 1 month postoperatively were also not statistically significant. Undiluted 0.5 % moxifloxacin can be safely injected intracamerally following cataract surgery without additional postoperative antibiotic prophylaxis to prevent endophthalmitis without adverse effects on patient outcomes. PMID:26577588

  6. Telephone follow-up for cataract surgery: feasibility and patient satisfaction study.

    Hoffman, Jeremy J S L; Pelosini, Lucia

    2016-05-01

    Purpose - The purpose of this paper is to investigate the feasibility of telephone follow-up (TFU) after uncomplicated cataract surgery in low-risk patients and patient satisfaction with this alternative clinical pathway. Design/methodology/approach - Prospective, non-randomised cohort study. A ten-point subjective ophthalmic assessment questionnaire and a six-point patient satisfaction questionnaire were administered to patients following routine cataract surgery at two to three weeks post-procedure. All patients were offered a further clinic review if required. Exclusion criteria comprised ophthalmic co-morbidities, hearing/language impairment and high risk of post-operative complications. Patient notes were retrospectively reviewed over the study period to ensure no additional emergency attendances took place. Findings - Over three months, 50 eyes of 50 patients (mean age: 80; age range 60-91; 66 per cent second eye surgery) underwent uncomplicated phacoemulsification surgery received a TFU at 12-24 days (mean: 16 days) post-operatively. Subjective visual acuity was graded as good by 92 per cent of patients; 72 per cent patients reported no pain and 20 per cent reported mild occasional grittiness. Patient satisfaction was graded 8.9 out of 10; 81.6 per cent defined TFU as convenient and 75.5 per cent of patients preferred TFU to routine outpatient review. No additional visits were required. Research limitations/implications - Non-randomised with no control group; small sample size. One patient was unable to be contacted. Practical implications - Post-operative TFU can be suitably targeted to low-risk patients following uncomplicated cataract surgery. This study demonstrated a high patient satisfaction. A larger, randomised study is in progress to assess this further. Originality/value - This is the first study reporting TFU results and patient satisfaction to the usual alternative two-week outpatient review. PMID:27142949

  7. Postoperative Endophthalmitis Caused by Staphylococcus haemolyticus following Femtosecond Cataract Surgery.

    Wong, Margaret; Baumrind, Benjamin R; Frank, James H; Halpern, Robert L

    2015-01-01

    A 53-year-old Caucasian man underwent femtosecond cataract surgery and then presented with pain and hand motions vision 1 day following surgery. Anterior segment examination showed a 2-mm-layered hypopyon, a well-centered intraocular lens in the sulcus, and an obscured view to the fundus. B-scan ultrasonography showed significant vitritis and that the retina was attached. A tap and an injection of vancomycin 1 mg per 0.1 ml and of ceftazidime 2.25 mg per 0.1 ml were performed. The tap eventually yielded culture results positive for Staphylococcus haemolyticus, which was sensitive to vancomycin. We report a case of endophthalmitis that occurred on postoperative day 1 following complicated cataract surgery. This is an uncommon bacterium that is not widely reported in the literature as a cause of endophthalmitis in the postoperative period. We urge clinicians to consider S. haemolyticus as an offending agent, especially when the infection presents very early and aggressively in the postoperative period. PMID:26951642

  8. A Comparison of Different Operating Systems for Femtosecond Lasers in Cataract Surgery

    Wu, B. M.; Williams, G P; Tan, A; Mehta, J S

    2015-01-01

    The introduction of femtosecond lasers is potentially a major shift in the way we approach cataract surgery. The development of increasingly sophisticated intraocular lenses (IOLs), coupled with heightened patient expectation of high quality postsurgical visual outcomes, has generated the need for a more precise, highly reproducible and standardized method to carry out cataract operations. As femtosecond laser-assisted cataract surgery (FLACS) becomes more commonplace in surgical centers, fur...

  9. DO WOMEN SEEK CATARACT SURGERY LATER THAN MEN: A CASE STUDY OF RURAL POPULATION OF GURGAON?

    Neeraj

    2014-01-01

    Cataract is the leading cause of preventable blindness in developing countries including India. Various barriers exist for acceptance of cataract surgery. Literature search reveals gender to be an important barrier in universal acceptance of cataract surgery. The present study seeks to explore one significant potential factor which may account for this, namely that females seek treatment later than males due to varied factors. METHOD: A retrospective study of 100 male and 100 ...

  10. Microbiological profile of anterior chamber aspirates following uncomplicated cataract surgery

    Prajna N

    1998-01-01

    Full Text Available Anterior chamber aspirate cultures were done for 66 patients who underwent either an uncomplicated intracapsular cataract extraction, extracapsular cataract extraction with posterior-chamber intraocular lens implantation, or phacoemulsification with posterior-chamber intraocular lens implantation. The aspirate was obtained at the time of wound closure. The aspirates were immediately transferred to the microbiology laboratory where one drop of the aspirate was placed on a glass slide for gram stain, and the remainder was unequally divided and inoculated into blood agar, chocolate agar and thioglycolate broth. The cultures were incubated at 37° C with 5% CO2 and held for 5 days. Of 66 patients 4 (6%, had smear-positive anterior chamber aspirates. None of the aspirates showed any growth on any of the 3 culture media used. None of the eyes in the study developed endophthalmitis. This study concludes that there is no contamination of the anterior chamber by viable bacteria after cataract surgery, irrespective of the mode of intervention.

  11. Selective suture cutting for control of astigmatism following cataract surgery

    Bansal R; Gupta Amod; Grewal SPS

    1992-01-01

    Use of 10-0 monofilament nylon in ECCE cataract surgery leads to high with the rule astigmatism. Many intraoperative and post operative methods have been used to minimise post operative astigmatism. We did selective suture cutting in 38 consecutive patients. Mean keratometric astigmatism at three and six weeks post operative was 5.76 and 5.42 dioptres (D) respectively. 77.5% of eyes had astigmatism above 2 D. Selective suture cutting along the axis of the plus high cylinder was done af...

  12. Astigmatism correction in cataract surgery with Rayner toric intraocular lenses

    Painter, Sally

    2010-01-01

    Sally L Painter, Kikkeri S Arun, Jonathan K Kam, CK PatelOxford Eye Hospital, John Radcliffe Hospital, Headley Way, Headington, Oxford, United KingdomBackground: Cataract surgery is increasingly regarded as a refractive procedure. Corneal astigmatism can be reduced by the insertion of a toric intraocular lens (T-IOL). Rayner T-flex T-IOLs are licensed for the correction of astigmatism.Methods: In this retrospective study, 46 eyes from 34 patients, in whom T-IOLs were inserted, have been exami...

  13. Changes in anterior chamber flare and cells following cataract surgery.

    Shah, S. M.; Spalton, D. J.

    1994-01-01

    The laser flare cell meter allows rapid non-invasive quantification of aqueous flare and cells. In this prospective study laser photometry was used to document the recovery of the blood-aqueous barrier in 27 normal eyes following cataract surgery. Aqueous flare and cells were highest on the first postoperative day, declining rapidly in the first week and returning to preoperative levels by 3 months. In six eyes (22.2%) there was an increase in either flare and cells or flare alone during the ...

  14. Strabismus and Nystagmus Following Cataract Surgeries in Childhood

    Ayşe Yeşim Oral

    2012-03-01

    Full Text Available Pur po se: To evaluate the incidence of strabismus in pediatric cataracts and the effects of strabismus and nystagmus accompanied by cataract on postoperative visual acuity. Ma te ri als and Met hod: Seventy-four eyes of 45 patients under 15 years old who had undergone cataract operation were included in this study. The mean postoperative follow-up period was 1.57±2.25 years (ranged between 3 months and 9 years. Twenty-nine of the patients (64% had bilateral and 16 of the patients (36% had unilateral cataract. Preoperative and postoperative visual acuities, as well as the presence of nystagmus and strabismus were recorded. Re sults: Seventeen of the patients (38% had strabismus: 9 of them (53% had esotropia (ET, and 8 of them had (47% exotropia (XT. Fourteen (19% of the total number of cases had nystagmus. The mean age was 5.8±4.4 years for the total group of patients, 4.6±3.0 years for patients with strabismus and 5.1±3.7 years for patients with nystagmus. Visual acuity measurements were not possible in 26 uncooperative patients. The visual acuity was 0.3 logMAR and over in 15 (31% and 1.0 logMAR and under in 12 (25% of the remaining of 48 eyes. Of a total of 28 eyes with strabismus, we were unable to measure visual acuity in 10 patients, and the visual acuities were 0.3 logMAR and over in 7 (39% and 1.0 logMAR and under in 5 (28% of the rest of the 18 patients. The mean visual acuity was significantly lower in the 8 of 14 patients with nystagmus whose visual acuity could be measured (1.25±0.45 logMAR than in both the patients without strabismus (0.44±0.59 logMAR and the patients with strabismus (0.66±0.56 logMAR (p=0.019 and p=0.015, respectively. Dis cus si on: Although strabismus is seen more often in childhood cataracts compared to general population, the presence of strabismus has no negative effect on visual acuity after cataract surgery, while nystagmus is the main factor limiting the visual outcome. (Turk J Ophthalmol 2012; 42

  15. Is ultrasonography essential before surgery in eyes with advanced cataracts?

    Salman Amjad

    2006-01-01

    Full Text Available Background: Ultrasonography is an important tool for evaluating the posterior segment in eyes with opaque media. Aim: To study the incidence of posterior segment pathology in eyes with advanced cataract and to see whether certain features could be used as predictors for an abnormal posterior segment on ultrasound. Setting: Tertiary care hospital in South India. Methods and Materials: In this prospective study conducted over a 6-month period, all eyes with dense cataracts precluding visualization of fundus underwent assessment with ultrasound. Presence of certain patient and ocular "risk" factors believed to be associated with a higher incidence of abnormal posterior segment on ultrasound were looked for and the odds ratio (OR for posterior segment pathology in these eyes was calculated. Results: Of the 418 eyes assessed, 36 eyes (8.6% had evidence of posterior segment pathology on ultrasound. Retinal detachment (17 eyes; 4.1% was the most frequent abnormality detected. Among patient features, diabetes mellitus (OR= 4.9, P=0.003 and age below 50 years (OR= 15.4, P=0.001 were associated with a high incidence of abnormal ultrasound scans. In ocular features, posterior synechiae (OR= 20.2, P=0.000, iris coloboma (OR= 34.6, P=0.000, inaccurate projection of rays (OR= 15.1, P=0.002, elevated intraocular pressure (OR= 15.1, P=0.004, and keratic precipitates (OR= 22.4, P=0.004 were associated with high incidence of posterior segment pathology. Only four eyes (1.5% without these features had abnormal posterior segment on ultrasonography. Conclusions: Certain patient and ocular features are indicative of a high risk for posterior segment pathology and such patients should be evaluated by ultrasonography prior to cataract surgery. In the absence of these risk factors, the likelihood of detecting abnormalities on preoperative ultrasonography in eyes with advanced cataracts is miniscule.

  16. Cirurgia da catarata infantil unilateral Unilateral pediatric cataract surgery

    Adriana Maria Drummond Brandão

    2008-04-01

    Full Text Available OBJETIVO: Analisar os resultados visuais de uma série de crianças operadas de catarata unilateral. MÉTODOS: Um estudo retrospectivo foi realizado através da análise de 35 prontuários médicos do Serviço de Catarata Congênita da UNIFESP/EPM. RESULTADOS: Quanto à etiologia, a primeira causa de catarata foi idiopática, a segunda causa foi o trauma e a terceira foi a rubéola congênita. Em 51,4% dos olhos tinham acuidade visual pré-operatória de ausência de fixação. E em 42,8% dos casos operados a acuidade visual final foi igual ou melhor que 20/200. DISCUSSÃO: Embora a cirurgia em catarata unilateral seja motivo de controvérsias entre os oftalmologistas, obteve-se melhora de acuidade visual em número significativo de casos.PURPOSE: To analyze the results in a series of children submitted to unilateral cataract surgery. METHODS: A retrospective study was conducted through the analysis of 35 patient files from the Congenital Cataract Service of UNIFESP/EPM. RESULTS: The main cause of unilateral cataract was idiopathic, the second cause was ocular trauma and the third cause was congenital rubella. Initial visual acuity was very poor in 51.4% of the cases (did not fix or follow, and the best corrected final visual acuity was better than 20/200 in 42.8% of the eyes. DISCUSSION: Although controversial, the surgical treatment of unilateral cataract, in this study, showed improvement in many cases.

  17. The challenges in improving outcome of cataract surgery in low and middle income countries

    Robert Lindfield

    2012-01-01

    Full Text Available Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income settings is frequently sub-optimal, often failing to reach the recommended standards set by the World Health Organization (WHO. Another way of measuring outcome of cataract surgery is to ask patients for their views on whether surgery has changed the functioning of their eyes and their quality of life. There are different tools available to capture patient views and now, these patient-reported outcomes are becoming more widely used. This paper discusses the visual outcome of cataract surgery and frames the outcome of surgery within the context of the surgical service, suggesting that the process and outcome of care cannot be separated. It also discusses the components of patient-reported outcome tools and describes some available tools in more detail. Finally, it describes a hierarchy of challenges that need to be addressed before a high quality cataract surgical service can be achieved.

  18. Phacoemulsification cataract surgery in a large cohort of diabetes patients: visual acuity outcomes and prognostic factors

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit; La Cour, Morten

    2011-01-01

    To assess visual acuity outcomes after phacoemulsification cataract surgery in a large population of diabetic patients with all degrees of diabetic retinopathy.......To assess visual acuity outcomes after phacoemulsification cataract surgery in a large population of diabetic patients with all degrees of diabetic retinopathy....

  19. The challenges in improving outcome of cataract surgery in low and middle income countries.

    Lindfield, Robert; Vishwanath, Kalluru; Ngounou, Faustin; Khanna, Rohit C

    2012-01-01

    Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income settings is frequently sub-optimal, often failing to reach the recommended standards set by the World Health Organization (WHO). Another way of measuring outcome of cataract surgery is to ask patients for their views on whether surgery has changed the functioning of their eyes and their quality of life. There are different tools available to capture patient views and now, these patient-reported outcomes are becoming more widely used. This paper discusses the visual outcome of cataract surgery and frames the outcome of surgery within the context of the surgical service, suggesting that the process and outcome of care cannot be separated. It also discusses the components of patient-reported outcome tools and describes some available tools in more detail. Finally, it describes a hierarchy of challenges that need to be addressed before a high quality cataract surgical service can be achieved. PMID:22944761

  20. Influence of Biometric Variables on Refractive Outcomes after Cataract Surgery in Angle-closure Glaucoma Patients

    Kim, Kyoung Nam; Lim, Hyung Bin; Lee, Jong Joo

    2016-01-01

    Purpose To evaluate the influence of biometric variables on refractive outcomes after cataract surgery in angle-closure glaucoma (ACG) patients. Methods In this case-control study, 42 ACG patients, 40 open-angle glaucoma (OAG) patients, and 35 controls without glaucoma who had undergone conventional cataract surgery were enrolled consecutively. Electronic medical records, including preoperative biometric variables (keratometric diopter, axial length, anterior chamber depth, and lens thickness), the refractive change (RC), and the absolute value of refractive change (ARC) were reviewed. Results In the control and OAG patients, the anterior chamber depth was negatively correlated with the ARC (r = -0.344, p = 0.043 and r = -0.431, p = 0.006, respectively), whereas there was no correlation in the ACG patients. Lens thickness was positively correlated with the RC, but not with the ARC, in the control and OAG groups (r = 0.391, p = 0.020 and r = 0.501, p = 0.001, respectively). In contrast, lens thickness in the ACG group was not correlated with the RC but was positively correlated with the ARC (r = 0.331, p = 0.032). Conclusions In contrast with the anterior chamber depth, preoperatively measured lens thickness may be a useful predictor of the direction of the RC after cataract surgery in control and OAG patients. However, in ACG patients, a thicker lens was correlated with a larger RC, regardless of the direction of the shift (hyperopic or myopic). PMID:27478355

  1. Small eyes big problems: is cataract surgery the best option for the nanophthalmic eyes

    Nanophthalmos refers to an eyeball of short axial length, usually less than 20 mm which leads to angle closure glaucoma due to relatively large lens. Intra-ocular lens extraction relieves the angle closure in nanophthalmos. Cataract surgery in a nanophthalmic eye is technically difficult with high risk of complications such as posterior capsular rupture, uveal effusion, choroidal haemorrhage, vitreous haemorrhage, malignant glaucoma, retinal detachment and aqueous misdirection. Various options are explained in the literature to perform cataract surgery in nanophthalmos, like extracapsular cataract extraction with or without sclerostomy; small-incision cataract extraction by phacoemulsification which not only helps maintain the anterior chamber during surgery but also reduces the incidence of complications due to less fluctuation of intraocular pressure (IOP) during the surgery. Cataract surgery deepens and widens the anterior chamber angle in nanophthalmic eyes and has beneficial effects on IOP in eyes with nanophthalmos but is associated with a high incidence of complications. (author)

  2. Small eyes big problems: is cataract surgery the best option for the nanophthalmic eyes?

    Utman, Saqib Ali Khan

    2013-09-01

    Nanophthalmos refers to an eyeball of short axial length, usually less than 20 mm which leads to angle closure glaucoma due to relatively large lens. Intra-ocular lens extraction relieves the angle closure in nanophthalmos. Cataract surgery in a nanophthalmic eye is technically difficult with high risk of complications such as posterior capsular rupture, uveal effusion, choroidal haemorrhage, vitreous haemorrhage, malignant glaucoma, retinal detachment and aqueous misdirection. Various options are explained in the literature to perform cataract surgery in nanophthalmos, like extracapsular cataract extraction with or without sclerostomy; small-incision cataract extraction by phacoemulsification which not only helps maintain the anterior chamber during surgery but also reduces the incidence of complications due to less fluctuation of intraocular pressure (IOP) during the surgery. Cataract surgery deepens and widens the anterior chamber angle in nanophthalmic eyes and has beneficial effects on IOP in eyes with nanophthalmos but is associated with a high incidence of complications. PMID:24034192

  3. Recognising ‘high-risk’ eyes before cataract surgery

    Parikshit Gogate

    2008-03-01

    Full Text Available Certain eyes are at a higher risk of complication during cataract surgery. Operations on such ‘high-risk’ eyes are also more likely to yield a poor visual outcome (defined as best corrected vision less than 6/60 after surgery.1Learning to recognise when eyes are at greater risk, and acting accordingly, will help you to avoid complications. Even so, before the operation takes place, it is good practice to explain to such patients that a poor outcome is a possibility. This makes these patients’ expectations more realistic and improves postoperative compliance and follow-up. In most cases, patients who are blind with complicated cataract will be happy with even a modest improvement of their vision.It is also important to have available all the equipment you may need to manage a possible complication, for example a vitrectomy machine in the case of capsular rupture and vitreous loss.Depending on where you are in the world, certain ‘high-risk’ eyes will be more common: for example, pseudoexfoliation in Somalia and India, onchocerciasis in Sudan, and angle-closure glaucoma in Asia. You will get to know your local problems as you perform more operations.

  4. Clinical features and treatment of endophthalmitis after cataract surgery.

    Zhu, J; Li, Z H

    2015-01-01

    The aim of this study was to investigate the clinical features and treatment results of endophthalmitis after cataract surgery. Five patients with endophthalmitis after phacoemulsification with intraocular lens implantation were enrolled in this study. The pathogenesis, clinical manifestation, and surgical outcomes of 5 patients were compared. Three patients were surgically treated with anterior chamber irrigation and vitrectomy with intravitreal injection. The remaining two patients were medically treated with an intravitreal injection of vancomycin and ceftazidime. Treatment results of the five patients were analyzed. Four patients had positive cultures for bacteria (two cases Staphylococcus epidermidis, one case Enterococcus faecalis, and one case head-like Staphylococcus). The culture of the fifth patient did not have bacterial growth. One year following treatment, four patients had restored visual acuity and a clear vitreous cavity. Retinal detachment and other complications were not observed. The remaining patient had a visual acuity of index at 30 cm one year following treatment. For patients with endophthalmitis after cataract surgery, a biochemical laboratory examination should be promptly performed and should include a bacterial culture and drug sensitivity test. When necessary, vitrectomy combined with an intravitreal injection of vancomycin should be performed to treat the infection early and to help retain useful vision. PMID:26125869

  5. Perioperative prophylaxis for endophthalmitis after cataract surgery in Iran

    Marzieh Katibeh

    2015-01-01

    Full Text Available Purpose: To describe prophylactic patterns employed against endophthalmitis after cataract surgery in Iran. Methods: This cross-sectional study included 486 ophthalmologists filling in a self-administered questionnaire during the 20 th Annual Congress of the Iranian Society of Ophthalmology in December 2010, Tehran, working in both private and academic medical centers. Prophylactic measures used preoperatively, intraoperatively and postoperatively and self-reported rates of endophthalmitis were assessed as the main outcome measurements. Results: In the preoperative phase, 75.5% of surgeons used povidone-iodine in the conjunctival sac and 71.4% of them did not use antibiotics. The rate of intraoperative prophylaxis was 61.9% either in the form of intracameral antibiotics or subconjunctival injection (mostly cephazolin or gentamicin. Only 7.8% of participants used intracameral cephalosporins. Postoperative antibiotics [mostly chloramphenicol (57% and ciprofloxacin (28%] were used by 94.2% of surgeons. On average, ten years of practice were required to observe one case of endophthalmitis. Conclusion: The surgeons in present setting used various prophylactic regimens against endophthalmitis after cataract surgery. Setting a local and evidence-based clinical practice guideline seems necessary.

  6. Nursing Care of the Laryngeal Mask Airway in Pediatric Cataract Surgery

    Aihuan Chen; Ronghua Ye; Yanchan Liu; Weici Liu; Jingyi Lin

    2014-01-01

    Purpose:To investigate the important experience of nursing care of the laryngeal mask airway (LMA) in children under-going cataract surgery. Methods: Fifty-five children undergoing cataract surgery were anesthetized by inhaling sevoflurane through a LMA and re-ceived perioperative nursing care. The safety of perioperative nursing for these children was also evaluated. Results:Through perioperative nursing care and psychological counseling for children with LMA,.all patients were anes-thetized without complications and underwent successful surgeries..No severe postoperative complications were ob-served. Conclusion: Nursing care specific for LMA is a vital part of the success of anesthesia and pediatric cataract surgery.

  7. Conjunctival sac bacterial flora isolated prior to cataract surgery

    Suto C

    2012-01-01

    Full Text Available Chikako Suto1,2, Masahiro Morinaga1,2, Tomoko Yagi1,2, Chieko Tsuji3, Hiroshi Toshida41Department of Ophthalmology, Saiseikai Kurihashi Hospital, Saitama; 2Department of Ophthalmology, Tokyo Women's Medical University, Tokyo; 3Department of Clinical Laboratory, Saiseikai Kurihashi Hospital, Saitama; 4Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, JapanObjective: To determine the trends of conjunctival sac bacterial flora isolated from patients prior to cataract surgery.Subjects and methods: The study comprised 579 patients (579 eyes who underwent cataract surgery. Specimens were collected by lightly rubbing the inferior palpebral conjunctival sac with a sterile cotton swab 2 weeks before surgery, and then cultured for isolation of bacteria and antimicrobial sensitivity testing. The bacterial isolates and percentage of drug-resistant isolates were compared among age groups and according to whether or not patients had diabetes mellitus, hyperlipidemia, dialysis therapy, oral steroid use, dry eye syndrome, or allergic conjunctivitis.Results: The bacterial isolation rate was 39.2%. There were 191 strains of Gram-positive cocci, accounting for the majority of all isolates (67.0%, among which methicillin-sensitive coagulase-negative staphylococci was the most frequent (127 strains, 44.5%, followed by methicillin-resistant coagulase-negative staphylococci (37 strains, 12.7%. All 76 Gram-positive bacillary isolates (26.7% were from the genus Corynebacterium. Among the 16 Gram-negative bacillary isolates (5.9%, the most frequent was Escherichia coli (1.0%. The bacterial isolation rate was higher in patients >60 years old, and was lower in patients with dry eye syndrome, patients under topical treatment for other ocular disorders, and patients with hyperlipidemia. There was no significant difference in bacterial isolation rate with respect to the presence/absence of diabetes mellitus, steroid therapy, dialysis, or

  8. The incidence of vitreous loss and visual outcome in patients undergoing cataract surgery in a teaching hospital.

    Kothari Mihir

    2003-01-01

    Full Text Available Purpose: To determine the incidence of vitreous loss in patients undergoing cataract surgery and the visual outcome in a tertiary teaching hospital. Methods: Hospital records of 2095 consecutive patients undergoing cataract surgery between July 1999 and June 2000 were reviewed in this non-concurrent cohort study. Incidence and visual outcome of vitreous loss managed using standard vitrectomy techniques were assessed for different cataract surgical techniques (extracapsular, Blumenthal technique and phacoemulsification as well as at different levels of surgical training. The outcome was compared with matched cases without vitreous loss (controls. Results: Vitreous loss occurred in 160 of 2095 eyes (7.63%; CI -7 to 9.3: 8.3% for ECCE, 8.1% for the Blumenthal technique and 5% with phacoemulsification. Vision ž 6/18 was achieved in 85% of cases and 95% of controls. For experienced surgeons, 95% of the cases and controls had vision ž 6/18. 5.8 % of cases and 0.7% of controls had vision < 6/60. One patient in each group was blind following cataract surgery; both had operable cataracts in the fellow eye. Conclusions: The vitreous loss rate in this tertiary teaching hospital is relatively high. This complication, managed with standard surgical techniques, is compatible with good visual outcome. In eyes with vitreous loss, the final visual acuity achieved by experienced surgeons was similar to that in uncomplicated cases.

  9. Cataract - adult

    ... home to avoid falls and injuries. The only treatment for a cataract is surgery to remove it. If a cataract ... Early diagnosis and treatment are key to preventing permanent ... a hypermature cataract) can begin to leak into other parts of ...

  10. Impact of cataract surgery on car driving: a population based study in Sweden

    Monestam, E.; Wachtmeister, L.

    1997-01-01

    AIMS—To investigate the outcome of cataract surgery on the patients' self estimation of visual function while driving. Furthermore, the benefit of surgery to the car driving population was determined.
METHODS—A total of 208 consecutive patients (211 cases) with driving licences, who underwent cataract surgery with intraocular lenses, were studied prospectively using self administered questionnaires. Their self estimated degree of visual functional problems while driving were analysed before a...

  11. Orbital cellulits following cataract surgery under peribulbar anaesthesia

    Mukherjee, Chandoshi

    2015-01-01

    Full Text Available [english] Introduction: Orbital cellulits following cataract surgery is extremely rare. We describe a case of orbital and facial cellulitis that occurred after routine cataract operation with peribulbar anaesthesia. There were no preoperative systemic or ocular risk factors for postoperative infection. Case description: An 89-year-old man presented to eye casualty, the day after he underwent an uneventful phacoemulsification and posterior chamber lens implantation in the left eye under peribulabr anaesthesia, with soreness, swelling and reduced visual acuity (6/18 in the operated eye. On initial presentation periorbital swelling was noted, the eye was minimally tender, intraocular pressure was raised at 28 mHg and fundoscopy was limited due to a hazy cornea. The patient was discharged on topical medication with a diagnosis of allergic reaction to postoperative drops.The following day, the patient re-presented with worsening orbital swelling involving the left cheek. Ocular findings remained unchanged. CT scan revealed left orbit soft tissue swelling and a locule of air medial to the medial rectus. There were no signs of sinus infection or periosteal inflammation. A diagnosis of left orbital and facial cellulitis was made and the patient was treated with intravenous antibiotics.Discussion: Our patient did not have any predisposing risk factors, therefore most likely cause of cellulitis is surgical trauma during administration of the peribulbar block. This case illustrates the need for adequate skin preparation before the administration of peribulbar anaesthesia and minimal tissue trauma during the procedure.

  12. WHEN TO POSTPONE CATARACT SURGERY: TAKING IN CONSIDERATION PATIENTS’ QUALITY OF LIFE

    Jovanovic Milos

    2015-12-01

    Full Text Available Purpose: Assessment of complication in surgery of complicated cataracts and option of postponement of surgery. Setting: Clinic for eye diseases, Clinical Centre of Serbia Methods: This was a retrospective observational case series. Results: In 16 patients subjected to cataract surgery by method of phacoemulsification, three experienced complications during surgery. Two experienced rupture of posterior lens capsule and prolapse of the vitreous body, and one, expulsive hemorrhage. The visual acuity in all three patients was lesser than the preoperative visual acuity. In the second group of 16 patients, after having been acquainted with the survey, the cataract surgery was postponed and the patients were controlled after one year. The cataract progressed just partially in certain patients and all the patients were satisfied with the status of their vision and did not demand surgery. Conclusions: Cataract surgery in complicated cases may be accompanied by complications with uncertain postoperative visual results. Therefore, in patients with complicated cataracts and relatively preserved visual acuity, it is necessary to be careful with proposing surgery and often obey their wish to postpone surgery. This should be done particularly with patients of advanced age, patients with poor general status of life and in monoculuses.

  13. Coaxial Microincision Cataract Surgery versus Standard Coaxial Small-Incision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials

    Shentu, Xingchao; Zhang, Xin; Tang, Xiajing; Yu, Xiaoning

    2016-01-01

    Background We conducted this meta-analysis to compare the outcomes of coaxial microincision cataract surgery (C-MICS) and standard coaxial small incision cataract surgery (C-SICS). Methods The outcomes of randomized controlled trials (RCTs) reporting C-MICS and C-SICS were collected from PubMed, Web of Science, and The Cochrane Library in May 2015. The final meta-analysis was conducted on the following intraoperative and postoperative outcomes: ultrasound time (UST), effective phacoemulsification time (EPT), balanced salt solution use (BSS use), cumulative dissipated energy (CDE), mean surgery time, endothelial cell loss percentage (ECL%), best corrected visual acuity (BCVA), increased central corneal thickness (CCT), laser flare photometry values and surgically induced astigmatism (SIA). Results A total of 15 RCTs, involving 1136 eyes, were included in the final meta-analysis. No significant between-group differences were detected in EPT, BSS use, CDE, BCVA, laser flare photometry values or increased CCT. However, the C-MICS group showed less SIA (at postoperative day 7: p<0.01; at postoperative day 30 or more: p<0.01) and greater ECL% (at postoperative day 60 or more: p<0.01), whereas the C-SICS group required a shorter UST (p<0.01). Conclusions The present meta-analysis suggested that the C-MICS technique was more advantageous than C-SICS in terms of SIA, but C-MICS required a longer UST and induced a higher ECL%. Further studies should be done to confirm our results. PMID:26745279

  14. Coaxial Microincision Cataract Surgery versus Standard Coaxial Small-Incision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials.

    Xingchao Shentu

    Full Text Available We conducted this meta-analysis to compare the outcomes of coaxial microincision cataract surgery (C-MICS and standard coaxial small incision cataract surgery (C-SICS.The outcomes of randomized controlled trials (RCTs reporting C-MICS and C-SICS were collected from PubMed, Web of Science, and The Cochrane Library in May 2015. The final meta-analysis was conducted on the following intraoperative and postoperative outcomes: ultrasound time (UST, effective phacoemulsification time (EPT, balanced salt solution use (BSS use, cumulative dissipated energy (CDE, mean surgery time, endothelial cell loss percentage (ECL%, best corrected visual acuity (BCVA, increased central corneal thickness (CCT, laser flare photometry values and surgically induced astigmatism (SIA.A total of 15 RCTs, involving 1136 eyes, were included in the final meta-analysis. No significant between-group differences were detected in EPT, BSS use, CDE, BCVA, laser flare photometry values or increased CCT. However, the C-MICS group showed less SIA (at postoperative day 7: p<0.01; at postoperative day 30 or more: p<0.01 and greater ECL% (at postoperative day 60 or more: p<0.01, whereas the C-SICS group required a shorter UST (p<0.01.The present meta-analysis suggested that the C-MICS technique was more advantageous than C-SICS in terms of SIA, but C-MICS required a longer UST and induced a higher ECL%. Further studies should be done to confirm our results.

  15. Preconditioner-based contact response and application to cataract surgery.

    Courtecuisse, Hadrien; Allard, Jérémie; Duriez, Christian; Cotin, Stéphane

    2011-01-01

    In this paper we introduce a new method to compute, in real-time, the physical behavior of several colliding soft-tissues in a surgical simulation. The numerical approach is based on finite element modeling and allows for a fast update of a large number of tetrahedral elements. The speed-up is obtained by the use of a specific preconditioner that is updated at low frequency. The preconditioning enables an optimized computation of both large deformations and precise contact response. Moreover, homogeneous and inhomogeneous tissues are simulated with the same accuracy. Finally, we illustrate our method in a simulation of one step in a cataract surgery procedure, which require to handle contacts with non homogeneous objects precisely. PMID:22003632

  16. Nucleus management in manual small incision cataract surgery by phacosection

    Ravindra M

    2009-01-01

    Full Text Available Nucleus management is critical in manual small incision cataract surgery (MSICS, as the integrity of the tunnel, endothelium and posterior capsule needs to be respected. Several techniques of nucleus management are in vogue, depending upon the specific technique of MSICS. Nucleus can be removed in toto or bisected or trisected into smaller segments. The pressure in the eye can be maintained at the desired level with the use of an anterior chamber maintainer or kept at atmospheric levels. In MSICS, unlike phacoemulsification, there is no need to limit the size of the tunnel or restrain the size of capsulorrhexis. Large well-structured tunnels and larger capsulorrhexis provide better control on the surgical maneuvers. Safety and simplicity of MSICS has made it extremely popular. The purpose of this article is to describe nucleus management by phacosection in MSICS.

  17. Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracamaral use of cefuroxime

    Çakır B; Celik E; Aksoy NÖ; Bursalı Ö; Uçak T; Bozkurt E; Alagoz G

    2015-01-01

    Burçin Çakir, Erkan Celik, Nilgün Özkan Aksoy, Özlem Bursali, Turgay Uçak, Erdinç Bozkurt, Gursoy AlagozSakarya University Education and Research Hospital, Sakarya, TurkeyPurpose: To report toxic anterior segment syndrome (TASS) after cataract surgery possibly associated with intracameral use of cefuroxime.Methods: We conducted a retrospective chart review and analysis on the pre- and postoperative conditions of the subjects who had developed TASS.Re...

  18. The Effect of Large Capsulorhexis (>7mm) on the Stability of Refraction Post Cataract Surgery

    Chen, Ming

    2012-01-01

    Purpose: To investigate if the larger capsulorhexis (7mm) is associated with a stable post-operative refraction with Acrysof IQ one-piece IOL (SN60WF, Alcon USA) implantation from 1month to 2 years after cataract surgery. Method: Retrospective chart review was made on 31 eyes of 20 patients. All eyes had uncomplicated phacoemulsification by the author with 7mm capsulorhexis and Acrysof one-piece IOLIQ (SN60WF, Alcon USA) implantation between 4/2007 and 7/2008. IOL Master was used to select th...

