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Sample records for clear corneal phacoemulsification

  1. Corneal invasion of ocular surface squamous neoplasia after clear corneal phacoemulsification: in vivo confocal microscopy analysis.

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    Balestrazzi, Angelo; Martone, Gianluca; Pichierri, Patrizia; Tosi, Gian Marco; Caporossi, Aldo

    2008-06-01

    We describe an unusual case of ocular surface squamous neoplasia (OSSN) that occurred in a male patient after superonasal clear corneal phacoemulsification with extensive papillomatous corneal invasion near a side port. The features of the macroscopic invasion of the corneal superficial layers were analyzed by in vivo confocal analysis using the Heidelberg Retina Tomograph II. After OSSN was diagnosed, topical mitomycin-C 0.02% eyedrops were prescribed 4 times a day in a cyclic manner (3 cycles of 1 week on drops followed by 1 week off). After 1 month (second cycle), the natural visual acuity was 20/20, the corneal epithelium had healed completely, and the limbal lesion had regressed markedly. The patient remained asymptomatic without recurrence during a 6-month follow-up.

  2. Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification for rhegmatogenous retinal detachment repair

    Institute of Scientific and Technical Information of China (English)

    Hoseok; Moon; Hee; Jin; Sohn; Dea; Yeong; Lee; Jong; Yeon; Lee; Dong; Heun; Nam

    2015-01-01

    AIM: To assess the outcomes of combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for rhegmatogenous retinal detachment(RRD) repair.METHODS: This was a retrospective, consecutive,noncomparative, interventional case series of 30 eyes of30 patients who underwent combined sutureless vitrectomy and clear corneal cataract surgery for the repair of RRD. The principal outcome measures were primary anatomical success rate, reasons for redetachment, final visual acuity, and surgical complications.RESULTS: Primary reattachment was achieved in 27eyes(90.0%). The reasons for redetachment(3 eyes, 10%)were incomplete laser retinopexy, persistent chronic subretinal fluid, and proliferative vitreoretinopathy,respectively. The logarithm of the minimum angle of resolution visual acuity(mean±SD) improved from 0.76±0.74 preoperatively to 0. 21 ± 0. 37 6 months’ postoperatively(P <0.0001). Postoperative hypotony was not detected,but 1 eye( 3. 3 %) had increased intraocular pressure(30 mm Hg) with spontaneous resolution. No endophthalmitis developed during follow-up. Macular pucker was detected in 3 eyes(10.0%).· CONCLUSION: Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for RRD repair was proven safe and effective. It may provide not only the known advantages of conventional combined surgery, but also additional advantages such as less conjunctival fibrosis and the maintenance of stable intraocular pressure with low risks of postoperative hypotony and intraocular pressure elevation.

  3. Combined clear corneal phacoemulsification and ab interno trabeculectomy: three-year case series.

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    Ferrari, Ettore; Bandello, Francesco; Roman-Pognuz, Derri; Menchini, Francesca

    2005-09-01

    To evaluate the efficacy and safety of a novel surgical approach, ab interno trabeculectomy, in a combined procedure (clear corneal phacoemulsification + ab interno trabeculectomy) for the management of concurrent cataract and glaucoma with prognostic factors for filtration failure. Department of Ophthalmology, Palmanova Hospital, Udine, Italy. A prospective noncomparative case series of 11 eyes of 11 consecutive cataract patients with medically uncontrolled primary open-angle glaucoma or pseudoexfoliation glaucoma was performed. Each patient had phacoemulsification + intraocular lens implantation + ab interno trabeculectomy, which consisted of a gonioscopically controlled ab interno removal of a quadrant (3 clock hours) of the trabecular meshwork. The main outcome measures were intraocular pressure (IOP), the number of antiglaucomatous medications used, and complications. Ten patients completed a 3-year follow-up. One patient had further surgery because of poor IOP control; in this case, the last valid observation was carried forward for IOP calculation. Mean preoperative IOP and IOPs measured 1, 3, 6, 12, 24, and 36 months after surgery were 25.0, 15.8, 15.4, 15.4, 15.2, 15.0, and 15.3 (-38.56%) mm Hg respectively. The number of medications averaged 2.4 before surgery and dropped to 0.8 at the end of follow-up. No major complications occurred during the follow-up period. The new surgical procedure combining phacoemulsification with ab interno trabeculectomy can induce a clinically relevant decrease in IOP in eyes with cataract and glaucoma with poor prognosis for filtering surgery. However, a randomized controlled clinical trial with a more extended follow-up and a larger series of patients is needed to ascertain the actual effectiveness and safety of this procedure.

  4. Comparison of the Keratometric Corneal Astigmatic Power after Phacoemulsification: Clear Temporal Corneal Incision versus Superior Scleral Tunnel Incision

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    Yongqi He

    2009-01-01

    Full Text Available Objective. This is prospective randomized control trial to compare the mean keratometric corneal astigmatism diopter power (not surgical induced astigmatism among preop and one-month and three-month postop phacoemulcification of either a clear temporal corneal incision or a superior scleral tunnel Incision, using only keratometric astigmatic power reading to evaluate the difference between the two cataract surgery incisions. Methods. 120 patients (134 eyes underwent phacoemulcification were randomly assigned to two groups: Group A, the clear temporal corneal incision group, and Group B, the superior scleral tunnel incision group. SPSS11.5 Software was used for statistical analysis to compare the postsurgical changes of cornea astigmatism on keratometry. Results. The changes of corneal astigmatic diopter in Groups A and B after 3 month postop from keratometric reading were 1.04 + 0.76 and 0.94 + 0.27, respectively (=.84>.05, which showed no statistic significance difference. Conclusion. The incision through either temporal clear cornea or superior scleral tunnel in phacoemulcification shows no statistic difference in astigmatism change on keratometry 3-month postop.

  5. SURGICALLY INDUCED ASTIGMATISM AFTER 2.8 MM TEMPORAL AND NASAL CLEAR CORNEAL INCISIONS IN PHACOEMULSIFICATION CATARACT SURGERY OF SAME PATIENT

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    Preeti

    2015-04-01

    Full Text Available PURPOSE: To evaluate and compare the surgically induced astigmatism in phacoemulsification cataract surgery after 2.8 mm temporal and nasal clear corneal incision of same patient . MATERIAL AND METHOD : This prospective study comprised a consecutive case series of 60 eyes. Eyes from 30 patients with phacoemulsification those were implanted with a 6.00 mm foldable intraocular le ns through a 2.8 mm horizontal clear corneal incision (temporal in the right eye , nasal in the left eye. RESULTS : T he outcome measures were surgically induced astigmatism (SIA and uncorrected visual acuity (UCVA , at 1 and 3 months post - operatively. A 1 month the mean SIA was 0.81 D. for the temporal incision and 0.92 D for nasal incision (P = 0.139 at 3 months the mean SIA was 0.53 D for temporal incision and 0.62 D for nasal incision (P =0.309. The pre - operative parameters i.e. (UCVA , mean keratomet ry & keratometric cylinder between these groups were comparable. There was no statistically significant difference found between three groups pre - operatively . CONCLUSION : After cataract surgery using 2.8mm temporal and nasal horizontal corneal incision , t he induced corneal astigmatic changes was similar in both incision groups. Especially in Asian eyes , both temporal and nasal incisions (2.8 mm or less would be equally favourable for astigmatism neutral cataract surgery

  6. Corneal relaxing incision combined with phacoemulsification and IOL implantation

    Institute of Scientific and Technical Information of China (English)

    沈晔; 童剑萍; 李毓敏

    2004-01-01

    Objective: To analyze the effectiveness and safety of corneal relaxing incisions (CRI) in correcting keratometric astigmatism during cataract surgery. Methods: A prospective study of two groups: control group and treatment group. A treatment group included 25 eyes of 25 patients who had combined clear corneal phacoemulsification, IOL implantation and CRI. A control group included 25 eyes of 25 patients who had clear corneal phacoemulsification and IOL implantation.Postoperative keratometric astigmatism was measured at 1 week, 1 month, 3 months and 6 months. Results: CRI signifi-cantly decreased keratometric astigmatism in patients with preexisting astigmatism compared with astigmatic changes in the control group. In eyes with CRI, the mean keratometric astigmatism was 0.29±0.17 D(range 0 to 0.5 D) at 1 week, 0.41±0.21 D (range 0 to 0.82 D) at 1 month, respectively reduced by 2.42 D and 2.30 D at 1 week and 1 month postoperatively (P=0.000, P=0.000), and postoperative astigmatism was stable until 6 months follow-up. The keratometric astigmatism of all patients decreased to less than 1.00 D postoperatively. Conclusions: CRI is a practical, simple, safe and effective method to reduce preexisting astigmatism during cataract surgery. A modified nomogram is proposed. The long-term effect of CRI should be investigated.

  7. Mechanism of Corneal Endothelial Cells Lesion during Phacoemulsification and Aspiration

    Institute of Scientific and Technical Information of China (English)

    Songtao Yuan; Lina Xie; Qinghuai Liu; Nanrong Yuan

    2003-01-01

    Purpose: To evaluate the proportions of corneal endothelial lesion caused by differentfactors during phacoemulsification and aspiration.Methods: Fourteen cats (twenty eight eyes) were divided into four groups. The processedfactors were ultrasonic power, lens extraction by phacoemulsification or not, and lensextraction using different levels of ultrasonic power. The density of central cornealendothelial cells was measured before and after operation.Results: There is no statistic difference between pre-operation density and post-operationdensity for releasing ultrasonic power only without lens extraction group. But for the lensextraction group, there is difference in density of central corneal endothelial cells andthe higher level of ultrasonic power, the more the central corneal endothelial cells densitydecreased through operation.Conclusion: The primary factor that causes corneal endothelial lesion duringphacoemulsification and aspiration procedure is debris of lens nucleus, and the otherfactors cause the lesion of corneal endothelium in normal operations just in very smalldegree.

  8. Correlation between Corneal Endothelial Cell Loss and Location of Phacoemulsification Incision

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    Hamid Gharaee

    2011-01-01

    Full Text Available Purpose: To assess the relationship between corneal endothelial cell loss after phacoemulsification and the location of the clear corneal incision. Methods: A total of 92 patients (92 eyes with senile cataracts who met the study criteria were included in this cross sectional study and underwent phacoemulsification. The incision site was determined based on the steep corneal meridian according to preoperative keratometry. Endothelial cell density was measured using specular microscopy in the center and 3 mm from the center of the cornea in the meridian of the incisions (temporal, superior, and superotemporal. Phacoemulsification was performed by a single surgeon using the phaco chop technique through a 3.2 mm clear cornea incision. Endothelial cell loss (ECL was evaluated 1 week, and 1 and 3 months postoperatively. Results: At all time points during follow-up, ECL was comparable among the 3 incision sites, both in the central cornea and in the meridian of the incision (P > 0.05 for all comparisons. However, 3 months postoperatively, mean central ECL with superior incisions and mean sectoral ECL with temporal incisions were slightly higher. Superotemporal incisions entailed slightly less ECL than the other 2 groups. Overall, one month after surgery, mean central ECL was 10.8% and mean ECL in the sector of the incisions was 14.0%. Axial length and effective phaco time (EFT were independent predictors of postoperative central ECL (P values 0.005 and < 0.0001, respectively. Conclusion: A superotemporal phacoemulsification incision may entail less ECL as compared to other incisions (although not significantly different. The amount of central ECL may be less marked in patients with longer axial lengths and with procedures utilizing less EFT.

  9. Effects of phacoemulsification on the intraocular pressure and corneal endothelial cells of the patients with glaucoma

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    Ye Zhao; Zhi-Feng Liu

    2016-01-01

    Objective:To explore the intraocular pressure and corneal endothelial cells integrity changes in cataract phacoemulsification after anti-glaucoma surgery.Methods:Phacoemulsification was performed in 102 patients (118 eyes) with cataract after anti-glaucoma surgery and the intraocular pressure and corneal endothelial cell integrity changes of patients were observed at Day 1 and 3, first week and first month before and after surgery, including central corneal endothelial cell density, average cell area (AVE), cell area of coefficient of variation (CV) and central corneal thickness (CCT).Results:The intraocular pressure was elevated, the central endothelial cell density was reduced, the AVE, the CV and CTT thicken were increased at Day 1 and 3, first week and first month after surgery. The difference compared with preoperative was statistically significant. The intraocular pressure and CTT almost recovered to preoperative levels in 1 month after cataract phacoemulsification and the difference was not statistically significant; while the central endothelial cell density was still decreased and AVE and CV were still increased and the difference of these indexes and the coefficient of the patients was statistically significant compared with before surgery.Conclusions:For the patients with anti-glaucoma after cataract phacoemulsification, intraocular pressure and endothelial cell integrity change was initially observed at Day 1 after surgery, whereas they can almost return to the preoperative level in a month after surgery.

  10. Comparison of corneal endothelial changes following phacoemulsification with transversal and torsional phacoemulsification machines

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    Mustafa; Atas; Süleyman; Demircan; Arzu; Seyhan; Karatepe; Hashas; Ahmet; Gülhan; Gkmen; Zararsιz

    2014-01-01

    AIM:To compare and evaluate the phacoemulsification parameters and postoperative endothelial cell changes of two different phacoemulsification machines, each with different modes, but also to assess the relationship between postoperative endothelial cell loss and the phacoemulsification parameters, as well as the other factors in both groups.METHODS:This prospective observational study was comprised of consecutive eligible cataract patients operated with phacoemulsification technique performed by the same surgeon using either a WHITESTAR Signature Ellips FX(transversal, group 1) or Infiniti OZil IP(torsional, group 2) machine.RESULTS:The study included 86 patients. Baseline characteristics in the groups were similar. The median nuclear sclerosis grade was 3(2-4) in the first group and2(2-4) in the second group(P =0.265). Both groups had similar phacoemulsification needle times(group 1: 60.63±36 s; group 2: 55.98±30 s; P =0.789). The percentage of endothelial cell loss 30 d after surgery ranged from 3% to15% with a median of 7% in group 1, and from 2% to13% with a median of 6% in group 2; however, there was no statistically significant difference between the groups(P =0.407). Hexagonality(P =0.794) and the coefficient of variation(CV; P =0.142) did not differ significantly between the groups before and 30 d after surgery. Asignificant positive correlation was found between the endothelial cell loss and nuclear sclerosis grade(group1: P <0.001; group 2: P <0.001) and between the endothelial cell loss and average phacoemulsification power(group 1: P =0.007; group 2: P =0.008).CONCLUSION:Both of these machines were efficient,with similar endothelial cell loss. This endothelial cell loss was related to the increased nuclear sclerosis grade and increased phacoemulsification power.

  11. Clinical comparative study of changes in the tear film and ocular surface after 1.8mm and 3.0 mm clear corneal incision phacoemulsification%1.8mm和3.0mm透明角膜切口白内障超声乳化术后泪膜和眼表变化对比研究

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    崔巍; 刘志英; 路强; 马晓程

    2014-01-01

    Objective To observe and compare changes in tear film and ocular surface in patients after clear corneal incision phacoemulsification with 1.8 mm and 3.0 mm.Methods A prospective randomized study.Using a random number table,109 continuously selected patients (109 eyes) with age-related cataract in our hospital received phacoemulsification cataract surgery with intraocular lens implantation were randomly divided into two groups:56 eyes in the micro-incision group A:coaxial 1.8 mm micro-incision phacoemulsification cataract extraction and intraocular lens implantation; 53 eyes in the small incision group B:The traditional coaxial 3.0 mm small incision phacoemulsification cataract extraction and intraocular lens implantation.Dried foreign body sensation (dry eye symptom,DES),Schirmer I test without anesthesia (SIT),tear film break-up time (BUT),comeal fluorescent staining and integral (corneal fluorescent staining,CFS) were assessed preoperatively and postoperatively and at 2d,5d,10d,30d.Results At 2d postoperative,in micro-incision group:DES (1.98 ± 0.67),SIT (18.37 ± 6.21) mm,BUT (5.27 ± 2.63) s,CFS score (3.41 ± 2.52),and in small-incision group:DES (3.17 ± 0.53),SIT (26.38 ± 5.87) mm,BUT (2.27 ± 3.68) s,CFS score (6.31 ± 2.29); At 2d,5d,10d postoperative,DES was significantly improved,SIT extension,BUT shorten,CFS score high in the small incision group compared with the micro-incision group.The difference was statistically significant (P <0.05); at 30d postoperative,SIT,BUT and CFS score were not statistically significant difference (P >0.05) in two groups,DES difference was statistically significant (P <0.05).Conclusion Ocular surface less damage and tear film has little influence early postoperative in the micro coaxial 1.8mm incision phacoemulsification,compared with the traditional coaxial 3.0 mm incision phacoemulsification surgery.%目的 观察和比较1.8、3.0mm透明角膜切口白内障超声乳化术后泪膜和眼表的变化.方法

  12. 白内障超声乳化术中行巩膜隧道切口与透明角膜隧道切口对泪膜的影响对比%Comparison of the influence on tear film between scleral tunnel incision and clear corneal tunnel incision in phacoemulsification

    Institute of Scientific and Technical Information of China (English)

    胡新苗

    2016-01-01

    目的:比较白内障超声乳化摘除术中分别行巩膜隧道切口与透明角膜隧道切口对泪膜的影响。  方法:将2012-02/2015-06在我院进行白内障手术的患者94例126眼纳入本研究。随机均衡分为研究组和对照组,研究组( A组)46例63眼,行巩膜隧道切口;对照组( B组)48例63眼,行透明角膜隧道切口。参考白内障LOCSⅡ核硬度分级标准细分为:AⅡ组、BⅡ组;AⅢ组、BⅢ组;AⅣ组、BⅣ组。患者在术前1 d和术后1、7、30、90 d进行主观干眼症状问卷评分( subjective sylptols of dry eye questionnaire scores,SDES),同时测定患者泪膜破裂时间(break-up tile,BUT)、角膜荧光素钠染色评分(staining scores of sodiul fluorescein, SCSF )、泪液分泌试验(Schirler l test,Slt),对比不同手术切口对患者泪膜影响。  结果:研究组和对照组患者术前泪膜功能指标进行比较,无统计学差异(P>0.05);术后第1、7d,研究组和对照组患者泪膜功能指标与术前1d比较,差异均有统计学意义(P  结论:在进行白内障超声乳化摘除术时,Ⅲ级和Ⅳ级核白内障采用透明角膜隧道切口进行手术,能够加重对患者泪膜功能损伤,手术效果比巩膜隧道切口方式差,尤其Ⅳ级核中更为明显。因此,可以在Ⅳ级核进行白内障超声乳化摘除手术治疗时选择巩膜隧道切口。%AlM:To study the influence on tear film by scleral tunnel incision and clear corneal tunnel incision in phacoemulsification. METHODS: Ninety - four patients ( 126 eyes ) who underwent cataract surgery from February 2012 to June 2015 in our hospital were selected in this study. They were divided into research group ( group A ) with 46 cases ( 63 eyes) underwent surgery though scleral tunnel incision, and the control group (group B) with 48 cases (63 eyes) through clear corneal tunnel incision. According to referencing cataract LOCS Ⅱ nuclear hardness classification standard

  13. Corneal endothelial cell loss during phacoemulsification: bevel-up versus bevel-down phaco tip.

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    Faramarzi, Amir; Javadi, Mohammad Ali; Karimian, Farid; Jafarinasab, Mohammad Reza; Baradaran-Rafii, Alireza; Jafari, Fariba; Yaseri, Mehdi

    2011-11-01

    To compare corneal endothelial cell loss during cataract extraction by phacoemulsification with 2 different phaco-tip positions. Ophthalmic Research Center and Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti Medical University, Tehran, Iran. Randomized clinical trial. Eyes scheduled for cataract extraction were randomly assigned stop-and-chop phacoemulsification with the phaco tip in the conventional bevel-up position or with the phaco tip in the bevel-down position. During surgery, the effective phacoemulsification time (EPT) was recorded. Preoperative endothelial cell parameters were compared with measurements taken 3 months postoperatively. Each group comprised 30 eyes (30 patients). There were no statistically significant differences in age, sex, anterior chamber depth, axial length, or EPT between the 2 groups. The mean preoperative endothelial cell density (ECD) was 2544 cells/mm(2) ± 64 (SD) in the bevel-up group and 2471 ± 59 cells/mm(2) in the bevel-down group (P=.610). Postoperatively, both groups had a significant decrease in ECD. The mean endothelial cell loss was 5.9% in the bevel-up group and 13.6% in the bevel-down group (P=.012). The percentage of hexagonal cells and coefficient of variation in cell size were not different between the 2 groups preoperatively or postoperatively; however, after surgery, there was a significant decrease in the percentage of hexagonal cells in both groups. Corneal endothelial cell loss during phacoemulsification was significantly higher when the phaco tip was in the bevel-down position than in the conventional bevel-up position. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. Consistency of corneal sublayer thickness measurements using Fourier-domain optical coherence tomography after phacoemulsification.

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    López-Miguel, Alberto; Calabuig-Goena, María; Marqués-Fernández, Victoria; Fernández, Itziar; Alió, Jorge L; Maldonado, Miguel J

    2016-11-04

    To assess the reliability of corneal epithelial thickness (CET), nonepithelial central corneal thickness (NECCT), and central corneal thickness (CCT) measurements using Cirrus high-definition optical coherence tomography (HD-OCT) in patients who did and did not undergo cataract surgery. Forty patients who underwent uneventful phacoemulsification and 40 healthy participants were recruited to evaluate the intraobserver repeatability and interobserver reproducibility of CET, NECCT, and CCT measurements using Cirrus HD-OCT. To analyze repeatability, one examiner obtained 5 consecutive scans in each participant; for interobserver reproducibility, another examiner randomly obtained another scan. Within-subject standard deviation, coefficient of variation (CV), limits of agreement, and intraclass correlation coefficient (ICC) data were obtained. For intraobserver repeatability, the intrasession CV (CVw) and ICC values of the CET in the operated and nonoperated groups were 3.7% and 0.80 and 3.8% and 0.73, respectively; for NECCT, 0.7% and 0.98 and 0.8% and 0.97; and for CCT, 0.6% and 0.99 and 0.7% and 0.98. For interobserver reproducibility, the CVw and ICC values for the CET in the operated and nonoperated groups were 2.6% and 0.82 and 2.3% and 0.62, respectively; for NECCT, 0.7% and 0.98 and 0.5% and 0.98; and for CCT, 0.5% and 0.99 and 0.4% and 0.99. The corneal sublayer thickness can be measured reliably using Cirrus HD-OCT in patients who underwent cataract surgery and elderly participants; however, the CET consistency is poorer than the NECCT. Corneal epithelial thickness modifications exceeding 4% reflect true thickness changes instead of random error variations using HD-OCT.

  15. [Comparison of corneal endothelial cells after ECCE and phacoemulsification of the lens].

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    Trnavec, B; Cuvala, J; Cernák, A; Vodrázková, E

    1997-08-01

    The authors evaluate the finding on the corneal endothelium before and after operation of cataract. For examination of the endothelium they used a specular microscope SP 1.000 of Topcon Co. The group comprised 64 eyes of 64 patients. The patients were divided at random into two groups. The first group comprised 26 patients, where ECCE was performed. The second group comprised 38 patients and the opaque lens was removed by phacoemulsification. The mean age in the first group was 69.3 years and in the second group 70.7 years. The same viscoelastic material (methylcellulose) was used and the same synthetic lens from PMMA material was implanted into the capsule. The endothelium was examined one day after operation and on the 7th to 10th day after operation. The following parameters were evaluated: density of the endothelial cells in the centre, mean cell size, polymegethism, coefficient of variation, pleomorphism. In the group of patients who had ECCE the loss of endothelial cells was 18.53%, in the group with phacoemulsification of the nucleus the loss was 16.43%. This difference is not statistically significant. After operation in both groups enlargement of the minimal, maximal as well as mean cell size was observed, the coefficient of variation increased while the grade of cell hexagonality decreased. However these differences in endothelial cells were not statistically significant. After operation of cataract not only endothelial cells are lost but also significant changes in cell morphology occur.

  16. Clear Corneal Phacovitrectomy with Posterior Capsulorhexis and IOL Implantation in Management of Selective Vitreoretinal Cases

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    Ernest V. Boiko

    2015-01-01

    Full Text Available Purpose. To describe our technique, clear corneal phacovitrectomy with posterior capsulorhexis (CCPV, for the management of selected posterior segment intraocular foreign body (IOFB, posteriorly dislocated lens fragments (PDLF, and proliferative diabetic retinopathy (PDR cases. Methods. This was a single-center retrospective interventional case series. In 21 patients (21 eyes we performed phacovitrectomy through three clear corneal tunnel incisions (CCTI and posterior capsulorhexis to remove IOFB (n=8, PDLF from the vitreous cavity after complicated phacoemulsification (n=6, and vitreous hemorrhage and epiretinal membranes in PDR (n=7. The procedure was completed with implantation of a hydrophobic acrylic IOL through the CCTI. Results. The mean visual acuity (logMAR was 0.90 preoperative and improved to 0.26 over a mean follow-up of 8.7 months (range, 6–12 months. The intraocular lens was implanted into the capsular bag (n=12 or onto the anterior capsule (n=9. One PDR patient experienced an intraprocedural complication, hemorrhage from isolated fibrovascular adhesions. One IOFB patient developed apparent anterior proliferative vitreoretinopathy and required a repeat intervention. Conclusion. Selected vitreoretinal IOFB, PDLF, and PDR cases can be successfully managed by a combined surgical approach involving clear corneal phacovitrectomy with posterior capsulorhexis and implantation of an IOL, with good visual outcome and a low complication rate.

  17. Clear Corneal Phacovitrectomy with Posterior Capsulorhexis and IOL Implantation in Management of Selective Vitreoretinal Cases.

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    Boiko, Ernest V; Churashov, Sergey V; Kulikov, Alexei N; Maltsev, Dmitrii S

    2015-01-01

    Purpose. To describe our technique, clear corneal phacovitrectomy with posterior capsulorhexis (CCPV), for the management of selected posterior segment intraocular foreign body (IOFB), posteriorly dislocated lens fragments (PDLF), and proliferative diabetic retinopathy (PDR) cases. Methods. This was a single-center retrospective interventional case series. In 21 patients (21 eyes) we performed phacovitrectomy through three clear corneal tunnel incisions (CCTI) and posterior capsulorhexis to remove IOFB (n = 8), PDLF from the vitreous cavity after complicated phacoemulsification (n = 6), and vitreous hemorrhage and epiretinal membranes in PDR (n = 7). The procedure was completed with implantation of a hydrophobic acrylic IOL through the CCTI. Results. The mean visual acuity (logMAR) was 0.90 preoperative and improved to 0.26 over a mean follow-up of 8.7 months (range, 6-12 months). The intraocular lens was implanted into the capsular bag (n = 12) or onto the anterior capsule (n = 9). One PDR patient experienced an intraprocedural complication, hemorrhage from isolated fibrovascular adhesions. One IOFB patient developed apparent anterior proliferative vitreoretinopathy and required a repeat intervention. Conclusion. Selected vitreoretinal IOFB, PDLF, and PDR cases can be successfully managed by a combined surgical approach involving clear corneal phacovitrectomy with posterior capsulorhexis and implantation of an IOL, with good visual outcome and a low complication rate.

  18. Corneal endothelial cell loss in post-penetrating keratoplasty patients after cataract surgery: phacoemulsification versus planned extracapsular cataract extraction.

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    Acar, Banu Torun; Buttanri, Ibrahim Bulent; Sevim, Mehmet Sahin; Acar, Suphi

    2011-08-01

    To compare the changes in endothelial cell density (ECD) in post-penetrating keratoplasty (PKP) patients after cataract extraction with phacoemulsification or planned extracapsular cataract extraction (ECCE). Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey. Clinical trial. Eyes with hard nuclear cataract that had previous PKP were randomly assigned to have phacoemulsification or ECCE. Noncontact specular microscopy was performed preoperatively and 1, 3, and 6 months postoperatively. Twenty-six eyes of 26 patients were enrolled (14 phacoemulsification; 12 ECCE). Six months postoperatively, the mean corneal ECD was statistically significantly lower in the phacoemulsification group (1869.50 cells/mm(2) ± 158.05 [SD]) than in the ECCE group (1996.00 ± 127.96 cells/mm(2)) (P=.024). The mean percentage of endothelial cell loss at 6 months was 20.3% and 12.7%, respectively (P.05). Extracapsular cataract extraction seemed to cause less endothelial cell damage than phacoemulsification in post-PKP patients with hard nuclear cataract. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  19. Corneal Endothelial Cell Changes Due to Combined Phacoemulsification-Posterior Chamber Intraocular Lens Implantation and Transpupillary Silicone Oil Removal

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    Mehmet Hanifi Alp

    2014-12-01

    Full Text Available Objectives: The aim of this study was to evaluate the effects of combined phacoemulsification-posterior chamber intraocular lens (PCIOL implantation and removal of transpupillary silicone oil on the corneal endothelial cell layer. Materials and Methods: In this study, we included seven eyes of 7 patients who had intravitreal hemorrhage resulting from retinal detachment or tractional retinal detachment due to proliferative diabetic retinopathy and who underwent pars plana vitrectomy and silicone oil injection. Complicated cataract developed, and phacoemulsification-PC-IOL implantation combined with transpupillary silicon oil removal were performed. Preoperative and postoperative corneal endothelial cell count values were taken by Topcon SP-2000P automatic non-contact specular microscopy and were assessed by IMAGEnet 2000 Endothelial Cell Analysis. The results were compared with the findings in the literature. Results: The mean endothelial cell density (ECD was 2461 cell/mm2 preoperatively. The silicone oil removal was performed after an average of 10±3.5 months (range 5-14 months, and then endothelial cells were counted after a mean of 17±21.2 months (range 1-49 months of the combined surgery. The mean ECD was determined as 1906 cell/mm2 postoperatively. While mean endothelial cell loss was found to be 32% in two patients with diabetes mellitus, five non-diabetic patients had 19% cell loss. Corneal decompensation was not observed in any patient during the follow-up period. Conclusion: After combined phacoemulsification-PC-IOL implantation and transpupillary silicone oil removal, significant reduction in endothelial cells was observed. We detected that this reduction was greater in diabetics. (Turk J Ophthalmol 2014; 44: 424-7

  20. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery

    Directory of Open Access Journals (Sweden)

    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.

  1. Effects of Cataract Surgery on Endothelium in Transplanted Corneal Grafts: Comparison of Extracapsular Cataract Extraction and Phacoemulsification for Complicated Cataract after Penetrating Keratoplasty.

    Science.gov (United States)

    Zhou, Hong-Wei; Xie, Li-Xin

    2016-09-05

    The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal. Therefore, we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted corneal grafts. A total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty (PKP) eyes at the Shandong Eye Institute between February 2001 and June 2014 were included, and clinical records were reviewed. Baseline demographic details, clinical characteristics, endothelial cell density (ECD), and best-corrected visual acuity (BCVA) were recorded. Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians. A regression model was constructed to compare the reduced rate of ECD. Of the 54 eyes included in this study, extracapsular cataract extraction (ECCE) was performed in 34 eyes of 33 patients (ECCE group) whereas phacoemulsification was performed in 20 eyes of 20 patients (phacoemulsification group). There was no significant difference in the median age (P = 0.081) or preoperative ECD (P = 0.585) between the two groups. At 6 months after cataract surgery, ECD in ECCE group was significantly higher than that in phacoemulsification group (P = 0.043). In addition, the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months (P = 0.018), 4 months (P ECCE group (P ECCE in transplanted corneal grafts (P ECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.

  2. Comparison of early corneal endothelial cell loss after coaxial phacoemulsification through 1.8 mm microincision and bimanual phacoemulsification through 1.7 mm microincision.

    Science.gov (United States)

    Wilczynski, Michal; Supady, Ewa; Loba, Piotr; Synder, Aleksandra; Palenga-Pydyn, Dorota; Omulecki, Wojciech

    2009-09-01

    To compare corneal endothelial cell loss after coaxial 1.8 mm microincision cataract surgery (MICS) and bimanual 1.7 mm MICS. Department of Ophthalmology, Medical University of Lodz, Lodz, Poland. The study comprised a nonrandomized prospective consecutive series of 51 eyes of 51 patients who had coaxial MICS with implantation of an MI60 foldable intraocular lens (IOL) using a 1.8 mm temporal clear corneal microincision. Fifty eyes of 50 patients who had uneventful bimanual MICS through a 1.7 mm temporal clear corneal incision for a sleeveless phaco tip and a side port for an irrigating chopper with a foldable Acri.Smart 48S foldable IOL implantation served as a reference group. Corneal endothelial cell density, intraoperative phaco power, effective phaco time, and preoperative and postoperative visual acuities were evaluated. The measurements were performed in a semiautomated masked manner. Statistical analysis was done using nonparametric tests (Wilcoxon signed rank test and Mann-Whitney U test). The patients were examined preoperatively and 2 weeks to 1 month postoperatively. The mean follow-up was 22.58 days +/- 5.08 (SD). Postoperatively, the mean corrected distance visual acuity (CDVA)was 0.95 +/- 13 in both groups. There was a significant decrease in endothelial cell density in both groups, 9.46% in Group 1 and 9.27% in Group 2. The between-group difference was not statistically significant (P>.05, Mann-Whitney U test). The visual results were excellent in both groups. Both MICS techniques enabled preservation of corneal endothelial cells equally well and were similar in terms of minor surgical trauma and the influence of surgery on corneal endothelial cell density. Our results support the use of both MICS techniques for cataract surgery.