  19. Efficacy and safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: a meta-analysis of randomized controlled trials

    Xiaoyun Chen; Wei Xiao; Shaobi Ye; Weirong Chen; Yizhi Liu

    2015-01-01

    The aim of this study was to evaluate the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification cataract surgery (CPCS) in the treatment of cataract. Randomized controlled trials (RCTs) were searched in PubMed, Embase and the Cochrane Central Register of Controlled Trials. Nine qualified studies with a total of 989 eyes were included. Compared with CPCS, FLACS significantly reduced mean phaco energy and effective phacoemulsification...

  20. EVALUATION OF VISUAL OUTCOME AFTER CATARACT EVALUATION OF VISUAL OUTCOME AFTER CATARACT SURGERY IN CAMP PATIENTS - A STUDY FROM CENTRAL INDIA

    Madhu; Sarkar,, D.; Manghani; Soni

    2014-01-01

    BACKGROUND : Cataract is the leading cause of avoidable blindness in India. Around 4 million people become blind each year because of cataract. AIM : To assess the visual outcome and complications associated with cataract surgery in camp patients operated at a Medical College tertiary hospital. MATERIALS AND METHODS : It was a retrospective study where 412 camp patients underwent posterior chamber intrao cular lens implantation surgery over a period of o...

  1. Intraoperative and Immediate Postoperative Outcomes of Cataract Surgery using Phacoemulsification in Eyes with and without Pseudoexfoliation Syndrome

    Dwivedi, Neelam R; Dubey, Arun K; Shankar, P Ravi

    2014-01-01

    Background: To compare the intraoperative and immediate postoperative behavior and complications in eyes with pseudoexfoliation (PEX) syndrome with eyes having senile cataract without PEX during cataract surgery using phacoemulsification (PKE).

  2. Uncorrected visual acuity in the immediate postoperative period following uncomplicated cataract surgery: bimanual microincision cataract surgery versus standard coaxial phacoemulsification.

    Saeed, Ayman

    2012-02-01

    AIM: We compared bimanual microincision cataract surgery (MICS) and standard coaxial phacoemulsification (CAP) in terms of uncorrected visual acuity (UCVA) recorded 1 h and 2 weeks postoperatively. METHODS: This was a prospective, nonrandomised comparative study. All MICS procedures were performed by one surgeon (MGM), and all CAP procedures were performed by another surgeon (SB). Eyes with visually consequential ocular morbidity were excluded. The primary outcome measure was UCVA recorded 1 h postoperatively. RESULTS: One hundred eyes underwent MICS and CAP (50 eyes in each group). The treatment groups did not differ significantly in terms of preoperative mean best corrected visual acuity (6\\/24 +\\/- 4.3 lines and 6\\/20 +\\/- 4.4 lines in the MICS and the CAP groups, respectively; P = 0.65). Also, there was no significant difference in terms of postoperative UCVA at 1 h or at 2 weeks (mean +\\/- standard deviation UCVA 1 h postoperatively: MICS: 6\\/36 +\\/- 5.7 lines; CAP: 6\\/30 +\\/- 4.7 lines; P = 0.80; UCVA 2 weeks postoperatively: MICS: 6\\/10 +\\/- 1.9 lines; CAP: 6\\/10 +\\/- 2.2 lines; P = 0.90). However, nine eyes (18%) and one eye (2%) achieved a UCVA of C6\\/12 at 1 h following MICS and CAP, respectively, and this difference was statistically significant (P = 0.02). CONCLUSION: Mean UCVA at 1 h and at 2 weeks following cataract surgery was not significantly different between eyes undergoing MICS and CAP. However, a greater proportion of patients achieved a UCVA of C6\\/12 following MICS when compared with CAP.

  3. Comparing the Curative Effects between Femtosecond Laser-Assisted Cataract Surgery and Conventional Phacoemulsification Surgery: A Meta-Analysis

    Chen, Xinyi; Chen, Kailin; He, Jiliang; Yao, Ke

    2016-01-01

    Purpose To compare the outcomes of femtosecond laser-assisted cataract surgery (FLACS) with those of conventional phacoemulsification surgery (CPS) for age-related cataracts. Methods A comprehensive literature search of PubMed, EMBASE, and the Cochrane Controlled Trials Register was conducted to identify randomized controlled trials (RCT) and comparative cohort studies comparing FLACS with CPS. Endothelial cell loss percentage (ECL%), central corneal thickness (CCT), corrected and uncorrected...

  4. Induced astigmatism after cataract surgery - a retrospective analysis of cases from the University of Port Harcourt Teaching Hospital, Nigeria

    A. O. Adio; N. Aruoto

    2011-01-01

    Visual rehabilitation after cataract surgery may often be disappointing due to induction of corneal astigmatism following issues in realigning, point to point, the corneal wound margin in the process of surgery despite biometry and use of the appropriateintraocular lens. The purpose of this study is to determine the amount of surgically induced astigmatism after sutured cataract extraction-extracapsular cataract extraction (ECCE) and intracapsular cataract extraction (ICCE) and intraocular le...

  5. Femtosecond laser combined with non-chopping rotation phacoemulsification technique for soft-nucleus cataract surgery: a prospective study

    Hui Chen; Haotian Lin; Wan Chen; Bo Zhang; Wu Xiang; Jing Li; Weirong Chen; Yizhi Liu

    2016-01-01

    Soft-lens cataract surgeries are becoming increasingly common for cataract surgeons and chopping the soft nucleus using conventional techniques is problematic. We introduced a femtosecond laser combined with a non-chopping rotation phacoemulsification technique for soft-nucleus cataract surgery and evaluated the safety and efficacy of using this technique. Sixty-six patients with soft-nucleus cataracts ranging from grade 1~3 were divided into 3 groups based on nuclear staging. Those groups we...

  6. Virtual reality phacoemulsification: a comparison between skilled surgeons and students naive to cataract surgery

    Soderberg, Per; Laurell, Carl-Gustaf; Simawi, Wamidh; Nordqvist, Per; Skarman, Eva; Nordh, Leif

    2005-04-01

    We have developed a simulator for virtual phacoemulsification surgery. In the current study, the performance of one experienced cataract surgeon was compared to the performance of four subjects naive to cataract surgery. They all operated on the same virtual patient and a number of different response variables were measured. It was found that the experienced subject performed better than the naive subjects on almost all response variables. This indicates that the simulator developed by us is authentic for phaco emulsification surgery. The lack of negative effects in case of complications during virtual phacoemulsification surgery makes the phaco simulator that we developed a very attractive tool for learning phacoemulsification surgery.

  7. A COMPARATIVE STUDY OF POST OPERATIVE ASTIGMATISM IN SUPERIOR VERSUS TEMPORAL APPROACH OF MANUAL SMALL INCISION CATARACT SURGERY

    Jawed; Himadri; De, Abhijit; Rathindra; Surabhi; Uttam; Deepak; Madhusudan,

    2014-01-01

    BACKGROUND: Manual small incision cataract surgery is a simple and less expensive technique of cataract surgery but gives visual result almost equivalent to Phacoemulsification. PURPOSE: To compare surgery induced astigmatism in manual small incision cataract surgery through superior and temporal approaches. METHODOLOGY: One hundred and thirty eyes were included in this study. Eyes with steeper vertical keratometric reading were subjected to superior small incision catarac...

  8. Dealings between Cataract and Retinal Reattachment Surgery in PVR

    Svenja Deuchler

    2016-01-01

    Full Text Available Introduction. To evaluate the impact of the eye lens status and oil side effects on the outcome of vitreoretinal surgery in retinal detachment with proliferative vitreoretinopathy (PVR and a temporary silicone oil tamponade (SOT. Methods. 101 eyes were analyzed retrospectively and 103 eyes prospectively in regard to their retinal reattachment success rate and key factors for the outcome. Subgroup analysis of 27 eyes with Scheimpflug lens photography (SLP before and after retinal reattachment service with SOT was performed. For SLP (65% phakic eyes a Pentacam densitometry reference body with 3 mm diameter was chosen and 3 segments (anterior/mid/posterior were evaluated separately after a quality check. Results. The retinal reattachment rate was highest in the prospective pseudophakic group (p=0.039. Lens transparency loss occurred earlier in middle aged patients than in younger patients. Besides the nucleus, layers posterior and anterior to it showed specific transparency changes. The emulsification rate was higher when eyes had been operated on in the anterior chamber before retinal reattachment service. Conclusions. Retinal reattachment surgery seems to benefit from preoperative cataract removal. We found significant lens changes in the nucleus as well as in the layers anterior and posterior to it. This corresponds to the histology of the lens epithelium published before.

  9. Capsulotomy and hydroprocedures for nucleus prolapse in manual small incision cataract surgery.

    Venkatesh, Rengaraj; Veena, Kannusamy; Ravindran, Ravilla D

    2009-01-01

    Manual small incision cataract surgery (MSICS) involves the manual removal of nucleus through a scleral tunnel. To achieve 100% success every time, one has to do a good capsulotomy and should master the technique to prolapse the nucleus into anterior chamber. During conversion from extracapsular cataract surgery to MSICS, one can perform a can-opener capsulotomy and prolapse the nucleus. However, it is safer and better to perform a capsulorrhexis and hydroprolapse the nucleus, as it makes the rest of the steps of MSICS comfortable. Use of trypan blue in white and brown cataracts makes the capsulorrhexis and prolapse simple and safe. Extra caution should be taken in cases with hypermature cataracts with weak zonules and subluxated cataracts. PMID:19075402

  10. Capsulotomy and hydroprocedures for nucleus prolapse in manual small incision cataract surgery

    Venkatesh Rengaraj

    2009-01-01

    Full Text Available Manual small incision cataract surgery (MSICS involves the manual removal of nucleus through a scleral tunnel. To achieve 100% success every time, one has to do a good capsulotomy and should master the technique to prolapse the nucleus into anterior chamber. During conversion from extracapsular cataract surgery to MSICS, one can perform a can-opener capsulotomy and prolapse the nucleus. However, it is safer and better to perform a capsulorrhexis and hydroprolapse the nucleus, as it makes the rest of the steps of MSICS comfortable. Use of trypan blue in white and brown cataracts makes the capsulorrhexis and prolapse simple and safe. Extra caution should be taken in cases with hypermature cataracts with weak zonules and subluxated cataracts.

  11. Feasibility and Complications between Phacoemulsification and Manual Small Incision Surgery in Subluxated Cataract

    Ruchi Goel

    2012-01-01

    Full Text Available Purpose. To compare the feasibility of cataract surgery with implantation of endocapsular supporting devices and intraocular lens (IOL in subluxated cataract in phacoemulsification and manual small incision cataract surgery (MSICS. Design. Prospective randomized intervention case series consisting of 60 eyes with visually significant subluxated cataract. Method. The patients were randomly distributed between the two groups equally. The main outcome measure was implantation of in-the-bag IOL, requirement of additional procedure and complications, if any. Results. Capsular bag retention in subluxated lenses is possible in 90% cases in phacoemulsification versus 76.67% cases in MSICS (=0.16. Both groups, achieved similar best corrected visual acuity (=0.73, although additional procedures, intraoperative, and postoperative complications were more common in MSICS. Conclusions. Achieving intact capsulorhexis and nuclear rotation in MSICS may be difficult in cases with large nucleus size and severe subluxation, but subluxated cataracts can be effectively managed by both phacoemuslification and MSICS.

  12. Capsulotomy and hydroprocedures for nucleus prolapse in manual small incision cataract surgery

    Venkatesh Rengaraj; Veena Kannusamy; Ravindran Ravilla

    2009-01-01

    Manual small incision cataract surgery (MSICS) involves the manual removal of nucleus through a scleral tunnel. To achieve 100% success every time, one has to do a good capsulotomy and should master the technique to prolapse the nucleus into anterior chamber. During conversion from extracapsular cataract surgery to MSICS, one can perform a can-opener capsulotomy and prolapse the nucleus. However, it is safer and better to perform a capsulorrhexis and hydroprolapse the nucleus, as it ma...

  13. Minimizing Surgically Induced Astigmatism at the Time of Cataract Surgery Using a Square Posterior Limbal Incision

    Richard Potvin; Paul Ernest; Warren Hill

    2011-01-01

    Purpose. To compare the surgically induced astigmatism from clear corneal and square posterior limbal incisions at the time of cataract surgery. Methods. Surgically induced astigmatism was calculated for a set of eyes after cataract surgery using a temporal 2.2 mm square posterior limbal incision. Results were compared to similar available data from surgeons using clear corneal incisions of similar size. Results. Preoperative corneal astigmatism averaged 1.0 D and was not significantly differ...

  14. ANTERIOR CAPSULE STAINING USING 0.025% TRYPAN BLUE IN ALL PHACOEMULSIFICATION CATARACT SURGERIES

    Karthigeyan

    2013-01-01

    ABSTRACT: PURPOSE: To describe the use of anterior capsule staining in all phacoemulsification cataract surgery using a 0.025% trypan blue solution . METHODS: Thirty eyes of 30 patients with cataracts were submitted to phacoemulsification using a direct injection of 0.2 to 0.5 ml of 0.025% trypan blue in the anterior chamber through the side port before injecting viscoelastic injection. All patients h ad preop ophthalmologic examination prior to surgery. RESULTS:...

  15. Factors Influencing Efficacy of Peripheral Corneal Relaxing Incisions during Cataract Surgery

    Nino Hirnschall; Jörg Wiesinger; Petra Draschl; Oliver Findl

    2015-01-01

    Purpose. To evaluate influencing factors on the residual astigmatism after performing peripheral corneal relaxing incisions (PCRIs) during cataract surgery. Methods. This prospective study included patients who were scheduled for cataract surgery with PCRIs. Optical biometry (IOLMaster 500, Carl Zeiss Meditec AG, Germany) was taken preoperatively, 1 week, 4 months, and 1 year postoperatively. Additionally, corneal topography (Atlas model 9000, Carl Zeiss Meditec AG, Germany), ORA (Ocular Resp...

  16. Lensectomy using a bimanual microincision cataract surgery technique during pars plana vitrectomy.

    Byeon, Suk Ho; Kwon, Oh W

    2009-01-01

    Lens extraction during vitrectomy is sometimes necessary to obtain an adequate view of the retina. Currently, phacoemulsification through a clear corneal incision with implantation of a foldable intraocular lens has become the preferred technique for cataract extraction during pars plana vitrectomy. The authors described the technique of lensectomy using a bimanual microincisional cataract surgery technique during pars plana vitrectomy and insertion of the intraocular lens at the end of surgery, which has several advantages over conventional coaxial phacoemulsification procedures. PMID:19205506

  17. Anaesthetic Management of Cataract Surgery in a Patient with Sturge-Weber Syndrome

    Vasantha Kumar

    2015-05-01

    Full Text Available Sturge-Weber Syndrome (SWS, also called as encephalo trigeminal angiomatosis, is a rare congenital syndrome, characterized by lepto meningeal haemangioma, a facial port-wine stains distributed over the trigeminal nerve area, (usually involving one side and glaucoma. During cataract surgery, there may be rupture of choroid haemangioma, leading to excessive bleeding, or of haemangioma involving the airway, leading to difficult mask ventilation, laryngoscopy and intubation. We discuss the anaesthetic management of the patient with SWS for cataract surgery.

  18. Towards achieving small-incision cataract surgery 99.8% of the time.

    Thomas R; Kuriakose T; George R

    2000-01-01

    A surgical approach designed to reliably attain the modern goal of small incision cataract surgery 99.8% of the time is described. Phacoemulsification as well as a manual small incision technique is utilised to achieve the desired outcome as often as possible and for all types of cataracts. The logic, and required surgical steps are described and illustrated. This surgical technique allows the advantages of small incision surgery to be reliably achieved. The method is flexible and allo...

  19. Cataract surgery under topical anesthesia: Gender-based study of pain experience

    Sanjiv Kumar Gupta; Ajay Kumar; Swati Agarwal

    2010-01-01

    Background : Pain perception, expression, tolerance, and the healthcare provider′s evaluation and management of pain are affected by the gender of the patient. To the best of our knowledge, there is lack of gender-based evaluation of pain during cataract surgery under topical anesthesia. Aims : This study has been initiated to evaluate and determine pain experience during cataract surgery under topical anesthesia and to study the gender-based differences of the same. Settings and Desi...

  20. Cataract surgery in India: Results of a 1995 survey of ophthalmologists

    Gupta A; Tewari H; Ellwein Leon

    1998-01-01

    The aim of this study was to investigate cataract surgery procedures and caseloads among Indian ophthalmologists in private and government practices. Members of the All India Ophthalmological Society and state ophthalmic societies were surveyed by mail questionnaire in December 1995. Out of 6,800 surveyed, 2,098 responses (31%) were received. Over 61% of the 990,249 reported cataract surgeries were carried out in private facilities with 24% of private patients receiving e...

  1. Economic and social factors that influence households not willing to undergo cataract surgery

    Muralikrishnan Radhakrishnan; Rengaraj Venkatesh; Vijayakumar Valaguru; Frick, Kevin D.

    2015-01-01

    Purpose: Literature investigating barriers to cataract surgery is mostly done from the patient's point of view. However, many medical decisions are jointly taken by household members, especially in developing countries such as India. We investigated from the household head's (or representative's) perspective, households' view on those not willing to undergo cataract surgery along with the economic and social factors associated with it. Materials and Methods: A cross-sectional survey of four r...

  2. Blood Pressure and Heart Rate Alterations through Music in Patients Undergoing Cataract Surgery in Greece

    Kyriakoula Merakou; Georgia Varouxi; Anastasia Barbouni; Eleni Antoniadou; Georgios Karageorgos; Dimitrios Theodoridis; Aristea Koutsouri; Jenny Kourea-Kremastinou

    2015-01-01

    INTRODUCTION Music has been proposed as a safe, inexpensive, nonpharmacological antistress intervention. The purpose of this study was to determine whether patients undergoing cataract surgery while listening to meditation music experience lower levels of blood pressure and heart rate. METHODS Two hundred individuals undergoing cataract surgery participated in the study. Hundred individuals listened to meditation music, through headphones, before and during the operation (intervention group) ...

  3. Profitability analysis of a femtosecond laser system for cataract surgery using a fuzzy logic approach

    Trigueros, José Antonio; Piñero, David P; Ismail, Mahmoud M

    2016-01-01

    AIM To define the financial and management conditions required to introduce a femtosecond laser system for cataract surgery in a clinic using a fuzzy logic approach. METHODS In the simulation performed in the current study, the costs associated to the acquisition and use of a commercially available femtosecond laser platform for cataract surgery (VICTUS, TECHNOLAS Perfect Vision GmbH, Bausch & Lomb, Munich, Germany) during a period of 5y were considered. A sensitivity analysis was performed considering such costs and the countable amortization of the system during this 5y period. Furthermore, a fuzzy logic analysis was used to obtain an estimation of the money income associated to each femtosecond laser-assisted cataract surgery (G). RESULTS According to the sensitivity analysis, the femtosecond laser system under evaluation can be profitable if 1400 cataract surgeries are performed per year and if each surgery can be invoiced more than $500. In contrast, the fuzzy logic analysis confirmed that the patient had to pay more per surgery, between $661.8 and $667.4 per surgery, without considering the cost of the intraocular lens (IOL). CONCLUSION A profitability of femtosecond laser systems for cataract surgery can be obtained after a detailed financial analysis, especially in those centers with large volumes of patients. The cost of the surgery for patients should be adapted to the real flow of patients with the ability of paying a reasonable range of cost. PMID:27500115

  4. Cataract surgery following cobalt-60 plaque radiotherapy for posterior uveal malignant melanoma

    The authors reviewed the records of thirteen patients with posterior uveal malignant melanoma who had developed a mature radiation cataract following cobalt-60 plaque radiotherapy. Cataract extraction had been performed in seven of these patients as of the survey date of this investigation. The authors attempted to determine if cataract extraction increased the risk of metastatic melanoma, improved or worsened visual function, or resulted in any consistent intraoperative or postoperative complications that did not occur if the cataract was retained. This analysis showed that removing the cataract did not appear to increase the risk of death from metastatic melanoma, but it also indicated that cataract extraction did not seem to improve the visual function of the irradiated eye. On the basis of this experience to date, the authors offer suggested guidelines for the management of patients who develop a mature cataract following cobalt-60 plaque radiotherapy of a posterior uveal malignant melanoma

  5. Postoperative increase in grey matter volume in visual cortex after unilateral cataract surgery

    Lou, Astrid R.; Madsen, Kristoffer Hougaard; Julian, Hanne O.;

    2013-01-01

    more symmetrical visual acuity became after unilateral cataract surgery, the more pronounced was the grey matter increase in visual cortex. Conclusion:  The data suggest that cataract surgery triggered a use-dependent structural plasticity in V2 presumably through improved binocular integration of......Purpose:  The developing visual cortex has a strong potential to undergo plastic changes. Little is known about the potential of the ageing visual cortex to express plasticity. A pertinent question is whether therapeutic interventions can trigger plastic changes in the ageing visual cortex by...... restoring vision. Methods:  Twelve patients aged 50–85 years underwent structural high-resolution T1-weighted MRI of the whole brain 2 days and 6 weeks after unilateral cataract surgery. Voxel-based morphometry (VBM) based on T1-weighted magnetic resonance imaging (MRI) was employed to test whether cataract...

  6. Cytological factors relating to posterior capsule opacification following cataract surgery.

    Jacob, T J; Humphry, R. C.; Davies, E. G.; Thompson, G M

    1987-01-01

    Simulated extracapsular cataract extractions on cadaver eyes were performed which demonstrated that the cells of the anterior capsule remain largely intact and that only a small amount of cortical lens matter remains postoperatively. Human lens epithelial cells from normal and cataractous lenses were grown in culture. There was no appreciable difference in growth rate between cells from normal and those from cataractous lenses or between equatorial and central capsule cells. The cells grew fr...

  7. Training of Resident Ophthalmologists in Cataract Surgery: A Comparative Study of Two Approaches

    Tzamalis, Argyrios; Lamprogiannis, Lampros; Chalvatzis, Nikolaos; Symeonidis, Chrysanthos; Tsinopoulos, Ioannis

    2015-01-01

    Purpose. To evaluate and compare the efficacy of two different training methods in resident-performed phacoemulsification surgery. Methods. 502 eyes of 467 patients who underwent resident-performed phacoemulsification were included in the study by reviewing their medical records. Residents were allocated into two groups according to the method applied during their training in cataract surgery; Group A included residents that were trained with the “step-by-step” method and Group B those trained with the “one-step” method. Primary outcome was the incidence of main complications, defined as posterior capsular ruptures and/or zonular dehiscence with vitreous loss. Results. Each resident performed a median of 63 phacoemulsification surgeries. A statistically significant difference (p = 0.0032) was noted in the main complications rate between the two groups, yielding a mean of 17.3% in Group A and 7.25% in Group B. Other intraoperative complications were not shown to differ statistically significantly between study groups (p > 0.05). Among the first 40 surgeries of each resident, main complications rate differed also statistically significantly (p = 0.0048) between Group A (21.67%) and Group B (8.5%), while a better surgical performance-yielding statistical significance in Group A (p = 0.017) was indicated in both groups between the 20th and the 30th procedure. Conclusions. Training in cataract surgery using the “one-step” method may lead to an improvement in surgical competency, when measured by complications rates and, therefore, to significantly better quality of training for resident ophthalmologists. PMID:26075088

  8. Comparison between Subjective Sensations during First and Second Phacoemulsification Eye Surgeries in Patients with Bilateral Cataract.

    Yu, Ji-Guo; Ye, Ting; Huang, Qing; Feng, Yi-Fan; Wang, Jue; Fu, Xun-An; Xiang, Yi

    2016-01-01

    Purpose. To evaluate and compare the subjective sensations reported by patients during first and second cataract extractions. Methods. Consecutive patients undergoing bilateral sequential cataract extraction using phacoemulsification were recruited. Following cataract surgery, patients completed questionnaires designed to evaluate subjective sensations, including anxiety, eye bulges, pain, and light sensitivity. Changes in painful sensations experienced by patients between the two surgeries were also recorded. Comparisons were also performed for each subjective sensation between different age groups (79 years). Results. A total of 127 patients were included in the final evaluation. Statistical comparison of the results showed that there were significant differences in perception of anxiety, eye bulges, and pain scores between the first and second cataract surgeries (P anxiety, perception of eye bulges, pain, and light sensitivity scores between both the surgeries showed no correlation with age (P > 0.05 for all). Conclusions. Our research confirms the common observation that patients with bilateral cataracts often report more ocular discomfort during the second surgery. There are, therefore, additional factors that should be considered upon treating patients with bilateral cataracts, and the provision of preoperative counseling could play an important role in providing adequate patient care. PMID:27239336

  9. MANUAL SMALL - INCISION CATARACT SURGERY USING AC MAINTAINER UNDER LIGNOCAINE 2% JELLY AND INTRACAMERAL LIDOCAINE

    Rahul

    2015-08-01

    Full Text Available M anual small incision cataract surgery (MSICS is a very popular technique of cataract surgery in India. It’s a surgery which is done and in short time and in a country like India with a huge back - log of cataract blindness this surgery is very useful. OBJECTIVE: To evaluate the outcome of manual small incision cataract surgery (MSICS with AC mantainer under topical anesthesia with lignocaine 2% jelly and intracameral lignocaine . MATERIALS AND METHODS : This study was a prospectiv e interventional case series. One hundred patients of senile cataract were operated by MSICS under topical anesthesia using lignocaine 2% jelly and intracameral 1% lignocaine. The patients and the single operating surgeon were given a questionnaire to eval uate their experience in terms of pain, surgical experience and complications. RESULTS : The mean pain score was 0.82(SD±0.97. 63 patients (63% had a pain score of zero, that is, no pain. 37 patients (37 % had a score of 3 or less, that is, mild to none pain. 95 surgeries were free of complications while 5 had complications but they were not related to anaesthesia. Surgeon’s experience was favorable in terms of patient’s cooperation, anterior chamber stability, difficulty, and complications. CONCLUSIONS: MSICS can be comfortably performed under topical anesthesia with lignocaine jelly and intracameral lignocaine, which makes the surgery patient - friendly, without compromising the outcome.

  10. Lens Epithelial Cell Death Secondary to Acanthamoeba Keratitis: Absence of Capsular Bag Opacification Six Years after Cataract Surgery

    Moreno-Montañes, J. (Javier); Barrio-Barrio, J. (Jesús); E. Nova; Werner, L.

    2011-01-01

    Purpose: To show the evolution of anterior chamber structures 6 years after cataract surgery in a case with Acanthamoeba keratitis (AK). Methods: A 37-year-old woman with AK receiving long-term treatment with chlorhexidine, propamidine isethionate and steroids developed a white cataract and iris atrophy. Penetrating keratoplasty and cataract surgery were performed with subsequent intraocular pressure elevation requiring Molteno shunt implantation. Two years after the last surgery, endothel...

  11. Meta-analysis to compare the safety and efficacy of manual small incision cataract surgery and phacoemulsification

    Parikshit Gogate; Optom, Jyoti Jaggernath B.; Swapna Deshpande; Kovin Naidoo

    2015-01-01

    Purpose: A systematic review and meta-analysis comparing the safety, efficacy, and expenses related to phacoemulsification versus manual small incision cataract surgery (SICS). Methods: PubMed, Cochrane, and Scopus databases were searched with key words manual SICS 6/18 and 6/60; astigmatism and endothelial cell loss postoperatively, intra- and post-operative complications, phacoemulsification, and comparison of SICS and phacoemulsification. Non-English language manuscripts and manuscript...

  12. Photodynamic treatment of lens epithelial cells for cataract surgery

    Lingua, Robert W.; Parel, Jean-Marie A.; Simon, Gabriel; Li, Kam

    1991-06-01

    Photodynamic therapy (PDT) eiiploying Dihematopor*iyrin ethers (DHE) (Photofrin II) at pharmacologic lvels, has been denonstrate3 to kill rabbit lens epithelial cells, in vivo. This in vitro study, reports on the minimal necessary parameters for rabbit lens epithelial cell death. Explants of rabbit lenses were incubated in various concentrations of DHE (1O,, 100, 500, 1000 ug/ml) for 1, 2, or 5 minutes. 30 to 120 Joules/an of collimated 514.5 nm Argon laser light re delivered to the locier concentrations of 10, 50, and 100 ug,'ml DHE treated cells. One hundre1 fifteen explants were treated, in all. Higher concentrations of DHE alone (500 and 1000 ug/ml) were sufficient to induce cellular swelling. Lower concentrations required light for cellular effect. Trypan blue staining revealed cell death at these minimal pa9ieters: DHE 50 ug/ml, incubation 1 minute, 514.5 r Argon light 1.0 Watt/an for 30 sec (30 Joules) . In future studies, these rameters will be tested in vivo, for their ability to eliminate lens epithelial proliferation after cataract surgery.

  13. Optical coherence tomography in patients undergoing cataract surgery

    Carlos Augusto Moreira Neto

    2015-08-01

    Full Text Available ABSTRACTPurpose:To assess the ability of spectral domain optical coherence tomography (SD-OCT to diagnose macular changes pre- and post-cataract surgery and to identify changes in central foveal thickness (CFT relative to age, sex, and presence of concomitant ophthalmic pathologies, for a period of 6 months post-surgery.Methods:A prospective study of patients evaluated by SD-OCT within 5 h before surgery at 7, 30, 60, 90, and 180 days post-op, with respect to CFT and presence of maculopathy.Results:Ninety-eight eyes of 98 patients were evaluated, with the following mean results: age = 71.4 years, pre-op VA = 0.27 logMAR, and final VA = 0.73 logMAR. There were 21 eyes in patients with diabetes mellitus (DM and 10 eyes with age-related macular degeneration (AMD, three with epiretinal membrane, and four with glaucoma. Sixty eyes had no other ophthalmic-related pathologies (NOO, and had a mean pre-op CFT of 222 μm, which progressively increased up to the 60thday post-op, reaching a mean of 227.2 μm. No pseudophakic cystoid macular edema was observed. The mean CFT was statistically significantly different (p<0.001 between NOO and diabetic patients from 30 days post-op. Four eyes presented with preoperative diagnosis of AMD as measured by ophthalmoscopy. After completion of the OCT, which was performed within 5 h before surgery, six additional patients were found to have AMD. Of the 98 total eyes, 10 were diagnosed with maculopathy only by OCT exam. Binocular indirect ophthalmoscopy (BIO was unable to detect such changes.Conclusion:OCT diagnosed preoperative maculopathies in 21.4% of the patients, and was more effective than BIO (11.2%. OCT showed a progressive increase in CFT in diabetics up to 180 days post-operatively, as well as greater CFT in male patients and patients older than 70 years.

  14. Incidence, risk factors and impact of age on retinal detachment following cataract surgery in France: a national population study

    Daien, Vincent; Le Pape, Annick; Hève, Didier; Carriere, Isabelle; Villain, Max

    2015-01-01

    Objective: To assess the incidence, risk factors and impact of age on retinal detachment (RD) following cataract surgery.Design: Cohort study Subjects: All patients > 40 years old who underwent a primary cataract surgery in France between January 2009 and December 2012. Methods: A Cox proportional-hazard regression model was used to analyze risk factors of RD after cataract surgery.Main Outcome Measures: Risk factors of RD after cataract surgeryResults: Over 4 years, 2,680,167 eyes in 1,787,0...

  15. Cataract surgery: interim results and complications of a randomised controlled trial. Oxford Cataract Treatment and Evaluation Team (OCTET).

    1986-01-01

    A randomised controlled trial in progress for more than five years, with no loss to follow-up (except death), assessed 333 eyes treated by three methods of cataract surgery. They were (A) intracapsular extraction and contact lens usage, (B) intracapsular extraction and implantation of an iris supported lens (Federov I), and (C) extracapsular extraction and implantation of an iridocapsular lens (Binkhorst 2-loop). The purpose of the paper is to report interim visual results, complications, and...

  16. Favorable Long-term Prognosis of Cataract Surgery in Herpes Zoster Ophthalmicus

    Chaudhary, Kulbhushan Prakash; Mahajan, Deepti; Panwar, Praveen

    2016-01-01

    Purpose: Scleritis is a rare presentation of herpes zoster ophthalmicus, complicated most commonly by iridocyclitis and raised intraocular pressure. These complications can recur in subsequent years, therefore they should be managed well. Case Report: We describe a female patient who developed scleritis, complicated cataract and secondary glaucoma 2 years after being diagnosed by HZO. Secondary glaucoma was managed medically, and the patient underwent extracapsular cataract extraction for the complicated cataract. Final visual acuity was 6/6 and IOP was 22.4 mm Hg. This is a rare report describing favorable long-term (>20 years) prognosis for surgical management of cataract associated with HZO together with scleritis, secondary glaucoma and post-herpetic neuralgia. Conclusion: A favorable outcome may be attained with surgery for complicated cataract associated with HZO if the condition is managed optimally and intraocular inflammation is well controlled. PMID:27413505

  17. Changes in intraocular pressure and anterior segment morphometry after uneventful phacoemulsification cataract surgery.

    Dooley, I

    2012-02-01

    PURPOSE: To study changes in anterior segment morphometry after uneventful phacoemulsification cataract surgery, and to investigate whether there is a relationship between any observed changes and intraocular pressure (IOP) reduction after the procedure. METHODS: The anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), central corneal thickness (CCT), and IOP were measured in 101 non-glaucomatous eyes before and after uneventful phacoemulsification cataract surgery. RESULTS: After cataract surgery, the mean ACD, ACV, and ACA values increased by 1.08 mm, 54.4 mm(3), and 13.1 degrees , respectively, and the mean IOP (corrected for CCT) decreased by 3.2 mm Hg. The predictive value of a previously described index (preoperative ACD\\/preoperative IOP (corrected for CCT) or CPD ratio) for IOP (corrected for CCT) reduction after cataract surgery was confirmed, reflected in an r(2) value of 23.3% between these two parameters (P<0.001). Other indices predictive of IOP reduction after cataract surgery were also identified, including preoperative IOP\\/preoperative ACV and preoperative IOP\\/preoperative ACA, reflected in r(2) values of 13.7 and 13.7%, respectively (P<0.001 and P<0.001, respectively). CONCLUSIONS: Our study confirms the predictive value of the CPD ratio for IOP reduction after cataract surgery, and may contribute to the decision-making process in patients with glaucoma or ocular hypertension. Furthermore, two novel indices of preoperative parameters that are predictive for IOP reduction after cataract surgery were identified, and enhance our understanding of the mechanisms underlying IOP changes after this procedure.

  18. REASONS FOR DELAYED UTILIZATION OF CATARACT SURGERY AMONG PATIENTS ATTENDING A TERTIARY REFERRAL CENTRE, MAHARASHTRA .