  3. Central corneal thickness changes in bevel-up versus bevel-down phacoemulsification cataract surgery: study protocol for a randomised, triple-blind, parallel group trial.

    Science.gov (United States)

    Kaup, Soujanya; Shivalli, Siddharudha; Ks, Divyalakshmi; Arunachalam, Cynthia; Varghese, Rejitha Chinnu

    2016-09-29

    Corneal endothelial damage following phacoemulsification is still one of the major concerns of modern day cataract surgery. Although many techniques have been proposed, the risks of posterior capsular rupture and corneal endothelium damage persist. In theory, damage to the corneal endothelium is minimised by delivering the lowest phaco energy only in the direction necessary to emulsify the lens nucleus. Hence, it is believed that the bevel of the needle should be turned towards the nucleus or the nuclear fragment (ie, bevel-down. However, there is a difference of opinion among ophthalmologists with reference to the phaco tip's position (bevel-up vs bevel-down) during phacoemulsification. This subject has not been extensively studied earlier. This is a prospective, triple-blinded (trial participant, outcome assessor and the data analyst), randomised controlled trial with 2 parallel groups and with an allocation ratio of 1:1. It will be conducted in a tertiary care hospital, Mangaluru, India. The objective is to compare the postoperative central corneal thickness changes between the bevel-up and bevel-down techniques of phacoemulsification. Patients aged >18 years with immature cataract undergoing phacoemulsification will be selected for the study. The important exclusion criteria are the history of previous significant ocular trauma or intraocular surgery, corneal pathology, pseudoexfoliation syndrome, intraocular inflammation, a preoperative fully dilated pupil 4. After randomisation, patients will undergo phacoemulsification surgery either by a bevel-up or bevel-down procedure. With an estimated power of 80%, the calculated sample size is 55 patients in each group. The recruitment will start from April 2016. Yenepoya University Ethics Committee, India has approved the study protocol (YUEC/148/2016 on 18 February 2016). It complies with the Declaration of Helsinki, local laws and the International Council for Harmonization-good clinical practices. CTRI/2016

  4. Histomorphological and immunofluorescence evaluation of bimanual and coaxial phacoemulsification incisions in rabbits.

    Science.gov (United States)

    Johar, S R Kaid; Vasavada, Abhay R; Praveen, Mamidipudi R; Pandita, Deepak; Nihalani, Bharati; Patel, Udayan; Vemuganti, Geeta

    2008-04-01

    To compare the changes in the histomorphology and immunofluorescence of collagen type I in clear corneal incisions (CCIs) at the end of bimanual and coaxial phacoemulsification in rabbits. Iladevi Cataract and IOL Research Centre, Ahmedabad, India. In this randomized study, the left eye of 30 rabbits had bimanual phacoemulsification through 1.2 mm CCIs for phaco tip access accompanied by an additional 1.4 mm incision for irrigating chopper access or coaxial phacoemulsification through a 2.6 mm single-plane CCI. The right eyes acted as controls. Samples collected at the end of surgery were processed for histomorphology using periodic acid-Schiff-hematoxylin staining and immunofluorescence localization of type I collagen. Incisions exposed to bimanual phacoemulsification had loss of epithelium, stromal fiber shrinkage, keratocyte nuclei fragmentation and condensation, ragged tunnel margins, and Descemet membrane and endothelial cell loss. The changes were minimal or absent in incisions exposed to coaxial phacoemulsification. Immunofluorescence showed a loss of parallel arrangement of type I collagen fibers in bimanual phacoemulsification incisions, while the fibers were well preserved in coaxial phacoemulsification incisions. The changes were more prominent in the roof of the incision tunnel than in the floor. Corneal incisions for bimanual phacoemulsification were more prone to damage than those for coaxial phacoemulsification. This may be attributed to the absence of a sleeve, which places the incision tunnel in direct contact with the metal phaco tip.

  5. 个性超声乳化切口并不同类型人工晶状体植入术后角膜散光和视觉质量的比较%The clinical investigation of dynamic changes of corneal astigmatism and visual quality for patients after phacoemulsification surgery through different incision and implantation of different designed intraocular lens

    Institute of Scientific and Technical Information of China (English)

    王佃科; 张杰; 王杰; 李艳; 梁山; 刘育霞

    2009-01-01

    Objective To compare the corneal astigmatism and wavefront aberration differences of patients with cataract coexisting corneal astigmatism after phacoemulsification surgery through traditional superior clear corneal incision or phacoemulsification surgery through clear corneal incision guided by corneal topography and implantation of different spherical aberration intraocular lenses (IOL). Methods In a prospective randomized sample controlled clinical trial, 90 patients (90 eyes) with age-related cataract and corneal astigmatism were randomly divided into 3 groups: (Group A) traditional superior corneal incision phacoemulsification surgery and AcrySof SN60AT IOL implantation, (Group B) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60AT IOL implantation and (Group C ) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60WF IOL implantation. Corneal topography tests were performed at 1 week, 1 month, 3 months and 6 months postoperatively. The Wavefront aberration was measured using a custom built Tschcming wavefront sensor--ALLEGRETTO WAVE Analyze at 90 days postoperatively. Third-, 4th-, 5th-, total and higher-order aberration (HOA) root-mean-square (RMS), spherical aberration and coma aberration were compared at virtual pupil diameters of 6 mm postoperatively. Statistical analyses were performed using the analysis of chi square test, repeated measurement data analysis of variance, one-way analysis of variance (ANOVA), and multiple comparisons Studcnts-Newman-Keuls test. Results Corneal topography tests indicated that no significant difference for corneal astigmatism was found between these three groups preoperatively( F =0. 08 ,P >0. 05). The corneal astigmatism was decomposed into J0, J45 and P with a Vector-based method, and statistically analyzed . When compared with Group B and GroupC, Group A had higher values of corneal J0 ( F = 9.54, P 0. 05 ). However groups and times had interactions ( F = 13

  6. Effects of Cataract Surgery on Endothelium in Transplanted Corneal Grafts: Comparison of Extracapsular Cataract Extraction and Phacoemulsification for Complicated Cataract after Penetrating Keratoplasty

    Institute of Scientific and Technical Information of China (English)

    Hong-Wei Zhou; Li-Xin Xie

    2016-01-01

    Background:The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal.Therefore,we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted comeal grafts.Methods:A total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty (PKP) eyes at the Shandong Eye Institute between February 2001 and June 2014 were included,and clinical records were reviewed.Baseline demographic details,clinical characteristics,endothelial cell density (ECD),and best-corrected visual acuity (BCVA) were recorded.Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians.A regression model was constructed to compare the reduced rate of ECD.Results:Of the 54 eyes included in this study,extracapsular cataract extraction (ECCE) was performed in 34 eyes of 33 patients (ECCE group) whereas phacoemulsification was performed in 20 eyes of 20 patients (phacoemulsification group).There was no significant difference in the median age (P =0.081) or preoperative ECD (P =0.585) between the two groups.At 6 months after cataract surgery,ECD in ECCE group was significantly higher than that in phacoemulsification group (P =0.043).In addition,the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months (P =0.018),4 months (P < 0.001),and 6 months (P < 0.001) after cataract surgery.Endothelial cell loss rate after cataract surgery increased over the 6-month study duration in both ECCE group (P < 0.00 l) and phacoemulsification group (P < 0.001),but phacoemulsification resulted in a greater reduction in ECD than that of ECCE in transplanted corneal grafts (P < 0.001).There was no significant difference in postoperative BCVA between the two groups (P =0.065).Conclusion:ECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.

  7. Scleral tunnel phacoemulsification: Approach for eyes with severe microcornea.

    Science.gov (United States)

    Khokhar, Sudarshan; Gupta, Shikha; Tewari, Ruchir; Agarwal, Renu; Gogia, Varun; Sinha, Gautam; Agarwal, Tushar

    2016-04-01

    Cataract surgery in eyes with microcornea is associated with frequent complications such as corneal edema, posterior capsular rent, and risk of unplanned aphakia. We describe an improved surgical technique for the creation of surgical incisions during phacoemulsification in eyes with cataract associated with microcornea. A retrospective analysis of eight patients (8 eyes) operated at our center was undertaken. The mean age of the patients was 29.5 ± 10.9 years. All eyes were operated using the scleral pocket incision for phacoemulsification. This scleral pocket incision was tangential to the limbus and created approximately 2.5 mm behind limbus through which phacoemulsification probe was inserted. Because of the posterior placement of incision, the anterior chamber crowding was minimized. There was no incidence of port-site peripheral corneal edema. Fifty percent eyes developed transient central corneal edema, the intraocular lens in bag was implanted in 5/8 eyes, and none developed Descemet's membrane detachment. Mean best-corrected visual acuity improved from 1.85 ± 0.38 logarithm of minimum angle of resolution (LogMAR) to 1.26 ± 0.70 LogMAR postoperatively (P = 0.01; paired t-test). Posterior incision placement during phacoemulsification in microcornea helps achieve favorable postoperative outcomes in contrast to outcomes using clear corneal approach described in literature.

  8. Scleral tunnel phacoemulsification: Approach for eyes with severe microcornea

    Directory of Open Access Journals (Sweden)

    Sudarshan Khokhar

    2016-01-01

    Full Text Available Cataract surgery in eyes with microcornea is associated with frequent complications such as corneal edema, posterior capsular rent, and risk of unplanned aphakia. We describe an improved surgical technique for the creation of surgical incisions during phacoemulsification in eyes with cataract associated with microcornea. A retrospective analysis of eight patients (8 eyes operated at our center was undertaken. The mean age of the patients was 29.5 ± 10.9 years. All eyes were operated using the scleral pocket incision for phacoemulsification. This scleral pocket incision was tangential to the limbus and created approximately 2.5 mm behind limbus through which phacoemulsification probe was inserted. Because of the posterior placement of incision, the anterior chamber crowding was minimized. There was no incidence of port-site peripheral corneal edema. Fifty percent eyes developed transient central corneal edema, the intraocular lens in bag was implanted in 5/8 eyes, and none developed Descemet′s membrane detachment. Mean best-corrected visual acuity improved from 1.85 ± 0.38 logarithm of minimum angle of resolution (LogMAR to 1.26 ± 0.70 LogMAR postoperatively (P = 0.01; paired t-test. Posterior incision placement during phacoemulsification in microcornea helps achieve favorable postoperative outcomes in contrast to outcomes using clear corneal approach described in literature.

  9. Corneal tissue welding with infrared laser irradiation after clear corneal incision.

    Science.gov (United States)

    Rasier, Rfat; Ozeren, Mediha; Artunay, Ozgür; Bahçecioğlu, Halil; Seçkin, Ismail; Kalaycoğlu, Hamit; Kurt, Adnan; Sennaroğlu, Alphan; Gülsoy, Murat

    2010-09-01

    The aim of this study was to investigate the potential of infrared lasers for corneal welding to seal corneal cuts done in an experimental animal model. Full-thickness corneal cuts on freshly enucleated bovine eyes were irradiated with infrared (809-nm diode, 980-nm diode, 1070-nm YLF, and 1980-nm Tm:YAP) lasers to get immediate laser welding. An 809-nm laser was used with the topical application of indocyanine green to enhance the photothermal interaction at the weld site. In total, 60 bovine eyes were used in this study; 40 eyes were used in the first part of the study for the determination of optimal welding parameters (15 eyes were excluded because of macroscopic carbonization, opacification, or corneal shrinkage; 2 eyes were used for control), and 20 eyes were used for further investigation of more promising lasers (YLF and Tm:YAP). Laser wavelength, irradiating power, exposure time, and spot size were the dose parameters, and optimal dose for immediate closure with minimal thermal damage was estimated through histological examination of welded samples. In the first part of the study, results showed that none of the applications was satisfactory. Full-thickness success rates were 28% (2 of 7) for 809-nm and for 980-nm diode lasers and 67% (2 of 3) for 1070-nm YLF and (4 of 6) for 1980-nm Tm:YAP lasers. In the second part of the study, YLF and Tm:YAP lasers were investigated with bigger sample size. Results were not conclusive but promising again. Five corneal incisions were full-thickness welded out of 10 corneas with 1070-nm laser, and 4 corneal incisions were partially welded out of 10 corneas with 1980-nm laser in the second part of the study. Results showed that noteworthy corneal welding could be obtained with 1070-nm YLF laser and 1980-nm Tm:YAP laser wavelengths. Furthermore, in vitro and in vivo studies will shed light on the potential usage of corneal laser welding technique.

  10. Corneal astigmatism change and wavefront aberration evaluation after cataract surgery: "Single" versus "paired opposite" clear corneal incisions

    Directory of Open Access Journals (Sweden)

    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.

  11. Single clear corneal incision for glaucoma drainage device shortening in pediatric glaucoma.

    Science.gov (United States)

    Radke, Phillip M; Bitrian, Elena; Grajewski, Alana L

    2016-06-01

    Glaucoma drainage devices are commonly used for management of glaucoma in adults and children. With time, the position of the tube can change and cause damage such as corneal scarring, iris or lens contact, and uveitis. Most of these problems can be improved with tube shortening and/or excision of adherent iris or fibrous tissue. We describe a surgical technique that uses a single clear corneal incision to externalize and trim the shunt in pediatric patients. The technique has a short surgical. We review the indications and outcomes for this procedure in 13 eyes of 12 children who required shunt revision.

  12. 角膜地形图引导下白内障超乳手术对角膜散光的影响%Impact on corneal astigmatism during phacoemulsification guided by corneal Topography

    Institute of Scientific and Technical Information of China (English)

    陈艳; 张暹梅

    2009-01-01

    目的 观察角膜地形图引导白内障超声乳化术对角膜散光状态的影响.方法 对采用白内障超乳手术治疗的72例白内障患者进行观察,随机分为两组,34例角膜切口选择在角膜地形图垂直高曲率经线上,38例角膜切口选择在常规角膜12点左右方向,应用角膜地形图对手术前后角膜散光状态进行比较.结果根据角膜地形图曲率信息做角膜切口组散光度由术前的(1.11±0.36)D降低为术后3月的(0.96±0.32)D,常规12点左右方向角膜切口组散光度由术前的(1.08±0.54)D改变为术后3月的(1.36±0.43)D.根据角膜地形图曲率信息做角膜切口组术后1d和3月视力>0.5者27只眼(78.6%)和30只眼(87.4%),要多于常规12点左右方向角膜切口组27只眼(72.5%)和31只眼(80.4%).结论 根据角膜地形图的曲率信息在手术切口的方位和角度进行选择,可以减轻术后角膜的散光状态,对视力的恢复有益.%Objective To study the impact on corneal astigmatism during phacoemulsification guided by corneal topography.Methods The cohort consisted of 72 patients treated by phacoemulsification and intraocular lens implantation.All patients were divided into two groups randomly.Of 34 eyes were made corneal incision on the steepest meridian,while 38 eyes chose the line on the superior position.Corneal topography was used to compare the corneal astigmatism before and after operation.Results The group which made incision using curvature message in corneal topography had an astigmatism change from(1.11±0.36)D before operation to(0.96±0.32)D after operation.And in this group the vision of 27 eyes were above 0.5(78.6%)first day after operation and 30(87.4%)eyes 3 months after operation.The group which made incision on the superior position had an astigmatism change from(1.08±0.54)D before operation to(1.36±0.43)D after operation.In this group the vision of 27 eyes were above 0.5(72.5%)first day after operation and 31 eyes(80

  13. [Effect of phacoemulsification on the cornea].

    Science.gov (United States)

    Stănilă, D M; Stănilă, Adriana; Mihai, Elena; Sîrbu, N G; Stupariu, A L

    2013-01-01

    Cataracta is the more common surgical diesease of the eye. The removal of the cataract is done my phacoemulsification. To evaluate the effect of phacoemulsifcation on the cornea. We have studied 80 patients with cataract that underwent cataract surgery by phacoemulsification. We measured the corneal thickness and the number of endothelial cell before and after the surgery. REZULTS AND DISCUSSIONS: Corneal thickness grew with 3% and the number of endothelial cells decresed with 13%. Phacoemulsification with the use of vascoelastic substancees is a very safe method of lens extraction

  14. The change of corneal astigmatism after cataract surgery with different locations of clear corneal incision%非球面和球面人工晶状体植入术后视功能观察

    Institute of Scientific and Technical Information of China (English)

    吴智敏; 徐国旭

    2011-01-01

    Objective To analyze the corneal astigmatism before cataract surgery and evaluate the astigmatism changes after cataract surgery performed using clear corneal incisions with different locations. Methods This randomized prospective clinical study comprised 295 eyes of 218 patients underwent phacoemulsification and implantation of foldable intraocular lens through a corneal tunnel incision. Patients were randomly divided into three groups depending on the different locations of the incision: temporal, superotemporal and superior. Corneal topography was performed preoperatively and 1week, 1 month, and 3 months postoperatively. Surgically induced changes were calculated by vector analyses using the Holladay-Cravy-Koch method. Results Preoperatively, in 60.68% of eyes, corneal astigmatism was between 0.5 and 1.5 diopters (D) and in 11.86%, it was 1.5 D or higher. Meanwhile,about 29.49 percent of eyes had with-the-rule (WTR) astigmatism, while 51.19% had against-the-rule (ATR) astigmatism, and the others had oblique astigmatism. At three follow-up visits postoperatively,the mean magnitude of surgically-induced astigmatism (SIA) was lowest in the temporal incision group and highest- in the superior incision group. In addition, an ATR shift was found in the superior incision group. Conclusions Corneal astigmatism less than 1.5 D is present in most cataract surgery candidates. Cataract surgery using temporal clear corneal incision induces significantly less SIA in the early postoperative period. Superior incision may lead to an ATR astigmatism shift.%目的 观察非球面人工晶状体和球面人工晶状体植入术后视功能的变化.方法 收集行超声乳化联合IOL植入术的年龄相关性白内障患者85例96只眼,其中植入非球面(Alcon SN60WF)IOL48只眼,植入球面(Alcon SN60AT)IOL48只眼,所有病例术后裸眼视力均>0.1,术后6个月对色觉、对比敏感度、表观调节力等视功能检查.结果 术后6个月Alcon SN60WF和SN60AT

  15. Evaluation of early results of quick-chop phacoemulsification in the patients with high myopic cataract

    Institute of Scientific and Technical Information of China (English)

    Ali; Akal; Tugba; Goncu; Sevin; Soker; Cakmak; Isa; Yuvaci; Mustafa; Atas; Süleyman; Demircan; Omer; Faruk; Yilmaz

    2014-01-01

    AIM:To assess the early surgical outcomes of quickchop phacoemulsification technique in patients with high myopia.METHODS:The data of patients with high myopia who underwent quick-chop phacoemulsification were reviewed retrospectively. There were 42 eyes of 31 patients. The axial length was more than 26 mm in all eyes. All eyes underwent quick-chop phacoemulsification surgery with the placement of an intraocular lens(IOL) in the capsular bag. Postoperative visits were performed at 1, 3d; 2wk,1mo. Early postoperative best corrected visual acuity(BCVA), preoperative and postoperative corneal endothelial cell density(ECD), central corneal thickness(CCT) and postoperative complications were assessed.Paired sample t-test or Wilcoxon tests were used to compare data between preoperative and postoperative data.· RESULTS:There was no statistically significant difference between preoperative and postoperative ECD and CCT. Retinal detachment was developed in one eye at postoperative first day. There was an iris prolapsus from side port insicion.· CONCLUSION:Quick-chop phacoemulsification technique is a safe surgical technique. However we can encounter some complications in high myopic eyes due to histopathological differences. Both side port and clear corneal tunnel insicion size is crucial for preventing postoperative complications. If any persistent leakage is noticed, suture should be placed.

  16. Formation of free radicals during phacoemulsification.

    Science.gov (United States)

    Holst, A; Rolfsen, W; Svensson, B; Ollinger, K; Lundgren, B

    1993-04-01

    During phacoemulsification cavitation bubbles are formed. These bubbles are believed to be one source of damage to corneal endothelium seen after phacoemulsification. Free radicals are induced whenever cavitation bubbles implode. The aim of this study was to confirm the initiation of free radicals by phacoemulsification and to correlate the power of ultrasound in the phacoemulsification process to the amount of free radicals formed, using both in vitro and in vivo techniques. The formation of free radicals was determined by adding luminol to a buffer and measuring the chemoluminescence in vitro and in rabbit eyes (Lumacounter 2080 or a single-photon-counting apparatus) during phacoemulsification. The data obtained show that free radicals are formed during phacoemulsification and that the amount of free radicals correlates with the power of ultrasound. Furthermore, the radical formation could be inhibited by the radical scavengers SOD, Healon and Healon GV. These results were achieved both in vitro in the test tube and in vivo in rabbit eyes. By showing that the addition of SOD to the irrigation buffer during phacoemulsification decreases the corneal endothelial cell damage, we show that free radicals could have a role in postoperative complications seen clinically.

  17. Corneal Laceration

    Medline Plus

    Full Text Available ... Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment What Is Corneal Laceration? Written By: Daniel Porter Reviewed By: ... A Harrison MD Sep. 01, 2016 The cornea is the clear front window of the eye . A ...

  18. Outcomes of Phacoemulsification with Anterior Chamber Maintainer in Vitrectomized Eyes

    Directory of Open Access Journals (Sweden)

    Elif Betül Türkoğlu

    2012-07-01

    Full Text Available Pur po se: To evaluate the outcomes of phacoemulsification with anterior chamber maintainer in vitrectomized eyes with complicated cataract. Ma te ri al and Met hod: Twenty eyes of 20 patients who developed complicated cataract after pars plana vitrectomy (PPV were included in the study. Phacoemulsification with clear corneal incision and foldable intraocular lens implantation was performed. In group 1, anterior chamber maintainer (ACM was used during phacoemusification and in group 2, ACM was not used. Pre- and postoperative visual acuities as well as per- and postoperative complications were reviewed retrospectively. Re sults: Anterior chamber maintainer was used during the surgery in 12 (60% cases and was not used in 8 (40% cases. Phacoemulsification was performed 16.5±9.2 (4-40 months after PPV. Best-corrected visual acuities were between hand motions and 0.4 preoperatively and between counting fingers from 1 meter and 1.0 postoperatively in group 1. Best-corrected visual acuities were between hand motions and 0.1 preoperatively and between counting fingers from 1 meter and 0.8 postoperatively in group 2. Posterior capsule was ruptured in 1 eye peroperatively in group 1. In group 2, phacoemulsification was more difficult due to deep anterior chamber in 8 eyes and intraoperative complications were iris sphincter rupture in 1 eye and posterior capsule rupture in 1 eye. Mild corneal edema in 7 (58.3% eyes, fibrin reaction in 2 (16.6%, intraocular lens decentralization in 1 (8.3% and posterior capsule opacification in 4 (33.3% eyes were the postoperative complications in group 1. Mild corneal edema in 5 (62.5% eyes, fibrin reaction in 1 (12.5% and posterior capsule opacification in 2 (25% eyes were the postoperative complications in group 2. Dis cus si on: Complicated cataracts which may develop after PPV can be treated safely with phacoemulsification. Continuous irrigation during the surgery may provide a stable anterior chamber and prevents

  19. Clinical study on postoperative astigmatism of phacoemulsification guided by Astramax corneal topography%Astramax角膜综合检查站引导白内障手术术后屈光状态的临床研究

    Institute of Scientific and Technical Information of China (English)

    郑艳霞; 杨卫国; 魏宝丰; 高亚玲; 穆金卫

    2012-01-01

    目的 观察Astramax三维角膜综合检查站引导白内障超声乳化手术5.5mm透明角膜切口对术后屈光状态的影响.方法 对89例(100眼)老年性白内障患者随机分为观察组51眼及对照组49眼.观察组透明角膜切口位于角膜曲率最大子午线方向,对照组透明角膜切口位于10点位方向,2组行白内障超声乳化,植入5.5mm非折叠人工晶体.于术后1周、1个月及3个月时对患者进行视力、裂隙灯、眼底、角膜地形图检查,观察患者屈光状态的变化.结果 术后1个月及3个月观察组裸眼视力≥0.5者分别为42眼(82%)和43眼(84%),对照组分别为31眼(63%)和33眼(67%),2组比较有显著性差异(P均<0.05).观察组术后1个月、3个月角膜散光度明显减小(P<0.01);对照组术后3个月角膜散光度明显减小(P<0.05).结论 Astramax三维角膜综合检查站引导白内障超声乳化5.5mm角膜透明切口手术可以减少手术性散光、矫正角膜散光、提高术后视觉效果.%Objective It is to observe the influence of phacoemulsification guided by Astramax corneal topography system on postoperative astigmatism. Methods One hundred eyes with cataract were randomly divided into treatment groups (51 eyes, incision at the steepest corneal meridian ) and control group ( 49 eyes, incision at 10 o' clock ). The 5. 5 mm non-folded artificial lens was imbeded after phacoemulsification. The refraction state was observed after operation by sight, slit lamp, eye ground and corneal topography and compared. Results There were 42 eyes ( 82% ) and 43 eyes ( 84% ) which sight & 0. 5 at 1 and 3 month after operation in treatment group and 31 eyes ( 63% ) and 33 eyes ( 67% ) in control group with significant difference ( all P < 0.05 ). The corneal astigmatism degree was extremely significant smaller ( P < 0. 01 ) at 1 and 3 month after operation in treatment group, and was significant smaller ( P <0.05 ) at 3 month after operation in control group

  20. Observation of corneal astigmatism induced by 2.2mm micro-incision coaxial phacoemulsification%同轴微切口白内障超声乳化术后角膜散光的临床观察

    Institute of Scientific and Technical Information of China (English)

    林英杰; 梁先军; 何锦贤; 赵抒羽; 杨雪艳; 曾胜

    2013-01-01

    目的:评价2.2mm同轴微切口白内障超声乳化手术后角膜散光的变化.方法:老年性白内障患者56例78眼,将患者随机分为2组,2.2mm组38眼,3.0mm组40眼,分别行2.2mm同轴微切口白内障超声乳化联合人工晶状体(IOL)植入术及3.0mm常规白内障超声乳化联合IOL植入术,术后1,3mo评价术眼裸眼视力(uncorrected visual acuity,UCVA)、角膜散光、术源性角膜散光(surgically induced astigmatism,SIA).结果:术后1mo,2.2mm组角膜散光为0.85±0.42D,3.0mm组角膜散光为1.18±0.37D,两组角膜散光比较有统计学差异(P0.05).术后UCVA,在术后1mo和3mo,2.2mm组均优于3.0mm组.结论:2.2mm同轴微切口白内障超声乳化手术后能产生更小的SIA和更好的UCVA.%AIM: To evaluate the effect of 2. 2mm micro-incision coaxial phacoemulsification on corneal astigmatism and surgically induced astigmatism (SIA).METHODS: Fifty-six cataract patients (78 eyes) were randomized into two groups: 38 eyes in the 2. 2mm incision group and 40 eyes in the 3. Omm group. Torsional phacoemulsification was followed. Corneal astigmatism, SIA and uncorrected distance visual acuity (UCVA) were assessed at 30 and 90 days after cataract surgery.RESULTS: One month postoperatively, the corneal astigmatism of the 2.2mm group was 0.85±0.42D and the 3.0mm group was 1. 18 ± 0. 37D. Three months postoperatively, the corneal astigmatism of the 2. 2mm group was 0. 74 ± 0. 40D and the 3. Omm group was 1. 00 ± 0. 30D. One month and 3 months postoperatively, SIA of the 3. Omm group was greater than SIA of the 2. 2mm group ( P< 0. 05). In the 3. Omm group, mean SIA at 1 month was greater than SIA at 3 months ( P<0. 05), but SIA was similar. There was no statistical significance between the mean SIA between 1 month and 3 months. Postoperative UCVA was better in the 2. 2mm group at both 1 month and 3 months postoperatively.CONCLUSION; 2. 2mm micro - incision coaxial phacoemulsification contributed to postoperative corneal

  1. Ingress of bacterial inoculum into the anterior chamber after bimanual and microcoaxial phacoemulsification in rabbits.

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    Gajjar, Devarshi; Praveen, Mamidipudi R; Vasavada, Abhay R; Pandita, Deepak; Vasavada, Vaishali A; Patel, Dhara B; Johar, Kaid; Raj, Shetal

    2007-12-01

    To compare the amount of bacterial ingress from the ocular surface into the anterior chamber at the end of bimanual and microcoaxial phacoemulsification in rabbits. Iladevi Cataract & IOL Research Centre, Raghudeep Eye Clinic, Memnagar, Ahmedabad, India. This randomized study comprised 40 eyes of 20 rabbits. Rabbits had microcoaxial phacoemulsification through a 2.2 mm single-plane clear corneal incision or bimanual phacoemulsification through a clear corneal 1.2 mm incision for phaco tip access accompanied by an additional 1.4 mm incision for irrigating chopper access. At the end of lens removal, 0.5 mL of culture suspension of Staphylococcus epidermidis (105 colony-forming units [CFU]/mL) was instilled on the ocular surface and kept for 2 minutes. Next, 0.1 mL of aqueous fluid was collected from the anterior chamber and subjected to a microbial viable count. The microcoaxial group had statistically significantly lower ingress of bacteria than the bimanual group (250.0 CFU/mL and 1538.1 CFU/mL, respectively) (P<.002) irrespective of the presence or absence of wound distortion. Bacterial ingress occurred in both groups, although it was statistically significantly higher in the bimanual group.

  2. Surgical results of combined pars plana vitrectomy and phacoemulsification for vitreous hemorrhage in PDR

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    Canan H

    2013-08-01

    Full Text Available Handan Canan,1 Selçuk Sizmaz,2 Rana Altan-Yaycioğlu1 1Department of Ophthalmology, Adana Teaching and Medical Research Center, Baskent University School of Medicine, 2Department of Ophthalmology, Cukurova University School of Medicine, Yuregir, Adana, Turkey Background: The purpose of this study was to evaluate the effectiveness, safety, and incidence of complications after combined clear corneal phacoemulsification with intraocular lens implantation and pars plana vitrectomy in eyes with proliferative diabetic retinopathy coexistent with significant cataract. Methods: Eighty-five eyes of 85 patients with proliferative diabetic retinopathy underwent primary standard three-port vitrectomy with 20-gauge instruments and phacoemulsification with intraocular lens implantation for vitreous hemorrhage from 2008 to 2011. The main outcome measures were visual outcomes and surgical complications. Results: Forty patients were male and 45 were female. Their age ranged from 40 to 77 years with a mean of 59.6 years. The mean follow-up was 13 months, with a range of 6–48 months. The preoperative logMAR visual acuity changed from 2.62 ± 0.6 to 0.8 ± 0.7 postoperatively. Postoperatively, visual acuity improved in 79 eyes (92.9%, and did not change in six eyes (7.1%. Intraoperative complications were transient corneal edema (five eyes and posterior capsular rupture (one eye. Postoperative complications consisted of transient intraocular pressure elevation (25 eyes, corneal epithelial defects (six eyes, anterior chamber reaction (four eyes, hyphema (two eyes, posterior synechiae (four eyes, vitreous hemorrhage (23 eyes, retinal tears (five eyes, retinal detachment (one eye, and neovascular glaucoma (one eye. Conclusion: Our study suggests that the combined operation of pars plana vitrectomy, phacoemulsification, and intraocular lens implantation is safe and effective for patients with proliferative diabetic retinopathy. We believe that the visual outcome and

  3. Clinical study on astigmatism of phacoemulsification incision decided by corneal topography%角膜地形图引导下的角膜切口白内障手术矫正角膜散光的研究

    Institute of Scientific and Technical Information of China (English)

    张欣; 王颖; 卢山; 何伟

    2010-01-01

    Objective To observe preoperative and postoperative astigmatism of corneal incision decided by the corneal topography. Methods A total of 240 eyes underwent phacoemulsification with corneal incision were randomly divided into three groups. Group A (80 eyes), incision at the steepest corneal meridian decided by corneal topography; group B (80 eyes), incision at 90 °; group C (80 eyes), incision at 180 °. Corneal astigmatism, visual changes of preoperative and 1 week, 1 month and 3 months postoperative were observed. Results Uncorrected visual acuity (>0.7) of group A were better than group B and C (P0.6) were the same in all three groups of the patients. Astigmatism of group A were significantly reduced (P 0.05). Astigmatism of group A were significantly reduced (P <0.05) 1 week, 1 month and 3 months postoperative compared with group B and group C (P <0.05). Conclusions The incision which located at the steepest corneal meridian under the guidance of corneal topography reduces the preoperative and postoperative astigmatism, and attains better uncorrected visual acuity postoperative.%目的 观察角膜地形图引导下的透明角膜切口白内障手术对术前及术后散光度的影响.方法 透明角膜切口晶状体超声乳化术240只眼,随机分成三组,每组80只眼.A组:切口位于角膜最大屈光轴方向;B组:切口位于90°方向;C组:切口位于180°方向.观察术前、术后1周、1月、3月角膜散光度和视力变化.结果 (1)A组术后1周、1月和3月裸眼视力> 0. 7者多于B组和C组(P < 0. 05);三组患者术后最佳矫正视力> 0. 6者基本相同.(2)A组患者术后1周、1月及3月与术前相比,散光度明显减小(P<0.01);术后1周与术后1月、3月相比,散光度也减小(P<0.05);而术后1月与3月相比,散光度基本相似(P>0.05).(3)A组与B组相比,术后1周、1月及3月时的散光度均明显减小(P<0.05);A组与C组相比,术后1周、1月及3月时

  4. Visual acuity and refractive outcomes of different corneal incisions in phacoemulsification%角膜地形图引导下不同部位角膜切口白内障超声乳化术后角膜散光分析

    Institute of Scientific and Technical Information of China (English)

    石春和; 姜焕荣; 倪鸿昌

    2014-01-01

    目的:比较角膜地形图引导下不同部位透明角膜切口白内障超声乳化术后散光情况。方法选择行透明角膜切口超声乳化白内障吸除联合人工晶状体植入术的年龄相关性白内障患者198例(231例)为研究对象,分成A、B、C 3组,A组选择在上方11点位透明角膜切口,B组选择在颞侧透明角膜切口,C组选择在角膜最大曲率子午线上透明角膜切口,分别于术前,术后1周、1个月及3个月随访,行视力及角膜地形图检查,记录并比较3组术后视力及角膜散光的变化情况。结果术后3个月时C组裸眼视力≥1.0者多于A组和B组( P <0.05);C组患者术后3个月与术前相比,散光度明显减小( P <0.05);C组分别与A组、B组相比,术后1周、1个月及3个月时的散光度均明显减小( P <0.05);术后3个月平均手术源性角膜散光度(SIA),C组最小。结论角膜地形图引导下位于角膜最大曲率子午线上透明角膜切口有助于减小术前及术后散光,术后获得较好的裸眼视力。%Objective To compare the effects of different corneal topography guided incisions on corneal refraction after phacoemulsification.Methods Totally 198 cataract patients (231 eyes) enrolled in the study.Patients were random-ly assigned into 3 groups and clear corneal incisions were made at either superior , or temporal, or along the steepest meridi-an.Routine ophthalmic examinations and corneal topography were performed for each patient before surgery and at 1 week, 1 month, and 3 months after the surgery.Results At 3 months after the surgery,uncorrected visual acuity (≥1.0) was-significantly better in patients whose corneal incisions were made at the deepest meridian than in patients whose corneal in -cisions were made elsewhere ( P <0.05 ) .Astigmatism was also significantly reduced in this group of patients ( P <0.05) starting from 1 week after the surgery and

  5. Corneal oedema after phacoemulsification in the early postoperative period: A qualitative comparative case-control study between diabetics and non-diabetics

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    Konstantinos T. Tsaousis

    2016-02-01

    Conclusions: The existence of diabetes mellitus type 2 appears to be a significant risk factor for the development of persistent corneal oedema. The results of our study led to the modification of the algorithm for postoperative follow-up of patients of this remote area of Greece.