    Gadekar

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Cataract is a major cause of vision impairment in many low - income settings. Cataract blindness is a disease which has severe economic repercussions and adversely affects the productivity of country. However, despite rapid increase in the availability of quality services, surgical acceptance is still low in some segments of society. AIM : To study the various reasons for delayed utilization of cataract surgery. METHODS : In this cross sectional study 450 patients above 40 years of age who were admitted in ophthalmology ward for cataract surgery were enrolled by systematic random sampling technique. Socio - demographic data was collected by interviews in local language on predesigne d and semi struct ur ed proforma. The various reasons for delayed utilization of cataract surgery were asked to them. Statistical tests applied were chi square test and percentages. RESULTS : Majority of the study subjects were illiterate females above 60 yea rs of age belonging to lower socioeconomic status. Most of the study subjects were Hindus from rural area having unilateral blindness. The various reasons for delayed utilization of cataract surgery were economic problems (76.7%, ignorance by patient (29. 1%, fear of operation (26.4%, ignorance by head of family (22.4% and suspicion about improvement of vision after surgery (21.5%. Some subjects gave reasons as lack of accompanying person, fear of surgery causing death, lack of time, its God will and la ck of transport. CONCLUSION : The predominant reason for delayed utilization of cataract surgery was economic constraints. Other reasons were ignorance by patients and head of family, fear of operation and death, suspicion about improvement of vision, God’s will, lack of accompanying person and lack of transport

  19. The effect of health insurance reform on the number of cataract surgeries in Chongqing, China

    Yuan Rongdi

    2011-03-01

    Full Text Available Abstract Background Cataracts are the leading cause of blindness in China, and poverty is a major barrier to having cataract surgery. In 2003, the Chinese government began a series of new national health insurance reforms, including the New Cooperative Medical Scheme (NCMS and the Urban Resident Basic Health Insurance scheme (URBMI. These two programs, combined with the previously existing Urban Employee Basic Health Insurance (UEBMI program, aimed to make it easier for individuals to receive medical treatment. This study reports cataract surgery numbers in rural and urban populations and the proportion of these who had health insurance in Chongqing, China from 2003 to 2008. Methods The medical records of a consecutive case series, including 14,700 eyes of 13,262 patients who underwent age-related cataract surgery in eight hospitals in Chongqing from January 1, 2003, to December 31, 2008, were analysed retrospectively via multi-stage cluster sampling. Results In the past six years, the total number of cataract surgeries had increased each year as had the number of patients with insurance. Both the number of surgeries and the number of insured patients were much higher in the urban group than in the rural group. The rate of increase in the rural group however was much higher than in the urban group, especially in 2007 and 2008. The odds ratios of having health insurance for urban vs. rural individuals were relatively stable from 2003 to 2006, but it decreased in 2007 and was significantly lower in 2008. Conclusions Health insurance appears to be an important factor associated with increased cataract surgery in Chongqing, China. With the implementation of health insurance, the number of Chongqing's cataract surgeries was increased year by year.

  20. Comparison between Subjective Sensations during First and Second Phacoemulsification Eye Surgeries in Patients with Bilateral Cataract

    Ji-guo Yu

    2016-01-01

    Full Text Available Purpose. To evaluate and compare the subjective sensations reported by patients during first and second cataract extractions. Methods. Consecutive patients undergoing bilateral sequential cataract extraction using phacoemulsification were recruited. Following cataract surgery, patients completed questionnaires designed to evaluate subjective sensations, including anxiety, eye bulges, pain, and light sensitivity. Changes in painful sensations experienced by patients between the two surgeries were also recorded. Comparisons were also performed for each subjective sensation between different age groups (79 years. Results. A total of 127 patients were included in the final evaluation. Statistical comparison of the results showed that there were significant differences in perception of anxiety, eye bulges, and pain scores between the first and second cataract surgeries (P0.05 for all. Conclusions. Our research confirms the common observation that patients with bilateral cataracts often report more ocular discomfort during the second surgery. There are, therefore, additional factors that should be considered upon treating patients with bilateral cataracts, and the provision of preoperative counseling could play an important role in providing adequate patient care.

  1. Comparison between Subjective Sensations during First and Second Phacoemulsification Eye Surgeries in Patients with Bilateral Cataract

    Yu, Ji-guo; Ye, Ting; Huang, Qing; Feng, Yi-fan; Wang, Jue; Fu, Xun-an; Xiang, Yi

    2016-01-01

    Purpose. To evaluate and compare the subjective sensations reported by patients during first and second cataract extractions. Methods. Consecutive patients undergoing bilateral sequential cataract extraction using phacoemulsification were recruited. Following cataract surgery, patients completed questionnaires designed to evaluate subjective sensations, including anxiety, eye bulges, pain, and light sensitivity. Changes in painful sensations experienced by patients between the two surgeries were also recorded. Comparisons were also performed for each subjective sensation between different age groups (79 years). Results. A total of 127 patients were included in the final evaluation. Statistical comparison of the results showed that there were significant differences in perception of anxiety, eye bulges, and pain scores between the first and second cataract surgeries (P 0.05 for all). Conclusions. Our research confirms the common observation that patients with bilateral cataracts often report more ocular discomfort during the second surgery. There are, therefore, additional factors that should be considered upon treating patients with bilateral cataracts, and the provision of preoperative counseling could play an important role in providing adequate patient care. PMID:27239336

  2. Cataract surgery under topical anesthesia using 2% lignocaine jelly and intracameral lignocaine: Is manual small incision cataract surgery comparable to clear corneal phacoemulsification?

    Gupta, Sanjiv K; Kumar, Ajai; Agarwal, Swati

    2010-01-01

    A prospective comparative study was undertaken to compare the patients’ pain experience, surgical outcome and surgeon’s experience in phacoemulsification and manual small incision cataract surgery (MSICS) under topical anesthesia supplemented with intracameral lignocaine (TASIL). In Group 1 (n=88) phacoemulsification was done and in Group 2 (n=92) MSICS was done. Pain scores were marked by the patients on a Visual analog scale (VAS) after the surgery. The surgical experience was noted on a qu...

  3. Cataract surgery under topical anesthesia using 2% lignocaine jelly and intracameral lignocaine: Is manual small incision cataract surgery comparable to clear corneal phacoemulsification?

    Gupta Sanjiv; Kumar Ajai; Agarwal Swati

    2010-01-01

    A prospective comparative study was undertaken to compare the patients′ pain experience, surgical outcome and surgeon′s experience in phacoemulsification and manual small incision cataract surgery (MSICS) under topical anesthesia supplemented with intracameral lignocaine (TASIL). In Group 1 (n=88) phacoemulsification was done and in Group 2 (n=92) MSICS was done. Pain scores were marked by the patients on a Visual analog scale (VAS) after the surgery. The surgical experience was...

  4. Effect of fentanyl versus buprenorphine on the pupil size in phacoemulsification cataract surgery

    Abdolreza Najafi Anaraki; Abbas Akrami; Niloofar Motamed; Elham Seydali

    2012-01-01

    Background: Despite several recent innovations in phacoemulsification surgery, importance of pupil diameter in this surgery is becoming more evident. Purpose : To compare the effect of opioid agonist (fentanyl) versus opioid agonist-antagonist (buprenorphine) on pupil diameter in cataract surgery and to choose the best opioid in high-risk phacoemulsification surgery. Methods: In this randomized double-blinded clinical trial, 60 patients who were candidates for elective phacoemulsification sur...

  5. Adoption of intracameral antibiotic prophylaxis of endophthalmitis following cataract surgery: update on the ESCRS Endophthalmitis Study.

    Barry, Peter

    2014-01-01

    To determine the use of intracameral cefuroxime at the end of cataract surgery since the beneficial results were first reported by the European Society of Cataract and Refractive Surgeons Endophthalmitis Study Group in 2006, 250 ophthalmic surgeons affiliated with both public and private hospitals and clinics across Europe were surveyed. The questions regarded their awareness of the results of the ESCRS endophthalmitis study and their current use or non-use of intracameral antibiotics in their cataract procedures. Seventy-four percent of respondents said they always or usually use intracameral antibiotics in their cataract surgery procedures. The most frequently cited reasons for not using cefuroxime or other intracameral antibiotics was the lack of an approved commercial preparation and related anxieties regarding the risk of dilution errors and contamination. More than 90% of respondents said they would use cefuroxime if an approved single-unit dose product were commercially available.

  6. Cataracts

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  7. Mild toxic anterior segment syndrome mimicking delayed onset toxic anterior segment syndrome after cataract surgery

    Su-Na Lee

    2014-01-01

    Full Text Available Toxic anterior segment syndrome (TASS is an acute sterile postoperative anterior segment inflammation that may occur after anterior segment surgery. I report herein a case that developed mild TASS in one eye after bilateral uneventful cataract surgery, which was masked during early postoperative period under steroid eye drop and mimicking delayed onset TASS after switching to weaker steroid eye drop.

  8. [The value of methods for morphofunctional analysis of cornea in cataract surgery].

    Borodina, N B; Kobzova, M V; Musaeva, G M

    2011-01-01

    The characteristics of morphofunctional status of cornea after extracapsular cataract extraction and phakoemulsification with IOL implantation (30 and 58 operations respectively) were analyzed in detail using up-to-date diagnostic techniques. The results of examination using developed algorithm including study of light transmission, refraction and protective function of cornea show advantage of microinvasive ultrasound technique of cataract surgery in terms of minimal impact on corneal structure, optical and biomechanical characteristics. PMID:22165096

  9. Influence of cataract surgery and blood pressure changes caused by sodium restriction on retinal vascular diameter

    Takatoshi Tano

    2010-11-01

    Full Text Available Takatoshi Tano1, Yoshimune Hiratsuka2, Koichi Ono1, Akira Murakami11Department of Ophthalmology, Juntendo University School of Medicine, Tokyo; 2National Institute of Public Health, Tokyo, JapanPurpose: To investigate the impact of cataract surgery and blood pressure changes induced by one week of sodium restriction on retinal vascular diameter.Methods: Fundus photographs of 200 patients were obtained before and one week after cataract surgery. For one week after admission, 100 patients received sodium restriction and 100 patients (ie, the control group did not receive sodium restriction. The diameter of the retinal vessels and blood pressure were compared between the sodium restriction group and the control group. The vascular diameter was measured using an objective computer-based method.Results: Neither group had a significant change in the diameter of the retinal vessels after cataract surgery. Although there was no significant change in retinal arterial and venular diameter in the sodium restriction group, one-week sodium restriction significantly reduced mean blood pressure. However, multiple linear regression analyses indicated that an increase in retinal arteriolar diameter was significantly associated with diabetes, hyperlipidemia, and alcohol intake.Conclusion: Cataract surgery and blood pressure reduction induced by one week of sodium restriction resulted in no significant change in retinal arteriolar diameter.Keywords: cataract surgery, hypertension, retinal blood vessel diameter, retinal fundus camera, sodium restriction.

  10. Oxidative stress as a predictor of cataract surgery outcomes

    M. A. Kovalevskaya; N. V. Vedrintseva

    2015-01-01

    Exhaustion of anti-oxidative potential and oxidative stress are considered as trigger mechanisms of cataract development. Products of free radical oxidation are accumulated in lens. Decrease in water solubility of proteins results in the sorption of uncharged proteins on cellular membranes. This affects regular lenticular membrane folding. Light scattering on folded membranes of lenticular fibers is considered as a primary cause of lens opacities in cataract. Most problems occur in complicate...

  11. Cost-effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery

    Khan, Ashiya; Amitava, Abadan Khan; Rizvi, Syed Ali Raza; Siddiqui, Ziya; Kumari, Namita; Grover, Shivani

    2015-01-01

    Context: Cost-effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery. Aims: To compare the cost effectiveness of phacoemulsification (PE) versus manual small-incision cataract surgery (MSICS). Settings and Design: Prospective randomized controlled trial. Tertiary care hospital setting. Subjects and Methods: A total of 52 consenting patients with age-related cataracts, were prospectively recruited, and block r...

  12. Cost-effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery

    Ashiya Khan; Abadan Khan Amitava; Syed Ali Raza Rizvi; Ziya Siddiqui; Namita Kumari; Shivani Grover

    2015-01-01

    Context : Cost-effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery. Aims: To compare the cost effectiveness of phacoemulsification (PE) versus manual small-incision cataract surgery (MSICS). Settings and Design: Prospective randomized controlled trial. Tertiary care hospital setting. Subjects and Methods: A total of 52 consenting patients with age-related cataracts, were prospectively recruited, and block ...

  13. [The progress of studies on intraocular lens implantation in cataract with high myopia].

    Liu, Xue; Wan, Xiuhua

    2015-07-01

    With development of the technology of cataract surgery, combined phacoemulsification and intraocular lens implantation in cataract with high myopia has been widely carried out in clinical treatment. Due to the particularity of high myopia, phacoemulsification in patients with cataract and high myopia is difficult and has recently received a lot of attentions. In this paper, preoperative examinations, the selection of intraocular lenses, surgery methods and surgical complications of cataract surgery in patients with cataract and high myopia are briefly reviewed. PMID:26310259

  14. Combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery in cases with cataract and posterior segment diseases

    Yazici Ahmet

    2010-01-01

    Full Text Available Background: Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. Aim: To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery. Settings and Design: A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital. Materials and Methods: In this study, 28 eyes of 28 patients underwent combined 23-gauge transconjunctival sutureless vitrectomy and phacoemulsification and IOL implantation for cataract and various posterior segment diseases. The outcome measures included, visual acuity, intraocular pressure changes, and anatomical success were evaluated. Results: The mean follow-up was 4.8 months (range, 3-15 months. Mean overall preoperative visual acuity was 20/333, and final acuity was 20/95 (P < 0.001. Mean intraocular pressure (IOP on the preoperative and first postoperative day was 15.6 ± 7.5 and 13.8 ± 3.3 mmHg, respectively (P > 0.05. Three eyes (10.7% had postoperative hypotony (<6 mmHgthat all recovered spontaneously within the first postoperative week. Three eyes (10.7% required laser treatment for iatrogenic retinal tears. Anatomical success was obtained in all cases. No serious complications such as endophthalmitis were observed during the follow-up period. Conclusion: Combined transconjunctival sutureless vitrectomy and phacoemulsification was effective and safe in patients with significant lens opacities and vitreoretinal pathology. Although the anatomic and visual outcomes were satisfactory, the outcomes depended mainly on underlying vitreoretinal pathology.

  15. Manual suture less small incision cataract surgery in patients with uveitic cataract

    Rahul Bhargava

    2014-01-01

    Conclusion: SICS with posterior chamber intraocular lens implantation is safe in most cataracts due to uveitis and improves BCVA at 6 months. Inflammation should be well-controlled pre-operatively for at least 3 months. Posterior capsule opacification, macular edema and persistent uveitis were the main factors affecting visual outcome. SICS requires minimal instrumentation, surgical time is short and can also be performed in rural clinics and eye-camps, where phacoemulsification machines are unavailable. SICS may be a more practical and cost-effective technique for uveitic cataract, in such circumstances.

  16. Cataract Surgery in Elderly Patients: Impact on Life Quality and Functionality

    Armando Rafael Milanés Armengol

    2012-11-01

    Full Text Available Background: cataract surgery becomes highly valuable in our days because it acts on one of the leading causes of preventable blindness. Objective: To assess the impact of cataract surgery on the functionality and life quality of the elderly. Methods: case series study of all elderly patients who attended Ophthalmology Consultation at the Integral Diagnostic Center Mesones in Bolivar, Anzoategui State, Venezuela, from February to November 2007 for cataract surgery and who met the inclusion criteria. A survey and a set of assessment tools were applied in order to measure: functional status, siymptoms score and visual VF-14 function index which provided an assessment of life quality in two stages: in the preoperative stage and three months after surgery, thus allowing restoration of the various functions after surgery. Results: There was a significant improvement in visual acuity represented by a visual recovery of a 92%; according VF-14 index of visual function, life quality improved in a 92 %; general validism was recovered in 482 patients and 57 of them are considered to depend on other people for only one activity of their daily living, 6.1% of patients still present symptoms related to symptom score. Conclusions: patients who underwent cataract surgery showed evidence of improvement in visual acuity, functionality and life quality.

  17. IOL Implants: Lens Replacement and Cataract Surgery (Intraocular Lenses)

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  18. Postoperative Astigmatic Outcomes Based on the Haptic Axis of Intraocular Lenses Inserted in Cataract Surgery

    Kim, In-Tae; Park, Hae-Young Lopilly; Kim, Hyun-Seung

    2011-01-01

    Purpose This study was conducted to compare post-operative astigmatic outcomes of two groups, with-the-rule (WTR) and against-the-rule (ATR) astigmatism patients, according to the haptic axis of intraocular lenses (IOLs) inserted in cataract surgery. Methods Seventy-two eyes with WTR astigmatism and 79 eyes with ATR astigmatism had cataract surgery through a clear corneal temporal incision. These two groups of eyes were then each divided into 2 groups based on whether the haptic axis of the i...

  19. Acute pulmonary oedema due to single dose acetazolamide taken after cataract surgery.

    Guven Yilmaz, Suzan; Palamar, Melis; Gurgun, Cemil

    2016-01-01

    An increase in intraocular pressure following cataract surgery is very common. The main reason for this condition is viscoelastic agent remaining in the eye, which leads to mechanical obstruction of the trabecular meshwork. Prophylaxis with oral acetazolamide is frequently practised to prevent this early rise in intraocular pressure in the preoperative and postoperative periods. We report a case of an 81-year-old man with acute pulmonary oedema due to prophylactic acetazolamide intake after cataract surgery. The case is presented in order to draw attention to this serious complication. PMID:27170607

  20. Towards achieving small-incision cataract surgery 99.8% of the time.

    Thomas R

    2000-01-01

    Full Text Available A surgical approach designed to reliably attain the modern goal of small incision cataract surgery 99.8% of the time is described. Phacoemulsification as well as a manual small incision technique is utilised to achieve the desired outcome as often as possible and for all types of cataracts. The logic, and required surgical steps are described and illustrated. This surgical technique allows the advantages of small incision surgery to be reliably achieved. The method is flexible and allows decisions and steps to be modified depending on the skill and comfort zone of the individual surgeon.

  1. The Effect of Therapeutic Touch Performed During Cataract Surgery on Anxiety and Patient Satisfaction

    Emel Yılmaz; Zeliha Birer; Hakan Baydur

    2016-01-01

    Objective: The aim of the study was to determine the ef­fect of therapeutic touch (TT) on anxiety and patient satis­faction when performed during a cataract surgery. Methods: A randomized controlled trial sample consisted of 114 individuals, 57 in the intervention group and 57 controls, who were hospitalized for cataract surgery and who conformed to the study criteria. Prior to the study approval was obtained from the ethics committee and informed consent was given by the patients. Data wa...

  2. Towards achieving small-incision cataract surgery 99.8% of the time.

    Thomas, R; Kuriakose, T; George, R

    2000-06-01

    A surgical approach designed to reliably attain the modern goal of small incision cataract surgery 99.8% of the time is described. Phacoemulsification as well as a manual small incision technique is utilised to achieve the desired outcome as often as possible and for all types of cataracts. The logic, and required surgical steps are described and illustrated. This surgical technique allows the advantages of small incision surgery to be reliably achieved. The method is flexible and allows decisions and steps to be modified depending on the skill and comfort zone of the individual surgeon. PMID:11116514

  3. Comparative evaluation of aqueous and plasma concentration of topical moxifloxacin alone and with flurbiprofen in patients of cataract surgery

    Sujash Halder; Kanchan Kumar Mondal; Supreeti Biswas; Tapan Kumar Mandal; Bakul Kumar Dutta; Mithilesh Haldar

    2013-01-01

    Objectives: To determine the aqueous and plasma concentrations of moxifloxacin administered topically alone and with flurbiprofen in patients undergoing cataract surgery. Materials and Methods: A total of 50 subjects scheduled for routine cataract surgery were randomly allocated to two groups (n = 25 each). Group-1 patients were treated with topical moxifloxacin alone: One drop 6 times/day for 3 days before surgery and one drop 4 times on the day of surgery: Group-2 patients were treated ...

  4. Comparison of surgically induced astigmatism between one-handed and two-handed cataract surgery techniques

    Kawahara A

    2013-10-01

    Full Text Available Atsushi Kawahara,1 Daijiro Kurosaka,2 Akitoshi Yoshida31Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, 2Department of Ophthalmology, Iwate Medical University, Morioka, 3Department of Ophthalmology, Asahikawa Medical University, Asahikawa, JapanBackground: The purpose of this study was to compare surgically induced astigmatism (SIA between one-handed and two-handed cataract surgery techniques.Methods: Eighty-eight eyes of 44 patients with no ocular disease other than cataract, who underwent cataract surgery by a single surgeon, were selected for this study. Cataract surgery was performed by coaxial phacoemulsification and intraocular lens implantation via a 2.4 mm transconjunctival single-plane sclerocorneal incision at the 12 o'clock position. In each patient, one eye was subjected to coaxial phacoemulsification using a one-handed technique while the fellow eye was subjected to coaxial phacoemulsification using a two-handed technique. For the two-handed technique, a corneal side port was created at the 2 o'clock position. The appropriate incision meridian was identified by a preoperative axis mark. SIA was calculated using the Alpins method.Results: Mean SIA was 0.40 ± 0.28 diopters (D in the one-handed technique group and 0.39 ± 0.25 D in the two-handed technique group. No statistically significant difference was found in the mean SIA score. The mean torque value was −0.05 ± 0.26 D in the one-handed technique group and 0.11 ± 0.37 D in the two-handed technique group. Mean torque was significantly lower (P<0.05 in the one-handed technique group than in the two-handed technique group.Conclusion: The results indicate that the corneal side port in two-handed cataract surgery has a rotating effect on the axis of astigmatism.Keywords: cataract surgery, corneal side port, surgically induced astigmatism

  5. Optimal incision sites to reduce corneal aberration variations after small incision phacoemulsification cataract surgery

    Chu, Ling; Zhao, Jiang-Yue; Zhang, Jin-Song; Meng, Jie; Wang, Ming-Wu; Yang, Ya-Jing; Yu, Jia-Ming

    2016-01-01

    AIM To analyze the effect of steep meridian small incision phacoemulsification cataract surgery on anterior, posterior and total corneal wavefront aberration. METHODS Steep meridian small incision phacoemulsification cataract surgery was performed in age-related cataract patients which were divided into three groups according to the incision site: 12 o'clock, 9 o'clock and between 9 and 12 o'clock (BENT) incision groups. The preoperative and 3-month postoperative root mean square (RMS) values of anterior, posterior and total corneal wavefront aberration including coma, spherical aberration, and total higher-order aberrations (HOAs), were measured by Pentacam scheimpflug imaging. The mean preoperative and postoperative corneal wavefront aberrations were documented. RESULTS Total corneal aberration and total lower-order aberrations decreased significantly in three groups after operation. RMS value of total HOAs decreased significantly postoperatively in the 12 o'clock incision group (Pastigmatism changes in all three corneal incision location. CONCLUSION Corneal incision of phacoemulsification cataract surgery can affect corneal wavefront aberration. The 12 o'clock corneal incision eliminated more HOAs and the spherical aberrations decreased in BENT incision group obviously when we selected steep meridian small incision. Cataract lens replacement using wavefront-corrected intraocular lens combined with optimized corneal incision site would improve ocular aberration results. PMID:27162725

  6. Cataract surgery in India: Results of a 1995 survey of ophthalmologists

    Gupta A

    1998-01-01

    Full Text Available The aim of this study was to investigate cataract surgery procedures and caseloads among Indian ophthalmologists in private and government practices. Members of the All India Ophthalmological Society and state ophthalmic societies were surveyed by mail questionnaire in December 1995. Out of 6,800 surveyed, 2,098 responses (31% were received. Over 61% of the 990,249 reported cataract surgeries were carried out in private facilities with 24% of private patients receiving extracapsular cataract extraction (ECCE and 41% ECCE with intraocular lens (IOL. Intracapsular cataract extraction remains more common in government facilities with 62% of cases. Over 85% of all surgeons reported some experience with ECCE/IOL. Surgeons operating in both private and government facilities carry an average annual caseload of 861 cataract surgeries, which is twice that of their colleagues operating exclusively in either private or government settings. Although the questionnaire response rate was low, the findings suggest that ECCE is more common in India than is generally recognized, and with the recent availability of low-cost IOLs, its popularity is rapidly expanding.

  7. Induced astigmatism after cataract surgery - a retrospective analysis of cases from the University of Port Harcourt Teaching Hospital, Nigeria

    A. O. Adio

    2011-12-01

    Full Text Available Visual rehabilitation after cataract surgery may often be disappointing due to induction of corneal astigmatism following issues in realigning, point to point, the corneal wound margin in the process of surgery despite biometry and use of the appropriateintraocular lens. The purpose of this study is to determine the amount of surgically induced astigmatism after sutured cataract extraction-extracapsular cataract extraction (ECCE and intracapsular cataract extraction (ICCE and intraocular lens (IOLimplantation in the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. Folders of all cataract patients operated on in the eye theatre of the aforenamed tertiary facility between2002 and 2006 were considered.  Relevant patient details and intraoperative and postoperative management were examined and reported upon. One hundred and fourteen eyes (114 of one hundred patients who had cataract surgeries done within the five-year period of this study were examined. ECCE + IOL implantation were examined in the period under review. The post-operative refraction objectively and subjectively was retrieved from the records of each patient. The post-operative cylinderpower (total astigmatism was recorded.Of 114 eyes, only 83 eyes (72.8% had refraction results postoperatively due to loss of fol-low-up. The total number with astigmatism was 57(68.7%. Forty-two had against-the-rule (73.7%, twelve (21.1% with-the-rule, while five (0.09% were oblique. The mean post-operative astigmatism was 1.85 D. The surgically induced corneal astigmatism was highest with ECCE with PCIOL. Astigmatism less than 2 D was highest in this group (ECCE with IOL while ICCE with ACIOL had the highest number with astigmatism in the range between 2 D and 4 D. The total astigmatism which was mainly with-the-rule (vertical plus cylinder did not seem to impair severely the post-operative visual acuity of the patients.In conclusion, surgically induced astigmatism affected almost

  8. Effect of air bubble on inflammation after cataract surgery in rabbit eyes

    Goktug Demirci

    2013-01-01

    Full Text Available Purpose: Intense inflammation after cataract surgery can cause cystoid macular edema, posterior synechia and posterior capsule opacification. This experimental study was performed to investigate the effect of air bubble on inflammation when given to anterior chamber of rabbit eyes after cataract surgery. Materials and Methods: 30 eyes of 15 rabbits were enrolled in the study. One of the two eyes was in the study group and the other eye was in the control group. After surgery air bubble was given to the anterior chamber of the study group eye and balanced salt solution (BSS; Alcon was left in the anterior chamber of control eye. Results: On the first, second, fourth and fifth days, anterior chamber inflammations of the eyes were examined by biomicroscopy. On the sixth day anterior chamber fluid samples were taken for evaluation of nitric oxide levels as an inflammation marker. When the two groups were compared, in the air bubble group there was statistically less inflammation was seen. (1, 2, 4. days P = 0,001, and 5. day P = 0,009. Conclusions: These results have shown that when air bubble is left in anterior chamber of rabbits′ eyes after cataract surgery, it reduced inflammation. We believe that, air bubble in the anterior chamber may be more beneficial in the cataract surgery of especially pediatric age group, uveitis patients and diabetics where we see higher inflammation. However, greater and long termed experimental and clinical studies are necessary for more accurate findings.

  9. Role of socio-economic factors in cataract surgery utilization in JIPMER Pondicherry

    Prasanna T

    2007-01-01

    Full Text Available Background : This study was conducted in JIPMER & Kurusukuppam, Pondicherry. Objectives : To identify the socioeconomic factors influencing the utilization of cataract surgery & to identify the persons motivating the patients to utilize these services. This was a case-control study; cases were patients (age group 50-70 years who were operated in JIPMER for senile cataract without complications and one control was selected for each case. Controls were also of the same age group residing at Kurusukuppam with complaints of dimness of vision and who had not undergone cataract surgery, selected by random sampling. Both the groups were interviewed using a pretested interview schedule. Results : Subjects who were literate and with high school education and more and with income more than Rs.1050 (class III utilized the cataract surgery services more. In majority of cases, motivation for getting operated comes from relatives. Peer groups who have undergone the surgery before, were the predominant sources of health information about the surgery. Higher income & higher education affect the utilization significantly. Relatives & Previously operated peers play an important role.

  10. Anesthetic management of cardiac patient for cataract surgery

    We are reporting the successful anesthetic management of a 6 years old child, who had cyanotic congenital heart disease and underwent an operation for cataract extraction. Ketamine was used for the induction and maintenance of anesthesia. Ventilation was assisted manually by using laryngeal masks. (author)

  11. Femtosecond laser combined with non-chopping rotation phacoemulsification technique for soft-nucleus cataract surgery: a prospective study.

    Chen, Hui; Lin, Haotian; Chen, Wan; Zhang, Bo; Xiang, Wu; Li, Jing; Chen, Weirong; Liu, Yizhi

    2016-01-01

    Soft-lens cataract surgeries are becoming increasingly common for cataract surgeons and chopping the soft nucleus using conventional techniques is problematic. We introduced a femtosecond laser combined with a non-chopping rotation phacoemulsification technique for soft-nucleus cataract surgery and evaluated the safety and efficacy of using this technique. Sixty-six patients with soft-nucleus cataracts ranging from grade 1~3 were divided into 3 groups based on nuclear staging. Those groups were further divided into three subgroups: femtosecond laser pretreatment combined with a non-chopping rotation phacoemulsification technique (subgroup 1), conventional manual cataract surgery with a non-chopping rotation technique (subgroup 2) and conventional manual cataract surgery with a quick-chop technique (subgroup 3).Patients were followed up at 1, 7, and 30 days after surgery. There was an 84.6% and a 63.34% reduction in ultrasound time and cumulative dissipated energy, respectively, between the subgroup 1 and the subgroup 3; and this was associated with a 36.1% and 29.7% reduction in endothelial cell loss and aqueous flare. There were no adverse events at the follow-up times. With its reduced ultrasound energy, endothelial cell loss and aqueous flare, the femtosecond laser pretreatment combined with a non-chopping rotation technique was more efficient than conventional manual cataract surgery for soft-nucleus cataracts. PMID:26728573

  12. Time-trend and variations in the proportion of second-eye cataract surgery

    Bernal-Delgado Enrique

    2007-04-01

    Full Text Available Abstract Background Despite recommendations for greater use of second-eye cataract surgery and the bilateral progression of the disease, there is a substantial proportion of unmet need for this treatment. Few studies have explored the factors associated with second-eye cataract surgery utilisation. The objective of our study was to estimate the proportion of second-eye cataract surgery, evaluate its time-trend, and explore differences in utilisation by patients' gender, age, and region of residence. Methods All senile cataract surgeries performed between 1999 and 2002 in the public health system of Catalonia (Spain were obtained from the Minimum Data Set. The proportion of second-eye surgery from November 2000 to December 2002 was calculated. The time-trend of this proportion was characterised through linear regression models with the logarithmic transformation of time. Results The proportion of second-eye surgery was 30.0% and showed an increasing trend from 24.8% (95% Confidence Interval [CI] 21.6; 26.1 in November 2000 to 31.8% (95% CI 31.4; 33.6 in December 2002. This proportion was 1.9% (95% CI 0.9; 2.9 higher in women (p Conclusion We predict greater utilization of second-eye surgery in patients aged 70 to 79 years and in women. A greater increase in the utilisation rates of second-eye surgery is expected in the regions with lower proportions and in older patients. The observed trend suggests that there will be a substantial proportion of unmet need for bilateral surgery.

  13. BARRIERS RESPONSIBLE FOR DELAYED UTILIZATION OF CATARACT SURGERY: AN EYE CAMP STUDY FROM CENTRAL INDIA

    Umesh

    2014-03-01

    Full Text Available INTRODUCTION: Blindness is one of the significant social problems in India with 7 million of the total 45 million blind people in the world residing in our country. Apart from health and status of vision, there are many other socio-economic factors and perceptions, which influence the decision making of the people for getting operated for cataract. But very few studies have been done on the social factors influencing the utilization of cataract surgery. MATERIAL AND METHODS: It was a hospital-based, descriptive study. The study subjects were recruited from the Ophthalmology department from cataract camp held in Chirayu medical College, Hospital during October 2013 to January 2014. RESULTS: In present study, insufficient family income and no one to accompany (60% and 10% was responded by majority of the subjects. In present study, the barriers for delayed utilization of cataract surgery like could manage to do daily work was responded by 513 (85.5% out of total 600 subjects, could see with the other eye clearly 470 (78.3%, busy with work 118 (19.6%, being female70 (11.6%, fear of surgery 115 (19.1%, old age 200 (33.3%, fear that surgery could lead to loss of eyesight 55 (9.1%, it was Gods will 35 (5.8%, fear about the cost of surgery 375 (62.5% and fear that surgery could lead to death was responded by 15 (2.5% out of total 600 subjects. CONCLUSION: Expansion of outreach programmes to different communities rather than concentrate in urban areas, and offering cataract surgical services at affordable rates will also be of help. Health Education has a great role to play as well, especially in creating awareness. Adequate dissemination of information through various media is usually will be very helpful

  14. Cataract prevalence and prevention in Europe: a literature review

    Prokofyeva, Elena; Wegener, Alfred; Zrenner, Eberhart

    2012-01-01

    This literature review is aimed at the evaluation of the potential for cataract prevention in Europe. It was performed using Pub-MED with Mesh and free text terms. Studies included were: a) performed on a population of Caucasian origin at an age range of 40-95 years, b) cataract was clinically verified, c) drug record of prescriptions, their indication, a record of every diagnosis, dosage, and quantity of prescribed medicine were available, d) sample size >300, e) published between 1990 and 2...

  15. Comparing different fentanyl concentrations added to local anesthetic mixture in peribulbar block for cataract surgery

    Inas Kamel

    2016-04-01

    Conclusion: Adding Fentanyl at concentrations ⩾ 2–3 μg/ml to the local anesthetic mixture (Lidocaine and Hyaluronidase for regional peribulbar block provides safe and effective method in improving postoperative analgesia in patients undergoing cataract surgery.

  16. Addition of hyaluronidase to lignocaine with adrenaline for retrobulbar anaesthesia in the surgery of senile cataract.

    Thomson, I.

    1988-01-01

    A double-blind trial demonstrates the effectiveness of adding hyaluronidase to lignocaine with adrenaline in producing ocular akinesia and anaesthesia in retrobulbar nerve blocks. 92% of the blocks in which hyaluronidase was used for intracapsular cataract surgery were judged successful compared with 56% of those without added hyaluronidase (p less than 0.01).

  17. COMPARISON OF SURGICALLY INDUCED ASTIGMATISM WITH SMALL INCISION CATARACT SURGERY AND PHACOEMULSIFICATION

    Umesh; Shivanand; Smitha; Arvind L.; Kshama; Anju; Kathyayini; Abhinav,

    2015-01-01

    BACKGROUND: Surgically induced astigmatism is the cause of poor postoperative vision even after uneventful cataract surgery. AIM: The aim of the study was to compare the effect of surgically induced astigmatism in SICS and Phacoemulsification after taking the incision in the steepest meridian. SETTING: KLE Hospital, Belagavi, Karnataka. DESIGN: Lon...