  6. Small Incision Cataract Surgery (SICS with Clear Corneal Incision and SICS with Scleral Incision – A Comparative Study

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    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

  7. Comparison of stromal hydration techniques for clear corneal cataract incisions: conventional hydration versus anterior stromal pocket hydration.

    Science.gov (United States)

    Mifflin, Mark D; Kinard, Krista; Neuffer, Marcus C

    2012-06-01

    Anterior stromal pocket hydration was compared with conventional hydration for preventing wound leak after 2.8 mm uniplanar clear corneal incisions (CCIs) in patients having routine cataract surgery. Conventional hydration involves hydration of the lateral walls of the main incision with visible whitening of the stroma. The anterior stromal pocket hydration technique involves creation of an additional supraincisional stromal pocket overlying the main incision, which is then hydrated instead of the main incision. Sixty-six eyes of 48 patients were included in the data analysis with 33 assigned to each study group. The anterior stromal pocket hydration technique was significantly better than conventional hydration in preventing wound leak due to direct pressure on the posterior lip of the incision. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Torsional Phacoemulsification and Tip Selection

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    Fırat Helvacıoğlu

    2014-10-01

    Full Text Available One of the recent advances in cataract surgery is torsional phacoemulsification. It was developed to increase the efficacy of ultrasonic emulsification. In torsional phacoemulsification, the torsional movement of the tip is translated to side-to-side cutting action with the aid of bent phaco tips. Lens material is cut in both directions, rather than only during a forward stroke. The efficiency of this technique is further enhanced by an improvement in followability provided by the inherent non-repulsive nature of the side-to-side motion. Tip selection is very important for the efficiency of torsional phacoemulsification. Theoretically, there are 2 ways to enhance the cutting efficiency of the tip. First is the stroke length; the 22-degree bent 30-degree Kelman mini-flared tip cuts longer than the 12-degree bent 30-degree mini-flared Kelman tip. Second is the angulation or bevel; the higher the degree (45 degrees, the better cutting efficiency. Retrospective analyses of the previously published clinical studies clearly demonstrated that the efficacy of the torsional phacoemulsification has positive correlation with both the aperture angles and neck angles of the tips. (Turk J Ophthalmol 2014; 44: 392-5

  9. Relationship between endothelial cell loss and microcoaxial phacoemulsification parameters in noncomplicated cataract surgery.

    Science.gov (United States)

    Mahdy, Mohamed Ae Soliman; Eid, Mohamed Z; Mohammed, Mahmoud Abdel-Badei; Hafez, Amr; Bhatia, Jagdish

    2012-01-01

    To assess the relationship between postoperative endothelial cell loss and microcoaxial phaco parameters using Ozil IP (Alcon Laboratories, Inc, Fort Worth, TX) in noncomplicated cataract surgery. In this prospective observational study, 120 consecutive cases of cataract patients with different grades of nuclear hardness underwent microcoaxial phacoemulsification through a 2.2-mm clear corneal incision. An Alcon Infinity Vision System with Ozil IP (Alcon Laboratories) was used with an Ozil torsional handpiece and a Kelman-style 45° phacoemulsification tip. Patients underwent preoperative and postoperative central endothelial cell counts. The study included 120 cases of age-related cataract whose mean age (standard deviation [SD]) was 59.68 years (9.47). There was a highly statistically significant endothelial cell loss (P phaco parameters. The Spearman's rank-order correlation coefficient values, rho, (ρ) were as follows: CDE (ρ = 0.425), aspiration time (ρ = 0.176), and volume (ρ = 0.278). Also, ECLoss% was significantly correlated with the grade of nuclear opalescence (Kendall's tau τ = 0.42). Microcoaxial phacoemulsification was efficient in removing noncomplicated cataracts; however a statistically significant endothelial cell loss was noted, especially with increased nuclear hardness. This endothelial cell loss was mostly related to the increased cumulative dissipated energy (CDE), aspiration time, and volume of balanced salt solution used.

  10. Phaco-emulsification in completely vitrectomized eyes: Intraoperative analysis of modified phaco sleeve

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    Rajesh S Joshi

    2016-01-01

    Full Text Available Purpose: The purpose was to evaluate the results of modified sleeve in phacoemulsification of cataract in completely vitrectomised eyes, Materials and Methods: Twenty-five previously completely vitrectomized eyes of 23 patients having visually significant cataract were included. After through evaluation they underwent phaco-emulsification by phaco chop with a modified sleeve via temporal clear corneal incision. The modified sleeve was made by creating a small round port of approximate 1 × 1 mm size at the proximate end of the sleeve in line with the already existing ports. This port faced the posterior capsule while performing phacoemulsification. Patients were observed for any intraoperative complications. Result: The most common indication for pars plana vitrectomy in our study group was vitreous hemorrhage due to diabetic retinopathy [13 out of 25 eyes (52%]. Intraoperative findings included miosis [seen in 3 (12% eyes] and posterior capsular plaque [seen in 2(8% eyes]. No other significant intraoperative complications (posterior capsular tear, dropped nucleus were observed. Average effective phaco time was 33 sec. (±15.11. Conclusion: Though cataract surgery in postvitrectomized eyes is a challenging situation, modified sleeve prevents anterior chamber fluctuation and avoids complications arising out of it, making the surgery safe.

  11. The correlation between variation of visual acuity and the anterior chamber depth in the early period after phacoemulsification

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    Kai-jian CHEN

    2011-04-01

    Full Text Available Objective To investigate the correlation between the visual acuity variation and the anterior chamber depth in the early period after phacoemulsification.Methods Thirty-six eyes of 32 patients with age-related cataract underwent 3.2mm clear corneal incision phacoemulsification and intraocular lens(IOL implantation.The visual acuity was examined and horizontal curvature(K1,vertical curvature(K2,corneal astigmatism,and anterior chamber depth were measured with IOL-master preoperatively and also on 1,3,7 and 15 postoperative days.The changes in parameters were compared,and the correlations among visual acuity,corneal astigmatism and anterior chamber depth were analyzed.Results Before operation and 1d,3d,7d and 15d after operation,the corneal astigmatism was-0.87±0.40D,-1.92±1.38D,-1.69±1.13D,-1.45±0.79D and-1.36±0.74D;the anterior chamber depth was 3.08±0.35mm,4.04±0.38mm,4.28±0.29mm,4.22±0.17mm and 4.22±0.16mm;the visual acuity was 0.18±0.10,0.44±0.14,0.59±0.12,0.61±0.11 and 0.62±0.14.Significant difference was found between pre-operative and postoperative visual acuity,corneal astigmatism and anterior chamber depth,and it was also found in corneal astigmatism between 1d and 15d post operation(P < 0.05,as well as in anterior chamber depth and visual acuity between 1d and 3d post operation(P < 0.05.A positive correlation was found between visual acuity and corneal astigmatism on 1d(r=0.42,P < 0.05,3d(r=0.35,P < 0.05 and 7d(r=0.35,P < 0.05 post operation;and a negative correlation was found between visual acuity and anterior chamber depth on 3d(r=-0.29,P < 0.05,7d(r=-0.43,P < 0.01 and 15d(r=-0.37,P < 0.05 post operation.Conclusion Both the corneal astigmatism and the anterior chamber depth are correlated with the visual acuity variation in the early period after phacoemulsification.

  12. iStent with Phacoemulsification versus Phacoemulsification Alone for Patients with Glaucoma and Cataract: A Meta-Analysis.

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    Monali S Malvankar-Mehta

    Full Text Available Minimally invasive glaucoma surgeries (MIGS have attracted significant attention, as they have been reported to lower intra-ocular pressure (IOP and have an excellent safety profile. The iStent is an example of a minimally invasive glaucoma device that has received particular attention due to its early and wide spread utilization. There is a growing body of evidence supporting its use at the time of phacoemulsification to help lower IOP. However, it is still not clear how much of the IOP lowering effect can be attributed to the iStent, the crystalline lens extraction or both when inserted concurrently at the time of phacoemulsification. This has been an important issue in understanding its potential role in the glaucoma management paradigm.To conduct a systematic review and meta-analysis comparing the IOP lowering effect of iStent insertion at the time of phacoemulsification versus phacoemulsification alone for patients with glaucoma and cataracts.A systematic review was conducted utilizing various databases. Studies examining the IOP lowering effect of iStent insertion in combination with phacoemulsification, as well as studies examining the IOP lowering effect of phacoemulsification alone were included. Thirty-seven studies, reporting on 2495 patients, met the inclusion criteria. The percentage reduction in IOP (IOPR% and mean reduction in topical glaucoma medications after surgery were determined. The standardized mean difference (SMD was computed as a measure of the treatment effect for continuous outcomes taking into account heterogeneity. Fixed-effect and random-effect models were applied.A 4% IOP reduction (IOPR% from baseline occurred following phacoemulsification as a solo procedure compared to 9% following an iStent implant with phacoemulsification, and 27% following 2 iStents implants with phacoemulsification. Compared with cataract extraction alone, iStent with phacoemulsification resulted in significant reduction in the post

  13. Comparación del endotelio corneal antes y después de la extracción extracapsular del cristalino: Blumenthal vs facoemulsificación Comparison of the corneal endothelium before and after extracapsular extraction of the Blumenthal crystalline: vs phacoemulsification

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    Maurin A Francis Pérez

    2010-01-01

    Full Text Available OBJETIVO: Determinar el estado del endotelio corneal mediante la microscopia óptica convencional, antes y después de la extracción extracapsular del cristalino o facoemulsificación. MÉTODOS: Se realizó un estudio descriptivo, prospectivo y transversal a 100 pacientes diagnosticados de catarata a los que se les realizó técnica de Blumenthal y facomeulsificación, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", entre septiembre- noviembre 2006. RESULTADOS: Predominaron pacientes masculinos, en los grupos de edades 40 a 59 y 60 a 79 años. La técnica de Blumenthal modificó la densidad celular y la hexagonalidad, pero no modificó el coeficiente de variabilidad. La técnica de facoemulsificación modificó todos los parámetros morfométricos. En la técnica de facoemulsificación, donde el tiempo de ultrasonido fue mayor, los pacientes tuvieron mayor pérdida endotelial. CONCLUSIONES: La microscopia especular debe ser incluida como un examen de rutina prequirúrgico y posquirúrgico en la cirugía de catarata para demostrar el efecto de la misma sobre el endotelio corneal.OBJECTIVE: To determine the state of the corneal endothelium by means of the conventional optic microscopy, before and after the extracapsular extraction of the crystalline lens or phacoemulsification. METHOD: Prospective, descriptive and cross-sectional study was performed in 100 patients diagnosed with cataract, who underwent surgery with the Blumenthal technique or Phacomeulsification procedure at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from September - November 2006. RESULTS: Males prevailed in the age groups of 40-59 and 60-79 years. The Blumenthal technique changed the cellular density and hexagonality, except for the variability coefficient. The phacooemulsificación method modified all the morphometric parameters and the longer application of ultrasound meant greater endothelial loss in patients subjected to this technique

  14. Corneal endothelial cell changes associated with cataract surgery in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hugod, Mikkel; Storr-Paulsen, Allan; Norregaard, Jens Christian;

    2011-01-01

    To investigate the corneal endothelial cell density and morphology in patients with and without diabetes after phacoemulsification with intraocular lens implantation.......To investigate the corneal endothelial cell density and morphology in patients with and without diabetes after phacoemulsification with intraocular lens implantation....

  15. Evaluation of tensile strength of tissue adhesives and sutures for clear corneal incisions using porcine and bovine eyes, with a novel standardized testing platform

    Directory of Open Access Journals (Sweden)

    Kaja S

    2012-02-01

    Full Text Available Simon Kaja, Daryl L Goad, Fatima Ali, Ashley Abraham, R Luke Rebenitsch, Savak Teymoorian, Rohit Krishna, Peter KoulenVision Research Center and Department of Ophthalmology, University of Missouri-Kansas City, School of Medicine, Kansas City, MO, USABackground: Tissue adhesives for ophthalmologic applications were proposed almost 50 years ago, yet to date no adequate tissue glues have been identified that combine strong sealing properties with adequate safety and absence of postsurgical side effects. In recent years, cataract surgeries and Descemet's stripping with endothelial keratoplasty procedures have significantly increased the number of clear corneal incisions performed. One of the obstacles to discovery and development of novel tissue adhesives has been the result of nonstandardized testing of potential tissue glues.Methods: We developed an instrument capable of controlling intraocular pressure in explanted porcine and bovine eyes in order to evaluate sealants, adhesives, and surgical closure methods used in ophthalmic surgery in a controlled, repeatable, and validated fashion. We herein developed and validated our instrument by testing the adhesive properties of cyanoacrylate glue in both porcine and bovine explant eyes.Results: The instrument applied and maintained intraocular pressure through a broad range of physiological intraocular pressures. Cyanoacrylate-based glues showed significantly enhanced sealing properties of clear corneal incisions compared with sutured wounds.Conclusion: This study shows the feasibility of our instrument for reliable and standardized testing of tissue adhesive for ophthalmological surgery.Keywords: manometer, intraocular pressure, applanation tonometry, clear corneal incision, tissue adhesive, ocular surgery

  16. Changes of tear film and tear secretion after phacoemulsification in diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Xi LIU; Yang-shun GU; Ye-sheng XU

    2008-01-01

    Objective: To evaluate tear film stability and tear secretion in patients with diabetes after phacoemulsification. Methods: Twenty-five diabetic cataract patients and 20 age-matched non-diabetic cataract patients as control underwent phacoemulsification. Tear film break-up time (TFBUT), Schirmer I test (SIT), corneal fluorescein staining, and dry eye symptoms were measured pre- and postoperatively. Results: Diabetics had a decreased preoperative TFBUT and SIT. TFBUT was reduced on Day 1 and recovered on Day 180 postoperatively in both groups. SIT was increased after phacoemulsification, but returned to preoperative levels by Day 180 in non-diabetics, whereas it was lower than preoperative level in diabetics. Positive corneal fluorescein staining was elevated in both groups, and returned to preoperative levels only in controls. Dry eye symptoms were similar to fluorescein staining in both groups. Conclusion: Tear secretion was reduced in diabetic cataract patients after phacoemulsification, which worsened dry eye symptoms and predisposed those patients to ocular damage.

  17. Monovision法超声乳化透明晶状体吸除术治疗高度近视的临床观察%Clear lens phacoemulsification with monovision for the correction of high myopia

    Institute of Scientific and Technical Information of China (English)

    武哲明; 张静琳; 陈韵; 林振德

    2012-01-01

    目的 探讨Monovision法超声乳化透明晶状体吸除术联合人工晶状体植入治疗高度近视的临床疗效.方法 对45例(90眼)高度近视患者行双眼透明晶状体超声乳化吸除联合人工晶状体植入术,术前行常规眼科检查和眼底检查、视觉需要调查、主视眼检测、生物测量,术中植入单焦点折叠式IOL.根据患者视觉需要分为两组:Monovision组28例,男11例,女17例,根据生物测量结果,术中植入的人工晶状体度数使患者主视眼术后目标屈光度-0.5~0.0D,非主视眼术后目标屈光度-2.0~-2.5D;对照组17例,男5例,女12例,双眼术后目标屈光度-0.5~0.0D.对术后双眼裸跟远近视力、屈光度等随访观察3个月,结合术后问卷评估结果进行统计学分析.结果 两组术后屈光度与术前预留屈光度无统计学差异(P>0.05).术后3个月,Monovision组和对照组双眼同时视裸眼远视力分别为(0.83±0.15)、(0.81±0.13),差异无统计学意义(P> 0.05).Monovision组双眼同时视近视力(0.68±0.25)好于对照组(0.38±0.21),差异有统计学意义(P< 0.03).术后3个月远距离用眼,两组不带眼镜分别是97.5%、98.3%,差异无统计学意义(P>0.05 ).术后3个月近距离用眼从不带眼镜的比例,两组分别为78.5%,20.3%,差异有统计学意义(P<0.05).术后3个月,两组均无视网膜脱离、黄斑囊样水肿发生.结论 Monovision法超声乳化透明晶状体吸除术治疗高度近视是安全有效的方法,具有术后视力好、并发症少、预测屈光状态准确、远近用眼均不用戴镜等优点.%Objective To explore the clinical efficacy of clear lens phacoemulsification with monovision combined with artificial lens implantation for the correction of high myopia.Methods This study included 45 patients ( 90 eyes ) diagnosed as high myopia.The distant and near visual acuity ( VA ) and the dominant eye were examined.All the eyes received binocular

  18. Corneal Laceration

    Medline Plus

    Full Text Available ... By: Devin A Harrison MD Sep. 01, 2017 The cornea is the clear front window of the eye . A corneal laceration is a cut on the cornea. It is usually caused by something sharp ...

  19. Goat′s eye integrated with a human cataractous lens: A training model for phacoemulsification

    Directory of Open Access Journals (Sweden)

    Sabyasachi Sengupta

    2015-01-01

    Full Text Available A relatively simple and inexpensive technique to train surgeons in phacoemulsification using a goat′s eye integrated with a human cataractous nucleus is described. The goat′s eye is placed on a bed of cotton within the lumen of a cylindrical container. This is then mounted on a rectangular thermocol so that the limbus is presented at the surgical field. After making a clear corneal entry with a keratome, the trainer makes a 5-5.5 mm continuous curvilinear capsulorhexis in the anterior lens capsule, creates a crater of adequate depth in the cortex and inserts the human nucleus within this crater in the goat′s capsular bag. The surgical wound is sutured, and the goat′s eye is ready for training. Creating the capsulorhexis with precision and making the crater of adequate depth to snugly accommodate the human nucleus are the most important steps to prevent excessive wobbling of the nucleus while training.

  20. Safety and efficacy of phacoemulsification and intraocular lens implantation through a small pupil using minimal iris manipulation

    Directory of Open Access Journals (Sweden)

    Papaconstantinou D

    2016-05-01

    Full Text Available Dimitris Papaconstantinou, George Kalantzis, Dimitris Brouzas, Anastasios Kontaxakis, Chryssanthi Koutsandrea, Andreas Diagourtas, Ilias Georgalas Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece Purpose: The aim of this study was to compare the results of phacoemulsification through a small pupil using minimal iris manipulation versus phacoemulsification through a well-dilated pupil.Methods: This prospective randomized control (comparative study comprised 78 patients (group I with a maximally dilated pupil size of ≤4.00 mm and 45 patients (group II with dilated pupil size of ≥7.00 mm. In group I patients, only viscodilation and minimal push-and-pull iris stretching with two collar-button iris-retractor hooks were utilized without iris manipulation. Phacoemulsification was performed by two senior surgeons and the technique used consisted of either stop and chop or quick chop, infusion/aspiration of lens cortex, capsular bag refill with ocular viscoelastic devices, and implantation of an acrylic foldable intraocular lens. Patients were examined on the first day and 1 month postoperatively.Results: Forty-six eyes of group I patients had pseudoexfoliation syndrome, eleven eyes had previous glaucoma surgery, 14 eyes had angle-closure or open-angle glaucoma, and seven eyes had posterior synechiae with iritis. In group I patients, the mean pupil size measured under an operating microscope was 3.2 mm preoperatively, 4.3 mm after viscoelastic and mechanical pupil dilation, and 4.1 mm at the end of a surgical procedure. Rupture of the zonular fibers occurred in six patients of group I and the intraocular lens was implanted in the sulcus. Small iris-sphincter rupture and small hemorrhages occurred in four eyes during pupillary manipulation, but they were not evident at the end of the surgery. In group II patients, no intraoperative complications occurred. Signs of significant corneal edema and iritis

  1. Simultaneous bilensectomy and endothelial keratoplasty for angle-supported phakic intraocular lens-induced corneal decompensation

    Directory of Open Access Journals (Sweden)

    Vikas Mittal

    2011-01-01

    Full Text Available A 40-year-old lady presented with severe endothelial cell loss in both eyes 14 years after angle-supported phakic intraocular lens (AS PIOL implantation. The left eye had severe corneal edema with bullous keratopathy. The right eye had markedly reduced endothelial cell count (655 cells/mm 2 although the cornea was clear. She underwent simultaneous bilensectomy (AS PIOL explantation and phacoemulsification and Descemet′s stripping and endothelial keratoplasty (DSEK in the left eye. Explanted AS PIOL was identified as ZSAL-4 (Morcher, Stuttgart, Germany model. Corneal edema cleared completely in 2 months with a best corrected visual acuity (-2.25 D sph of 20/60. No intervention was done in the right eye. The present case illustrates that AS PIOL-induced endothelial decompensation can be effectively managed by simultaneous bilensectomy and endothelial keratoplasty.

  2. Relationship between endothelial cell loss and microcoaxial phacoemulsification parameters in noncomplicated cataract surgery

    Directory of Open Access Journals (Sweden)

    Soliman Mahdy MAE

    2012-03-01

    Full Text Available Mohamed AE Soliman Mahdy1,2, Mohamed Z Eid1, Mahmoud Abdel-Badei Mohammed3, Amr Hafez4,5, Jagdish Bhatia21Ophthalmic Department, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt; 2Ophthalmic Department, Rustaq Hospital, Rustaq, Sultanate of Oman; 3Research Institute of Ophthalmology, Cairo, Egypt; 4Magrabi Eye and Ear Center, Muscat, Sultanate of Oman; 5Ophthalmic Department, Al-Azhar University Hospital, Assuit, EgyptPurpose: To assess the relationship between postoperative endothelial cell loss and microcoaxial phaco parameters using Ozil IP (Alcon Laboratories, Inc, Fort Worth, TX in noncomplicated cataract surgery.Methods: In this prospective observational study, 120 consecutive cases of cataract patients with different grades of nuclear hardness underwent microcoaxial phacoemulsification through a 2.2-mm clear corneal incision. An Alcon Infinity Vision System with Ozil IP (Alcon Laboratories was used with an Ozil torsional handpiece and a Kelman-style 45° phacoemulsification tip. Patients underwent preoperative and postoperative central endothelial cell counts.Results: The study included 120 cases of age-related cataract whose mean age (standard deviation [SD] was 59.68 years (9.47. There was a highly statistically significant endothelial cell loss (P < 0.001. The endothelial cell loss ranged 11–1149 cells/mm2 with a median (interquartile range of 386 cells/mm2 (184.5–686 cells/mm2. The percentage of postoperative ECLoss% ranged from 0.48% to 47.8% with a median (interquartile range of 15.4% (7.2% to 26.8%. A significant positive correlation was found between the ECLoss% and different phaco parameters. The Spearman’s rank-order correlation coefficient values, rho, (ρ were as follows: CDE (ρ = 0.425, aspiration time (ρ = 0.176, and volume (ρ = 0.278. Also, ECLoss% was significantly correlated with the grade of nuclear opalescence (Kendall’s tau τ = 0.42.Conclusion: Microcoaxial phacoemulsification was efficient

  3. Safety and efficacy of phacoemulsification and intraocular lens implantation through a small pupil using minimal iris manipulation

    Science.gov (United States)

    Papaconstantinou, Dimitris; Kalantzis, George; Brouzas, Dimitris; Kontaxakis, Anastasios; Koutsandrea, Chryssanthi; Diagourtas, Andreas; Georgalas, Ilias

    2016-01-01

    Purpose The aim of this study was to compare the results of phacoemulsification through a small pupil using minimal iris manipulation versus phacoemulsification through a well-dilated pupil. Methods This prospective randomized control (comparative) study comprised 78 patients (group I) with a maximally dilated pupil size of ≤4.00 mm and 45 patients (group II) with dilated pupil size of ≥7.00 mm. In group I patients, only viscodilation and minimal push-and-pull iris stretching with two collar-button iris-retractor hooks were utilized without iris manipulation. Phacoemulsification was performed by two senior surgeons and the technique used consisted of either stop and chop or quick chop, infusion/aspiration of lens cortex, capsular bag refill with ocular viscoelastic devices, and implantation of an acrylic foldable intraocular lens. Patients were examined on the first day and 1 month postoperatively. Results Forty-six eyes of group I patients had pseudoexfoliation syndrome, eleven eyes had previous glaucoma surgery, 14 eyes had angle-closure or open-angle glaucoma, and seven eyes had posterior synechiae with iritis. In group I patients, the mean pupil size measured under an operating microscope was 3.2 mm preoperatively, 4.3 mm after viscoelastic and mechanical pupil dilation, and 4.1 mm at the end of a surgical procedure. Rupture of the zonular fibers occurred in six patients of group I and the intraocular lens was implanted in the sulcus. Small iris-sphincter rupture and small hemorrhages occurred in four eyes during pupillary manipulation, but they were not evident at the end of the surgery. In group II patients, no intraoperative complications occurred. Signs of significant corneal edema and iritis were observed more frequently in group I eyes (26 eyes and 20 eyes, respectively) on the first postoperative day in comparison with group II eyes (ten eyes and six eyes, respectively). Intraocular pressure was <20 mmHg in all eyes of both groups. One month

  4. Effect of torsional mode phacoemulsification on cornea in eyes with/without pseudoexfoliation

    Institute of Scientific and Technical Information of China (English)

    Süleyman; Demircan; Mustafa; Atas; Yusufcan; Yurtsever

    2015-01-01

    AIM: To evaluate the effect of torsional mode phacoemulsification on central corneal thickness, corneal endothelial cell density, and morphology in eyes with/without pseudoexfoliation(PEX) syndrome.METHODS: Fourty-two consecutive patients with and42 patients without PEX as a control group scheduled for cataract surgery was studied. Phacoemulsification, using OZi L IP system, was performed with quick chop technique. Using noncontact specular microscopy, the central endothelial cell density(ECD), coefficient of variation, percentage of hexagonal cells, and the central corneal thickness(CCT) were evaluated preoperatively and postoperatively at 1, 7 and 30 d.RESULTS: The ECD in PEX syndrome was statistically significantly lower than that in the control group preoperatively and postoperatively(P ≤0.001).Percentage change in ECD was statistically significantly higher in PEX than that in control group after surgery follow up(P ≤0.04).There was no statistically significant difference between both groups comparing percentage of hexagonal cells and coefficient of variation in the cell size before and after the surgery. At 1 and 7d after surgery, percentage change in CCT was statistically significantly higher in PEX group than that in the control group(P ≤0.041).CONCLUSION: Although torsional mode phacoemulsification and intraocular lens(IOL) implantation provided a safe and favorable surgical outcome in patients with/without PEX, torsional phacoemulsification led to significantly higher ECD loss in the PEX group than that in the control group during the whole follow up period.In addition, more corneal swelling in the PEX group than that in the control group during the early postoperative period has indicated that the corneal endothelium, in presence of PEX endotheliopathy, seems to be more susceptible to the effects of phacoemulsification surgeryin eyes with PEX. The increased risk of anterior chamber manipulations in patients with PEX should be taken into account for

  5. Investigation of surgically induced astigmatism resulting from femtosecond laser-assisted cataract surgery using a 2.2 mm clear corneal incision%2.2mm透明角膜切口飞秒激光辅助白内障超声乳化手术术源性散光的临床研究

    Institute of Scientific and Technical Information of China (English)

    李博; 张素华; 张哲; 刘建亭; 曹伟芳; 李晓艳; 董慧; 郭彩虹; 张海宁

    2016-01-01

    Objective To evaluate surgically induced astigmatism (SIA) resulting from femtosecond laser-assisted phacoemulsification cataract surgery with a 2.2 mm clear corneal incision.Methods A prospective,comparative analysis was performed in a case series.A total of 105 eyes of 84 patients (from No.1 cataract department of Shanxi Eye Hospital) who underwent femtosecond laser-assisted phacoemulsification cataract surgery between March 2014 and April 2016 were enrolled in this study.The main outcomes were a comparison of SIA,far visual acuity,and spherical refractive power preoperatively and 1,3,and 6 months postoperatively.Distance visual acuity was recorded as logMAR.Based on follow-up times (1,3,and 6 months postoperatively),lens nucleus hardness (grades Ⅱ,Ⅲ,Ⅳ),corneal astigmatism types (with-the-rule,against-the-rule,oblique) and laterality (left,right),SIA was analyzed using Alphins vector analysis.Data were analyzed using repeated measured ANOVA.Results The mean preoperative logMAR visual acuity was 0.65±0.24,which was significantly different from postoperative logMAR visual acuity at 1 month (0.07±0.02),3 months (0.06±0.01),and 6 months (0.06±0.01).No significant logMAR visual acuity differences were found at the three postoperative follow-up times.SIAs at 1,3,and 6 months after surgery were 0.28±0.11 D,0.25±0.13 D,0.24±0.10 D,respectively.No statistically significant differences in SIA were found when postoperative follow-up times (1,3,and 6 months) and factor groups for lens nucleus hardness (grades Ⅱ,Ⅲ,Ⅳ),corneal astigmatism types (with-the-rule,against-the-rule,oblique) and laterality (left,right) were compared.Conclusion Femtosecond laser-assisted phacoemulsification cataract surgery using a 2.2 mm clear corneal incision can provide stable SIA and better postoperative visual acuity.%目的 观察飞秒激光辅助白内障超声乳化手术中2.2 mm透明角膜切口引起的术源性散光(SIA)的影响因素.方法 前瞻性研究.纳入2014

  6. Alteraciones en el endotelio corneal después de la facoemulsificación por técnica de pre chop versus extracción tunelizada esclerocorneal del cristalino Alterations of the corneal endothelium after prechop phacoemulsification versus tunnelized scleracorneal extraction of the crystalline

    Directory of Open Access Journals (Sweden)

    Belkys Rodríguez Suárez

    2012-12-01

    Full Text Available Objetivo: evaluar los cambios endoteliales y resultados visuales en los ojos de pacientes con diagnóstico de catarata senil, operados por técnica de facoemulsificación por pre chop o extracción extracapsular del cristalino por túnel esclerocorneal. Métodos: se realizó un estudio descriptivo y prospectivo de 100 pacientes (ojos atendidos en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", de septiembre a diciembre de 2010. La mitad fueron operados por facoemulsificación y el resto por túnel esclerocorneal. Se analizaron las variables: mejor agudeza visual corregida y sin corrección, dureza del cristalino, conteo celular endotelial, hexagonalidad, coeficiente de variabilidad, astigmatismo medio inducido y tiempo efectivo de ultrasonido. Resultados: la pérdida celular endotelial en el grupo de facoemulsificación fue de 9,8 % y en el de extracción tunelizada, de 6,8 %. La hexagonalidad promedio posoperatoria fue mejor en el grupo de facoemulsificación (53 %. El coeficiente de variabilidad promedio preoperatorio disminuyó de 0,32 a 0,28 en el grupo de facoemulsificación. En este grupo el astigmatismo resultante fue de 1,35 D y el tiempo efectivo de facoemulsificación estuvo por debajo de los 2 minutos. En ambos grupos la mejor agudeza visual preoperatoria sin corrección promedio fue de 0,29 y mejoró a 0,56 en la extracción por túnel esclerocorneal y a 0,8 en la facoemulsificación. Conclusiones: la facoemulsificación por pre chop, constituye una buena opción en la cirugía de catarata. Las alteraciones endoteliales que provoca son similares a las de la extracción tunelizada, con ventaja sobre esta en la visión sin cristales por la menor inducción de astigmatismo.Objective: to evaluate the endothelial changes occurred and the visual results achieved in the eyes of patients diagnosed with senile cataract, who were operated on either by the prechop phacoemulsification technique or by the extracapsular extraction of