  18. Cataract surgery and the risk of aging macula disorder: The Rotterdam study

    L. Ho (Lintje); S. Boekhoorn (Sharmila); A. Liana (Alin); P. Tikka-Kleemola (Päivi); A.G. Uitterlinden (André); A. Hofman (Albert); P.T.V.M. de Jong (Paulus); Th. Stijnen (Theo); J.R. Vingerling (Hans)

    2008-01-01

    textabstractPURPOSE. To investigate still-controversial associations between prior cataract surgery and aging macula disorder (AMD) in a general population. METHODS. Baseline lens status and risk of incident AMD (iAMD) were examined in participants of the prospective population-based Rotterdam Study

  19. Outcomes of cataract surgery in a rural and urban south Indian population

    Vijaya, Lingam; George, Ronnie; A, Rashima; Raju, Prema; Arvind, Hemamalini; Baskaran, Mani; Ve, Ramesh S

    2010-01-01

    Purpose: To assess the visual outcome after cataract surgery in a south Indian population. Materials and Methods: Population-based cross-sectional study of subjects aged 40 years or more. Three thousand nine hundred and twenty-four rural subjects from 27 contiguous villages and 3850 urban subjects from five randomly selected divisions were studied. All subjects underwent a comprehensive ophthalmic examination that included visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated retinal examination. Statistical Analysis: Chi square test, t test and multivariate analysis were used. Results: Five hundred and twenty-eight (216 males, 312 females, 781 eyes) rural subjects (13.5%, 95% confidence interval (CI) 12.4% to 14.6%) and 406 (197 males, 209 females, 604 eyes) urban subjects (10.5%, 95% CI 9.6-11.5%) had undergone cataract surgery. Outcome of cataract surgery was defined based on visual acuity. Using best-corrected visual acuity for classification, the single most important cause for visual impairment was cystoid macular edema in the aphakic group and posterior capsule opacification in the pseudophakic group. Aphakia (visual acuity of visual acuity of visual acuity of visual acuity of visual impairment. The urban cataract-operated population had significantly more pseudophakics (P visual impairment. Conclusions: Surgery-related complications were major causes for visual acuity of <20/60. PMID:20413926

  20. Three cases of post-cataract surgery endophthalmitis due to Rhizobium (Agrobacterium) radiobacter.

    Moreau-Gaudry, Viviane; Chiquet, Christophe; Boisset, Sandrine; Croize, Jacques; Benito, Yvonne; Cornut, Pierre Loïc; Bron, Alain; Vandenesch, François; Maurin, Max

    2012-04-01

    We present three unrelated post-cataract surgery endophthalmitis cases caused by Rhizobium radiobacter, hospitalized in three different hospitals. Early diagnosis was obtained in two cases by bacterial DNA detection in vitreous samples. All patients recovered from infection, but pars plana vitrectomy was needed in two patients due to rapid clinical deterioration. PMID:22259203

  1. A novel index for predicting intraocular pressure reduction following cataract surgery

    Issa, S A; Pacheco, J.; Mahmood, U; Nolan, J; Beatty, S

    2005-01-01

    Aim: The results of a study designed to investigate the predictive value of preoperative anterior chamber depth (ACD) and intraocular pressure (IOP) are reported. The relation between these factors and their effect on the reduction in IOP following phacoemulsification cataract surgery was also studied.

  2. Experimental studies on the usage possibilities of the holmium laser in cataract surgery

    Kecik, Tadeusz; Kecik, Dariusz; Kasprzak, Jan; Pratnicki, Antoni; Jankiewicz, Zdzislaw; Zajac, Andrzej

    1996-03-01

    The authors present initial investigations of used holmium laser during experimental cataract surgery. The investigations were performed 'in vitro' and 'in vivo.' The presented results of the experiments show that structure of the lens can be emulsified with the use of the holmium laser.

  3. Two episodes of anaphylaxis following exposure to hydroxypropyl methylcellulose during cataract surgery

    Munk, Sofie J; Heegaard, Steffen; Mosbech, Holger;

    2013-01-01

    UNLABELLED: We report a case of immediate severe anaphylaxis to hydroxypropyl methylcellulose (HPMC) on 2 separate occasions during cataract surgery in a 71-year-old patient. Skin prick tests were positive for HPMC, a constituent of Ocucoat and Xylocaine gel, which were administered intraocularly...

  4. Nuclear management in manual small incision cataract surgery by snare technique

    Bhattacharya Debasish

    2009-01-01

    Full Text Available Manual small incision cataract surgery has evolved into a popular method of cataract surgery in India. However, in supra hard cataract, bringing out the whole nucleus through the sclerocorneal flap valve incision becomes difficult. A bigger incision required in such cataracts loses its value action, as the internal incision and corneal valve slips beyond the limbus into sclera. Struggling with the supra hard cataracts through a regular small incision. Phacofracture in the anterior chamber becomes a useful option in these cases. In the snare technique, a stainless steel wire loop when lassoed around the nucleus in the anterior chamber constricts from the equator, easily dividing the hardest of the nuclei into two halves. The wire loop constricts in a controlled way when the second cannula of snare is pulled. The divided halves can easily be brought out by serrated crocodile forceps. This nuclear management can be safely performed through a smaller sclerocorneal flap valve incision where the corneal valve action is retained within the limbus without sutures, and the endothelium or the incision is not disturbed. However, the technique requires space in the anterior chamber to maneuver the wire loop and anterior chamber depth more than 2.5 mm is recommended. Much evidence to this wonderful technique is not available in literature, as its popularity grew through live surgical workshops and small interactive conferences.

  5. [The pros and cons of femtosecond laser-assisted cataract surgery].

    Li, Z H; Ye, Z

    2016-02-11

    Femtosecond laser-assisted cataract surgery (FLACS) is known as an innovative new technology. Compared with traditional surgical approach, FLACS is more accurate, more predictable and less energy used. However, in the current stage of development, there still may be intraoperative and postoperative complications, or even serious complications. FLACS has obvious advantages in certain surgical steps, but there are still clear disadvantages, so it still cannot completely replace the traditional phacoemulsification surgery. (Chin J Ophthalmol, 2016, 52: 89-92). PMID:26906702

  6. Etiopathogenesis of cataract: An appraisal

    Gupta, Varun B; Manjusha Rajagopala; Basavaiah Ravishankar

    2014-01-01

    Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise...

  7. A Comparative Study of Surgically Induced Astigmatism in Superior and Temporal Scleral Incision in Manual Small Incision Cataract Surgery

    Renu M Magdum; Abha Gahlot; Rupali D.Maheshgauri; Khevna Patel

    2012-01-01

    Aim: To evaluate the amount and type of surgically induced astigmatism in superior and temporal scleral incision in Manual Small Incision Cataract Surgery (MSICS). Material and Methods: A prospective randomized comparative study was carried out in 100 cases of senile or pre-senile cataract. All the patients underwent MSICS under peribulbar anaesthesia. The patients with very hard cataract were excluded so as to keep the incision size uniformity (6-6.5mm). 50 cases received superior scleral in...

  8. Relation between postoperative blood-aqueous barrier damage and LOCS III cataract gradings following routine phacoemulsification surgery

    Ursell, P; Spalton, D; Tilling, K

    1997-01-01

    AIM—To examine the relation between cataract density, the phacoemulsification energy required for its removal, and blood-aqueous barrier (BAB) damage on the first day after surgery.
METHODS—A prospective study recruiting patients with normal eyes apart from senile cataract. Preoperatively, visual acuity, anterior chamber laser flare, and cell values were measured using the Kowa laser flare meter, and the LOCS III grading of the cataract defined. The patients all underwent standardised phacoem...

  9. Equal access, (Un)equal uptake: a longitudinal study of cataract surgery uptake in older people in England

    Whillans, Jennifer; Nazroo, James

    2014-01-01

    Background Uptake of cataract removal is a function of the effectiveness of the healthcare delivery services: services that are inaccessible, inappropriate, or unaffordable will not be utilised by (sub)populations, who consequently live with untreated cataracts. The aim of the study was to identify the relationship between individual wealth inequalities and uptake of cataract surgery in England, having controlled for the effects of potentially confounding variables. Methods The final sample c...

  10. Causes of subnormal vision in patients following cataract surgery at a tertiary hospital in Kashmir.

    Ahangar, Andleeb; Sufi, Aalia Rasool; Nabi, Mushood; Rather, Muddasar Hassan

    2014-10-01

    Cataract surgery is aimed at restoring sight to near normal vision. This study, conducted at the Department of Ophthalmology, Government Medical College, Srinagar, is an attempt to determine the causes of subnormal vision in patients following cataract surgery at a tertiary hospital in Kashmir. One hundred patients who underwent cataract surgery with an unaided visual acuity of <6/9 at 16 weeks postoperatively were included in the study. Postoperative follow-up examinations were conducted until the 16th week. Intraoperative and postoperative complications were recorded to determine the cause of subnormal vision. Of 100 patients, 40 underwent extracapsular cataract extraction (ECCE), 30 underwent small incision cataract surgery (SICS) and 30 underwent phacoemulsification. Seventy-five percent of the patients who underwent ECCE had postoperative astigmatism with a mean astigmatism of 2.2 ± 0.81 diopters at 16 weeks, with the majority having with-the-rule astigmatism. In the SICS group, 17 (56.6 %) patients had a mean postoperative astigmatism of 0.75 ± 0.40 diopters, with the majority (82.3 %) having against-the-rule (ATR) astigmatism. In the phacoemulsification group, 13 (43.3 %) of the patients had a mean postoperative astigmatism of 0.48 ± 0.23 diopters with the majority having ATR astigmatism. Other causes of subnormal vision were pseudophakic ametropia, posterior capsular opacity and intraoperative complications like posterior capsular rent and vitreous loss. Postoperative astigmatism was the major cause of subnormal vision with greater astigmatism seen in the ECCE group. Therefore, procedures like smaller incision sutureless surgery and careful biometry are advocated to improve visual outcome and patient satisfaction. PMID:24522881

  11. Modern cataract surgery in a highly myopic population.

    Gross, K A; Pearce, J L

    1987-01-01

    A retrospective series of 117 highly myopic eyes with extracapsular cataract extractions and posterior chamber lens implants is presented. The results are analysed with reference to the current understanding of the complications anticipated. Of particular note is the use of low-powered posteriorly vaulted posterior chamber implants, with and without primary posterior capsulotomy. The results show a low retinal detachment rate (one eye, mean follow-up 12 months); low induced astigmatism (avera...

  12. αA crystallin may protect against geographic atrophy-meta-analysis of cataract vs. cataract surgery for geographic atrophy and experimental studies.

    Peng Zhou

    Full Text Available BACKGROUND: Cataract and geographic atrophy (GA, also called advanced "dry" age-related macular degeneration are the two major causes of visual impairment in the developed world. The association between cataract surgery and the development of GA was controversial in previous studies. METHODS/PRINCIPAL FINDINGS: We performed a meta-analysis by pooling the current evidence in literature and found that cataract is associated with an increased risk of geographic atrophy with a summary odds ratio (OR of 3.75 (95% CI: 95% CI: 1.84-7.62. However, cataract surgery is not associated with the risk of geographic atrophy (polled OR=3.23, 95% CI: 0.63-16.47. Further experiments were performed to analyze how the αA-crystallin, the major component of the lens, influences the development of GA in a mouse model. We found that theαA-crystallin mRNA and protein expression increased after oxidative stress induced by NaIO(3 in immunohistochemistry of retinal section and western blot of posterior eyecups. Both functional and histopathological evidence confirmed that GA is more severe in αA-crystallin knockout mice compared to wild-type mice. CONCLUSIONS: Therefore, αA-crystallin may protect against geographic atrophy. This study provides a better understanding of the relationship between cataract, cataract surgery, and GA.

  13. Ocular coherence tomography of symptomatic phototoxic retinopathy after cataract surgery: a case report

    Yunis Muhammad H

    2011-04-01

    Full Text Available Abstract Introduction High-resolution ocular coherence computed tomography enables unprecedented visualization of the retinal microarchitecture. To the best of our knowledge, this is the first report of high-resolution ocular coherence tomography findings in the healed form of photic post-cataract retinopathy. Case presentation A 76-year-old Caucasian man complained of paracentral scotoma, persisting for six weeks after cataract surgery. Conclusion Ocular coherence tomography demonstrated a localized juxta-foveal area of retinal atrophy involving the photoreceptor layer, and the retinal pigment epithelium layer.

  14. Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time

    Kohji Nishida

    2008-10-01

    Full Text Available Masahiko Shimura1, Toru Nakazawa2, Kanako Yasuda1, Takashi Shiono3, Kohji Nishida21Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Japan; 2Department of Ophthalmology and Visual Science, Tohoku University Graduate School of Medicine, Sendai, Japan; 3Department of Ophthalmology, Shiono Eye Center, Sendai, JapanPurpose: This study compares the effect of topical diclofenac with that of betamethasone against postoperative increase of intraocular pressure (IOP after cataract surgery in normal patients, and also investigated the risk factors for postoperative increase of IOP in each group.Methods: Fifty consecutive patients without systemic disease who have bilateral and symmetrical cataracts underwent uncomplicated cataract surgery in both eyes (100 eyes in total. Postoperatively, topical diclofenac was applied 4 times daily to one eye, and topical betamethasone to the other eye in each patient. IOP and best corrected logMAR visual acuity (BCVA in each eye were measured up to 8 weeks. Total surgery time and effective phacoemulsification time (EPT for each case was recorded.Results: BCVA in both diclofenac- and betamethasone-treated eyes significantly improved after the cataract surgery; however, no statistical difference in VA was noted between the diclofenac- and betamethasone-treated eyes throughout the observation period. IOP in the diclofenac-treated eyes decreased with time, in contrast to the IOP in the betamethasone-treated eyes, which showed a slight increase. At 4 and 8 weeks postoperatively, there was significant difference between these two eye groups. Multiple regression analysis revealed that postoperative increase in IOP at 8 weeks in the betamethasone-treated eyes was closely correlated with total surgery time and EPT, but the IOP in the diclofenac-treated eyes showed no correlation with any surgical or clinical parameters.Conclusions: Postoperative increase in IOP after cataract surgery was affected by total

  15. EVALUATION OF VISUAL OUTCOME AFTER CATARACT EVALUATION OF VISUAL OUTCOME AFTER CATARACT SURGERY IN CAMP PATIENTS - A STUDY FROM CENTRAL INDIA

    Madhu

    2014-02-01

    Full Text Available BACKGROUND : Cataract is the leading cause of avoidable blindness in India. Around 4 million people become blind each year because of cataract. AIM : To assess the visual outcome and complications associated with cataract surgery in camp patients operated at a Medical College tertiary hospital. MATERIALS AND METHODS : It was a retrospective study where 412 camp patients underwent posterior chamber intrao cular lens implantation surgery over a period of one year. Data was compiled based on demographic characteristics , and post - operative complications. It was graded as per Oxford Cataract Treatment and Evaluation Team (OCTET definitions on first post - operat ive day. After one month post - operative complications , best corrected visual acuity and refractive errors were also analyzed. RESULTS : 412 eyes underwent cataract surgery with posterior chamber intraocular lens implantation . The maximum patients were in th e age group of 60 - 69 years , 180 (43.6% patients. , Among these patients 240 were males (58.2 % and 172 were females (41.7 %. Small incision cataract surgery (SICS with intraocular lens implant was the commonest surgical method (80% used. 792 eyes of 41 2 patients had cataract , of which 596 had the cortical type (75.3 % and 196 had the nuclear type (24.7 %. Of the cortical type , 428 were immature and 168 were mature cataracts Based on OCTET grading , the most common first post - operative day complication was mild iridocyclitis (26.2% followed by transient corneal edema in 86 patients. The major post - operative complications after 4 weeks of cataract surgery were pigments on PCIOL in 18 (4.36% cases and capsular flap in 12 cases. After 4 weeks post - operati ve best corrected visual acuity of eye 6/18 in 89.8% cases. The commonest refractive error was Myopia with against the rule astigmatism seen in 172 out of 300 patients. CONCLUSION : Acceptable results can be obtained from eye camp surgery patients with expe rienced

  16. Topical diclofenac sodium for treatment of postoperative inflammation in cataract surgery

    Reddy Manjoo

    2000-01-01

    Full Text Available Purpose: To study the effect of a topical non-steroidal anti-inflammatory drug as an alternative to topical steroids for postoperative control of inflammation in cataract surgery. Methods: The effect of diclofenac sodium 0.1% following cataract surgery was studied and compared to routine corticosteroid, dexamethasone phosphate 1% in a prospective, double-blind randomized study. Both groups were similar in baseline parameters. Postoperative inflammatory response, intraocular pressure and best-corrected visual acuity following standard extracapsular cataract extraction were assessed in both groups in the initial 21 days and the severity of these parameters was graded. The severity of postoperative inflammatory response to the two drugs was graded at 1, 3, 7, 14 and 21 days. Intraocular pressure and visual acuity at baseline and endpoint were compared and statistically analyzed. Results: The two groups did not differ statistically in treatment effect for any of the variables including aqueous cells, flare, ciliary congestion, Descemet′s folds, visual acuity and intraocular pressure (p< 0.001. However there seemed to be a trend towards quicker improvement with corticosteroid when cells in the anterior chamber were considered. There were no side effects from topical diclofenac, and it was well tolerated. Conclusion: Dicfofenac sodium is as effective as topical corticosteroid and can be used as an alternative in routine postoperative treatment following uncomplicated cataract surgery.

  17. Effect of Corneal Incision Enlargement on Surgically Induced Astigmatism in Biaxial Microincision Cataract Surgery

    Mehmet Tetikoğlu

    2016-06-01

    Full Text Available Objectives: To evaluate surgically induced astigmatism (SIA in biaxial microincision cataract surgery with enlargement of one corneal incision during intraocular lens implantation (IOL. Materials and Methods: Data from 683 eyes with cataract that underwent biaxial microincision cataract surgery and IOL were retrospectively analyzed. The operated eyes were divided into 4 groups defined by final corneal incision length after IOL implantation. There were 83 eyes with 1.6 mm corneal incisions (group 1 and 200 eyes in each of the 2, 2.4, and 2.8 mm corneal incision groups (groups 2, 3 and 4, respectively. SIA was assessed using preoperative and postoperative keratometric values at one month. Results: The mean magnitude of SIA was 0.83±0.4 D in group 1, 0.93±0.5 D in group 2, 1.03±0.6 D in group 3 and 1.04±0.7 D in group 4. The SIA showed statistically significant differences between the four groups (p=0.05. Pairwise group comparisons revealed significant differences between groups 1 and 3 and groups 1 and 4 (p=0.005. Conclusion: Biaxial microincision cataract surgery with an incision size of 1.6 mm resulted in the least SIA. Enlargement of the corneal incision beyond 2.0 mm during IOL implantation led to significant increases in SIA. We believe that with the development and dissemination of IOLs which can be inserted through small corneal incisions, biaxial microincision cataract surgery will be the best choice to prevent SIA and increase visual acuity

  18. The laparotomy incision: a technique to facilitate capsulorhexis in microincision cataract surgery.

    O'Connor, Jeremy C; O'Connell, Eamon D; Sciscio, Andrea; Mulhern, Mark G

    2008-01-01

    Microincision cataract surgery is a new technique in the development of cataract surgery and is not without difficulties. Creation of the continuous curvilinear capsulorhexis as performed in conventional coaxial phacoemulsification surgery does not apply as readily. The authors describe a method for initiating the continuous curvilinear capsulorhexis (the laparotomy incision) using only an inexpensive 25-gauge bent needle cystototome. The technique involves a long linear incision in the anterior capsule down the belly of the lens as a means of initiating the capsulorhexis. Advantages of the technique include the creation of a large capsular flap, which allows easier completion of the continuous curvilinear capsulorhexis through a smaller range of movement, avoiding "oar locking" in the small incision and creation of striae in the cornea. It also allows better maintenance of anterior chamber depth, minimizing risk of radial tears. PMID:19065989

  19. Cataract surgery in a population-based cohort of patients with type 1 diabetes

    Grauslund, Jakob; Green, Anders; Sjølie, Anne K

    2011-01-01

    ABSTRACT. Purpose: To estimate the long-term cumulative incidence of cataract surgery and associated risk factors in a 25-year follow-up of a population-based cohort of patients with type 1 diabetes. Methods: Based on insulin prescriptions, a population-based cohort of 727 patients with type 1...... surgery was evaluated during follow-up. Results: The 25-year crude cumulative incidence of cataract surgery was 20.8% (117 of 562 patients at risk), corresponding to a mortality-adjusted incidence of 29.4% [95% confidence interval (CI) 25.6-33.1%]. Median age and duration of diabetes at the time of...... surgery were 59.3 and 42 years, respectively. Cataract surgery in the cohort took place approximately 20 years earlier compared to non-diabetic persons. In a multivariate regression analysis, baseline age [hazard ratio (HR) 1.89 per 10 years, 95% CI 1.46-2.27] and maculopathy (HR 1.89, 95% CI 1...

  20. The distribution of cataract surgery services in a public health eye care program in Nepal.

    Marseille, E; Brand, R

    1997-11-01

    The cost-effectiveness of public health cataract programs in low-income countries has been well documented. Equity, another important dimension of program quality which has received less attention is analyzed here by comparisons of surgical coverage rates for major sub-groups within the intended beneficiary population of the Nepal blindness program (NBP). Substantial differences in surgical coverage were found between males and females and between different age groups of the same gender. Among the cataract blind, the surgical coverage of males was 70% higher than that of females. For both genders, the cataract blind over 55 received proportionately fewer services than younger people blind from cataract. Blind males aged 45-54 had a 500% higher rate of surgical coverage than blind males over 65. Blind females aged 35-44 had nearly a 600% higher rate of surgical coverage than blind females over 65. There was wide variation in overall surgical coverage between geographic zones, but little variation by terrain type, an indicator of the logistical difficulties in delivery of services. Members of the two highest caste groupings had somewhat lower surgical coverage than members of lower castes. Program managers should consider developing methods to increase services to women and to those over 65. Reaching these populations will become increasingly important as those most readily served receive surgery and members of the under-served groups form a growing portion of the remaining cataract backlog. PMID:10175620

  1. Risk of Cataract Surgery in HIV-Infected Individuals: A Danish Nationwide Population-Based Cohort Study

    Rasmussen, Line D; Kessel, Line; Molander, Laleh D;

    2011-01-01

    cataract surgery were obtained from the Danish National Hospital registry. Cumulative incidence curves were constructed. Incidence rate ratios (IRRs) and impact of immunodeficiency, highly active antiretroviral therapy (HAART), and treatment with abacavir, tenofovir, protease inhibitors, and nonnucleoside...

  2. Visual outcome of cataract surgery with pupillary sphincterotomy in eyes with coexisting corneal opacity

    Vajpayee Rasik B

    2004-04-01

    Full Text Available Abstract Background To evaluate the visual outcome following cataract surgery with pupillary sphincterotomy in eyes with coexisting corneal opacity. Methods Patients with leucomatous corneal opacity with significant cataract were enrolled for the study. The uncorrected visual acuity and best-corrected visual acuity (BCVA were recorded and the anterior segment was thoroughly evaluated by a slit lamp biomicroscope before the surgery. Only those patients who had some amount of clear peripheral cornea were selected. Posterior segment pathology was ruled out by indirect ophthalmoscopy after pupillary dilatation, if possible, or by B-scan ultrasonography. Conventional extracapsular cataract extraction with pupillary sphincterotomy was performed and an intraocular lens was implanted. Postoperatively, the eyes were evaluated on day 1, and 1 week and 6 weeks following surgery for similar parameters. Results Fourteen eyes of 14 patients were included in the study, of which 13 (92.85% patients were male. The mean age of the patients was 47.85 ± 7.37 years. All the eyes had a dense central leucomatous corneal opacity. Twelve (85.71% eyes had two or more quadrants of deep vascularisation. Sphincterotomy was performed mostly (71.42% in the nasal or inferonasal quadrant. The intraocular lens was implanted in 13 (92.85% eyes, and one (7.1% eye was left aphakic due to the occurrence of a large posterior capsular tear. Preoperatively, all eyes had BCVA Conclusions Extracapsular cataract extraction and intraocular lens implantation with pupillary sphincterotomy provides ambulatory and useful vision to patients of cataract with coexisting central leucomatous corneal opacity.

  3. Preoperative automatic visual behavioural analysis as a tool for intraocular lens choice in cataract surgery

    Heloisa Neumann Nogueira

    2015-04-01

    Full Text Available Purpose: Cataract is the main cause of blindness, affecting 18 million people worldwide, with the highest incidence in the population above 50 years of age. Low visual acuity caused by cataract may have a negative impact on patient quality of life. The current treatment is surgery in order to replace the natural lens with an artificial intraocular lens (IOL, which can be mono- or multifocal. However, due to potential side effects, IOLs must be carefully chosen to ensure higher patient satisfaction. Thus, studies on the visual behavior of these patients may be an important tool to determine the best type of IOL implantation. This study proposed an anamnestic add-on for optimizing the choice of IOL. Methods: We used a camera that automatically takes pictures, documenting the patient’s visual routine in order to obtain additional information about the frequency of distant, intermediate, and near sights. Results: The results indicated an estimated frequency percentage, suggesting that visual analysis of routine photographic records of a patient with cataract may be useful for understanding behavioural gaze and for choosing visual management strategy after cataract surgery, simultaneously stimulating interest for customized IOL manufacturing according to individual needs.

  4. Modelling lifetime cost consequences of ReSTOR® in cataract surgery in four European countries

    Berdeaux Gilles

    2008-07-01

    Full Text Available Abstract Background To compare the lifetime costs of liberating patients from spectacles after cataract surgery by implanting the multifocal intraocular lens (IOL 'ReSTOR®' versus monofocal IOLs in France, Italy, Germany and Spain. Methods A Markov model was created to follow patient cohorts from cataract surgery until death. Prevalence rates of patients not needing spectacles after cataract surgery were obtained from clinical trials. Resource utilisation included implant surgery, IOLs, spectacles, visits to ophthalmologists and eye centres, transport, and time lost by patients. Economic perspectives were those of Society and Sickness Funds (SFs. Results The mean number of spectacles purchased after ReSTOR® was 1.34–1.61 and after monofocal IOLs 6.05–7.27. From the societal perspective, total cost estimates discounted by 3% were between €3,551 and €4,052 with ReSTOR® compared to €3,989 and €5,548 with monofocal IOLs. Undiscounted savings related to ReSTOR® ranged from €815 to €2,164. From the SFs' perspective total cost estimates discounted by 3% were between €2,150 and €2,524 with ReSTOR® compared to €2,324 and €2,610 with monofocal IOLs. Savings related to ReSTOR®, once costs discounted, ranged from €61 to €219. Discount and spectacle freedom prevalence rates were the most sensitive parameters. Conclusion The bulk of the savings related to ReSTOR® were realized outside the SF. From both a societal and SF perspective, savings, after a 3% discounting, achieved by liberating patients from spectacles counterbalanced the initially higher cost of ReSTOR®. ReSTOR® is a cost saving alternative to spectacles for patients requiring cataract surgery.

  5. Comparison of Blue Light-Filtering IOLs and UV Light-Filtering IOLs for Cataract Surgery: A Meta-Analysis

    Zhu, Xiao-Feng; Zou, Hai-dong; Yu, Yong-fu; Sun, Qian; Zhao, Nai-Qing

    2012-01-01

    Background A number of published randomized controlled trials have been conducted to evaluate visual performance of blue light-filtering intraocular lenses (IOL) and UV light-filtering intraocular lenses (IOL) after cataract phacoemulsification surgery. However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the effectiveness of blue light-filtering IOLs versus UV light-filtering IOLs in cataract surgery. Methods and Findings Comprehensive search...

  6. Assessment of corneal astigmatism following frown and straight incision forms in sutureless manual small incision cataract surgery

    Appenteng Osae, Eugene

    2016-01-01

    Angela Ofeibea Amedo, Kwadwo Amoah, Nana Yaa Koomson, David Ben Kumah, Eugene Appenteng Osae Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Abstract: To investigate which of two tunnel incision forms (frown versus straight) in sutureless manual small incision cataract surgery creates more corneal astigmatism. Sixty eyes of 60 patients who had consented to undergo cataract surgery and to partake in this study were followed from ba...

  7. Agreement between optical coherence tomography and fundus fluorescein angiography in post-cataract surgery cystoid macular edema

    Mitne Somaia; Paranhos Júnior Augusto; Rodrigues Ana Paula Silvério; Guia Tércio; Bordon Arnaldo; Moraes Nilva Simeren Bueno de; Farah Michel Eid; Bonomo Pedro Paulo

    2003-01-01

    PURPOSE: To evaluate the agreement between optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) regarding the detection of cystoid macular edema (CME) following cataract surgery. METHODS: Retrospective comparative observational series of 25 eyes with suspected CME. Patients with low visual acuity and alterations in fundus biomicroscopy after cataract surgery underwent OCT scanning followed by FFA on the same visit. The diagnosis of CME was established considering fluore...

  8. Topical anaesthesia with oxybuprocaine versus sub-Tenon's infiltration with 2% lignocaine for small incision cataract surgery

    Chittenden, H; MEACOCK, W.; Govan, J

    1997-01-01

    AIMS—To determine whether topical anaesthesia in small incision self-sealing phacoemulsification cataract surgery provides comparable anaesthesia to sub-Tenon's infiltration.
METHODS—Thirty five patients undergoing small incision self-sealing phacoemulsification cataract surgery were allocated randomly to receive topical anaesthesia with 0.4% oxybuprocaine or sub-Tenon's infiltration with 2% lignocaine. Pain experienced during the operation was assessed by asking the patient to score on a vis...

  9. Intraocular Lens Opacification following Intracameral Injection of Recombinant Tissue Plasminogen Activator to Treat Inflammatory Membranes after Cataract Surgery

    2015-01-01

    Purpose. To report 7 cases of intraocular lens (IOL) opacification following treatment of postoperative anterior chamber fibrin with recombinant tissue plasminogen activator (rtPA) after cataract surgery. Methods. Retrospective case series of 7 eyes in 7 patients who developed IOL opacification after receiving rtPA for anterior chamber inflammatory membrane formation resulting from phacoemulsification cataract surgery. Three explanted IOLs were investigated with light microscopy, histochemica...

  10. A COMPARATIVE STUDY OF POST OPERATIVE ASTIGMATISM IN SUPERIOR VERSUS TEMPORAL APPROACH OF MANUAL SMALL INCISION CATARACT SURGERY

    Jawed

    2014-06-01

    Full Text Available BACKGROUND: Manual small incision cataract surgery is a simple and less expensive technique of cataract surgery but gives visual result almost equivalent to Phacoemulsification. PURPOSE: To compare surgery induced astigmatism in manual small incision cataract surgery through superior and temporal approaches. METHODOLOGY: One hundred and thirty eyes were included in this study. Eyes with steeper vertical keratometric reading were subjected to superior small incision cataract surgery (SICS and those with a steeper horizontal keratometric reading were subjected to temporal small incision cataract surgery (SICS. Eyes with no astigmatism were randomly subjected to either type of surgery. Each group had 65 eyes. All the patients were followed up on 1st , 7th, 30th and 90th postoperative days. During each follow up, UCVA and BCVA were recorded, slit lamp examination was performed; autorefractometry and keratometric examinations were also performed. RESULTS: Out of 65 in the temporal incision group only 55 completed follow up till 90th day. The mean surgery induced astigmatism was found to be 1.45 ± 0.4 D in superior and 0.70 ± 0.3 D in the temporal incision group. Amount of surgery induced astigmatism was found to be significantly lower among the temporal incision group (t = 11.444, p = 0.000. CONCLUSION: SICS through temporal approach provides a better stabilization of refraction with significantly lesser amount of SIA than superior approach.

  11. [Aberration corrected intraocular lens for microincision cataract surgery (MICS). Intraindividual comparison with a conventional lens - 1-year follow-up].

    Möglich, M; Häberle, H; Pham, D T; Wirbelauer, C

    2009-10-01

    Microincision cataract surgery (MICS) is an important advancement in the field of cataract surgery. This article compares an aberration corrected hydrophilic acrylic intraocular lens (IOL) having a hydrophobic surface for MICS with a one-piece hydrophobic acrylic IOL with respect to capsule sac stability, image quality, and after-cataract formation over the course of 1 year. The operations were performed as bimanual MICS or coaxial phacoemulsification. Overall the results after implantation of the IOL by MICS can be regarded as positive in comparison to the standard operation. PMID:18836727

  12. Knowledge of patients’ visual experience during cataract surgery: a survey of eye doctors in Karachi, Pakistan

    Tauqir Mohammad Zain

    2012-11-01

    Full Text Available Abstract Background Several recent studies have recommended that ophthalmologists must be aware of the visual sensations (and their associated anxiety/fear experienced by patients undergoing cataract surgery. We assessed the knowledge of a group of eye doctors in Pakistan regarding these phenomena. Methods This was a cross-sectional survey. Eye doctors (ophthalmologists, residents and medical officers attending the Ophthalmological Society of Pakistan Annual Conference 2011, in Karachi were invited to participate in the study. A self-administered structured questionnaire was used to examine their knowledge of visual sensations and their associated anxiety/fear experienced by patients during cataract surgery. Simple frequencies and proportions were calculated to describe the data. Results A total of 150 ophthalmologists, residents and medical officers were invited to participate in the study. Of these, 68 (45.3% responded. The mean age (±SD of the participants was 42.9 (13.2 years. The proportion of participants who thought that patients could experience visual sensations during cataract surgery under regional anaesthesia was 89.7% and that under topical anaesthesia was 73.5%. The most frequently cited sensations included: light perception, changes in light brightness, movements, instruments and surgeon’s hands or fingers. The eye doctors estimated that 38.9% and 64.3% patients would see at least something during cataract surgery under regional anaesthesia and topical anaesthesia, respectively. They also believed that 24.2%-36.9% of patients may experience anxiety/fear as a result of visual sensations during such surgery. Approximately half of the eye doctors did not think that retained vision was a source of fear or anxiety for the patients. While most of them acknowledged the importance of preoperative counselling in helping to alleviate such fear/anxiety, the majority of them did not regularly counsel their patients on what to expect during

  13. The combination of intravitreal triamcinolone and phacoemulsification surgery in patients with diabeticfoveal oedema and cataract

    Habib, Maged S; Cannon, Paul S; Steel, David HW

    2005-01-01

    Background The management of diabetic patients with refractory macular oedema or patients with no adequate pre-operative view to administer laser treatment provide a challenge to the ophthalmologist. We wished to assess the use, safety and effect of intravitreal triamcinolone injection at the time of cataract surgery in patients with diabetic foveal oedema and sight limiting lens opacities. Method This was a longitudinal non-randomised prospective pilot study in 18 eyes (12 patients). All pat...

  14. The combination of intravitreal triamcinolone and phacoemulsification surgery in patients with diabeticfoveal oedema and cataract

    Cannon Paul S; Habib Maged S; Steel David HW

    2005-01-01

    Abstract Background The management of diabetic patients with refractory macular oedema or patients with no adequate pre-operative view to administer laser treatment provide a challenge to the ophthalmologist. We wished to assess the use, safety and effect of intravitreal triamcinolone injection at the time of cataract surgery in patients with diabetic foveal oedema and sight limiting lens opacities. Method This was a longitudinal non-randomised prospective pilot study in 18 eyes (12 patients)...

  15. New technique to demonstrate corneal magnification using trypan blue in cataract surgery

    Frederico F. Marques; Daniela M.V. Marques; Robert H. Osher

    2011-01-01

    PURPOSE: To demonstrate the corneal magnification using trypan blue in cataract surgery. METHODS: Eight eyes of eight patients undergoing phacoemulsification with an intraocular lens implantation were enrolled in this study. After staining the anterior capsule with Trypan Blue 0.1% and performing the capsulorhexis, the excised anterior capsule was placed on the corneal surface. By observing and measuring the relationship between the border of the excised anterior capsule and the intracameral ...

  16. An analysis of ophthalmology trainees' perceptions of feedback for cataract surgery training

    Saedon, Habiba

    2013-01-01

    Habiba Saedon Birmingham Midland Eye Centre, Birmingham, West Midlands, UK Objectives: To determine whether feedback for cataract surgery is perceived to be given to trainee ophthalmologists, the way in which any feedback is given, and what the trainee perceives to be the effect of feedback on their performance. Design: Cross-sectional qualitative study. Participants: Twelve trainee ophthalmologists at various levels of specialty training in the UK. Methods: Semi-structured interviews were c...

  17. Prophylactic postoperative ketorolac improves outcomes in diabetic patients assigned for cataract surgery

    Elsawy MF

    2013-06-01

    Full Text Available Moataz F Elsawy, Nermine Badawi, Hany A KhairyOphthalmology Department, Menoufia University Hospital, Menoufia, EgyptObjective: To evaluate the prophylactic role of topical non-steroidal anti-inflammatory drugs in reducing the incidence of central macular edema (CME in diabetic eyes post-cataract surgery.Patients and methods: This study included 86 eyes (70 patients with high risk characteristics for the development of CME after cataract surgery. All patients underwent phacoemulsification and intraocular lens implantation. Patients were divided into two equal groups (n = 43 [eyes]: a control group given topical dexamethasone 0.1%, four times/day for 12 weeks postoperatively and a study group given topical ketorolac tromethamine 0.4% twice daily in addition to topical dexamethasone 0.1% four times daily for 12 weeks. Patients were examined at 3, 6, and 12 weeks postoperatively for evaluation of CME development. The main study outcome was the change in the retinal fovea thickness measured with ocular coherence topography.Results: Ten eyes developed CME (11.6%; eight eyes in the control group and only two eyes in the study group. Mean retinal fovea thickness was significantly higher in the control group compared to the study group. Moreover, eyes of the control group developed CME significantly earlier than those of the study group.Conclusion: Prophylactic postoperative ketorolac 0.4% may have a role in reducing the frequency and severity of CME in diabetic eyes post-cataract surgery.Keywords: diabetes mellitus, cataract surgery, central macular edema, ketorolac, dexamethasone

  18. Cataract surgery and the risk of aging macula disorder: The Rotterdam study

    Ho, Lintje; Boekhoorn, Sharmila; Liana, Alin; Tikka-Kleemola, Päivi; Uitterlinden, André; Hofman, Albert; Jong, Paulus; Stijnen, Theo; Vingerling, Hans

    2008-01-01

    textabstractPURPOSE. To investigate still-controversial associations between prior cataract surgery and aging macula disorder (AMD) in a general population. METHODS. Baseline lens status and risk of incident AMD (iAMD) were examined in participants of the prospective population-based Rotterdam Study at risk for AMD (n = 6032). Slit lamp examination was used to determine lens status and stereoscopic color fundus photography to determine the presence of AMD. Odds ratios (ORs) and corresponding ...

  19. The role of sideport incision in astigmatism change after cataract surgery

    Theodoulidou, Sofia

    2015-01-01

    Sofia Theodoulidou,1 Ioannis Asproudis,1 Christos Kalogeropoulos,1 Aristidis Athanasiadis,2 Miltiadis Aspiotis1 1Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece; 2Ophthalmology Clinic, General Hospital of Piraeus “Tzaneio”, Attiki, Greece Purpose: To study the changes in corneal astigmatism after cataract surgery when the sideport incision is performed at a predetermined location away from the tunnel incision. Setting: General Hospit...

  20. Comparison of surgically induced astigmatism between one-handed and two-handed cataract surgery techniques

    Kawahara A; Kurosaka D; Yoshida A

    2013-01-01

    Atsushi Kawahara,1 Daijiro Kurosaka,2 Akitoshi Yoshida31Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, 2Department of Ophthalmology, Iwate Medical University, Morioka, 3Department of Ophthalmology, Asahikawa Medical University, Asahikawa, JapanBackground: The purpose of this study was to compare surgically induced astigmatism (SIA) between one-handed and two-handed cataract surgery techniques.Methods: Eighty-eight eyes of 44 patients with no ocular disease other than catar...

  1. The role of sideport incision in astigmatism change after cataract surgery

    Theodoulidou S; Asproudis I; Kalogeropoulos C; Athanasiadis A; Aspiotis M

    2015-01-01

    Sofia Theodoulidou,1 Ioannis Asproudis,1 Christos Kalogeropoulos,1 Aristidis Athanasiadis,2 Miltiadis Aspiotis1 1Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece; 2Ophthalmology Clinic, General Hospital of Piraeus “Tzaneio”, Attiki, Greece Purpose: To study the changes in corneal astigmatism after cataract surgery when the sideport incision is performed at a predetermined location away from the tunnel incision. Setting: General Hospital of Pi...

  2. Rate of endothelial cell loss in the early postoperative period after cataract surgery.

    PRICE, N; Jacobs, P; H. Cheng

    1982-01-01

    Central corneal endothelial cell density was estimated in 33 consecutive patients preoperatively and at monthly intervals for 6 months after cataract surgery. The patients were divided into 3 groups by a random procedure to have either intracapsular extraction or intracapsular extraction plus Federov 4-loop iris clip lens, or extracapsular extraction with Binkhorst 2-loop iridocapsular lens. In all groups the greatest cell loss had occurred by one month and thereafter no accelerated loss was ...

  3. Suture-related keratitis following cataract surgery caused by methicillin-resistant Staphylococcus aureus

    Tarabishy, Ahmad B; Thomas L Steinemann

    2010-01-01

    Ahmad B Tarabishy1, Thomas L Steinemann21Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA; 2Cornea and External Eye Disease, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USAAbstract: A 54-year old-man presented with a two-day history of severe pain and decreased vision. Examination revealed a corneal ulcer associated with a loose suture from cataract surgery done approximately two years ago. The suture was removed and the patient was started on topic ant...

  4. Exudative Inflammatory Eye Response in Cataract Surgery: Current View on the Problem

    Belousova N.Y.

    2011-01-01

    There has been analyzed one of the most frequent and serious complications of cataract surgery — exudative inflammatory response (EIR) of eye. There has been presented current view on etiopathogenesis of the condition, classifications and the description of clinical presentation of various EIR types have been given. Known techniques of prognosis and prevention of postoperative exudative uveites have been presented. There have been given present methods of complex treatment of eye EIR: drug tr...

  5. An analysis of ophthalmology trainees’ perceptions of feedback for cataract surgery training

    Saedon H

    2013-01-01

    Habiba Saedon Birmingham Midland Eye Centre, Birmingham, West Midlands, UK Objectives: To determine whether feedback for cataract surgery is perceived to be given to trainee ophthalmologists, the way in which any feedback is given, and what the trainee perceives to be the effect of feedback on their performance. Design: Cross-sectional qualitative study. Participants: Twelve trainee ophthalmologists at various levels of specialty training in the UK. Methods: Semi-structured interviews were c...

  6. Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracamaral use of cefuroxime

    Çakır B

    2015-03-01

    Full Text Available Burçin Çakir, Erkan Celik, Nilgün Özkan Aksoy, Özlem Bursali, Turgay Uçak, Erdinç Bozkurt, Gursoy AlagozSakarya University Education and Research Hospital, Sakarya, TurkeyPurpose: To report toxic anterior segment syndrome (TASS after cataract surgery possibly associated with intracameral use of cefuroxime.Methods: We conducted a retrospective chart review and analysis on the pre- and postoperative conditions of the subjects who had developed TASS.Results: The patient group consisted of 17 patients. Tyndallization and fibrin fibers were positive in all eyes. In four eyes, hypopyon formation developed. These reactions diminished on the third day and fully resolved 1 week after the operations with the use of intensive topical steroid and mydriatic therapy. To determine the etiology of TASS, infusion fluid, viscoelastics, and intracameral antibiotic agent were changed respectively. After changing intracameral antibiotic agent from cefuroxime axetile to moxifloxacin no new cases of TASS were diagnosed.Conclusion: All agents injected into the anterior chamber can cause TASS. Ophthalmologists and operating room staff need to pay careful attention to all drugs and irrigating solutions.Keywords: phacoemulsification, fibrin reaction, drug toxicity

  7. Temporary graft for closed-system cataract surgery during corneal triple procedures.

    Nardi, M; Giudice, V; Marabotti, A; Alfieri, E; Rizzo, S

    2001-08-01

    Performing phacoemulsification during a triple corneal procedure has many advantages. Operating in a closed chamber makes surgery easier and safer. In some cases, however, a dense corneal opacity may prevent closed-chamber surgery, necessitating the use of an open-sky technique. In these cases, a temporary corneal graft using a corneal button not suitable for penetrating keratoplasty is proposed to allow phacoemulsification and foldable intraocular lens implantation through a corneal tunnel. The temporary corneal graft is replaced with a permanent graft after these steps are completed. This technique was effective in 3 patients with cataract and dense corneal opacity. PMID:11524186

  8. Reduction in astigmatism in manual small incision cataract surgery through change of incision site

    Gokhale Nikhil; Sawhney Saurabh

    2005-01-01

    To compare the astigmatism induced by a superior, supero-temporal and temporal incision in manual small incision cataract surgery. Induced astigmatism was analysed by Cartesian coordinates based analysis, using Holladay′s system. Mean astigmatism induced by surgery was 1.28 D x 2.9 degrees for superior incision, 0.20 D x 23.7 degrees for supero-temporal incision and 0.37 D x 90 degrees for temporal incision. The study found that induced astigmatism was lower in the temporal and super...

  9. Severe generalised hypersensitivity reaction to topical neomycin after cataract surgery: a case report

    Ansari Imran A

    2008-02-01

    Full Text Available Abstract Introduction Systemic hypersensitivity reactions to topical ophthalmic treatment occur rarely, but when they do they can be severe as highlighted by this case. Case presentation A post-operative cataract surgery patient developed a severe and generalised hypersensitivity reaction following topical treatment with Maxitrol (Dexamethasone and Neomycin eye drops. The patient reported a previous allergic reaction to Neomycin. Conclusion This case report emphasises the importance of a thorough drug and allergy history when patients are seen at pre-assessment or clerked in for surgery.

  10. Reduction in astigmatism in manual small incision cataract surgery through change of incision site

    Gokhale Nikhil

    2005-01-01

    Full Text Available To compare the astigmatism induced by a superior, supero-temporal and temporal incision in manual small incision cataract surgery. Induced astigmatism was analysed by Cartesian coordinates based analysis, using Holladay′s system. Mean astigmatism induced by surgery was 1.28 D x 2.9 degrees for superior incision, 0.20 D x 23.7 degrees for supero-temporal incision and 0.37 D x 90 degrees for temporal incision. The study found that induced astigmatism was lower in the temporal and superotemporal groups compared to that in the superior group.

  11. Effects of Cataract Surgery on Intraocular Pressure in Patients with and without Glaucoma

    Tülin İsmi

    2013-06-01

    Full Text Available Pur po se: To evaluate the effects of phacoemulsification surgery with primary intraocular lens (IOL implantation on intraocular pressure (IOP in various types of glaucoma patients with visually significant cataract and to compare these results with cataract patients without glaucoma. Ma te ri al and Met hod: This retrospective study included consecutive cases of 21 primary open-angle glaucoma patients, 13 primary angle-closure glaucoma (PACG patients, 11 pseudoexfoliation glaucoma patients, and 21 control eyes without any type of glaucoma; all patients had co-existing cataract. Visual acuities, IOP, number of glaucoma medications used, anterior chamber depth (ACD, and gonioscopic evaluations were noted both pre- and postoperatively. Phacoemulsification and IOL implantations were performed via clear corneal incisions in the whole study group. Study group was followed-up for six months. Re sults: Postoperative visits at the 1st, 3rd, and 6th months were noted. After surgery, visual acuities improved significantly (p=0.001 in all groups. Intraocular pressures decreased in all groups postoperatively, but the change was statistically significant in the PACG group (p=0.013. Increase in ACD was significant in PACG group (p=0.001. Widening of iridocorneal angle and decrease in the number of antiglaucoma drugs were observed in all groups, but these were significant in the PACG group (p=0.001 and p<0.05, respectively. Dis cus si on: In glaucoma patients with co-existing cataract, phacoemulsification surgery allows both the visual rehabilitation and IOP control. This IOP lowering effect is seen most markedly in the PACG group. (Turk J Ophthalmol 2013; 43: 167-72

  12. Safety of prophylactic intracameral moxifloxacin ophthalmic solution after cataract surgery in patients with penetrating keratoplasty

    Osman; Sevki; Arslan; Ceyhun; Arici; Mustafa; Unal; Erdogan; Cicik; Mehmet; Serhat; Mangan; Eray; Atalay

    2014-01-01

    AIM:To determine the safety of prophylactic intracameral moxifloxacin after cataract surgery in patients with penetrating keratoplasty(PKP).METHODS:In this retrospective study of consecutive patients who had phacoemulsification cataract surgery after PKP, were treated with intracameral moxifloxacin0.5% ophthalmic solution(0.5 mg/0.1 mL). The main outcome measures were anterior chamber reaction, best corrected visual acuity(BCVA), corneal endothelial cell count(ECC), and central corneal thickness(CCT).RESULTS:Fifty-five patients were recruited(26 males,29 females). The mean age was 54.36±4.97y(range 45-64y).All eyes had improved postoperative BCVA. The mean BCVA was 0.25 preoperatively and 0.57 postoperatively,which was statistically significant(P <0.001). One eye had 3+, 7 eyes had 2+, 12 eyes had 1+ and 8 eyes had trace amount of aqueous cells on the first day after surgery. All eyes had no anterior chamber cells at subsequent follow up examinations. Effective phacoemulsification time was 4.33 ±1.01 s. The mean ECC was 2340.20 cells/mm2 preoperatively and 1948.75 cells/mm21 mo postoperatively(P <0.001). The increase of21.09 μm in postoperative pachymetry 1mo after surgery was statistically significant(P <0.001).CONCLUSION:Nountowardeffectswereobservedafter intracameral injection of moxifloxacin(0.5 mg/0.1 mL) in terms of anterior chamber reaction, CCT, ECC, and visual rehabilitation at the conclusion of cataract surgery in patients with PKP.

  13. Efficacy and safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: a meta-analysis of randomized controlled trials.

    Chen, Xiaoyun; Xiao, Wei; Ye, Shaobi; Chen, Weirong; Liu, Yizhi

    2015-01-01

    The aim of this study was to evaluate the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification cataract surgery (CPCS) in the treatment of cataract. Randomized controlled trials (RCTs) were searched in PubMed, Embase and the Cochrane Central Register of Controlled Trials. Nine qualified studies with a total of 989 eyes were included. Compared with CPCS, FLACS significantly reduced mean phaco energy and effective phacoemulsification time (EPT) required in the surgery. Central corneal thickness (CCT) was significantly lower in FLACS at 1 day of follow-up, but CCT and corneal endothelial cells count was comparable at 1 week of follow-up or longer. FLACS achieved a better visual outcome at postoperative 1 week and 6 months, but the difference was not significant at postoperative 1-3 months. Regard to surgical complications, the incidences of intraoperative anterior capsule tear, postoperative macular edema and elevated intraocular pressure were similar. In conclusion, femtosecond laser pretreatment can reduce phaco energy and EPT, which may reduce the heat damage to ocular tissues by ultrasound. This novel technique might be beneficial for patients with dense cataract and/or low preoperative endothelial cell values. Well-designed RCTs with longer follow-up are still necessary to provide more reliable evidence. PMID:26269445

  14. Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II

    Parikshit Gogate

    2014-01-01

    Full Text Available Background: Regular follow up and amblyopia treatment are essential for good outcomes after pediatric cataract surgery. Aim: To study the regularity of follow-up after cataract surgery in children and to gauge the causes of poor compliance to follow up. Subjects: 262 children (393 cataracts who underwent cataract surgery in 2004-8. Materials and Methods: The children were identified and examined in their homes and a "barriers to follow-up" questionnaire completed. Demographic data collected, visual acuity estimated, and ocular examination performed. Statistical Analysis: SPSS version 19. Results: Of the 262 children, only 53 (20.6% had been regularly following up with any hospital, 209 (79.4% had not. A total of 150 (57.3% were boys and the average age was 13.23 years (Std Dev 5 yrs. Poor follow up was associated with the older age group ( P 1 line with regular follow-up. Conclusion: Regular follow-up is important and improves vision; eye care practitioners need to take special efforts to ensure better follow-up.

  15. COMPARISON OF SURGICALLY INDUCED ASTIGMATISM WITH SMALL INCISION CATARACT SURGERY AND PHACOEMULSIFICATION

    Umesh

    2015-09-01

    Full Text Available BACKGROUND: Surgically induced astigmatism is the cause of poor postoperative vision even after uneventful cataract surgery. AIM: The aim of the study was to compare the effect of surgically induced astigmatism in SICS and Phacoemulsification after taking the incision in the steepest meridian. SETTING: KLE Hospital, Belagavi, Karnataka. DESIGN: Longitudinal study. MATERIAL AND METHODS: A total of 100 eyes of 100 patients with mean age of 62 years were included in the study. Consecutive patients with cataract were randomly assigned to undergo phacoemulsification or manual SICS by a single surgeon experienced in both techniques. Group A underwent SICS (Small Incision Cataract Surgery and group B had phacoemulsification. Surgically induced astigmatism was analyzed by SIA software. STATISTICAL ANALYSIS : Non - parametric method (Mann whitney U test . RESULTS: The measurement of induced astigmatism was taken: dK, the net keratometric change in corneal toricity. Average dK for Group A (SICS was +0.05 D and for Group B (Phacoemulsification was - 0.53 D. There was a difference of - 0.49 D between the two groups in terms of induced keratometric astigmatism. The SICS group actually demonstrated on the average a greater iatrogenic astigmatism than the phacoemulsification group keratometrically. This is clinically or statistically significant (P<0.001. CONCLUSIONS: Phacoemulsification induces less astigmatism than SICS. Iatrogenic astigmatism is more with SICS.

  16. Understanding Cataract Risk in Aerospace Flight Crew And Review of Mechanisms of Cataract Formation

    Jones, Jeffrey A.; McCarten, M.; Manuel, K.; Djojonegoro, B.; Murray, J.; Cucinotta, F.; Feiversen, A.; Wear, M.

    2006-01-01

    Induction of cataracts by occupational exposure in flight crew has been an important topic of interest in aerospace medicine in the past five years, in association with numerous reports of flight-associated disease incidences. Due to numerous confounding variables, it has been difficult to determine if there is increased cataract risk directly caused by interaction with the flight environment, specifically associated with added radiation exposure during flight. Military aviator records from the United States Air Force (USAF) and Navy (USN) and US astronauts at the National Aeronautics and Space Administration (NASA)/Lyndon B. Johnson Space Center (JSC) were evaluated for the presence, location and age of diagnosis of cataracts. Military aviators were found to have a statistically significant younger average age of onset of their cataracts compared with astronauts, however the incidence density of cataracts was found to be statistically higher in astronauts than in military aviators. USAF and USN aviator s cataracts were most commonly located in the posterior subcapsular region of the lens while astronauts cataracts were most likely to originate generally in the cortical zone. A prospective clinical trial which controls for confounding variables in examination technique, cataract classification, diet, exposure, and pharmacological intervention is needed to determine what percentage of the risk for cataracts are due to radiation, and how to best develop countermeasures to protect flight crews from radiation bioeffects in the future.

  17. Unusually delayed presentation of persistent Descemet’s membrane tear and detachment after cataract surgery

    Morkin MI

    2014-08-01

    Full Text Available Melina I Morkin,1,2 Rehan M Hussain,2 Ryan C Young,2 Tracy Ravin,2 Sander R Dubovy,2 Eduardo C Alfonso2 1Department of Ophthalmology, Shiley Eye Center, University of California – San Diego, San Diego, CA, 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Abstract: A 51-year-old male who had undergone phacoemulsification in his left eye 11 months prior presented with complaint of sudden onset of blurred vision in the same eye. Review of his clinical course, slit-lamp exam, pachymetry, and specular endothelial microscopy led to the diagnosis of acute hydrops caused by Descemet’s membrane dehiscence at the site of the incision. He was initially managed with medical treatment and observation. In the subsequent months of follow-up, the corneal edema and the patient’s visual acuity did not improve. Intracameral gas injection was performed 7 months after presentation, but because of persistent corneal edema and nonattached Descemet’s membrane, penetrating keratoplasty was performed. Histopathologic examination confirmed the diagnosis. The patient has had a clear corneal graft since then. Although Descemet’s membrane detachment is a rather common complication after intraocular surgery, its unusually delayed presentation can also occur, and should not be confused with pseudophakic bullous keratopathy. Many mechanisms have been studied for the development of early tears and detachments after cataract surgery, but little is known about late presentations. The authors explore possible causes, and highlight the importance of instructing patients to avoid eye rubbing and any other type of trauma to the cornea after intraocular surgery. Keywords: Descemet’s membrane tear, detachment, cataract surgery, phacoemulsification

  18. An "epidemic" of post cataract surgery endophthalmitis by a new organism

    Korah Sanita

    2007-01-01

    Full Text Available We report a case series of endophthalmitis by an organism hitherto not reported in the eye. Nineteen of 63 cataract patients operated in a high-volume setup were urgently referred to us with acute onset of decreased vision one to two days following cataract surgery. All patients had clinical evidence of acute endophthalmitis with severe anterior chamber exudative reaction. Vitreous tap was done in three representative patients and repeated intravitreal injections were given as per established protocol. The vitreous sample from all three patients grew Enterobacter amnigenus Biogroup II, a gram-negative bacillus which, to the best of our knowledge, has never been reported in the eye. With prompt and accurate microbiological support, it was possible to salvage 17 of these eyes without performing vitrectomy. Six eyes regained 6/200 or better vision.

  19. Cost-Utility Analyses of Cataract Surgery in Advanced Age-Related Macular Degeneration

    Ma, Yingyan; Huang, Jiannan; Zhu, Bijun; Sun, Qian; Miao, Yuyu; Zou, Haidong

    2016-01-01

    ABSTRACT Purpose To explore the cost-utility of cataract surgery in patients with advanced age-related macular degeneration (AMD). Methods Patients who were diagnosed as having and treated for age-related cataract and with a history of advanced AMD at the Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, were included in the study. All of the participants underwent successful phacoemulsification with foldable posterior chamber intraocular lens implantation under retrobulbar anesthesia. Best-corrected visual acuity (BCVA) and utility value elicited by time trade-off method from patients at 3-month postoperative time were compared with those before surgery. Quality-adjusted life years (QALYs) gained in a lifetime were calculated at a 3% annual discounted rate. Costs per QALY gained were calculated using the bootstrap method, and probabilities of being cost-effective were presented using a cost-effectiveness acceptability curve. Sensitivity analyses were performed to test the robustness of the results. Results Mean logarithm of the minimum angle of resolution BCVA in the operated eye increased from 1.37 ± 0.5 (Snellen, 20/469) to 0.98 ± 0.25 (Snellen, 20/191) (p < 0.001); BCVA in the weighted average from both eyes (=75% better eye + 25% worse eye) was changed from 1.13 ± 0.22 (Snellen, 20/270) to 0.96 ± 0.17 (Snellen, 20/182) (p < 0.001). Utility values from both patients and doctors increased significantly after surgery (p < 0.001 and p = 0.007). Patients gained 1.17 QALYs by cataract surgery in their lifetime. The cost per QALY was 8835 Chinese yuan (CNY) (1400 U.S. dollars [USD]). It is cost-effective at the threshold of 115,062 CNY (18,235 USD) per QALY in China recommended by the World Health Organization. The cost per QALY varied from 7045 CNY (1116 USD) to 94,178 CNY (14,925 USD) in sensitivity analyses. Conclusions Visual acuity and quality of life assessed by utility value improved significantly after surgery

  20. A retrospective study of the indications and outcomes of capsular tension ring insertion during cataract surgery at a tertiary teaching hospital

    Wang BZ

    2013-03-01

    Full Text Available Bob Z Wang, Elsie Chan, Rasik B Vajpayee The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia Background: The purpose was to determine preoperative indications, intraoperative procedures, and outcomes of capsular tension ring (CTR insertion during cataract surgery. Methods: A review of all patients undergoing cataract surgery with insertion of a CTR between July 2000 and June 2010 was conducted at The Royal Victorian Eye and Ear Hospital, a large tertiary teaching hospital in Victoria, Australia. Information relating to each patient's demographic details, preoperative assessment, surgical procedure, and postoperative assessment were obtained. Results: Eighty-four eyes of 82 patients were included in this study. The main indications for CTR insertion were previous trauma, pseudoexfoliation syndrome, and mature cataracts. Twenty-one eyes (25.0% did not have any obvious preoperative indication. A posterior capsule tear was the most common intraoperative complication (3.6%. An intraocular lens was successfully implanted in the bag in 72 eyes (85.7%. Postoperatively, the most common complications were a decentered intraocular lens (8.3% and persistent corneal edema (6.0%. Overall, 61 eyes (72.6% had better postoperative visual acuity compared with preoperative acuity, with 67 patients (79.8% achieving vision of 20/40 or better. Conclusion: For the majority of cases, CTR use in complex cataract surgeries is associated with improved postoperative outcomes. CTR implantation is most commonly required in patients with known risk factors for zonular instability. Keywords: capsular tension ring, cataract extraction, indications, outcomes

  1. What effects has the cataract surgery on the development and progression of Age-Related Macular Degeneration (AMD)?

    Bockelbrink, A; Rasch, A; Roll, S.; Willich, SN; Greiner, W

    2006-01-01

    Background The cataract (Cataracta senilis) is the most frequent eye disease of elderly people worldwide. In Germany, the cataract operation - with currently 450,000 interventions each year the most frequent operation in ophthalmology - can be seen as routine surgery. The age related macular degeneration (AMD) is a further one of the most common, age-related eye diseases and the most frequent cause of blindness of elderly people in industrial nations. Due to demographic changes an increasing ...

  2. What effects has the cataract surgery on the development and progression of Age-Related Macular Degeneration (AMD)?

    Willich, Stefan N.; Roll, Stephanie; Rasch, Andrej; Bockelbrink, Angelina; Greiner, Wolfgang

    2006-01-01

    Background: The cataract (Cataracta senilis) is the most frequent eye disease of elderly people worldwide. In Germany, the cataract operation - with currently 450,000 interventions each year the most frequent operation in ophthalmology – can be seen as routine surgery. The age related macular degeneration (AMD) is a further one of the most common, age-related eye diseases and the most frequent cause of blindness of elderly people in industrial nations. Due to demographic changes an increasing...

  3. Comparative study of surgically induced astigmatism in superior versus temporal incision in small incision cataract surgery case

    Kuruva Nandyala Sree Kavitha; Arikeri Krishna Kishore; Ganta Sudhakar Reddy; Khaiser Jehan

    2015-01-01

    Background: Location of incision has a significant impact on surgical outcome. It has been reported that temporal incisions induce less astigmatism than superior incisions indicating the importance of incision location. The objective of the present study was to study the effect of surgical induced astigmatism in superior versus temporal incision in small incision cataract surgery cases. Methods: 100 patients of cataract attending to Sarojini Devi eye hospital with the rule and against the ...

  4. Corneal astigmatism change and wavefront aberration evaluation after cataract surgery: "Single" versus "paired opposite" clear corneal incisions

    Hasan Razmjoo; Nima Koosha; Mohammad Hadi Vaezi; Behrooz Rahimi; Alireza Peyman

    2014-01-01

    Background: Correcting the pre-existing astigmatism is an optimal goal in cataract surgery. The aim of this study is to compare the astigmatic correcting effect of a single regular 3.2 mm clear corneal incision (CCI) with paired opposite CCI in cataract patients and effect of these incisions on optical aberrations using the wavefront quantitative analysis. Materials and Methods: This was a randomized controlled trial study undertaken in an ophthalmology referral center on 50 patients plan...

  5. Evaluation of nepafenac in prevention of macular edema following cataract surgery in patients with diabetic retinopathy

    Singh R

    2012-08-01

    Full Text Available Rishi Singh,1 Louis Alpern,2 Glenn J Jaffe,3 Robert P Lehmann,4 John Lim,5 Harvey J Reiser,6 Kenneth Sall,7 Thomas Walters,8 Dana Sager91Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, 2The Cataract, Glaucoma, and Refractive Surgery Center, El Paso, TX, 3Duke Eye Center, Duke Reading Center, Duke University, Durham, NC, 4Lehmann Eye Center, Nacogdoches, TX, 5Houston Eye Associates, Houston, TX, 6Eye Care Specialists, Kingston, PA, 7Sall Research Medical Center, Artesia, CA, 8Texan Eye, Austin, TX, 9Alcon Research Ltd, Fort Worth, TX, USABackground: The purpose of this study was to evaluate nepafenac ophthalmic suspension 0.1% (Nevanac®; Alcon Research Ltd in the prevention of macular edema following cataract surgery in diabetic retinopathy patients.Methods: This was a multicenter, randomized, double-masked, vehicle-controlled study of 263 adult diabetic patients with nonproliferative diabetic retinopathy requiring cataract surgery. Patients were randomized (1:1 to instill nepafenac or vehicle three times daily beginning 1 day prior to surgery through day 90. Efficacy included the percentage of patients who developed macular edema (≥30% increase in central subfield macular thickness from baseline and the percentage of patients with decreases of more than five letters in best-corrected visual acuity from day 7 to 90.Results: A significantly lower percentage of patients in the nepafenac group developed macular edema relative to patients in the vehicle group (3.2% versus 16.7%; P < 0.001. A significantly lower percentage of patients in the nepafenac group had best-corrected visual acuity decreases of more than five letters relative to patients in the vehicle group on day 30 (P < 0.001, day 60 (P = 0.002, and day 90 (P = 0.006. The mean central subfield macular thickness and mean percent change from baseline in macular volume were also significantly lower in the nepafenac group versus the vehicle group at days 14 through 90 (P

  6. A COMPARATIVE STUDY OF CONVENTIONAL MANUAL SMALL INCISION CATARACT SURGERY (C-MSICS WITH MODIFIED MANUAL SMALL INCISION CATARACT SURGERY (M-MSICS

    Pankaj

    2014-10-01

    Full Text Available PURPOSE: A Comparative study of conventional manual small incision cataract surgery (C-MSICS with modified manual small incision cataract surgery (M-MSICS in terms of intra and postoperative complications, Best Corrected Visual Acuity, surgical duration and surgeon comfort. METHODS: In this prospective study, the patients having cataracts with nuclear sclerosis not more than early grade 3 were randomly assigned in 2-groups with 100- patients in each group[Group A (C-MSICS, Group B (M-MSICS]. Following table explains the two techniques (Table 1 Both techniques were compared for each stage in terms of surgical duration and surgeon comfort [graded as comfortable (C1, convenient (C2 and difficult (C3]. Also both techniques were compared in terms of Intra and postoperative complications and Best Corrected Visual Acuity. Follow ups in postoperative period were carried out on 1st and 3rd postoperative days, 2wks, 4wks and 6wks. RESULTS: Intraoperative complications were almost similar in 2-groups. As far as postoperative complications were concerned, in M-MSICS group the postoperative corneal edema on 1st POD was present in 2% cases as compared to 15% in C-MSICS (p<0.05%. Postoperative surgical induced astigmatism at 6-weeks was +0.80D in M-MSICS group as compared to +1.40D in C-MSICS group(p<0.05%. Average Surgical duration for stage1&2 in both techniques was almost similar, however for stage3 it was more in M-MSICS group (p<0.05.The surgeon comfort for both techniques in stage1&2 was similar, but for stage3 it was more comfortable for C-MSICS. Visual outcome was almost similar in both techniques at 6-weeks. CONCLUSION: M-MSICS is better technique than C-MSICS in terms of less postoperative corneal edema, fast visual recovery & less postoperative surgical induced astigmatism. However this technique (M-MSICS takes slightly more time and surgeon comfort is bit less for stage 3.

  7. Ectopic intraocular lens: An unusual complication of cataract surgery

    Mehul A Shah

    2014-01-01

    Full Text Available We wish to report an unusual complication of intraocular lens (IOL insertion following uneventful phacoemulsification. After successful phacoemulsification surgery, a hydrophobic acrylic IOL was loaded in the injector for insertion into the capsular bag. During insertion, the IOL inadvertently extended into the corneal stromal lamella. The complication was recognized at a late stage, and the foldable acrylic lens was retrieved and reinserted correctly in the bag. The anterior chamber was made viscoelastically taut and was maintained in this state for 10 min, followed by a routine viscoelastic wash and air bubble injection. Cornea was slightly edematous with stromal haze, and the corneal thickness was 908 μm. At the 1-month follow-up visit, the patient′s vision was 20/40, the stromal haze had subsided, the corneal thickness was 572 μm, and the patient was comfortable. Though it was unknown complication, following proper management patient recovered satisfactorily.

  8. Complexities and challenges of surgical data collection from cataract patients: comparison of cataract surgery rates between 2001 and 2008 in all provinces of Argentina

    Van C. Lansingh

    2014-01-01

    Full Text Available Purpose: To compare the cataract surgical rate (CSR in 2001 with that in 2008 in all Argentinean provinces using current reporting methods and verify the accuracy of CSRs by crosschecking these methods with the number of sold intraocular lenses (IOLs within the country. Methods: A longitudinal study including public and private setups was conducted, and it included 40 ophthalmologists from 22 provinces who provided cataract surgery data for 2001 and 2008. Other data were obtained from the Ministry of Health. Estimates were crosschecked against the market data for sold intraocular lens (IOLs in 2008 and 2010. Results: The number of cataract surgeries increased 2.7-fold, from 62,739 in 2001 to 169,762 in 2008, with increases in every province except Mendoza. Although the population also increased by 9.4% during the same time period, the apparent CSR jumped from 1,744 to 4,313 per million population. The number of IOLs sold in Argentina in 2008 was 186,652, suggesting that the number of cataract surgeries performed was slightly greater than anticipated. Crosschecks with other countries using IOL sales data did not show discrepancies when compared with previously reported CSRs. Conclusions: Although the CSR in Argentina increased considerably from 2001 to 2008 for several reasons, the main reason was that thorough crosschecking between the number of surgeries reported and the number of IOLs sold revealed that the number of surgeries performed annually were being underestimated as a result of incomplete reporting by private practitioners. Furthermore, the presence of multiple societies of ophthalmology in the country complicated the process of obtaining accurate data.