  7. Uso de viscoelásticos na facoemulsificação em cães portadores de catarata: efeitos sobre a pressão intraocular, a morfologia das células endoteliais e a espessura corneana Use of viscoelastic substances for the phacoemulsification in dogs with cataract: effects on the intraocular pressure, morphology of endothelial cells, and corneal thickness

    Directory of Open Access Journals (Sweden)

    J.L.V. Chiurciu

    2010-06-01

    Full Text Available Avaliaram-se as células endoteliais, a espessura corneana e a pressão intraocular (PIO de cães portadores de catarata madura, empregando-se viscoelástico à base de hialuronato de sódio 3% e sulfato de condroitina 4% e hidroxipropilmetilcelulose 2%, utilizando-se 20 cães, distribuídos entre os dois grupos dos viscoelásticos. A técnica cirúrgica adotada foi a da facoemulsificação bimanual. As avaliações tonométricas foram efetuadas antes e após o ato cirúrgico, aos 1, 7, 14, 21, 28 e 60 dias de pós-operatório, e a microscopia especular, antes e após 7, 28 e 60 dias. Não houve diferença estatística entre os grupos quanto à PIO, com exceção aos 14 dias, em que se observou maior PIO com o uso de hialuronato de sódio 3% e sulfato de condroitina 4%. Não houve diferença entre os grupos quanto aos parâmetros relacionados ao endotélio, com diminuição discreta da densidade celular endotelial e aumento da área celular com a utilização de hidroxipropilmetilcelulose 2%. A utilização de ambos os dispositivos viscoelásticos analisados é recomendada para o procedimento de facoemulsificação em cães.The endothelial cells, the corneal thickness, and the intraocular pressure (IOP were evaluated in dogs with cataract, using viscoelastic substances based on 3% sodium hyaluronate and 4% chondroitin sulfate and comparing them with 2% hydroxypropylmethylcellulose. Twenty dogs were distributed in two groups of ten, each using one viscoelastic material. The surgical technique was bimanual phacoemulsification. The tonometric evaluations were made before and at one, seven, 14, 21, 28, and 60 days after the surgery and the specular microscopy before and after seven, 28, and 60 days. No statistical difference between groups was found according to IOP, except at 14 days, which was significantly higher with the use of 3% sodium hyaluronate and 4% chondroitin sulfate. There was no statistical difference between the groups considering

  8. Estudo comparativo da densidade de células endoteliais da córnea após facoemulsificação pelas técnicas de "dividir e conquistar" e "quick chop" Corneal endothelial cell density comparative study after phacoemulsification by "divide and conquer" and "quick chop" techniques

    Directory of Open Access Journals (Sweden)

    Flavia Guedes Pinto Domingues

    2005-02-01

    Full Text Available OBJETIVOS: Uma vez que um dos fatores mais implicados na perda celular endotelial corneana após facoemulsificação é o tempo utilizado de ultra-som e que a técnica de "quick chop" utiliza menor tempo de ultra-som, o objetivo do estudo foi comparar e analisar a redução da densidade celular endotelial corneana entre os pacientes submetidos à facoemulsificação pelas técnicas de "dividir e conquistar" e "quick chop". MÉTODOS: A amostra do trabalho foi constituída por 56 pacientes, apresentando catarata senil grau 3, selecionados prospectivamente e submetidos à facoemulsificação endocapsular, através das técnicas de "dividir e conquistar" (28 pacientes, grupo 1 e "quick chop" (28 pacientes, grupo 2. Foram verificados os tempos de ultra-som utilizados em cada cirurgia e foram realizados exames de microscopia especular central de não-contato da córnea pré-operatórios e pós-operatórios de 1 mês, 3 meses e 6 meses. RESULTADOS: Verificamos que a técnica de "dividir e conquistar" utilizou em média 2,0 minutos de tempo de ultra-som e a de "quick chop" 1,1 minuto; que a redução da densidade celular endotelial central da córnea foi significativa, em ambas as técnicas, no primeiro mês pós-operatório (16,5% no grupo 1 e 19,4% no grupo 2; e que as variações de densidade celular endotelial corneana subseqüentes, aos 3 e 6 meses, não foram significativas. Não houve diferença estatística na variação da densidade celular endotelial corneana ocorrida entre os grupos (teste "t" de Student p=0,334; no 1º mês pós-operatório. CONCLUSÕES: Concluímos que a redução da densidade endotelial corneana central não foi estatisticamente diferente entre as técnicas.PURPOSE: Since one of the most implicated factors in corneal endothelial cell loss after phacoemulsification is the ultrasound time, and that the "quick chop" technique utilizes less ultrasound time, the objective of this study was to compare and analyze the reduction

  9. Clinical outcomes and costs of cataract surgery performed by planned ECCE and phacoemulsification.

    Science.gov (United States)

    Castells, X; Comas, M; Castilla, M; Cots, F; Alarcón, S

    1998-01-01

    To compare clinical outcomes and costs of cataract surgery between patients operated with standard extracapsular extraction (ECCE) and those undergoing phacoemulsification. Patients from the Ophthalmology Department of a teaching hospital in Barcelona (Spain) scheduled for cataract surgery, not combined with any other ophthalmic procedure. A retrospective analysis has been performed on a database of 1046 patients undergoing ECCE and phacoemulsification. The outcome measures used were: surgical complications, visual acuity and costs of surgery and of follow-up. Overall rate of all complications and postoperative visual acuity were compared between the two groups, adjusting for age, preoperative visual acuity, medical and ocular comorbidity. 31.9% of the patients (334) underwent phacoemulsification, and 68.1% (712) underwent ECCE. Patients undergoing phacoemulsification presented a frequency of intra- and postoperative complications lower than those undergoing ECCE (odds ratio 0.57, 95%CI 0.37-0.87 and 0.66, 95%CI 0.46-0.96, respectively), specifically for intraoperative iris trauma (3.1% vs 0.3%, p = 0.004), residual posterior capsular opacity (2% vs 0.3%, p = 0.035) and postoperative corneal edema (7.4% vs 3.6%, p = 0.016). Costs of intervention and follow-up were lower for phacoemulsification compared with ECCE (23.9% and 14%, respectively). But global costs were slightly higher for phacoemulsification (4.87%), due to supply costs, which were more than twice those of ECCE. Phacoemulsification, when performed by an experienced surgeon, has better clinical outcomes than planned extracapsular extraction, and costs may be lower since supply costs are expected to decrease as the phacoemulsification technique becomes more widespread.

  10. Phacoemulsification in subluxated cataract.

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    Praveen M

    2003-01-01

    Full Text Available Purpose: To evaluate the outcome of phacoemulsification in eyes with subluxated cataract. Materials and Methods: This retrospective study comprised 22 eyes of 20 consecutive patients with subluxated cataracts of varying aetiology operated between March 1998 and March 2001. Detailed preoperative assessment included visual acuity (VA, slitlamp examination, presence of vitreous in anterior chamber, extent of subluxation, intraocular pressure (IOP and detailed fundus examination. Phacoemulsification was done to retain the natural bag support and all patients had acrylic foldable Acrysof IOL implantation either in-the-bag or by scleral fixation. Postoperative observations included best-corrected visual acuity (BCVA, IOP, pupillary reaction and the IOL position. Results: The aetiology of the subluxation was traumatic in 11 patients and non-traumatic in 9 patients. Fifteen were males and 5 were females. Mean follow-up was 11.7 ± 9.71 months (range 4-39. The average age was 39.15 ± 16.33 (range 5 - 74. A 2-port anterior chamber vitrectomy was performed in 6 eyes (27.2%. Capsule tension ring (CTR was implanted in 15 eyes (68.18%. Twelve eyes (54.5% had in-the-bag implants, while 5 (22.72% had scleral fixation. The remaining 5 eyes (22.72% had one haptic in-the-bag and another sutured to sclera. No major intraoperative complications were noted. Twelve eyes (54.5% had clinically and geometrically well centered IOLs while 9 eyes (40.9% had geometrically decentered IOLs. One patient was lost to follow-up. Fifteen eyes (55.55% had postoperative BCVA of 6/12 - 6/6 while 2 eyes (7.40% had BCVA of 6/18. The remaining 4 eyes (14.81% had less than 6/24 BCVA due to pre-existing posterior segment pathology. Postoperative complications included rise in IOP in 1 eye (4.54%, pupillary capture of the IOL optic in 2 eyes (9.09%; the same 2 eyes (9.09% required redialing of IOL. One eye (4.54% had to undergo refixation (one haptic was fixed to sclera year after cataract

  11. Study on effect of phacoemulsification combined with goniosynechialysis on corneal endothelial cells for the treatment of angle closure glaucoma%超声乳化联合前房角分离术对伴有白内障的闭角型青光眼角膜内皮细胞的影响

    Institute of Scientific and Technical Information of China (English)

    汪涛; 颜华

    2016-01-01

    AIM:To observe the effect of phacoemulsification and intraocular lens ( IOL ) implantation combined with goniosynechialysis on corneal endothelial cells for the treatment of primary angle closure glaucoma ( PACG ) combined cataract, and to analyze the relative factors.METHODS: Ninety-five eyes of 95 patients with PACG combined cataract were documented in this study. Twenty-two patients were male, and 73 were female. The age ranged from 46 to 85y old with a mean of(66±7) y. All patients were examined for endothelial cell count ( ECC ) , intraocular pressure ( IOP ) and best corrected visual acuity ( BCVA ) 1wk, 1, 2, 3 and 6mo after operation. Meanwhile, the range of anterior chamber closure and anterior chamber depth ( ACD ) were recorded before operation and postoperative 6mo. RESULTS: The mean IOP was 36. 1±4. 3mmHg ( 28-42mmHg) preoperatively and 15. 8±3. 5mmHg ( 8-28 mmHg)(1mmHg=0. 133kPa) 6mo after operation. There was a decreasing trend in IOP after operation( t=17. 173, P CONCLUSION: Phacoemulsification and IOL -implantation combined with goniosynechialysis is an effective method to treat PACG combined cataract. It can increase BCVA and decrease IOP. ECC decreases after operation, but it is in the normal range. It is a safe and effective operation mode.%目的:探讨伴有白内障的原发性闭角型青光眼( primary angle closure glaucoma ,PACG)采用超声乳化白内障吸出(phacoemulsification,Phaco)人工晶状体(IOL)植入联合前房角分离术治疗后角膜内皮细胞的变化,并分析相关影响因素。  方法:回顾分析接受Phaco+IOL联合前房角分离术治疗的PACG合并白内障患者95例95眼,其中女73例,男22例,年龄46~85(平均66±7)岁。记录并分析术前及术后1wk,1、2、3、6mo 最佳矫正视力( BCVA)、眼内压( IOP)及角膜内皮细胞计数( endothelial cell count,ECC),同时记录术前及术后6 mo 前房深度( anterior chamber depth,ACD)以及前房角关闭范围。随访8mo~2a。 

  12. Ultrasonic phacoemulsification using a 1.4 mm incision: clinical results.

    Science.gov (United States)

    Tsuneoka, Hiroshi; Shiba, Takuya; Takahashi, Yoko

    2002-01-01

    To evaluate the intraoperative complications and postoperative results of bimanual phacoemulsification and aspiration using a sleeveless phaco tip inserted through an ultra-small incision. Department of Ophthalmology, Jikei University, Tokyo, Japan. This study comprised 637 eyes having cataract extraction using conventional phacoemulsification equipment. A 20-gauge phaco tip with the sleeve removed was inserted through a 19-gauge corneal incision. A 20-gauge hooked cannula with the wall thinned to increase the inner diameter was used for infusion. After the crystalline lens was removed, the incision was widened to 2.8 to 4.1 mm and and an intraocular lens (IOL) was implanted. Study parameters were operating time, amount of infusion solution used, incidence of intraoperative complications, and early postoperative results. The mean operating time was 8 minutes 42 seconds. Although the nuclear hardness was grade 4 or above in 35 eyes, there were no cases of thermal burn. The amount of infusion solution and the rate of postoperative decrease in corneal endothelial cell density did not differ greatly from results of conventional methods. This technique induced considerably less corneal astigmatism than surgery using conventional corneal incisions. A sleeveless phaco tip was used to perform successful bimanual phacoemulsification using conventional phaco machines and familiar surgical techniques. The cataracts were safely removed through an incision of 1.4 mm or smaller that was widened for IOL insertion.

  13. Wound temperature profiles of coaxial mini-incision versus sleeveless microincision phacoemulsification.

    Science.gov (United States)

    Belkin, Avner; Abulafia, Adi; Michaeli, Adi; Ofir, Shay; Assia, Ehud I

    2017-04-01

    Temperature profiles at the corneal wound of coaxial mini-incision (2.4 mm) cataract surgery and sleeveless microincision (1.1 mm) cataract surgery were compared. Prospective, controlled, paired-eye clinical trial conducted in a tertiary care hospital. Twenty patients with mild-to-moderate bilateral nuclear sclerotic cataract. Twenty patients underwent bilateral cataract surgery within a 1-month period. One eye was operated on by conventional coaxial mini-incision (2.4 mm) phacoemulsification. The second eye underwent microincision surgery by using a naked phacoemulsification tip and a specialized 19-gauge anterior chamber maintainer as the sole fluid source (three-port microincision cataract surgery technique). Patients had moderate bilateral cataracts with no other anterior segment pathology. Temperature at the corneal wound was constantly recorded by using infrared thermal imaging. Temperatures at the corneal wound. Mean temperatures at the corneal surgical wound were not significantly different between the coaxial and sleeveless groups (31.1 °C ± 2.3 vs. 31.0 °C ± 2. 0; P = 0.89). There was also no difference in maximum temperatures reached during phaco-emulsification. Temperatures did not rise above 40 °C during any surgery, and there were no corneal burns. Final visual acuity and intraoperative and postoperative complication rates were similar between the two groups. The temperature profile at the surgical wound using a microincisional sleeveless phacoemulsification technique is comparable with that of the conventional coaxial mini-incision method. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

  14. Effect of 3.0mm corneal incision guided by corneal topography on corneal astigmatism in cataract surgery%角膜地形图引导下3.0mm角膜切口对白内障术后角膜散光的影响

    Institute of Scientific and Technical Information of China (English)

    陆士恒; 张忆; 吕骄

    2013-01-01

    AIM: To compare preoperative and postoperative corneal astigmatism using 3.0mm corneal incision guided by corneal topography system in phacoemulsification.METHODS: Phacoemulsification was performed on 144 cases 156 eyes with 3.0mm corneal clear incision at the steepest corneal meridian. Preoperative corneal astigmatism and the data 3 months postoperatively were observed by the corneal topography system. Statistical analysis included sample Student's t - test, one way ANOVA test, Kruskal-Wallis test and Pearson correlation test.RESULTS: According to analysis, the postoperative corneal astigmatism correlated negatively with the preoperative corneal astigmatism (r=-0. 69, P<0. 01). The corneal cylinder changed significantly in each grade after the surgery (P< 0. 05). When the preoperative corneal cylinder was between 0. 12D and 0. 25D, the postoperative corneal cylinder was higher than before. Whereas, the postoperative corneal cylinder became lower than before when the preoperative cylinder ranged from 0.37D to 1.0D.CONCLUSION: The incision located at the steepest corneal meridian under the guidance of corneal topography changes the preoperative astigmatism. For astigmatic correction, 3.0mm on - axis clear corneal incision phacoemusification is recommended with preoperative corneal astigmatism between 0.37 and 1.0D.%目的:观察角膜地形图引导下3.0mm透明角膜切口白内障超声乳化手术前后患者角膜散光的变化.方法:在角膜最大曲率子午线上做3.0mm切口行白内障超声乳化手术,对术前散光度数≤1.0D的144例156眼术前、术后3mo的资料进行回顾性分析,统计手术前后角膜地形图散光的变化.采用t检验、单因素方差分析、Pearson相关分析对数据进行统计学处理.结果:3.0mm角膜透明手术切口的术源性散光为0.77±0.53D.患者手术前后的散光对比有统计学意义(P<0.05),散光变化具有相关性(r=-0.69,P<0.01).术前角膜散光≤0.25D者术后散光增大,其

  15. Effect of balanced phacoemulsification tip on the outcomes of torsional phacoemulsification using an active-fluidics system.