  9. Assessing patient satisfaction with cataract surgery under topical anesthesia supplemented by intracameral lidocaine combined with sedation

    Manuela Bezerril Cipião Fernandes

    2013-12-01

    Full Text Available PURPOSE: Ocular akinesia, the use of anticoagulants, and patient collaboration are some of the factors that must be taken into consideration when choosing the appropriate anesthesia for phacoemulsification cataract surgery. The satisfaction of patients with the use of topical anesthesia and conscious sedation for this procedure has not been enough described in Brazil. Conscious sedation allows patient walk and answer a voice command. To assess the satisfaction, pain, and perioperative hemodynamic alterations of patients subjected to phacoemulsification under conscious sedation and topical anesthesia supplemented with intracameral lidocaine. METHODS: Prospective cohort non-controlled study that included patients treated by the same surgical team over a 70-day period. Sedation was performed with midazolam at a total dose of 3 mg and topical anesthesia with 0.5% proxymetacaine chlorhydrate and 2% lidocaine gel combined with 2% lidocaine by intracameral route. The intraoperative vital parameters, scores based on the Iowa Satisfaction with Anesthesia Scale (ISAS, and the pain visual analog scale (VAS were recorded at several time points after surgery. RESULTS: A total of 106 patients were enroled in study (73.6% female, the mean age was 65.9 years. The surgical procedures lasted 11.2 minutes on average. The hemodynamic parameters did not exhibit significant changes at any of the investigated time points. The average ISAS score was 2.67 immediately after surgery and 2.99 eight hours after the surgery; this increase was statistically significant (p<0.0001. More than two-thirds (68.9% of the participants (73 patients did not report any pain in the transoperative period, and 98.1% of patients denied the occurrence of pain after surgery. CONCLUSIONS: Patients that received topical anesthesia supplemented by intracameral lidocaine combined with sedation for phacoemulsification cataract surgery reported adequate level of satisfaction with the anesthetic

  10. B - SCAN ULTRASONOGRAPHY BEFORE SURGERY I N EYES WITH ADVANCED CATARACTS: A USEFUL PROGNOSTIC TOOL

    Jatin

    2015-05-01

    Full Text Available BACKGROUND : Ocular ultrasonography is an important tool for evaluating the posterior segment in eyes with opaque media . In cases with dense cataract , where posterior segment evaluation by ophthalmoscopy is not possible , B - scan ultrasonography before surgery can help in surgical planning and guiding the expectations of patients . PURPOSE : To determine the relevance and prevalence of posterior segment abnormalities in patients with dense ca taracts prior to surgery by ultrasonography . DESIGN : Prospective diagnostic study . METHODS : Diagnostic B - scan ultrasound was performed on 158 eyes of 132 patients with dense cataract precluding visualization of fundus on ophthalmoscopy from January 2013 to December 2013 . Patients were divided in two groups , traumatic ( 22 and non - traumatic ( 136 . Patients in the age range of 1 to 79 years of both sexes were included . Detailed history and some basic eye examination techniques , like slit lamp and tonometry we re done . Patients having already posterior segment lesions and those who had previous history of ocular surgery were excluded from the study . RESULTS : 26 ( 16 . 4% patients , out of total 158 patients , had posterior segment lesions . Among traumatic group of 22 patients , 15 ( 68 . 1% had positive posterior segment lesions , while only 11 ( 8% patients in the non - traumatic group of 136 patients had positive posterior segment lesions . Out of the 26 positive cases , retinal detachment was found in 8 ( 5% patients , 7 ( 4 . 4% had posterior vitreous detachment , 7 ( 4 . 4% had vitreous hemorrhage , 2 ( 1 . 26% had retinal detachment with vitreous hemorrhage , 1 ( 0 . 63% had asteroid hyalosis , 1 ( 0 . 63% had intra - ocular foreign body . CONCLUSION : We concluded that B - scan ultrasound has sign ificant importance in the preoperative evaluation of patients with dense cataracts to detect pathologies that may influence the surgical strategy and the postoperative visual prognosis .

  11. Conjunctival bacterial flora and antibiotic resistance pattern in patients undergoing cataract surgery

    Arantes Tiago Eugênio Faria e

    2006-01-01

    Full Text Available PURPOSE: To evaluate the conjunctival bacterial flora and its antibiotic resistance pattern in eyes of patients undergoing cataract surgery. METHODS: From August to October 2004, 50 patients undergoing cataract surgery in the "Fundação Altino Ventura", Recife, Brazil, were prospectively evaluated. Conjunctival material was obtained on the day of surgery, before the application of topical anesthetic, antibiotic or povidone-iodine. The collected material was inoculated and bacterioscopic analysis was carried out. In the cases where there was bacterial growth, antibiotic susceptibility tests and cultures, for isolation and identification of the bacteria, were performed. RESULTS: Of the 50 eyes, 43 (86.0% had positive cultures. The coagulase-negative Staphylococcus (CNS, found in 27 (54.0% eyes, was the most frequent organism. More than 90% of the isolates of this bacterium were susceptible to cephalotin, vancomycin, chloramphenicol, ofloxacin and gatifloxacin; 70 to 90% were susceptible to gentamicin, cefotaxime, oxacillin and ciprofloxacin; and less than 70% were sensible to neomycin. Four (10.5% of the bacterial isolates were resistant to four or more antibiotics, two of them were CNS. CONCLUSION: The most frequent bacterium in the conjunctival flora is the coagulase-negative Staphylococcus. The isolates of this organism showed low susceptibility rate to neomycin, and high susceptibility rates to cephalotin, vancomycin, chloramphenicol, ofloxacin and gatifloxacin.

  12. A simulator to explore the role of haptic feedback in cataract surgery training.

    Doyle, Laura; Gauthier, Nicholas; Ramanathan, Saraswathy; Okamura, Allison

    2008-01-01

    Phacoemulsification cataract surgery, a minimally invasive technique to remove a cloudy lens from the eye, is one of the most commonly performed surgical procedures in the western world. Conventional training for this procedure involves didactic lectures and practice on pig and human cadaver eyes, none of which allow trainees to form an accurate predictive model of human tissue behavior during surgery. A virtual environment simulator for capsulorrhexis, one of the first steps in cataract surgery, has been developed that allows a trainee to use surgical instruments to excise a circle of tissue on the anterior side of the lens capsule through tearing. The simulator invokes a deformable mass-spring-damper mesh model of the tissue that can be grasped and torn via shearing. A novel algorithm for mesh division and maintenance enables realistic tearing behavior. The trainee controls tool motion using a 3-degree-of-freedom haptic device, and haptic feedback is provided from the virtual tissue. Although the haptic feedback in a real capsulorrhexis procedure is below the human threshold of haptic sensing, this simulator enables an experiment to determine the effectiveness of "haptic training wheels" -- the idea of haptic training for a task without haptic feedback. PMID:18391267

  13. Conjunctival bacterial flora and antibiotic resistance pattern in patients undergoing cataract surgery

    The purpose of this study was to evaluate the conjunctival bacterial flora and its antibiotic susceptibility pattern in eyes of patients undergoing cataract surgery. Conjunctival soap was obtained on the day of surgery before the application of topical anesthetic, antibiotic or povidone-iodine. Culture and antibiotic susceptibility tests were performed. The data was analysed with X/sup 2/ and T tests. Of the 170 patients 89 cases (52.4%) had positive cultures in the eyes. In 79 eyes (88.8%) found coagulase-negative Staphylococcus (CoNS). Eighty two cases (95.3%) of isolated Staphylococcus were susceptible to Amikacin, 86 (100%) sensitive to Ciprofloxacin and 42 (48.8%) sensitive to Ceftazidime. Average susceptibility and resistancy to antibiotics was 2.6 (+-1.8) antibiotics in women and 1.6(+-1.4) in men (P= 0.009). This study showed that the bacterium most frequently found in the conjunctival flora of the patients undergoing cataract surgery was CoNS. Isolates of this bacterium had low CoNS susceptibility rates to Caftazidime and Vancomycin and high susceptibility to Ciprofloxacin and Amikacin. (author)

  14. Delayed Descemet's membrane detachment after successful cataract surgery: a case report

    Aileen Walsh

    2012-10-01

    Full Text Available The detachment of Descemet's membrane can be a serious complication following cataract surgery, leading to severe corneal edema and reduced visual acuity. This report describes an unusual case of Descemet's membrane detachment 6 months after successful phacoemulsification, documented by anterior segment optic coherence tomography (OCT; RTVue, Optovue. The eye was treated successfully with pneumatic descemetopexy and transcorneal suturing, with reattachment of Descemet's membrane. This report should alert physicians that delayed corneal edema can be related to late-onset Descemet's membrane detachment, which requires proper treatment to avoid permanent corneal decompensation.

  15. Symbolic algebra approach to the calculation of intraocular lens power following cataract surgery

    Hjelmstad, David P.; Sayegh, Samir I.

    2013-03-01

    We present a symbolic approach based on matrix methods that allows for the analysis and computation of intraocular lens power following cataract surgery. We extend the basic matrix approach corresponding to paraxial optics to include astigmatism and other aberrations. The symbolic approach allows for a refined analysis of the potential sources of errors ("refractive surprises"). We demonstrate the computation of lens powers including toric lenses that correct for both defocus (myopia, hyperopia) and astigmatism. A specific implementation in Mathematica allows an elegant and powerful method for the design and analysis of these intraocular lenses.

  16. Use of a grading system in the evaluation of complications in a randomised controlled trial on cataract surgery. Oxford Cataract Treatment and Evaluation Team (OCTET).

    1986-01-01

    A randomised controlled trial in progress for more than five years assessed 333 eyes by three methods of cataract surgery. These were (A) intracapsular extraction and contact lens usage; (B) intracapsular extraction and implantation of an iris supported lens (Federov I); and (C) extracapsular extraction and implantation of an iridocapsular lens (Binkhorst 2-loop). This paper reports the use of a weighting scale for rank scoring complications which are dissimilar or are mutually exclusive (for...

  17. Long-Term Changes in Subfoveal Choroidal Thickness After Cataract Surgery.

    Yılmaz, Tolga; Karci, Ayse Aslihan; Yilmaz, İhsan; Yılmaz, Ahu; Yıldırım, Yusuf; Sakalar, Yildirim Bayezit

    2016-01-01

    BACKGROUND Cataract surgery is associated with the development of late-onset age-related macular degeneration (AMD). The pathogenic mechanism is still not fully established. The purpose of this study was to evaluate the possible changes in central macula thickness (CMT) and subfoveal choroid thickness (SCT) after uneventful cataract surgery. MATERIAL AND METHODS A total of 65 eyes of 65 patients who underwent phacoemulsification and intracapsular lens implantation were included in this prospective study. Patients had not undergone previous ocular surgery and had no other ocular abnormality. CMT and SCT were measured at baseline and postoperatively at week 1 and months 1, 3, 6 and 12 via spectral domain optical cohorence tomography (SD-OCT). RESULTS CMT was 252.4±27.6 μm (mean ±SD) preoperatively, then 253.5±29.8, 256.1±28.7, 257.4±27.2, 253.18±23.7, and 252.8±21.7 μm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. There were insignificant changes in CMT, and it returned to baseline at six months after surgery (all p>0.05). SCT was 237.4±21.6 μm preoperatively, and 240.5±24.8, 241.2±25.7, 242.7±26.3, 243.1±24.2, and 244.2±21.4 μm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. Although there was an increase in SCT during follow-up, the difference between preoperative and postoperative values was not significant (p>0.05). CONCLUSIONS Uncomplicated phacoemulsification induces subclinical changes in CMT, probably due to the inflammatory insult of surgery, and CMT returns to baseline value. There were slight, insignificant increases in choroid thickness during follow-up, and this did not return to baseline during follow-up. Changes in the choroid after cataract surgery may provide clues to the development of late-onset AMD. PMID:27158971

  18. Cataract surgery under topical anesthesia using 2% lignocaine jelly and intracameral lignocaine: Is manual small incision cataract surgery comparable to clear corneal phacoemulsification?

    Gupta Sanjiv

    2010-01-01

    Full Text Available A prospective comparative study was undertaken to compare the patients′ pain experience, surgical outcome and surgeon′s experience in phacoemulsification and manual small incision cataract surgery (MSICS under topical anesthesia supplemented with intracameral lignocaine (TASIL. In Group 1 (n=88 phacoemulsification was done and in Group 2 (n=92 MSICS was done. Pain scores were marked by the patients on a Visual analog scale (VAS after the surgery. The surgical experience was noted on a questionnaire by the operating surgeon. Descriptive analysis and one-tailed Mann-Whitney test were used to draw results. The average VAS score in Group 1 was 0.65 (SD 1.31 and in Group 2 it was 0.90 (SD 1.22. This difference in the average was not statistically significant with P=0.09. The study demonstrates that MSICS and phacoemulsification both can be done safely under TASIL with acceptable patient comfort, and the pain experienced by the patients during the procedures is comparable.

  19. Risk of Cataract Surgery in HIV-Infected Individuals: A Danish Nationwide Population-Based Cohort Study

    Rasmussen, Line D; Kessel, Line; Molander, Laleh D;

    2011-01-01

    cataract surgery were obtained from the Danish National Hospital registry. Cumulative incidence curves were constructed. Incidence rate ratios (IRRs) and impact of immunodeficiency, highly active antiretroviral therapy (HAART), and treatment with abacavir, tenofovir, protease inhibitors, and nonnucleoside...... adjusted IRRs were 0.60 (95% CI: 0.22-1.61) and 1.87 (95% CI: 1.46-2.39). Treatment with abacavir, tenofovir, protease inhibitors, or NNRTIs did not increase the risk substantially. Conclusions. HIV-infected individuals have an increased risk of cataract surgery. The risk is mainly associated with...

  20. CLINICAL STUDY OF VARIOUS TYPES OF INCISIONS IN SMALL INCISION CATARACT SURGERY IN RELATION TO THEIR ASTIGMATISM OUT COME

    Sindhura

    2015-06-01

    Full Text Available AIM: To evaluate the surgically induced astigmatism ¹with different types of incisions in manual small incision cataract surgery over a period of one week, two weeks, four weeks and six weeks post - operative period. As the incision is the major cause for surgically induced astigmatism and this effect is directly related to the length, shape, location and depth of the incision. METHODS: Pr ospective analysis of the medical records of a total of 100 patients who underwent manual small incision cataract surgery with various types of incisions with SIA.

  1. Intracameral anesthesia for cataract surgery: a population-based study on patient satisfaction and outcome

    Westborg I

    2013-10-01

    Full Text Available Inger Westborg,1,2 Eva Mönestam1 1Department of Clinical Sciences/Ophthalmology, Umeå University, Umeå, Sweden; 2Eye Clinic, Sunderby Hospital, Luleå, Sweden Purpose: To evaluate if the standard anesthetic regimen – topical combined with intracameral anesthesia without sedation – in a population-based cohort of unselected cataract surgery cases is adequate, optimal, and good practice, or if improvements are necessary. Methods: We conducted a prospective, observational study on all cases of cataract surgery during a 1-year period at one institution (n=1249. Data were collected from the patients’ records. Outcome measures were use of preoperative sedation, type of anesthesia, complications, and adverse events. In a subgroup of patients (n=124 satisfaction with the anesthetic regimen was evaluated using a short questionnaire. Results: Most cases (90%, 1125/1249 had combined topical and intracameral anesthesia without sedation. Patients who chose preoperative sedation (midazolam hydrochloride sublingually were significantly younger and more often female (P=0.0001 and P=0.011, respectively. In the questionnaire subgroup, the median pain score after surgery was 0.7 (visual analog scale, 0–10. A pain score of 1.9 or less was reported by 76% of the patients. Patients reporting a pain score of 2 or more had sedation and additional anesthetics more often. No significant difference was found regarding age, sex, pulse rate, oxygen saturation, first or second eye surgery, or adverse intraoperative events for patients with pain scores of 1.9 or less and 2 or more. Conclusion: This large population-based series of small-incision phacoemulsification surgery shows that combined topical and intracameral anesthesia without sedatives is well tolerated for most phacoemulsification patients. It is also effective in cases when complications or adverse events occur. It is important to be responsive to the individual patient’s needs and adjust operating

  2. An analysis of ophthalmology trainees' perceptions of feedback for cataract surgery training

    Saedon H

    2013-12-01

    Full Text Available Habiba Saedon Birmingham Midland Eye Centre, Birmingham, West Midlands, UK Objectives: To determine whether feedback for cataract surgery is perceived to be given to trainee ophthalmologists, the way in which any feedback is given, and what the trainee perceives to be the effect of feedback on their performance. Design: Cross-sectional qualitative study. Participants: Twelve trainee ophthalmologists at various levels of specialty training in the UK. Methods: Semi-structured interviews were conducted via telephone or face to face. Interviews were transcribed and underwent thematic analysis using a qualitative software data package. Main outcome measures: The importance of feedback to the trainee and methods to improve the giving of feedback. Results: Feedback was thought to be a useful tool for improving performance in cataract surgery by all participants. Emergent themes were the importance of specificity of feedback and having confidence in the supervisor. Participants suggested ways that the feedback given can be improved upon. An insight was gained into how the feedback has an effect on their performance. Conclusion: This study showed that trainees perceive the feedback they receive to be of high quality. Feedback enables the trainees to self-reflect and improve their surgical techniques. Keywords: postgraduate training, education, phacoemulsification, microsurgical skills, cognitive learning, reflection

  3. Topical Latanoprost Does Not Cause Macular Thickening after Uncomplicated Cataract Surgery

    Sasan Moghimi

    2012-01-01

    Full Text Available Purpose: To explore changes in central macular thickness (CMT after a two-month period of glaucoma therapy with topical latanoprost after uneventful phacoemulsification. Methods: Forty-one eyes of 31 patients with primary open angle or pseudoexfoliative glaucoma who required glaucoma medications after cataract surgery were prospectively enrolled. All eyes had undergone uneventful phacoemulsification with intraocular lens implantation at least 4 months before initiation of latanoprost. After a complete ophthalmic examination, spectral-domain optical coherence tomography (SD-OCT and fluorescein angiography (FA were performed at baseline before starting latanoprost. All eyes received latanoprost for 2 months, and clinical examinations were repeated one and two months afterwards; OCT and FA were repeated after 2 months. Outcome measures were CMT and loss of more than 2 lines of best corrected visual acuity (BCVA. Results: Mean patient age was 71.6±7.8 years. Intraocular pressure decreased from 21.5±3.4 mmHg to 14.4±2.6 mmHg (p0.05 for all comparisons. Conclusion: Topical use of latanoprost later than 4 months after uncomplicated cataract surgery does not seem to predispose to increased macular thickness or CME and may safely be used in this setting.

  4. Comparative efficacy of topical tetraVisc versus lidocaine gel in cataract surgery

    Gupta Shailesh K

    2009-08-01

    Full Text Available Abstract Background To compare the clinical efficacy of lidocaine 2% with tetracaine 0.5% for cataract surgery. Methods In a randomized, multi-surgeon, controlled clinical trial,122 consecutive cataract cases eligible for topical anesthesia, were randomly assigned to receive lidocaine 2% gel (1 ml or tetracaine solution 0.5% (TetraVisc, 0.5 ml before clear corneal phacoemulsification. Main outcome measure was visual analog scale (0 to 10, which was used to measure intra-operative pain. Secondary outcome measures included patients' discomfort due to tissue manipulation and surgeon graded patients' cooperation. Duration of surgery and intra-operative complications were also recorded. Results The mean age in TetraVisc (TV group was 70.4 years and in the lidocaine gel group (LG it was 70.6 years (p = 0.89. Patient reported mean intra-operative pain scores by visual analog scale were 0.70 ± 0.31 in TV group and 1.8 ± 0.4 in LG group (P Conclusion Topical TetraVisc solution was superior to lidocaine 2% gel for pain control in patients undergoing clear corneal phacoemulsification. Lidocaine 2% gel is similar to TetraVisc in patient comfort and surgeon satisfaction. Trial Registration Clinical trials number: ISRCTN78374774

  5. Factors Influencing Efficacy of Peripheral Corneal Relaxing Incisions during Cataract Surgery

    Nino Hirnschall

    2015-01-01

    Full Text Available Purpose. To evaluate influencing factors on the residual astigmatism after performing peripheral corneal relaxing incisions (PCRIs during cataract surgery. Methods. This prospective study included patients who were scheduled for cataract surgery with PCRIs. Optical biometry (IOLMaster 500, Carl Zeiss Meditec AG, Germany was taken preoperatively, 1 week, 4 months, and 1 year postoperatively. Additionally, corneal topography (Atlas model 9000, Carl Zeiss Meditec AG, Germany, ORA (Ocular Response Analyzer, Reichert Ophthalmic Instruments, USA, and autorefraction (Autorefractometer RM 8800 Topcon were performed postoperatively. Results. Mean age of the study population n=74 was 73.5 years (±9.3; range: 53 to 90 and mean corneal astigmatism preoperatively was −1.82 D (±0.59; 1.00 to 4.50. Mean corneal astigmatism was reduced to 1.14 D (±0.67; 0.11 to 3.89 4 months postoperatively. A partial least squares regression showed that a high eccentricity of the cornea, a large deviation between keratometry and topography, and a high preoperative astigmatism resulted in a larger postoperative error concerning astigmatism. Conclusions. PCRI causes a reduction of preoperative astigmatism, though the prediction is difficult but several factors were found to be a relevant source of error.

  6. Cirurgia de catarata realizada por residentes: avaliação dos riscos Cataract surgery performed by residents: risk analysis

    Jackson Barreto Junior

    2010-10-01

    Full Text Available OBJETIVO: Avaliar a frequência de complicações nas cirurgias de catarata realizada por residentes de um hospital universitário (segundo e terceiro anos, comparado com as realizadas por cirurgiões experientes (assistentes. MÉTODOS: Análise retrospectiva dos prontuários de todos pacientes submetidos à cirurgia de catarata realizadas nas primeiras quinzenas de março (época do início do aprendizado da técnica cirúrgica e de novembro (meados do aprendizado da técnica. Foram analisados a época da realização da cirurgia; graduação do cirurgião (residente ou médico assistente; técnica cirúrgica empregada (extração extracapsular ou facoemulsificação e a ocorrência de complicações per-operatórias e pós-operatórias. RESULTADOS: Foram analisadas 481 cirurgias, destas, 194 (40% foram realizadas pelos residentes do terceiro ano, 165 (34% pelos residentes do segundo ano e 116 (26% pelos assistentes. A complicação mais frequentemente encontrada em todas as cirurgias foi a rotura de cápsula posterior (4,8%. Não houve diferença estatisticamente significativa de complicações entre as cirurgias realizadas em março e novembro (p=0,97, bem como entre os residentes sob supervisão e os assistentes (p=0,08. CONCLUSÃO: A rotura de cápsula posterior continua sendo a complicação mais frequentemente encontrada nas cirurgias de residentes em treinamento. Não houve diferença estatisticamente significativa entre as taxas de complicação destes residentes e os assistentes, o que demonstra o importante papel de uma supervisão adequada.PURPOSE: To evaluate the complication's rate of cataract surgery performed by ophthalmology residents (second and third-year and experienced surgeons at a public teaching hospital. METHODS: A retrospective chart review of all patients who had cataract surgery between March (begin of the technique practice and November (end of the technique practice was conducted. RESULTS: In 481 cataracts surgeries

  7. The Effect of Therapeutic Touch Performed During Cataract Surgery on Anxiety and Patient Satisfaction

    Emel Yılmaz

    2016-03-01

    Full Text Available Objective: The aim of the study was to determine the ef­fect of therapeutic touch (TT on anxiety and patient satis­faction when performed during a cataract surgery. Methods: A randomized controlled trial sample consisted of 114 individuals, 57 in the intervention group and 57 controls, who were hospitalized for cataract surgery and who conformed to the study criteria. Prior to the study approval was obtained from the ethics committee and informed consent was given by the patients. Data was collected using a personal information form, a visual analogue scale (VAS to measure anxiety, the Spielberg State/Trait Anxiety Inventory (STAI and the Newcastle Satisfaction with Nursing Care Scale (NSNCS. During the surgery, patients in the intervention group received a 15-minute session of TT. Results: In the intervention group, patients’ mean VAS anxiety score after TT was 3.56±1.85, while that of the control group in the 15th minute of the operation was 8,88±1,50. It was found that anxiety levels were reduced in the intervention group after TT compared with the con­trol group, and that vital signs were affected positively. NSNCS scores of patients in the intervention group were higher than those in the control group. Conclusion: It was observed that TT applied during sur­gery reduced anxiety, affected vital signs positively and increased patent satisfaction. The application of TT dur­ing surgery is recommended. J Clin Exp Invest 2016; 7 (1: 52-62

  8. Real-time segmentation and recognition of surgical tasks in cataract surgery videos.

    Quellec, Gwénolé; Lamard, Mathieu; Cochener, Béatrice; Cazuguel, Guy

    2014-12-01

    In ophthalmology, it is now common practice to record every surgical procedure and to archive the resulting videos for documentation purposes. In this paper, we present a solution to automatically segment and categorize surgical tasks in real-time during the surgery, using the video recording. The goal would be to communicate information to the surgeon in due time, such as recommendations to the less experienced surgeons. The proposed solution relies on the content-based video retrieval paradigm: it reuses previously archived videos to automatically analyze the current surgery, by analogy reasoning. Each video is segmented, in real-time, into an alternating sequence of idle phases, during which no clinically-relevant motions are visible, and action phases. As soon as an idle phase is detected, the previous action phase is categorized and the next action phase is predicted. A conditional random field is used for categorization and prediction. The proposed system was applied to the automatic segmentation and categorization of cataract surgery tasks. A dataset of 186 surgeries, performed by ten different surgeons, was manually annotated: ten possibly overlapping surgical tasks were delimited in each surgery. Using the content of action phases and the duration of idle phases as sources of evidence, an average recognition performance of Az = 0.832 ± 0.070 was achieved. PMID:25055383

  9. Evaluation of response variables in computer-simulated virtual cataract surgery

    Söderberg, Per G.; Laurell, Carl-Gustaf; Simawi, Wamidh; Nordqvist, Per; Skarman, Eva; Nordh, Leif

    2006-02-01

    We have developed a virtual reality (VR) simulator for phacoemulsification (phaco) surgery. The current work aimed at evaluating the precision in the estimation of response variables identified for measurement of the performance of VR phaco surgery. We identified 31 response variables measuring; the overall procedure, the foot pedal technique, the phacoemulsification technique, erroneous manipulation, and damage to ocular structures. Totally, 8 medical or optometry students with a good knowledge of ocular anatomy and physiology but naive to cataract surgery performed three sessions each of VR Phaco surgery. For measurement, the surgical procedure was divided into a sculpting phase and an evacuation phase. The 31 response variables were measured for each phase in all three sessions. The variance components for individuals and iterations of sessions within individuals were estimated with an analysis of variance assuming a hierarchal model. The consequences of estimated variabilities for sample size requirements were determined. It was found that generally there was more variability for iterated sessions within individuals for measurements of the sculpting phase than for measurements of the evacuation phase. This resulted in larger required sample sizes for detection of difference between independent groups or change within group, for the sculpting phase as compared to for the evacuation phase. It is concluded that several of the identified response variables can be measured with sufficient precision for evaluation of VR phaco surgery.

  10. Intracameral dexamethasone reduces inflammation on the first postoperative day after cataract surgery in eyes with and without glaucoma

    Diane TW Chang

    2009-05-01

    Full Text Available Diane TW Chang, Michael C Herceg, Richard A Bilonick, Larissa Camejo, Joel S Schuman, Robert J NoeckerDepartment of Ophthalmology, University of Pittsburgh Medical Center, Eye Center, Pittsburgh, PA, USAPurpose: To evaluate whether dexamethasone injected intracamerally at the conclusion of surgery can safely and effectively reduce postoperative inflammation and improve surgical outcomes in eyes with and without glaucoma.Methods: Retrospective chart review of 176 consecutive eyes from 146 patients receiving uncomplicated phacoemulsification (PE (n = 118 total, 82 with glaucoma, glaucoma drainage device (GDD (n = 35, combined PE/GDD (n = 11 and combined PE/endoscopic cyclophotocoagulation (n = 12. Ninety-one eyes from 76 patients were injected with 0.4 mg dexamethasone intracamerally at the conclusion of surgery. All eyes received standard postoperative prednisolone and ketorolac eyedrops. Outcomes were measured for four to eight weeks by subjective complaints, visual acuity (VA, slit-lamp biomicroscopy, intraocular pressure (IOP and postoperative complications.Results: Dexamethasone significantly reduced the odds of having an increased anterior chamber (AC cell score after PE (p = 0.0013. Mean AC cell score ± SD in nonglaucomatous eyes was 1.3 ± 0.8 in control and 0.8 ± 0.7 with dexamethasone; scores in glaucomatous eyes were 1.3 ± 0.7 in control and 0.9 ± 0.8 with dexamethasone. Treated nonglaucomatous eyes had significantly fewer subjective complaints after PE (22.2% vs 64.7% in control; p = 0.0083. Dexamethasone had no significant effects on VA, corneal changes, IOP one day and one month after surgery, or long-term complications.Conclusions: Intracameral dexamethasone given at the end of cataract surgery significantly reduces postoperative AC cells in eyes with and without glaucoma, and improves subjective reports of recovery in nonglaucomatous eyes. There were no statistically significant risks of IOP elevation or other complications in

  11. Facts and Myths about Cataracts

    ... Lasers are used to remove cataracts FACT: In cataract treatment, the clouded lens is surgically removed and then ... membrane behind the implant may become cloudy after cataract surgery. Laser treatment then may be used to open up the ...

  12. Evaluation of the Ex-PRESS® P-50 implant under scleral flap in combined cataract and glaucoma surgery

    Huerva, Valentín; Soldevila, Jordi; Ascaso, Francisco J.; Lavilla, Laura; Muniesa, M. Jesús; Sánchez, M. Carmen

    2016-01-01

    AIM To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS® P-50 for combined cataract surgery and glaucoma. METHODS Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS® P-50 model placed under scleral flap was performed. RESULTS Out of 40 eyes of 40 patients (55% male and 45% female) completed the study during one-year follow-up. The mean of age was 76.6±11.02y. The intraocular pressure (IOP) decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg (Wilcoxon signed ranks test, Pphacoemulsification with ExPRESS® P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation. PMID:27162726

  13. Changes in central corneal thickness and endothelial cell count pediatric cataract surgery

    To evaluate the mean changes in Central Corneal Thickness (CCT) and Endothelial Cell Count (ECC) in eyes after pediatric cataract surgery with foldable intraocular lens using scleral tunnel incision micro-surgical technique. Study Design: Qausi experimental study. Place and Duration of Study: Department of Pediatric Ophthalmology and Strabismus, Al-Shifa Trust Eye Hospital, Rawalpindi, from May 2011 to March 2012. Methodology: Fifty-two eyes of 37 children with pediatric cataract were included in the study. Extracapsular Cataract Extraction (ECE) with foldable Intra Ocular Lens (IOL) implantation using sclera tunnel incision was performed in all children. Endothelial Cell Count (ECC) and Central Corneal Thickness (CCT) were recorded before surgery and 1 month, 3 months and 6 months after surgery and the effect of currently practiced surgical technique on ECC and CCTwas evaluated. Results: The mean age at the time of surgery was 8.8 ± 2.7 years (range: 4 to 15 years). The postoperative ECC and CCT were significantly different from the pre-operative values. Mean pre-operative ECC was 3175.3 ± 218.4 cell/mm2 and in first postoperative month the mean ECC was 3113.4 ± 210.8 cell/mm2 (p<0.0001). In the 3rd and 6th month postoperative means ECC were 3052 ± 202.5 cell/mm2 (p<0.0001) and 3015 ±190.6 cell/mm2 (p<0.0001), respectively. The mean cell loss at first postoperative month was 1.95% and at 3rd and 6th postoperative month were 3.9% and 5.05%, respectively. Mean pre-operative CCT was 514 ± 49.9 micro m and first postoperative mean CCT after 1 month was 524.1 ± 25 micro m (p = 0.084). After the 3rd and 6th months postoperative, mean CCT were 527.3 ± 24.6 micro m, and 530 ± 24.5 micro m, respectively. Third and 6th months postoperative means were significantly higher than baseline CCT, p = 0.024 and 0.007, respectively. Conclusion: Endothelial cell loss with closed chamber micro-surgical technique using scleral tunnel incision is within acceptable limits and

  14. Cost analysis of cataract surgery with intraocular lens implantation: a single blind randomised clinical trial comparing extracapsular cataract extraction and phacoemulsification.

    Rizal, A M; Aljunid, S M; Normalina, M; Hanom, A Faridah; Chuah, K L; Suzainah, Y; Zainal, M; Azman, A B

    2003-08-01

    A randomised single blinded clinical trial to compare the cost of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) between March and December 2000. A total of 60 patients were included in this study. The cost of a cataract surgery incurred by hospital, patients and households up to two months after discharge were included. The costs of training, loss of patients' income after discharge and intangible costs were excluded. Results showed that the average cost for one ECCE operation is RM1,664.46 (RM1,233.04-RM2,377.64) and for PEA is RM1,978.00 (RM1,557.87-RM3,334.50). During this short period of follow up, it can be concluded that ECCE is significantly cheaper than PEA by an average difference of RM 313.54 per patient (p < 0.001). Cost of equipment and low frequency of PEA technique done in HUKM were the two main reasons for the high unit cost of PEA as compared to ECCE. PMID:14750378

  15. Uveitis-glaucoma-hyphema syndrome caused by posterior chamber intraocular lens--a rare complication in pediatric cataract surgery.

    Lin, Chun-Ju; Tan, Chau-Yi; Lin, Szu-Yuan; Jou, Jieh-Ren

    2008-01-01

    We report a case of postoperative uveitis-glaucome-hyphema (UGH) syndrome following pediatric cataract surgery due to posterior chamber intraocular lens (PC-IOL). Slit-lamp examination revealed the optic of PC-IOL migrated into anterior chamber. The PC-IOL explantation was performed and ocular inflammation subsided. PMID:19230361

  16. A comparative study of complications of cataract surgery with phacoemulsification in eyes with high and normal axial length

    Hamid Fesharaki

    2012-01-01

    Conclusions: As the results illustrate, in this survey, age and high axial length were statistically significant risk factors for incidence of intraoperative complications of cataract surgery with phacoemulsification technique. Anticipation of these complications and also preparation and prophylactic measures may decrease incidence of these complications.

  17. Comparison of the effects of remifentanil and alfentanil on intraocular pressure in cataract surgery

    Godrat Akhavanakbari

    2013-01-01

    Full Text Available Background: Anesthesia for ophthalmic surgery requires management of intraocular pressure (IOP during perioperative period. In an open eye, in conditions such as after traumatic injury or during cataract surgery, IOP increase can lead to permanent vision loss. Administration of narcotics concomitant with anesthetics has the ability to reduce this increase of IOP. This clinical trial aims to compare the efficacy of remifentanil and alfentanil in preventing an increase in IOP after administration of succinylcholine, intubation and during anesthesia. Methods: This double-blind clinical trial was conducted on 50 patients undergoing elective general surgery for cataracts. Patients were randomly divided into two groups. Alfentanil (20 μg/kg in 30 s for group 1 and remifentanil (1 μg/kg in 30 s for group 2 were injected before induction of anesthesia, and 0.5 μg/kg/min alfentanil for group 1 and 0.1 μg/kg/min remifentanil for group 2 were infused during the anesthesia. Systolic and diastolic blood pressure, heart rate, and IOP from normal eye were measured before the induction, after administration of thiopental and succinylcholine, after tracheal intubation, and 2 min later, and were repeated in 2-min intervals until the end of operation. Results: IOP decreased after injection of anesthetics and remained lower all through the operation in both groups, but IOP decreased after injection of succinylcholine in remifentanil group while it increased in alfentanil group (P<0.05. Conclusions: Results of this study indicate benefits of both remifentanil and alfentanil in managing IOP after induction and during anesthesia. It seems that remifentanil is better than alfentanil in controlling the IOP after injection of succinylcholine.

  18. Outcomes of cataract surgery in diabetic patients: results of the Pan American Collaborative Retina Study Group

    Roberto Gallego-Pinazo

    2014-12-01

    Full Text Available Purpose: This study was designed to evaluate the visual and anatomical outcomes after cataract surgery in diabetic patients with different intraoperative therapeutic strategies. Methods: The research design comprised of a multicentric, retrospective, interventional study conducted at 6 centers in Argentina, Brazil, Costa Rica, Puerto Rico, Spain, and Venezuela. We included 138 diabetic patients with at least 6-month follow-up following phacoemulsification and intraocular lens implantation. Best-corrected visual acuity (BCVA and central subfield thickness were collected at baseline and at 1-, 2-, 3-, and 6-month follow-up. Of these, 42 cases were not treated with any intraoperative coadjuvant medication (Group 1, 59 patients received intraoperative bevacizumab (Group 2 and 37 patients received intraoperative triamcinolone (4 mg/0.1 ml (Group 3. Results: The mean logMAR [± standard deviation (SD] BCVA improved from 0.82 (± 0.43 at baseline, to 0.14 (± 0.23 at 6-month follow-up (p<0.001 in Group 1; from 0.80 (± 0.48 to 0.54 (± 0.45 (p<0.001 in Group 2; and from 1.0 (± 0.40 to 0.46 (± 0.34 (p<0.001 in Group 3. The mean central subfield thickness increased from 263.57 µm (± 35.7 at baseline to 274.57 µm (± 48.7 at 6-month follow-up (p=0.088 in Group 1; from 316.02 µm (± 100.4 to 339.56 µm (± 145.3 (p=0.184 in Group 2; and from 259.18 µm (± 97.9 to 282.21 µm (± 87.24 (p=0.044 in Group 3. Conclusion: Diabetic patients may significantly benefit from cataract surgery. This study provides evidence to support the use of intravitreal triamcinolone or bevacizumab at the time of cataract surgery in cases with pre-existent diabetic macular edema or moderate-severe non-proliferative diabetic retinopathy.

  19. Comparative outcomes of manual small incision cataract surgery and phacoemulsification performed by ophthalmology trainees in a tertiary eye care hospital in India: a retrospective cohort design

    Khanna, Rohit C; Kaza, Srivalli; Palamaner Subash Shantha, Ghanshyam; Virender S Sangwan

    2012-01-01

    Objective To compare the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification performed by ophthalmology trainees. Design Retrospective cohort design. Setting Tertiary eye care centre. Participants A total of 1029 subjects underwent cataract surgeries with MSICS technique or phacoemulsification by trainees during one quarter (July–September 2007). Only 484 (47%) subjects were males. Surgeries which were primarily large incision extracapsular or intracapsular cata...

  20. Schlieren visualization of fluid dynamics phenomena during phacosonication in cataract surgery

    Serafino, Gabriella; Piuzzi, Barbara; Sanguinetti, G.; Sirotti, C.; Sirotti, Paolo; Tognetto, D.

    2005-03-01

    In ultrasonic phacoemulsification during cataract surgery the lens material fragmentation has been described as being caused by a combination of several mechanisms. The different theories involve tip vibration, acoustic waves produced by the tip, particles and liquids impact on the surface of the lens and cavitation. However the mechanisms are still not clear. To better understand phaco-related phenomena we have tried to produce a description in term of images of the cataract phacoemulsification procedure. An expanded and collimated laser diode beam transilluminates a transparent tube containing a liquid medium. The machine is activated separating the different phases of irrigation, aspiration and phacosonication. Fluid turbulences and phenomena related to the tip vibration constitute the phase images, visualized using Schlieren or similar techniques. The optical Fourier transform is filtered by a blade or by a black dot. The filtered transform is reconstructed into the visualized phase image and this is acquired by a digital image processing system. The presence of acoustic cavitation and possibly of ultrasonic radiation has been revealed. The technique promises to be a possible means for evaluation of single phaco apparatus power setting and comparison between different machines in terms of power modulation and cavitation production.

  1. Congenital cataract. Report 2. Current strategies of congenital cataract management in children: a review

    N. Ya. Senchenko; K. A. Nagaeva; E. K. Ayuyeva1; T.N. Iureva

    2014-01-01

    Different approaches to surgical and pleoptic treatment of congenital cataract and amblyopia of obscure origin in children are represented. Main tendencies that determine the indications to surgical procedures and their terms are described. Current techniques of aphakia correction, their advantages and disadvantages as well as pleoptic methods of visual system stimulation are discussed

  2. Comparing the Curative Effects between Femtosecond Laser-Assisted Cataract Surgery and Conventional Phacoemulsification Surgery: A Meta-Analysis

    Chen, Xinyi; Chen, Kailin; He, Jiliang; Yao, Ke

    2016-01-01

    Purpose To compare the outcomes of femtosecond laser-assisted cataract surgery (FLACS) with those of conventional phacoemulsification surgery (CPS) for age-related cataracts. Methods A comprehensive literature search of PubMed, EMBASE, and the Cochrane Controlled Trials Register was conducted to identify randomized controlled trials (RCT) and comparative cohort studies comparing FLACS with CPS. Endothelial cell loss percentage (ECL%), central corneal thickness (CCT), corrected and uncorrected distant visual acuity (CDVA and UDVA), and mean absolute error (MAE) of refraction were used as primary outcomes. Secondary outcomes included surgically induced astigmatism (SIA), mean effective phacoemulsification time (EPT), phacoemulsification power and circularity of the capsulorhexis. Results Nine RCTs and fifteen cohort studies including 4,903 eyes (2,861 in the FLACS group and 2,072 in the CPS group) were identified. There were significant differences between the two groups in ECL% at one week, about one month and three months postoperatively, in CCT at one day, about one month postoperatively and at the final follow-up, in CDVA at one week postoperatively, and in UDVA at the final follow-up. Significant differences were also observed in MAE, EPT, phacoemulsification power, and the circularity of capsulorhexis. However, no significant differences were observed in CDVA at one week postoperatively or in surgically induced astigmatism. Conclusions Compared to CPS, FLACS is a safer and more effective method for reducing endothelial cell loss and postoperative central corneal thickening as well as achieving better and faster visual rehabilitation and refractive outcomes. However, there is no difference in final CDVA and surgically induced astigmatism between the two groups. PMID:26999612

  3. Comparing the Curative Effects between Femtosecond Laser-Assisted Cataract Surgery and Conventional Phacoemulsification Surgery: A Meta-Analysis.

    Xinyi Chen

    Full Text Available To compare the outcomes of femtosecond laser-assisted cataract surgery (FLACS with those of conventional phacoemulsification surgery (CPS for age-related cataracts.A comprehensive literature search of PubMed, EMBASE, and the Cochrane Controlled Trials Register was conducted to identify randomized controlled trials (RCT and comparative cohort studies comparing FLACS with CPS. Endothelial cell loss percentage (ECL%, central corneal thickness (CCT, corrected and uncorrected distant visual acuity (CDVA and UDVA, and mean absolute error (MAE of refraction were used as primary outcomes. Secondary outcomes included surgically induced astigmatism (SIA, mean effective phacoemulsification time (EPT, phacoemulsification power and circularity of the capsulorhexis.Nine RCTs and fifteen cohort studies including 4,903 eyes (2,861 in the FLACS group and 2,072 in the CPS group were identified. There were significant differences between the two groups in ECL% at one week, about one month and three months postoperatively, in CCT at one day, about one month postoperatively and at the final follow-up, in CDVA at one week postoperatively, and in UDVA at the final follow-up. Significant differences were also observed in MAE, EPT, phacoemulsification power, and the circularity of capsulorhexis. However, no significant differences were observed in CDVA at one week postoperatively or in surgically induced astigmatism.Compared to CPS, FLACS is a safer and more effective method for reducing endothelial cell loss and postoperative central corneal thickening as well as achieving better and faster visual rehabilitation and refractive outcomes. However, there is no difference in final CDVA and surgically induced astigmatism between the two groups.

  4. Liquefaction for cataract extraction

    Labiris, Georgios; Toli, Aspasia; Polychroni, Damaskini; Gkika, Maria; Angelonias, Dimitrios; Kozobolis, Vassilios P.

    2016-01-01

    A systematic review of the recent literature regarding the implementation of the liquefaction in cataract surgery and its short-term and long-term outcomes in various parameters that affect the quality of patients' life, including visual rehabilitation and possible complications was performed based on the PubMed, Medline, Nature and the American Academy of Ophthalmology databases in November 2013 and data from 14 comparative studies were included in this narrative review. Liquefaction is an innovative technology for cataract extraction that uses micropulses of balanced salt solution to liquefy the lens nucleus. Most studies reported that liquefaction is a reliable technology for mild to moderate cataracts, while fragmentation difficulties may be encountered with harder nuclei. PMID:26949656

  5. Application of trypan blue before continuous curvilinear capsulorhexis in the surgery for all white or over ripe stage cataract

    Chun-Tao Zhang; Yuan He; Jun Jia

    2016-01-01

    AIM:To discuss the application of trypan blue before continuous curvilinear capsulorhexis(CCC)during the surgery for all white or over ripe stage cataract. METHODS:Forty-two eyes in 42 patients with cataract in all white or over ripe stage were selected. During the operations, 0.2mL trypan blue(0.6mg/mL)was injected into the anterior chambers of all the 42 eyes. The anterior capsule was stained to light blue. Then the CCC was conducted. The density of corneal endothelial cells and the percent...

  6. Application of ultrasound biomicro-scopy in the planning of cataract surgery in anterior megalophthalmos

    Mohammad Ali Zare

    2011-01-01

    Full Text Available Anterior megalophthalmos, a rare hereditary disorder, is macrocornea (horizontal corneal diameter more than 13 mm in association with enlarged lens-iris diaphragm and ciliary ring. One of the major challenging issues in the cataract surgery of these patients is preventing intraocular lens (IOL malposition, because of probable large capsular bag. Several approaches have been selected by previous surgeons, such as, custom-made anterior chamber IOLs. In this study, we show a normal capsular bag diameter despite ciliary ring enlargement, with application of ultrasound biomicroscopy (UMB. We suggest that in cases of anterior megalophthalmos without phacodonesis, UBM could measure the actual size of the capsular bag and obviate the need for further procedures.

  7. Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery

    Kessel, Line; Andresen, Jens; Tendal, Britta; Erngaard, Ditte; Flesner, Per; Hjortdal, Jesper

    2016-01-01

    evaluated as surgical complications and residual astigmatism. CLINICAL RELEVANCE: Postoperative astigmatism is an important cause of suboptimal UCDVA and need for distance spectacles. Toric IOLs may correct for preexisting corneal astigmatism at the time of surgery. METHODS: We performed a systematic...... literature search in the Embase, PubMed, and CENTRAL databases within the Cochrane Library. We included randomized clinical trials (RCTs) if they compared toric with non-toric IOL implantation (± relaxing incision) in patients with regular corneal astigmatism and age-related cataracts. We assessed the risk.......36-0.71) and moderate quality evidence that toric IOL implantation was not associated with an increased risk of complications (RR, 1.73; 95% CI, 0.60-5.04). Residual astigmatism was lower in the toric IOL group than in the non-toric IOL plus relaxing incision group (mean difference, 0.37 diopter [D]; 95% CI...

  8. Case Payment and the Adoption of New Technology:An Empirical Study of Cataract Surgery in Taiwan.

    Yi-Chou Chuang

    2004-05-01

    Full Text Available Background: Case payment for cataract surgery with Government Employee Insurance(GEI was implemented at Chang Gung Memorial Hospital (CGMH inMarch 1994, and fee-for-service (FFS was retained for cataract inpatientswith or without other health insurance. We examined the impact of thischange in the reimbursement policy from FFS to case payment on the healthcare provider's practice behavior towards a new emerging technology, usingcataract surgery as an example.Methods: Secondary data analysis was performed using 1 year of CGMH data before(period 1, from March 1993 to February 1994 and after (period 2, fromMarch 1994 to February 1995 implementing the new policy. Inpatientrecords for cataract surgery using either extracapsular cataract extraction(ECCE, the old technology or phacoemulsification (Phaco, the new technologywere included. Logistic regression models were employed to assesshow case payment affected the health care provider's adoption of new technology.Results: The percentage of cases treated using the new Phaco technology grew fromperiod 1 (6.6% to period 2 (23.6% among all 4 study groups, despite Phacobeing more expensive than ECCE. More importantly, the increment ratio ofPhaco use from periods 1 to 2 was the smallest for GEI patients (3.26-foldwhen compared with the other 3 groups (4.16-5.29-fold.Conclusions: Both new technology and cost containment strategies should be taken intoaccount when setting up a reimbursement policy.

  9. Postoperative IOP prophylaxis practice following uncomplicated cataract surgery: a UK-wide consultant survey

    Dhillon Baljean

    2005-10-01

    Full Text Available Abstract Background In order to minimise postoperative intraocular pressure (IOP rise, after routine uncomplicated cataract surgery, prophylaxis may be adopted. Currently, there are no specific guidelines in this regard resulting in wide variation in practice across the UK. We sought to document these variations through a questionnaire survey. Methods A questionnaire was sent to all consultant ophthalmic surgeons in the UK. Results 62.6% of surgeons did not use any IOP lowering agents. 37.4% surgeons routinely prescribed some form of medication. The majority (86.8% used oral diamox. 20.6% of surgeons said they based their practice on evidence, 43.3% on personal experience, and 17.6% on unit policy. Surprisingly, among the two groups of surgeons (those who gave routine prophylaxis, and those who did not the percentages of surgeons quoting personal experience, unit policy, or presence of evidence was strikingly similar. The timing of the first postoperative IOP check varied from the same day to beyond 2 weeks. Only 20.2% of surgeons had ever seen an adverse event related to IOP rise; this complication is thus very rare. Conclusion This survey highlights a wide variation in the practice and postoperative management of phacoemulsification cataract surgery. What is very striking is that there is a similar proportion of surgeons in the diametrically opposite groups (those who give or do not give routine IOP lowering prophylaxis who believe that there practice is evidence based. The merits of this study suggests that consideration must be given to drafting a uniform guideline in this area of practice.

  10. A study of patient satisfaction after cataract surgery with implantation of different types of intraocular lenses

    Wei Ching-Kuo

    2012-10-01

    Full Text Available Abstract Background The implementation of capitated payment has driven medical institutions through developing balance billing for medical services. By exploring the patients’ decision-making factors on different self-pay items, a reference for the pricing and sales strategy for the related products can be formed. The major purposes of this study were to analyze the determinants of preoperative selection and postoperative satisfaction with implantation of different types of intraocular lenses in cataract surgery. Methods This cross-sectional study consisted of 127 patients that were 50 years of age and older, and who had phacoemulsification with intraocular lens implantation in both eyes. Data were collected by using a structured questionnaire. The following parameters were measured: access to medical care, attitude towards receiving medical products at one’s own expense, overall patient satisfaction and postoperative visual clarity. Results The results showed that the patient’s gender, educational level and economic status influenced the type of intraocular lens chosen. Patients in the insurance group cared about access to medical care, and patients in the balance billing group cared about product differentiation. ANOVA results showed no statistically significant differences in the overall satisfaction of the patients among the groups with different types of intraocular lenses. Patients that received cataract surgery with implantation of multifocal intraocular lenses had better vision when trying to view smaller objects and when looking at objects under strong light. Conclusions Manufacturers should increase the number of differences between their products, and health care providers can then recommend the appropriate intraocular lens in accordance with the needs or demands of their patients, and also by keeping in mind the financial constraints of their patients.

  11. Effect of biaxial versus coaxial microincision cataract surgery on optical quality of the cornea

    Tamer Fahmy Eliwa

    2015-01-01

    Full Text Available Context: Visual function is determined by a combination of the cornea, which has a larger effect and internal aberrations generated by the intraocular lens and those induced by the surgery. These corneal refractive changes are related to the location and size of the corneal incision. The smaller the incision, the lower the aberrations and the better the optical quality. Aims: To compare the effect of uneventful coaxial versus biaxial microincision cataract surgery (MICS on the corneal aberrations. Settings and Design: Retrospective interventional nonrandomized comparative case study comprised 40 eyes of 36 patients with primary senile cataract. Subjects and Methods: They were divided into two groups: Group I (20 eyes had operated by biaxial MICS and Group II (20 eyes had operated by coaxial MICS. Each group were assessed by corneal topography and wavefront analysis over 6 mm pupil size preoperatively and 1-month postoperatively. Statistical Analysis Used: Statistical analysis was performed using SPSS for Windows (version 17.0.1, SPSS, Inc.. The paired t-test was used to compare the mean values of corneal aberrations preoperatively and 1-month postoperatively in each group. Results: There was a significant increase in trefoil and quatrefoil in biaxial MICS (P = 0.063, 0.032 respectively while other aberrations insignificantly changed. The coaxial MICS showed a significant increase in root mean square (RMS of total high order aberrations (HOAs (P = 0.02 and coma (0.028, but not the others. In comparison to each other, there was the insignificant difference as regards astigmatism, RMS of individual and total HOAs. Conclusions: Coaxial and biaxial MICS are neutral on corneal astigmatism and aberrations.

  12. Late surgical complications to endophthalmitis after cataract surgery in the post-EVS era

    Solborg Bjerrum, Søren; Kiilgaard, Jens Folke; La Cour, Morten

    2015-01-01

    BACKGROUND: To compare the risk of surgical complications after primary surgical intervention for postoperative endophthalmitis after cataract surgery (PE) in cases that underwent a pars plana vitrectomy (PPV) or a vitreous tap (VT) in Denmark in the calendar period 1 January 2000 to 30 June 2011...... (p = 0.18). In all, 9.9 % of the PE cases had more than one surgical complication, and 97 % of the primary surgical complications occurred within the first 5 months. There was no statistically significant difference in the risk of retinal detachment (p = 0.45), surgery for PE (p = 0.22), intraocular...... lens removal (p = 0.19), or removal of the eye (p = 0.69) between the two groups. PE cases that underwent a VT had a statistically significantly higher risk of surgery for vitreous opacities (p = 0.047) compared to a PPV. CONCLUSIONS: In all, 27.3 % of all cases developed a surgical complication after...

  13. Which colours are seen by the patient during cataract surgery? Results of an intraoperative interview.

    Wenzel, M; Schulze Schwering, M

    2016-03-01

    PurposeTo discover what cataract patients see during phacoemulsification and if these light phenomena influence their anxiety levels during surgery.MethodsIn all, 200 patients were interviewed intraoperatively at the Eye Hospital, Petrisberg, Trier, Germany. The quality of the visual experiences was described and if these were pleasant, neutral or unpleasant. Systemic sedation was noted.ResultsAmong 200 patients (209 eyes): 88 were men (91 eyes; 44%) and 112 were women (118 eyes; 56%). Median age (years): men (71), women (70). Mean operating time was 8 min. 49/209 (23%) were not anxious before and during surgery. 110/209 (52%) were more anxious before than during surgery, 50/209 (24%) were still anxious during surgery, 27/209 (13%) got sedation with midazolam (1-5 mg). Colours in descending order seen: blue, red, pink, yellow, green, purple, turquois, and orange. The most dominant colour combination was red/blue. Structures were seen by 162/209 (78%). Most (61%) intraoperative visual experiences were pleasant, 38% were neutral, and 1% found them transiently unpleasant. Three patients felt blinded by the light of the operating microscope.ConclusionsThe experience of colours and other light phenomena was pleasant for most patients during phacoemulsification under topical anaesthesia. They occur spontaneously when the patient is fixating on the operating light. They are not dependent on the individual or environment. Sedation only in 13%. Direct questioning for visual sensations by the operating surgeon may lead to less need for sedation and lead to less side effects for elderly and multimorbidity people postoperatively. The surgeon can use this knowledge to reassure patients during surgery. PMID:26563653

  14. Imaging and investigating the effects of incision angle of clear corneal cataract surgery with optical coherence tomography

    Rao, Bin; Zhang, Jun; Taban, Mehran; McDonnell, Peter J.; Chen, Zhongping

    2003-12-01

    Effects of incision angle in construction of clear corneal cataract incision are studied with optical coherence tomography (OCT). A stable incision angle range is found to be existent for single-planed, clear corneal cataract incisions. When well pressurized, incision angles within this stable range result in well-apposed incision edges that resist gapping while incision angles falling outside this range have a larger tendency for wound leakage. It is also shown that a two-planed incision can effectively expand the stable range. For incision angles outside the stable range, the farther the incision angle is away from stable range, the larger the gap between incision wound edges when well pressurized. These findings emphasize the significance of incision construction to the self-sealing property of clear corneal cataract incisions. Finally, we demonstrate that OCT could be an effective modality for imaging and monitoring corneal surgery.

  15. A comprehensive review of Cataract (Kaphaja Linganasha) and its Surgical Treatment in Ayurvedic Literature.

    Dhiman, K S; Dhiman, Kamini; Puri, Samita; Ahuja, Deepak

    2010-01-01

    Ayurveda the science of life, since its origin is serving the mankind throughout in health & disease state of life. Shalakyatantra, one of its specialized branch deals with the science of Ophthalmology, Otorhinolaryngology, Orodental surgery & Head; was contributed and developed by Rajrishi Nimi, the King of Videha, who was a colleague of Atreya, Punarvasu, Dhanwantri, Bharadwaja, Kashyapa etc. The available literature related to this speciality is reproduced from original text of Nimitantra in Uttartantra of Sushruta samhita. So Rajrishi Nimi deserves all the credit and regards for Shalakyatantra and for being the first eye surgeon on this earth. The fact regarding the technique of cataract surgery adopted by ancient surgeons is still a matter of debate. Most of the medical fraternity accepts cataract surgery of ancient surgeons as couching procedure but after going through forth coming pages, the prevailing concept will prove to be a myth. It started with extra capsular extraction through small incision during the period of Sushruta Samhita but later shifted to couching like technique by Acharya Vagbhatta. Secondly, the objective of this literary research paper is to find proper co-relation of the disease cataract to those mentioned in Ancient Ayurvedic classic. Linganasha has been inadvertently taken as cataract but this is neither logical nor in accordance with classics. We find detailed description of cataract's differential diagnosis, indications, contra- indications, pre/intra/post operative procedures and complication in ancient texts of Ayurveda. Not only this, vivid description of treatment of various complications of cataract surgery are also given. Needless to say, no other surgically treatable diseases & its complications except Kaphaja Linganasha are given this much attention. PMID:22131692

  16. Corneal Graft and Cataract Surgery in Patients with Moderate to Severe Intellectual Disability

    Cooke, C. A.; Frazer, D. G.; Jackson, A. J.

    2006-01-01

    Background: Intraocular surgery in patients with intellectual disability can be hazardous. Our aim was to determine the outcomes of surgery on all such patients seen in a consultant-led service, and to assess the overall risks and benefits. Materials and Methods: A retrospective chart review of patients with moderate to severe intellectual…

  17. Cataract surgery: factors influencing decision to treat and implications for training (south-east Scotland 2008–2014

    Sniatecki JJ

    2015-09-01

    Full Text Available Jan J Sniatecki, Caroline Styles, Natalie Boyle, Roshini Sanders Cataract Unit, Queen Margaret Hospital, Dunfermline, Fife, UK Purpose: To describe the population referred for cataract surgery, identify factors that influenced decision to treat, and patients suitable for ophthalmic training. Patients and methods: A total of 2,693 consecutive referrals over 6 years were interrogated using Business Objects software on cataract electronic patient records. Results: A total of 2,693 patients were referred for cataract surgery (group A. Of these patients 2,132 (79% had surgery (group B and 561 (21% did not (group C. Age for group B vs group C: 672 (32% vs 115 (20% ≤69 years, P<0.001; 803 (38% vs 225 (40% 70–79 years, P=0.48; 586 (27% vs 203 (36% 80–89 years, P<0.05; 71 (3% vs 18 (3% ≥90 years, P=1.0. Visual acuity, group B vs group C: 556 (26% vs 664 (59% 6/12 or better; 1,275 (60% vs 367 (33% 6/18–6/60; 266 (12% vs 64 (6% counting fingers or worse, P<0.05. Medical history for group B vs C: cognitive impairment: 55 (2.6% vs 29 (5.2%, P<0.05; cardiovascular accident: 158 (7.4% vs 60 (10.7%, P<0.05; diabetes: 372 (17.4% vs 96 (17.1%, P=0.87; COPD/asthma: 382 (17.9% vs 93 (16.6%, P=0.53; heart disease: 535 (25.1% vs 155 (27.6%, P=0.35; hypertension: 971 (45.5% vs 263 (46.9%, P=0.73. Ocular history for group B vs C was significant (P<0.05 for age-related macular degeneration 255 (12.0% vs 93 (16.6%, other macular pathology 38 (1.8% vs 25 (4.5%, corneal pathology 92 (4.3% vs 36 (6.4%, amblyopia 37 (1.7% vs 22 (3.9%. Detailed data on presenting complaint, ophthalmic history, and social status is discussed. Conclusion: We observed that surgery at a younger age with good levels of visual acuity was a factor in deferring cataract surgery. Cognitive impairment, cardiovascular accident, amblyopia, corneal and macular pathology significantly affected decision not to operate. We estimate that 80% of patients would be suitable for ophthalmic training

  18. Effect of Ultrasound Time on Macular Thickness and Visual Acuity in Cataract Surgery

    Zeynep Gürsel Özkurt

    2011-10-01

    Full Text Available Pur po se: The aim of this study was to investigate the effect of ultrasound time on macular thickness and the influence of macular thickness on visual acuity after uneventful phacoemulsification surgery. Ma te ri al and Met hod: In this study, 42 eyes of 30 cataract patients who underwent uncomplicated phacoemulsification surgery were evaluated. The phacoemulsification was performed using 20% “pulse mode” ultrasound energy. The ultrasound time of each case was noted. Visual acuity (logMAR and macular thickness were measured pre- and postoperatively. Macular thickness was measured by “spectraldomain” optical coherence tomography using “macular map 6” (MM6 programme. Re sults: All patients who underwent uncomplicated phacoemulsification surgery showed a statistically significant improvement in bestcorrected visual acuity in postoperative first and third months (p=0.001. When minimum central macular, mean central zone, mean parafoveal and mean perifoveal macular thicknesses in the postoperative first week, first month and third month were compared with the preoperative values, a statistically significant increase in all zones was detected (p=0.001. The mean ultrasound time applied was 128 sec. ±11 SD: 70.17. No statistically significant correlation was found between ultrasound time and increase in macular thickness in the postoperative first week, first month and third month. There was no significant correlation between best-corrected visual acuity and minimum central macular/central zone macular thickness. Dis cus si on: This study shows that in patients who underwent uneventful phacoemulsification surgery, there is an increase in macular thickness independent of ultrasound time. We also found no correlation between macular thickness and visual acuity. (Turk J Ophthalmol 2011; 41: 286-90

  19. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery

    Je Hwan Yoon

    2013-01-01

    Full Text Available Aims: To compare the corneal refractive changes induced after 3.0 mm temporal and nasal corneal incisions in bilateral cataract surgery. Materials and Methods: This prospective study comprised a consecutive case series of 60 eyes from 30 patients with bilateral phacoemulsification that were implanted with a 6.0 mm foldable intraocular lens through a 3.0 mm horizontal clear corneal incision (temporal in the right eyes, nasal in the left eyes. The outcome measures were surgically induced astigmatism (SIA and uncorrected visual acuity (UCVA 1 and 3 months, post-operatively. Results: At 1 month, the mean SIA was 0.81 diopter (D for the temporal incisions and 0.92 D for nasal incisions (P = 0.139. At 3 months, the mean SIA were 0.53 D for temporal incisions and 0.62 D for nasal incisions (P = 0.309. The UCVA was similar in the 2 incision groups before surgery, and at 1 and 3 months post-operatively. Conclusion: After bilateral cataract surgery using 3.0 mm temporal and nasal horizontal corneal incisions, the induced corneal astigmatic change was similar in both incision groups. Especially in Asian eyes, both temporal and nasal incisions (3.0 mm or less would be favorable for astigmatism-neutral cataract surgery.

  20. Comparing resident cataract surgery outcomes under novice versus experienced attending supervision

    Puri S

    2015-09-01

    attending’s overall complication rate trended downward (rate from 28% in first 25 cases to 6.67% in last 15.Conclusion: Early cases for the novice attending were accompanied by greater complications (vitreous loss and anterior capsule tear, likely due to a learning curve. Surgical judgment in the operating room likely develops with experience. Training programs may focus on these specific areas to aid new instructors. Keywords: cataract surgery, attending experience, complication rate

  1. Suspensão de cirurgia de catarata e suas causas Reasons for cataract surgery cancelation

    Rodrigo Pessoa Cavalcanti Lira

    2001-10-01

    Full Text Available Com o objetivo de verificar as causas de suspensão de cirurgia de catarata e sugerir medidas para melhorar a eficiência do serviço prestado à população, foi realizado um estudo transversal no serviço de oftalmologia de um hospital universitário do Estado de São Paulo. A amostra foi composta por 200 indivíduos. A média de idade foi de 68± 11,4 anos. As causas de suspensão de cirurgia foram: condição clínica desfavorável (23,1%; horário cirúrgico insuficiente (35,9%; e não comparecimento do paciente (41%. Os fatores causadores foram, majoritariamente, as razões sociais e o funcionamento do hospital.To study the reasons for canceling cataract surgeries, and to suggest actions to improve the efficiency of patient care. A cross-sectional study was carried out in a university hospital's ophthalmology clinic of the state of São Paulo, Brazil. Two hundred subjects were randomly selected. The mean age was 68± 11.4 years old. The reasons for canceling surgery were: unpropitious clinical condition (23.1%; tight schedule (35.9%; and patient non-attendance (41%. Most of the reasons related to social issues and the hospital's administrative aspects.

  2. Laser welding in penetrating keratoplasty and cataract surgery of pediatric patients: early results

    Rossi, Francesca; Pini, Roberto; Menabuoni, Luca; Malandrini, Alex; Canovetti, Annalisa; Lenzetti, Ivo; Capozzi, Paolo; Valente, Paola; Buzzonetti, Luca

    2013-03-01

    Diode laser welding of ocular tissues is a procedure that enables minimally invasive closure of a corneal wound. This procedure is based on a photothermal effect: a water solution of Indocyanine Green (ICG) is inserted in the surgical wound, in order to stain the corneal tissue walls. The stained tissue is then irradiated with a low power infrared diode laser, delivering laser light through a 300-μm core diameter optical fiber. This procedure enables an immediate closure of the wounds: it is thus possible to reduce or to substitute the use of surgical threads. This is of particular interest in children, because the immediate closure improves refractive outcome and anti-amblyopic effect; moreover this procedure avoids several general anaesthesia for suture management. In this work, we present the first use of diode laser welding procedure in paediatric patients. 5 selected patients underwent cataract surgery (Group 1), while 4 underwent fs-laserassisted penetrating keratoplasty (Group 2). In Group 1 the conventional surgery procedure was performed, while no stitches were used for the closure of the surgical wounds: these were laser welded and immediately closed. In Group 2 the donor button was sutured upon the recipient by 8 single stitches, instead of 16 single stitches or a running suture. The laser welding procedure was performed in order to join the donor tissue to the recipient bed. Objective observations in the follow up study evidenced a perfect adhesion of the laser welded tissues, no collateral effects and an optimal restoration of the treated tissues.

  3. Comparison of Bigbag and Rayner620H intraocular lens in cataract surgeries in high myopia patients

    Zhan-Jiang Liu

    2016-01-01

    Full Text Available AIM:To investigate the effects of Bigbag and Rayner620H intraocular lens in cataract surgeries in high myopia patients. METHODS:Seventy-seven patients(128 eyeswere treated by phacoemulsification combined with intraocular lens implantation from January 2014 to March 2015 in our hospital. Thirty-nine patients(65 eyeswere treated with Bigbag intraocular lens, 38 cases(63 eyeswere treated with Rayner620H. The best corrected visual acuity(BCVAdistribution, the actual refractive value, the difference between predictive refractive value and actual refractive value and complications were measured and recorded in the two groups at 1mo after surgeries. RESULTS:The difference between the two groups on BCVA are statistically significant(PWilcoxon rank sum test. The differences between predictive refractive value and actual refractive value of the two groups were statistically significant(PPCONCLUSION:The effect of Bigbag intraocular lens for patients with phacoemulsification and intraocular lens implantation is good, and it can reduce the risk of complications.

  4. Clinical-epidemiological behaviour of patients after cataract surgery Comportamiento clínico - epidemiológico de operados de catarata

    Juan C. Medina Perdomo; Idalia Triana Casado; Leydi E. Jacomino Hernández

    2010-01-01

    Background: Cataract is the leading cause of blindness in the world. Its only effective treatment is surgery, with a high rate of efficiency, but it is not always practiced due to several reasons that limit access to health services. Objective: To identify clinical and epidemiological behaviour of patients after cataract surgery. Methods: An observational, descriptive and cross-sectional study conducted in ...

  5. Cataract Surgery Visual Outcomes and Associated Risk Factors in Secondary Level Eye Care Centers of L V Prasad Eye Institute, India

    Sumathi Matta; Jiwon Park; Ghanshyam Palamaner Subash Shantha; Rohit C Khanna; Gullapalli N Rao

    2016-01-01

    Purpose To evaluate cataract surgery visual outcomes and associated risk factors in rural secondary level eye care centers of L V Prasad Eye Institute (LVPEI), India. Methods The Eye Health pyramid of LVPEI has a network of rural secondary care centres (SCs) and attached vision centres (VCs) that provide high quality comprehensive eye care with permanent infrastructure to the most disadvantaged sections of society. The most common procedure performed at SCs is cataract surgery. We au...

  6. The risk of a new retinal break or detachment following cataract surgery in eyes that had undergone repair of phakic break or detachment: a hypothesis of a causal relationship to cataract surgery.

    Grand, M. Gilbert

    2003-01-01

    PURPOSE: To determine the risk of new retinal tear or detachment following cataract surgery in eyes that had undergone successful repair of phakic retinal tear or detachment. METHODS: A computerized search of records of patients evaluated at the Barnes Retina Institute from 1990 to 2000 for a diagnosis of phakic retinal tear or detachment was accomplished. The records of successfully treated patients were analyzed by type of tear or detachment, method of treatment, and development of sequenti...

  7. General versus regional anaesthesia for cataract surgery: effects on neutrophil apoptosis and the postoperative pro-inflammatory state.

    Goto, Y

    2012-02-03

    At clinically relevant concentrations, volatile anaesthetic agents influence neutrophil function. Our hypothesis was that sevoflurane would inhibit neutrophil apoptosis and consequently influence the postoperative pro-inflammatory state. In order to identify selectively the effect of the anaesthetic agent sevoflurane, we studied patients undergoing minimally stimulating (cataract) surgery randomly allocated to receive either sevoflurane (n = 11) or local anaesthesia (n = 12). Venous blood samples were taken immediately prior to anaesthesia and at 1, 8 and 24 h thereafter. The rate of neutrophil apoptosis, plasma concentration of cytokines and differential white cell count were measured. The rates of neutrophil apoptosis and plasma concentrations of IL-1beta, TNF-alpha and IL-8 at each time point were similar in the two groups. IL-6 concentrations increased significantly and to a similar extent compared to preanaesthetic levels at 8 and 24 h. This study demonstrates that sevoflurane does not influence the rate of neutrophil apoptosis, cytokine concentrations and neutrophil count following cataract surgery.

  8. Cataract surgery in the setting of severe pathologic myopia with high axial length: use of pars plana lensectomy and vitrectomy

    Gologorsky D

    2016-05-01

    Full Text Available Daniel Gologorsky, Harry W Flynn Jr Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Abstract: Cataract surgery in patients with pathologic myopia and high axial length can be challenging for a variety of reasons, including imprecise intraocular lens calculations in eyes with posterior staphylomas and intraoperative complications such as suprachoroidal hemorrhage, posterior capsular rupture, and retinal tears. Although most surgeons recommend standard phacoemulsification and preservation of the posterior capsule in these cases, an alternative approach presented in this series entails the removal of the lens through the pars plana and removal of formed vitreous during the concurrent procedure. Keywords: cataract surgery, pathologic myopia, high axial length, aphakia

  9. A comparison of patient pain and visual outcome using topical anesthesia versus regional anesthesia during cataract surgery

    Hosoda, Yoshikatsu

    2016-01-01

    Yoshikatsu Hosoda, Shoji Kuriyama, Yoko Jingami, Hidetsugu Hattori, Hisako Hayashi, Miho Matsumoto Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan Purpose: The purpose of this study was to compare the level of patient pain during the phacoemulsification and implantation of foldable intraocular lenses while under topical, intracameral, or sub-Tenon lidocaine.Patients and methods: This was a retrospective study. Three hundred and one eyes subjected to cataract surgery were i...

  10. Clinical experience with the first 40 cases with femtosecond laser cataract surgery technology: safety of the learning curve

    Joao Crispim; Ricardo Nose; Ana Claudia Medeiros A. Garcia; Milton Yogi; Walton Nose

    2015-01-01

    ABSTRACT Objective: To evaluate the introduction of the femtosecond laser (FSL) to perform the key steps of the traditional cataract surgery process and the operational difficulties and safety of this new technology during routine use in an operating room in Brazil. Methods A retrospective study was conducted using the first cases operated on at a single center using the laser platform LenSx/Alcon with a soft contact lens patient interface.All patients underwent a detailed preoperative asse...

  11. Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report

    Yoshino Hideaki; Seki Masaaki; Ueda Jun; Yoshino Takaiko; Fukuchi Takeo; Abe Haruki

    2012-01-01

    Abstract Background Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure. Case presentation A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a sha...

  12. Inadvertent Trypan Blue Staining of Posterior Capsule during Cataract Surgery Associated with “Argentinian Flag” Event

    Prinzi, Robert A.; Alapati, Neeti M.; Gappy, Shawn S.; Dilly, Jason S.

    2016-01-01

    Trypan blue is common in visualizing the anterior capsule during cataract surgery. Inadvertent staining of the posterior capsule during phacoemulsification is a rare complication and there are few reports in the literature. The proposed mechanism of posterior capsule staining in previous reports includes a compromised zonular apparatus or iris retractors facilitating the posterior flow of trypan blue. We report the first case of trypan blue staining of the posterior capsule associated with th...

  13. Sub-Conjunctival Injection of Antibiotics vs. Povidone-Iodine Drop on Bacterial Colonies in Phacoemulsification Cataract Surgery

    Panahibazaz, Mahamoudreza; Moosavian, Mojataba; Khataminia, Gholamreza; Feghhi, Mostafa; Yazdi, Farsim; Abbasi Montazeri, Effat

    2014-01-01

    Background: Postoperative endophthalmitis is one the most serious complications of cataract surgery. The majority of causative organisms in this destructive infection come from the patient’s own periocular flora. Efforts have been made to reduce the virulence of organisms in the eyelid and conjunctiva with perioperative topical antibiotics, preparation of surgical field, covering eyelids and conjunctival surface with 5% povidone–iodine solution and intracameral antibiotics at the time of surg...

  14. Improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery

    Elliott, D; Patla, A.; Bullimore, M.

    1997-01-01

    AIMS—To determine the improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery.
METHODS—Clinical vision (monocular and binocular high and low contrast visual acuity, contrast sensitivity, and disability glare), functional vision (face identity and expression recognition, reading speed, word acuity, and mobility orientation), and perceived visual disability (Activities of Daily Vision Scale) were measured in 25 subjects before a...

  15. Pharmacokinetics and aqueous humor penetration of levofloxacin 1.5% and moxifloxacin 0.5% in patients undergoing cataract surgery

    Bucci, Frank A; Nguimfack, Ines Teuma; Fluet, Angel T

    2016-01-01

    Purpose The objective of this study was to compare the pharmacokinetics of levofloxacin 1.5% and moxifloxacin hydrochloride 0.5% ophthalmic solutions in aqueous humor after multiple doses prior to cataract surgery. Methods Ninety-eight eyes underwent cataract surgery and met the requirements of PK analysis. Eligible eyes were randomly assigned in a 1:1 ratio to receive levofloxacin or moxifloxacin prior to cataract surgery and were randomized into one of four sampling time points (ie, 1, 2, 4, and 6 hour post-last dose). Randomization was investigator and laboratory-masked. Three days prior to cataract surgery, each patient instilled one drop of the assigned study medication into the operative eye four times daily. One aqueous humor specimen was collected from the eye at the randomized time point. Aqueous humor specimens were assayed for drug concentration using a validated liquid chromatography and tandem mass spectrometer. Results Concentrations of the drug in the aqueous humor, as described by mean Cmax and pooled AUC0–6 values, were greater for levofloxacin than moxifloxacin (Cmax: 1.43, 0.87 μg/ml, respectively, P=0.008; AUC0–6 6.1, 3.8 μg·min/ml, P<0.001 respectively). No treatment-emergent adverse events were reported. Conclusion Significantly greater drug exposures were attained in aqueous humor following the administration of levofloxacin 1.5% than moxifloxacin 0.5% ophthalmic solution. Achieving considerable higher drug concentration in the aqueous humor with levofloxacin 1.5% may demonstrate a greater potential for bacterial eradication. PMID:27194905

  16. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery

    Je Hwan Yoon; Kyun-Hyung Kim; Jong Yeon Lee; Dong Heun Nam

    2013-01-01

    Aims: To compare the corneal refractive changes induced after 3.0 mm temporal and nasal corneal incisions in bilateral cataract surgery. Materials and Methods: This prospective study comprised a consecutive case series of 60 eyes from 30 patients with bilateral phacoemulsification that were implanted with a 6.0 mm foldable intraocular lens through a 3.0 mm horizontal clear corneal incision (temporal in the right eyes, nasal in the left eyes). The outcome measures were surgically induced astig...

  17. CLINICAL STUDY OF VARIOUS TYPES OF INCISIONS IN SMALL INCISION CATARACT SURGERY IN RELATION TO THEIR ASTIGMATISM OUT COME

    Sindhura; Venkateswarlu; Sudhakar Rao; Balla Vidya

    2015-01-01

    AIM: To evaluate the surgically induced astigmatism ¹with different types of incisions in manual small incision cataract surgery over a period of one week, two weeks, four weeks and six weeks post - operative period. As the incision is the major cause for surgically induced astigmatism and this effect is directly related to the length, shape, location and depth of the incision. METHODS: Pr ospective analysis of the medical records of a total of 100 patients...

  18. Corneal astigmatism change and wavefront aberration evaluation after cataract surgery: "Single" versus "paired opposite" clear corneal incisions

    Hasan Razmjoo

    2014-01-01

    Full Text Available Background: Correcting the pre-existing astigmatism is an optimal goal in cataract surgery. The aim of this study is to compare the astigmatic correcting effect of a single regular 3.2 mm clear corneal incision (CCI with paired opposite CCI in cataract patients and effect of these incisions on optical aberrations using the wavefront quantitative analysis. Materials and Methods: This was a randomized controlled trial study undertaken in an ophthalmology referral center on 50 patients planned for cataract surgery who were randomized to either single 3.2 mm CCI or paired opposite CCI group. Post-operative evaluation was performed at 12 weeks and included refraction, keratometery, corneal topography and wavefront analysis. Corneal astigmatism and post-operative values were compared in two groups. Results: The mean pre-operative corneal astigmatism was 2.58 ± 1.03 D in the single incision group and 2.70 ± 0.94 D in the paired opposite incisions group. After 12 weeks of surgery, the corneal astigmatism was reached to 2.15 ± 0.82 D in single incision group and 1.63 ± 1.21 in the paired opposite incisions group. There was a statistically significant difference in two arms of treatment regarding to surgically induced astigmatism after 3 months. The mean post-operative total and higher order aberrations and values were not significantly different in two groups. Conclusion: The results of our study showed that paired opposite incisions is an effective procedure for reducing pre-existing corneal astigmatism in cataract surgery. Paired incisions did not show any beneficial effect regarding wavefront aberrations compared with conventional single incision method.

  19. Completion rates of anterior and posterior continuous curvilinear capsulorrhexis in pediatric cataract surgery for surgery performed by trainee surgeons with the use of a low-cost viscoelastic

    R Muralidhar

    2012-01-01

    Full Text Available Context : Pediatric cataract surgery is traditionally done with the aid of high-molecular-weight viscoelastics which are expensive. It needs to be determined if low-cost substitutes are just as successful. Aims : The study aims to determine the success rates for anterior and posterior capsulorrhexis and intraocular lens (IOL implantation in the bag for pediatric cataract surgery performed with the aid of a low-molecular-weight viscoelastic. Settings and Design : Nonrandomized observational study. Materials and Methods: Children less than 6 years of age who underwent cataract surgery with IOL implantation in the period May 2008-May 2009 were included. The surgeries were done by pediatric ophthalmology fellows. A standard procedure of anterior capsulorrhexis, lens aspiration with primary posterior capsulorrhexis, anterior vitrectomy, and IOL implantation was followed. Three parameters were studied: successful completion of anterior and posterior capsulorrhexis and IOL implantation in the bag. Results: 33 eyes of 28 children were studied. The success rate for completion was 66.7% and 88.2 % for anterior and posterior capsulorrhexis, respectively. IOL implantation in the bag was successful in 87.9%. Conclusions: 2% hydroxypropylmethylcellulose is a viable low-cost alternative to more expensive options similar to high-molecular-weight viscoelastics. This is of great relevance to hospitals in developing countries.

  20. Long-term outcomes of limbal relaxing incisions during cataract surgery: aberrometric analysis

    Monaco G

    2015-08-01

    Full Text Available Gaspare Monaco, Antonio ScialdoneDepartment of Ophthalmology, Ospedale Fatebenefratelli e Oftalmico, Milan, ItalyPurpose: To compare the final changes in corneal wavefront aberration by limbal relaxing incisions (LRIs after cataract surgery.Methods: This prospective cumulative interventional nonrandomized case study included cataract and astigmatic patients undergoing LRIs and phaco with intraocular lens implantation. LRIs were planned using Donnenfeld nomogram. The root mean square of corneal wave aberration for total Z(n,i(1≤n≤8, astigmatism Z(2,±1, coma Z(3–5–7,±1, trefoil Z(3–5–7,±2, spherical Z(4–6–8,0, and higher-order aberration (HOA Z(3≤n≤8 was examined before and 3 years after surgery (optical path difference-Scan II [OPD-Scan II]. Uncorrected distance visual acuity and best-corrected distance visual acuity (CDVA for distance, keratometric cylinder, and variations in average corneal power were also analyzed.Results: Sixty-four eyes of 48 patients were included in the study. Age ranged from 42 to 92 years (70.6±8.4 years. After LRIs, uncorrected distance visual acuity and best-corrected distance visual acuity improved statistically (P<0.01. The keratometric cylinder value decreased by 40.1%, but analysis of KP90 and KP135 polar values did not show any decrease that could be statistically confirmed (P=0.22 and P=0.24. No significant changes were detected in root mean square of total (P=0.61 and HOAs (P=0.13 aberrations. LRIs did not induce alteration in central corneal power confirming a 1:1 coupling ratio.Conclusion: LRIs determined a nonsignificant alteration of corneal HOA. Therefore, LRIs can be still considered a qualitatively viable mean in those cases where toric intraocular lenses are contraindicated or not available. Yet, the authors raise the question of nonpersonalized nomograms, as in the present study, LRIs did not reach the preset target cylinder. Keywords: astigmatism, ocular wavefront, intraocular

  1. Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery

    Edward F Hall

    2008-03-01

    Full Text Available Edward F Hall1, Garrett R Scott1, David C Musch1,2, David N Zacks11Department of Ophthalmology and Visual Sciences, Medical School; 2Department of Epidemiology, School of Public Health; University of Michigan, Ann Arbor, MI, USAPurpose: Controversy exists regarding the use of intravitreal dexamethasone (IVD as an anti-inflammatory adjunct to intravitreal antibiotics in patients with acute endophthalmitis following cataract surgery. The purpose of this project was to evaluate our experience regarding the effect of adjunctive IVD use on visual outcomes in such patients.Design: Retrospective, comparative case series.Methods: Study population: Patients treated for acute endophthalmitis following cataract surgery from 1995–2004. Intervention: In addition to standard intravitreal antibiotic treatment, some patients also received a single adjunctive injection of IVD. Primary outcome measures: Median visual acuity at last follow-up and percentage of patients achieving a ≥3-line improvement in visual acuity. Secondary outcome measures: Inflammatory index scoring, including amount of cell and flare, height of hypopyon, and presence of fibrin as a function of time after treatment.Results: Twenty-six eyes were treated with and 38 eyes without adjunctive IVD. Median presenting visual acuity was Hand Motion in both groups. Median visual acuity at last followup measured 20/40 in the IVD group and 20/50 in the No-IVD group (p = 0.75. Seventy-three percent of patients in the IVD group and 82% of patients in the No-IVD group achieved a ≥3-line improvement in visual acuity (p = 0.42. No significant difference was detected between the IVD and No-IVD groups for any of the three measures of inflammation.Conclusion: The use of IVD did not significantly improve the final median visual acuity, the chance of achieving a ≥3-line improvement in visual acuity, or the amount of intraocular inflammation. Based on these findings, and the possible detrimental effect of

  2. Comparative evaluation of aqueous and plasma concentration of topical moxifloxacin alone and with flurbiprofen in patients of cataract surgery

    Sujash Halder

    2013-01-01

    Full Text Available Objectives: To determine the aqueous and plasma concentrations of moxifloxacin administered topically alone and with flurbiprofen in patients undergoing cataract surgery. Materials and Methods: A total of 50 subjects scheduled for routine cataract surgery were randomly allocated to two groups (n = 25 each. Group-1 patients were treated with topical moxifloxacin alone: One drop 6 times/day for 3 days before surgery and one drop 4 times on the day of surgery: Group-2 patients were treated with topical moxifloxacin as in Group-1 and with topical flurbiprofen: One drop 4 times/day for 3 days before and on the day of surgery. The interval between two drugs was 30 min for last 3 days and 15 min on the day of surgery. Last dose was administered 1 h before aqueous humor and blood sampling for both the groups. The antibiotic concentration in aqueous humor and plasma were determined by using high performance liquid chromatography. Results: The mean concentration of moxifloxacin in aqueous humor was 1.71 ± 0.82 mg/ml in Group-1 and 2.39 ± 1.34 mg/ml in Group-2. Concentrations of moxifloxacin in aqueous humor were significantly higher in Group-2 than that of Group-1. Conclusion: Flurbiprofen may increase the concentration of moxifloxacin in aqueous humor.

  3. Lens and cataract research of the 20th century: a review of results, errors and misunderstandings.

    Hockwin, Otto; Kojima, Masami; Müller-Breitenkamp, Ursula; Wegener, Alfred

    2002-01-01

    essential standard methods of a lens research team. Another disadvantage still is the use of the general diagnosis 'cataract' by the clinicians without further classification of the topography of the opacification, which supports the concept that all cataracts have the same trigger mechanism. But most regrettable is the fact that many clinicians have never been really interested in basic research of the lens, in cataract pathogenesis and epidemiology of risk factors or in testing the efficacy of cataract-preventing medication. Their main goal was cataract surgery. On the basis of the success of the cataract surgery at the present time clinicians have even developed the opinion that lens and cataract research is no longer necessary to overcome cataract blindness. But as we all know this refers only to highly industrialized countries; millions of cataract-blind people are still without such help and a change of this condition is not in sight. In our opinion lens and cataract research is still necessary and it will be more successful if we bear in mind the mostly unintentional errors of the 20th century but keep them out of our daily practice. PMID:12061266

  4. Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report

    Yoshino Hideaki

    2012-03-01

    Full Text Available Abstract Background Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure. Case presentation A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a shallow anterior chamber five days after uneventful cataract surgery. Initially, slit lamp examination provided only limited information due to severe corneal edema. After resolution of corneal edema with systemic glaucoma therapy, a complete fibrin membrane was observed across the pupil by slit lamp examination. Anterior segment optic coherence tomography clearly revealed a thin fibrin membrane covering the entire pupillary space, a shallow anterior chamber, and a deep posterior chamber. The intraocular lens was not observed by anterior segment optic coherence tomography. In contrast, ultrasound biomicroscopy, which has superior penetration depth, was able to visualize the intraocular lens deep in the posterior chamber. Injection of tissue plasminogen activator into the anterior chamber resulted in complete fibrinolysis and released the pupillary block. Conclusion This case suggests that ocular anterior segment imaging modalities, especially ultrasound biomicroscopy, serve as powerful diagnostic tools to identify mechanisms of acute angle closure glaucoma, which is often accompanied by poor intraocular visibility. This is the first reported case of fibrin pupillary-block glaucoma after cataract surgery successfully treated with intracameral tissue plasminogen activator.

  5. A Cost-benefit Analysis of Cataract Surgery based on the English Longitudinal Survey of Ageing

    Martin Weale

    2009-01-01

    This paper uses the English Longitudinal Survey of Ageing to explore the selfreport effect of cataract operations on eyesight. Calibrating the results to an existing study of the effect of imperfect eyesight on qualty of life, the impact of cataract operations on quality-adjusted life-years is found to be very similar to that established in specific studies and well above the costs of cataract operations. The implications of this for the treatment of medical care in the national accounts are ...

  6. Etiopathogenesis of cataract: An appraisal

    Varun B Gupta

    2014-01-01

    Full Text Available Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise various etiological factors of cataract to make their perception clear to build up counterpart treatment. Present study is an assortment of various available literatures and electronic information in view of cataract etiopathogenesis. Various risk factors have been identified in development of cataracts. They can be classified in to genetic factors, ageing (systemic diseases, nutritional and trace metals deficiencies, smoking, oxidative stress etc., traumatic, complicated (inflammatory and degenerative diseases of eye, metabolic (diabetes, galactosemia etc., toxic substances including drugs abuses, alcohol etc., radiation (ultraviolet, electromagnetic waves etc. are implicated as significant risk factors in the development of cataract.

  7. The impact of cataract surgery on activities and time-use: results from a longitudinal study in Kenya, Bangladesh and the Philippines.

    Sarah Polack

    Full Text Available BACKGROUND: Cataract is the leading cause of blindness in the world, and blindness from cataract is particularly common in low-income countries. The aim of this study is to explore the impact of cataract surgery on daily activities and time-use in Kenya, Bangladesh and the Philippines. METHODS/PRINCIPAL FINDINGS: A multi-centre intervention study was conducted in three countries. Time-use data were collected through interview from cases aged >or=50 years with visually impairing cataract (VA or=6/18. Cases were offered free/subsidized cataract surgery. Approximately one year later participants were re-interviewed about time-use. At baseline across the three countries there were 651 cases and 571 controls. Fifty-five percent of cases accepted surgery. Response rate at follow up was 84% (303 out of 361 for operated cases, and 80% (459 out of 571 for controls. At baseline, cases were less likely to carry out and spent less time on productive activities (paid and non-paid work and spent more time in "inactivity" compared to controls. Approximately one year after cataract surgery, operated cases were more likely to undertake productive activities compared to baseline (Kenya from 55% to 88%; Bangladesh 60% to 95% and Philippines 81% to 94%, p<0.001 and mean time spent on productive activities increased by one-two hours in each setting (p<0.001. Time spent in "inactivity" in Kenya and Bangladesh decreased by approximately two hours (p<0.001. Frequency of reported assistance with activities was more than halved in each setting (p<0.001. CONCLUSIONS/SIGNIFICANCE: The empirical evidence provided by this study of increased time spent on productive activities, reduced time in inactivity and reduced assistance following cataract surgery among older adults in low-income settings has positive implications for well-being and inclusion, and supports arguments of economic benefit at the household level from cataract surgery.

  8. Change in Astigmatism After Temporal Clear Corneal Cataract Extraction in the Pediatric Population

    Lam, Helene Y; Yen, Kimberly G

    2008-01-01

    Purpose: To evaluate the early postoperative change in astigmatism in pediatric patients having cataract extraction with intraocular lens implantation using sutured temporal clear corneal incision. Methods: A retrospective chart review was performed on all pediatric patients who underwent clear corneal cataract surgery with intraocular lens implantation between 12/01/2005 and 11/30/2006. Results: A total of 31 eyes of 22 patients who underwent temporal clear corneal cataract surgery and intra...

  9. Recognizing Cataracts

    ... please review our exit disclaimer . Subscribe Recognizing Cataracts Watch for Vision Changes as You Age As life ... your eyes from harmful ultraviolet rays from the sun. Try wearing sunglasses or a hat with a ...

  10. A Meta-analysis on the clinical efficacy and safety of optic capture in pediatric cataract surgery

    Zhou, Hong-Wei; Zhou, Fang

    2016-01-01

    AIM To evaluate the clinical efficacy and safety of optic capture in pediatric cataract surgery. METHODS Searches of peer-reviewed literature were conducted in PubMed, Embase and the Cochrane Library. The search terms were “optic capture” and “cataract”. The retrieval period ended in December 2014. Relevant randomized controlled trials (RCTs), case-control studies and cohort studies were included. Meta-analyses were performed. Pooled weighted mean differences and risk ratios with 95% confidence intervals were estimated. RESULTS Ten studies involving 282 eyes were included, 5 of which were RCTs involving 194 eyes. The application of optic capture significantly reduced both opacification of the visual axis (RR: 0.12; 95% CI: 0.02 to 0.85; P=0.03) and occurrence of geometric decentration (RR: 0.09; 95% CI: 0.02 to 0.46; P=0.004). But it did not significantly affect best corrected visual acuity (BCVA) (WMD: -0.01; 95%CI: -0.07 to 0.05; P=0.75) and influence the occurrence of posterior synechia (RR: 1.53; 95% CI: 0.84 to 2.77; P=0.17). Deposits in the anterior intraocular lens were significantly increased in the optic capture group early after surgery (RR: 1.40; 95% CI: 1.05 to 1.86; P=0.02) and at the last follow-up (RR: 2.30; 95% CI: 1.08 to 4.92; P=0.03). The quality of the evidence was assessed as high. CONCLUSION The application of optic capture significantly reduces opacification of visual axis and occurrence of geometric decentration but do not significantly improve BCVA with notable safety. PMID:27162735

  11. Assessment of corneal astigmatism following frown and straight incision forms in sutureless manual small incision cataract surgery

    Amedo AO

    2016-04-01

    Full Text Available Angela Ofeibea Amedo, Kwadwo Amoah, Nana Yaa Koomson, David Ben Kumah, Eugene Appenteng Osae Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Abstract: To investigate which of two tunnel incision forms (frown versus straight in sutureless manual small incision cataract surgery creates more corneal astigmatism. Sixty eyes of 60 patients who had consented to undergo cataract surgery and to partake in this study were followed from baseline through >12-week postoperative period. Values of preoperative and postoperative corneal astigmatism for the 60 eyes, measured with a Bausch and Lomb keratometer, were extracted from the patients’ cataract surgery records. Residual astigmatism was computed as the difference between preoperative and postoperative keratometry readings. Visual acuity was assessed during the preoperative period and at each postoperative visit with a Snellen chart at 6 m. Fifty eyes of 50 patients were successfully followed-up on. Overall, the mean residual astigmatism was 0.75±0.12 diopters. The differences in mean residual astigmatism between the two different incision groups were statistically significant (t [48]=6.33, P<0.05; frown incision group recorded 1.00±0.12 diopters, whereas the straight incision group recorded 0.50±0.12 diopters. No significant difference was observed between male and female groups (t [48]=0.24, P>0.05. Residual corneal astigmatism in the frown incision group was significantly higher than in the straight incision group. Fisher’s exact test did not reveal a significant association between incision forms and visual acuity during the entire postoperative period (P>0.05. Keywords: cataract, residual corneal astigmatism, frown incision, straight incision

  12. Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery

    Li X-R

    2011-06-01

    Full Text Available Jian-Guo Wu, Rui-Hua Wei, Ai-Hua Liu, Xiao-Xu Zhou, Guo-Ling Sun, Xiao-Rong LiTianjin Medical University Eye Center, Tianjin, ChinaBackground: The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery.Methods: We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15. In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15. The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit.Results: Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01, and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05.Conclusion: This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.Keywords: pars plana vitrectomy, contact lens, silicone ring, cataract surgery

  13. The refractive outcome of Toric Lentis Mplus implant in cataract surgery

    Chiam, Patrick J; Quah, Say A

    2016-01-01

    AIM To evaluate the refractive outcome of Toric Lentis Mplus intraocular lens (IOL) implant. METHODS This is a retrospective case series. Consecutive patients with corneal astigmatism of at least 1.5 D had Toric Lentis Mplus IOL implant during cataract surgery. The exclusion criteria included irregular astigmatism on corneal topography, large scotopic pupil diameter (>6 mm), poor visual potential and significant ocular comorbidity. Postoperative manifest refraction, uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BCVA), uncorrected intermediate visual acuity (UIVA) at 3/4 m and uncorrected near visual acuity (UNVA) were obtained. RESULTS There were 70 eyes from 49 patients in this study. Patients were refracted at a median of 8.9wk (range 4.0 to 15.5) from the operation date. Sixty-five percent of eyes had 6/7.5 (0.10 logMAR) or better, and 99% 6/12 (0.30 logMAR) or better postoperative UDVA. Eighty-nine percent could read Jaeger (J) 3 (0.28 logMAR) and 95% J5 (0.37 logMAR) at 40 cm. The median magnitude of astigmatism decreased from 1.91 D to 0.49 D (Wilcoxon, Pastigmatism. PMID:27275424

  14. Visual Hallucinations in an Old Patient after Cataract Surgery and Treatment.

    Ozcan, Halil; Yucel, Atakan; Ates, Orhan

    2016-02-01

    Sensory visual pathologies, accompanying simple or complex visual hallucinations that occur in visually-impaired individuals due to ophthalmologic or brain pathologies related to visual pathways in patients without mental disorders, are defined as Charles Bonnet syndrome. Between 10% and 60% of the patients having age-related eye diseases involving retina, cornea and the lens, commonly with macular degeneration experience complex visual hallucinations depending on the severity of visual problems. The neurophysiology of the visual hallucinations in Charles Bonnet Syndrome is not clearly known, and they may differ in content and severity over time. In differential diagnoses of Charles Bonnet Syndrome, many aetiologies (drugs, uraemia, exposure to toxic materials, neurodegenerative and psychiatric conditions) need to be ruled out. In the treatment of Charles Bonnet syndrome, first the management of the reason of visual loss should be clarified if possible. If needed, neuroleptics, anticonvulsants, antidepressants, benzodiazepines, cognitive enhancer agents such as cholinesterase inhibitors can be used also. In this case, an 83-year-old female patient experiencing visual hallucinations as burning candles in both eyes' visual field after left eye cataract surgery, treated with 0.5 milligram/day risperidone will be presented. PMID:27026767

  15. Stereo-PIV study of flow inside an eye under cataract surgery

    Sakakibara, Jun; Yamashita, Masaki; Kobayashi, Tatsuya; Kaji, Yuichi; Oshika, Tetsuro

    2012-04-01

    We measured velocity distributions in the anterior chamber of porcine eyes under simulated cataract surgery using stereoscopic particle image velocimetry (stereo-PIV). The surface of the cornea was detected based on the images of laser-induced fluorescent light emitted from fluorescent dye solution introduced in a posterior chamber. A coaxial phacoemulsification procedure was simulated with standard size (standard coaxial phacoemulsification) and smaller (micro coaxial phacoemulsification) surgical instruments. In both cases, an asymmetric flow rate of irrigation was observed, although both irrigation ports had the same dimensions prior to insertion into the eye. In cases where the tip of the handpiece was placed farther away from the top of the cornea, i.e., closer to the crystalline lens, direct impingement of irrigation flow onto the cornea surface was avoided and the flow turned back toward the handpiece along the surface of the corneal endothelium. Viscous shear stress on the corneal endothelium was computed based on the measured mean velocity distribution. The maximum shear stress for most cases exceeded 0.1 Pa, which is comparable to the shear stress that caused detachment of the corneal endothelial cells reported by Kaji et al. in Cornea 24:S55-S58, (2005). When direct impingement of the irrigation flow was avoided, the shear stress was reduced considerably.

  16. Pediatric cataract: challenges and future directions.

    Medsinge, Anagha; Nischal, Ken K

    2015-01-01

    Cataract is a significant cause of visual disability in the pediatric population worldwide and can significantly impact the neurobiological development of a child. Early diagnosis and prompt surgical intervention is critical to prevent irreversible amblyopia. Thorough ocular evaluation, including the onset, duration, and morphology of a cataract, is essential to determine the timing for surgical intervention. Detailed assessment of the general health of the child, preferably in conjunction with a pediatrician, is helpful to rule out any associated systemic condition. Although pediatric cataracts have a diverse etiology, with the majority being idiopathic, genetic counseling and molecular testing should be undertaken with the help of a genetic counselor and/or geneticist in cases of hereditary cataracts. Advancement in surgical techniques and methods of optical rehabilitation has substantially improved the functional and anatomic outcomes of pediatric cataract surgeries in recent years. However, the phenomenon of refractive growth and the process of emmetropization have continued to puzzle pediatric ophthalmologists and highlight the need for future prospective studies. Posterior capsule opacification and secondary glaucoma are still the major postoperative complications necessitating long-term surveillance in children undergoing cataract surgery early in life. Successful management of pediatric cataracts depends on individualized care and experienced teamwork. We reviewed the etiology, preoperative evaluation including biometry, choice of intraocular lens, surgical techniques, and recent developments in the field of childhood cataract. PMID:25609909

  17. Prioritisation of patients on waiting lists for hip and knee arthroplasties and cataract surgery: Instruments validation

    Moharra Montse

    2008-04-01

    Full Text Available Abstract Background Prioritisation instruments were developed for patients on waiting list for hip and knee arthroplasties (AI and cataract surgery (CI. The aim of the study was to assess their convergent and discriminant validity and inter-observer reliability. Methods Multicentre validation study which included orthopaedic surgeons and ophthalmologists from 10 hospitals. Participating doctors were asked to include all eligible patients placed in the waiting list for the procedures under study during the medical visit. Doctors assessed patients' priority through a visual analogue scale (VAS and administered the prioritisation instrument. Information on socio-demographic data and health-related quality of life (HRQOL (HUI3, EQ-5D, WOMAC and VF-14 was obtained through a telephone interview with patients. The correlation coefficients between the prioritisation instrument score and VAS and HRQOL were calculated. For the reliability study a self-administered questionnaire, which included hypothetic patients' scenarios, was sent via postal mail to the doctors. The priority of these scenarios was assessed through the prioritisation instrument. The intraclass correlation coefficient (ICC between doctors was calculated. Results Correlations with VAS were strong for the AI (0.64, CI95%: 0.59–0.68 and for the CI (0.65, CI95%: 0.62–0.69, and moderate between the WOMAC and the AI (0.39, CI95%: 0.33–0.45 and the VF-14 and the CI (0.38, IC95%: 0.33–0.43. The results of the discriminant analysis were in general as expected. Inter-observer reliability was 0.79 (CI95%: 0.64–0.94 for the AI, and 0.79 (CI95%: 0.63–0.95 for the CI. Conclusion The results show acceptable validity and reliability of the prioritisation instruments in establishing priority for surgery.

  18. What effects has the cataract surgery on the development and progression of Age-Related Macular Degeneration (AMD?

    Willich, Stefan N.

    2006-12-01

    Full Text Available Background: The cataract (Cataracta senilis is the most frequent eye disease of elderly people worldwide. In Germany, the cataract operation - with currently 450,000 interventions each year the most frequent operation in ophthalmology – can be seen as routine surgery. The age related macular degeneration (AMD is a further one of the most common, age-related eye diseases and the most frequent cause of blindness of elderly people in industrial nations. Due to demographic changes an increasing number of patients will suffer from cataract and AMD at the same time. This coincidence leads to a greater interest in the question of a mutual influence of both diseases, respectively their therapies, on each other. Objectives: The aim of this report was the evaluation of the medical and health economic effects of cataract operations on the development and progression of an age related macular degeneration (AMD. It was differentiated between first manifestations of AMD, progression of early stages of AMD and influence on further impairment in late stages of AMD. Methods: The relevant publications for this report were identified by DIMDI via structured database enquiry as well as common, self-made enquiry and were evaluated, based on the criteria of evidence based medicine. The present report included German and English literature published since 1983. Results: The database enquiry generated a record of 2769 issue-related publications. Eight medical publications were eligible for analysis in the course of the present HTA report. No relevant studies on health economical, ethical, social or legal issues could be included. Three epidemiological cohort studies provided some evidence for a promoting influence of cataract extractions on the progression of early types of AMD. Two of the epidemiological studies assessed the risk of first manifestation of AMD after cataract extraction. Both came up with up with increased incidences that did not reach statistical

  19. Small Incision Cataract Surgery (SICS with Clear Corneal Incision and SICS with Scleral Incision – A Comparative Study

    Md Shafiqul Alam

    2014-01-01

    Full Text Available Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3% was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of

  20. Six year trend in cataract surgical techniques in Iran

    Hassan Hashemi

    2011-01-01

    Full Text Available Purpose : To determine the cataract surgery techniques performed in Iran from 2000 to 2005. Materials and Methods : This study was part of the Iranian Cataract Surgery Survey (ICSS which was a retrospective cross-sectional study. All major ocular surgery units and 10% of randomly selected minor units throughout Iran were included. Excluding the 2 week Iranian New Year holiday, 1 week per season between 2000 and 2005 (a total of 24 weeks was selected for each center, and data on all cataract surgeries performed during these weeks were collected by reviewing patient records. The ANOVA repeated measure test was performed to determine longitudinal changes with a P0.05. Conclusion : Phacoemulsification with IOL implantation has become the preferred cataract surgery method in Iran during recent years.