    Science.gov (United States)

    Khokhar, Sudarshan; Aron, Neelima; Sen, Sagnik; Pillay, Ganesh; Agarwal, Esha

    2017-01-01

    To compare the outcomes of torsional phacoemulsification with a new balanced tip (Intrepid) and a conventional tip (Kelman) using a single active-fluidics torsional phacoemulsification machine (Centurion). Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Prospective comparative case-control study. Patients with senile cataract had torsional phacoemulsification with the Kelman conventional tip or the new Intrepid balanced tip using the active-fluidics torsional machine. Intraoperative parameters, such as cumulative dissipated energy (CDE), total ultrasound (US) time, torsion use time, torsion amplitude, aspiration time, and fluid use, were noted and compared. Endothelial cell loss and central corneal thickness (CCT) changes were evaluated at 1 month. The new tip showed significantly less CDE, total US time, torsion amplitude, aspiration time, and fluid use (8.55 ± 6.9 [SD], 33.59 ± 28.12 seconds, 37.8 ± 13.42, 173.19 ± 47.26 seconds, and 66.59 ± 20.44 mL, respectively) than the conventional tip (13.47 ± 10.65, 42.8 ± 33.46 seconds, 42.58 ± 16.38, 202.25 ± 71.28 seconds, and 97.14 ± 36.86 mL, respectively) (P < .01), especially in higher grades of cataract. Anterior capsulorhexis margin tear occurred in 2 patients with the new tip. There were no corneal burns in either group. The mean endothelial cell loss and the percentage change in CCT were not significantly different at 1 month. The new balanced tip performed phacoemulsification more efficiently, especially in hard cataracts requiring higher energy and prolonged phacoemulsification time. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  16. Intraoperative fracture of phacoemulsification tip

    Directory of Open Access Journals (Sweden)

    Dewang Angmo

    2014-01-01

    Full Text Available Phacoemulsification (phaco is an established procedure for cataract extraction and has undergone a significant advances in techniques, machines and phaco tips. The Aspiration Bypass System (ABS phaco tip was introduced for phacoemulsification in 1998. The ABS tip allows fluid to be drawn through the opening when the phaco tip is occluded by nuclear material. The ABS tip allowed the safe use of high vacuum and flow rates and improved chamber stability by decreasing surge and therefore reducing intraoperative complications. To date, no disadvantages of ABS tips have been reported. We report a unique case of an intraoperative break of an ABS phaco tip during routine cataract surgery.

  17. Intraoperative fracture of phacoemulsification tip.

    Science.gov (United States)

    Angmo, Dewang; Khokhar, Sudarshan K; Ganguly, Anasua

    2014-01-01

    Phacoemulsification (phaco) is an established procedure for cataract extraction and has undergone a significant advances in techniques, machines and phaco tips. The Aspiration Bypass System (ABS) phaco tip was introduced for phacoemulsification in 1998. The ABS tip allows fluid to be drawn through the opening when the phaco tip is occluded by nuclear material. The ABS tip allowed the safe use of high vacuum and flow rates and improved chamber stability by decreasing surge and therefore reducing intraoperative complications. To date, no disadvantages of ABS tips have been reported. We report a unique case of an intraoperative break of an ABS phaco tip during routine cataract surgery.

  18. Intraoperative Fracture of Phacoemulsification Tip

    Science.gov (United States)

    Angmo, Dewang; Khokhar, Sudarshan K.; Ganguly, Anasua

    2014-01-01

    Phacoemulsification (phaco) is an established procedure for cataract extraction and has undergone a significant advances in techniques, machines and phaco tips. The Aspiration Bypass System (ABS) phaco tip was introduced for phacoemulsification in 1998. The ABS tip allows fluid to be drawn through the opening when the phaco tip is occluded by nuclear material. The ABS tip allowed the safe use of high vacuum and flow rates and improved chamber stability by decreasing surge and therefore reducing intraoperative complications. To date, no disadvantages of ABS tips have been reported. We report a unique case of an intraoperative break of an ABS phaco tip during routine cataract surgery. PMID:24669153

  19. Crack and flip phacoemulsification technique.

    Science.gov (United States)

    Fine, I H; Maloney, W F; Dillman, D M

    1993-11-01

    The crack and flip phacoemulsification technique combines the advantages of circumferential division of the nucleus and nucleofactis techniques. As such, it adds safety and control to the procedure. We describe each of the surgical maneuvers, including machine settings, and explain the rationale for maneuvers and machine settings.

  20. Combined scleral buckling and phacoemulsification

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    Pukhraj Rishi

    2009-01-01

    Conclusion: Combined scleral buckling and phacoemulsification is a safe and effective procedure that spares the patient the burden of repeated surgeries. It may be considered as a treatment option in selected cases of rhegmatogenous retinal detachment with significant cataract with/without early PVR.

  1. Comparison of the clinical effect of phacoemulsification and middle incision extracapsular cataract extraction

    Directory of Open Access Journals (Sweden)

    Yan-Mei Wen

    2015-02-01

    Full Text Available AIM: To compare the clinical effect of phacoemulsification and middle incision extracapsular cataract extraction(MI-ECCE.METHODS: One hundred and eighty-five eyes of phacoemulsification(137 casesand 185 eyes of 139 cases for MI-ECCE from January 2011 to May 2013 were involved in this study. And the ratio posterior capsular rupture during surgery, visual acuity, corneal edema, corneal astigmatism and intraocular pressure post operation were followed up.RESULTS: On 1d after surgery, uncorrected visual acuity in the group of MI-ECCE was better than that of phacoemulsification group, while from 3d; 1 and 3mo after surgery, no significant difference was found from the above two groups. On 1d postoperation, corneal edema ratio in phacoemulsification group(45 eyeswas higher than that in MI-ECCE group(20 eyes(χ2=11.665, P=0.0006. No significant difference was found for the ratio of posterior capsule rupture during surgery in these two surgical technique groups(χ2=0.094,P=0.759. On 1wk; 1 and 3mo after surgery, significant difference was found for the average of surgical induced corneal astigmatism between two groups(u=6.661, 6.880, 4.187, P=0.00, respectively. During following up, no significant difference was found for the intraocular pressure between two groups(u=1.858, 0.963, 0.471, 1.349, 1.388; P=0.063, 0.335, 0.638, 0.177, 0.165. Intraocular pressure on 1d postoperation in phacoemulsification and MI-ECCE groups was higher than before operation(u=19.86, 19.39, P=0.00, respectively. And on 1wk; 1 and 3mo postoperation, intraocular pressure in the operated eyes in both groups was lower than before operation for 2~3mmHg.CONCLUSION: Although phacoemulsification and MI-ECCE could both get good visual rehabilitation, with similar visual outcome, no significant effect for intraocular pressure, and no severe complications, the latter one owns the advantage that easier maneuver, quicker recovery, and cheaper instruments needed, which is suitable for the

  2. Genetics Home Reference: lattice corneal dystrophy type I

    Science.gov (United States)

    ... corneal dystrophy type I lattice corneal dystrophy type I Enable Javascript to view the expand/collapse boxes. ... All Close All Description Lattice corneal dystrophy type I is an eye disorder that affects the clear, ...

  3. Comparison of central corneal edema and visual recovery between liquefaction and conventional phacoemulsification in soft cataracts Comparação do edema de córnea central e da recuperação visual após facoemulsificação por liquefação e convencional em cataratas moles

    Directory of Open Access Journals (Sweden)

    Celso Takashi Nakano

    2009-02-01

    Full Text Available PURPOSE: The aim of the present study is to assess central corneal edema and visual recovery after cataract surgery performed according to two technologies: conventional ultrasonic and liquefaction (Aqualase®. METHODS:This is a prospective contralateral study in wich 20 patients with comparable preoperative conditions were submitted to cataract surgery were evaluated. Preoperative assessment involved complete ophthalmological examination and the study included patients with bilateral cataracts up to grade 2, according to the Lens Opacity Classification System II. The same cristaline fracture technique was used in all cases, and surgical procedures were performed by the same experienced surgeon, using two technologies: liquefaction or conventional phacoemulsification. Postoperative central corneal edema was measured by corneal optical pachymetry (Orbscan II® on the 1st, 3rd, 7th and 10th postoperative days. RESULTS:None of the 20 patients submitted to surgery was lost during the postoperative follow-up or excluded from the analysis. On the first postoperative, the visual acuity average was 0.031 logMAR in the Aqualase® group and 0.043 logMAR in the conventional surgery group. No statistical difference was detected in the assessment of visual acuity throughout the postoperative period. Central corneal pachymetry varied from 543.93 + 34.69 preoperatively to 545.08 ± 25.67 on the last day of follow-up in the Aqualase® group, and from 543.13 + 30.62 to 536.08 + 34.89 in the conventional technique group, without statistical significance. CONCLUSION:This study suggests that both techniques are equally effective for surgery on lenses with grade I or II cataract, and that they provide similar results in terms of visual recovery and central corneal edema.OBJETIVO: Avaliar o edema corneano central e a recuperação visual após cirurgia de catarata realizada através de duas tecnologias: ultrassônica convencional e liquefação (Aqualase®. M

  4. Treatment of a dislocated lens by transcorneal vitrectomy and bimanual phacoemulsification

    Directory of Open Access Journals (Sweden)

    Watanabe A

    2014-08-01

    Full Text Available Akira Watanabe, Tamaki Gekka, Hiroshi Tsuneoka Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan Background: As a method of treatment for a dropped lens nucleus, which occurred during cataract surgery, the dropped lens nucleus was removed through the corneal wound without using pars plana vitrectomy (PPV. After vitrectomy, the dropped lens nucleus was floated on the perfluorocarbon liquid (PFCL. The floating lens nucleus was then phacoemulsified and aspirated. During surgery, irrigation from the anterior chamber was performed. This method was very effective for treatment of a dropped hard nucleus.Case report: During cataract surgery on the left eye of an 80-year-old woman, a posterior capsule rupture occurred. As a result, the lens nucleus dropped into the vitreous cavity. Irrigation to the anterior chamber was performed, with an anterior chamber maintainer inserted through a newly created side port at the corneal limbus. A vitreous cutter and a light guide were inserted in order to perform vitrectomy through the corneal incisions that were created for the cataract surgery. After vitrectomy, the dropped lens nucleus was floated using PFCL. The floating lens nucleus was removed by a bimanual phacoemulsification technique, with the anterior chamber irrigation continuing. The separation of the irrigation port and the aspiration port allowed for effective treatment of the dropped nucleus that was floating on the PFCL, even using a ­phacoemulsification machine with a peristaltic pump system. Safe and effective vitrectomy, similar to a PPV, could be performed with this method using three corneal ports.Conclusion: This technique may allow safer and more effective treatment for a dropped lens nucleus compared with conventional PPV. With this technique, corneal distortion due to surgical manipulation can lead to reduced visibility of the posterior eye. Keywords: dislocated lens, transcorneal vitrectomy, bimanual

  5. Corneoscleral burn during phacoemulsification surgery.

    Science.gov (United States)

    Majid, M A; Sharma, M K; Harding, S P

    1998-10-01

    We report a case in which a severe corneoscleral burn occurred during phacoemulsification surgery. The equipment-tuning process was uneventful and routine surgery was expected. Severe tissue injury occurred because the anterior chamber collapsed momentarily and the phaco tip touched corneoscleral tissue. We discuss mechanisms by which this type of injury may occur and the likely cause in our case. We also suggest methods to reduce the incidence.

  6. Methylene blue-related corneal edema and iris discoloration.

    Science.gov (United States)

    Timucin, Ozgur Bulent; Karadag, Mehmet Fatih; Aslanci, Mehmet Emin; Baykara, Mehmet

    2016-04-01

    We report the case of a 70-year-old female patient who developed corneal edema and iris discoloration following the inadvertent use of 1% methylene blue instead of 0.025% trypan blue to stain the anterior capsule during cataract phacoemulsification surgery. Copious irrigation was performed upon realization of incorrect dye use. Corneal edema and iris discoloration developed during the early postoperative period and persisted at 24-months follow-up. However, keratoplasty was not required. The intracameral use of 1% methylene blue has a cytotoxic effect on the corneal endothelium and iris epithelium. Copious irrigation for at least 30 min using an anterior chamber maintainer may improve outcomes.

  7. Visual outcomes after anterior vitrectomy: comparison of ECCE and phacoemulsification.

    Science.gov (United States)

    Bobrow, J C

    1999-01-01

    To determine whether vitrectomy instrumentation improved outcomes when vitreous loss occurred during either extracapsular cataract extraction (ECCE) or phacoemulsification (PE) with posterior chamber lens implantation (PCIOL). A consecutive series of ECCE + PCIOL (group 1: 1985-1989) and PE + PCIOL (group 2: 1993-1997) surgeries by a single surgeon was reviewed retrospectively. In group 1, 14 of 647 patients (2.2%) and in group 2, 9 of 665 patients (1.4%) experienced vitreous loss. In group 1, final visual acuity averaged 20/83; in group 2, 20/25 (P = .005). Average follow-up was 5.7 years (group 1) and 3.2 years (group 2). Uveitis, glaucoma, corneal problems, and retinal problems were assessed. Anterior vitrectomy reduced complications from vitreous loss. Fewer vitreous losses occurred with PE than ECCE. Patients with vitreous loss after PE attained better vision.

  8. Comparison of surgically induced astigmatism after coaxial phacoemulsification through 1.8 mm microincision and bimanual phacoemulsification through 1.7 mm microincision.

    Science.gov (United States)

    Wilczynski, Michal; Supady, Ewa; Piotr, Loba; Synder, Aleksandra; Palenga-Pydyn, Dorota; Omulecki, Wojciech

    2009-09-01

    To compare surgically induced astigmatism (SIA) after coaxial 1.8 mm microincision cataract surgery (MICS) and bimanual 1.7 mm MICS calculated with 3 mathematical methods. Department of Ophthalmology, Medical University of Lodz, Lodz, Poland. Study comprised a nonrandomized prospective consecutive series of 58 eyes of 58 patients who had uneventful coaxial MICS with implantation of an Akreos MI60 foldable intraocular lens (IOL) using a 1.8 mm temporal clear corneal incision. Fifty eyes of 50 patients who had uneventful bimanual MICS through a 1.7 mm clear corneal incision for a sleeveless phaco tip and a 1.5 mm side port for an irrigating chopper with implantation of an Acri.Smart 48S foldable IOL served as a comparison group. All surgery was performed by 2 experienced surgeons. Surgically induced astigmatism was calculated using 3 methods. The patients were examined preoperatively and 2 weeks to 1 month postoperatively. No intraoperative or postoperative complications were seen in any patient. The corrected distance visual acuity improved significantly in both groups after surgery (P.05). In vector analysis, the mean SIA was 0.42 +/- 0.29 in the coaxial MICS group and 0.50 +/- 0.24 in the bimanual group; the difference was not statistically significant (P>.05). In vector decomposition, the mean SIA (C90) coaxial MICS group was 0.23 +/- 0.29 in the coaxial MICS group and 0.23 +/- 0.22 in the bimanual MICS group; the difference was not significant. Using the Naeser method, DeltaKP-90 was calculated, amounting to 0.05 +/- 0.44 in the coaxial MICS group and -0.04 +/- 0.42 in the bimanual MICS group; the difference was not significant. The amount of SIA induced by bimanual MICS and coaxial MICS phacoemulsification was very small. The bimanual MICS induced a slightly higher degree of SIA; however, according to all methods of SIA analysis, there was no significant difference in the mean SIA induced by both techniques.

  9. The Impact of Reused Phaco Tip on Outcomes of Phacoemulsification Surgery.

    Science.gov (United States)

    Demircan, Suleyman; Gokce, Gokcen; Atas, Mustafa; Baskan, Burhan; Goktas, Emre; Zararsiz, Gokmen

    2016-05-01

    To evaluate the impact of reused phaco tip on intraoperative performance and postoperative outcomes after 2.2 mm micro-coaxial torsional and transversal phacoemulsification. This prospective randomized study enrolled 136 eyes of 136 cataract patients; 68 eyes in torsional group (34 eyes with single use tip, 34 eyes with reused tip) and 68 eyes in transversal group (34 eyes with single use tip, 34 eyes with reused tip). Intraoperative measurements were total ultrasound (U/S) time, torsional U/S time, cumulative dissipated energy (CDE), estimated fluid use (EFU) in the torsional group and total phacoemulsification time (TPT), and effective phacoemulsification time (EPT) in transversal phacoemulsification. The central endothelial cell density (ECD) and the central corneal thickness (CCT) were evaluated preoperatively and postoperatively at 1 and 30 days using noncontact specular microscopy. Intraoperative measurements in torsional phacoemulsification showed significant increase in total U/S time (p = 0.01), torsional U/S time (p = 0.01), and CDE (p = 0.01) with the reused tip. The EFU was similar in both tip groups (p = 0.36). The total U/S time, torsional U/S time, and CDE in torsional group were significantly increased with the reused tip for grade III (p = 0.03 for all parameters) and grade IV cataracts (p = 0.005 for torsional U/S time and CDE; p = 0.006 for total U/S time). Intraoperative measurements in transversal phacoemulsification showed no differences in TPT and EPT between tip groups (p > 0.05). The change in ECD and CCT in torsional and transversal phacoemulsification groups were similar in both tip groups (p > 0.05). This study showed that sharpness of phaco tip edge increases the efficiency of torsional phacoemulsification for hard cataracts. This result does not mean that reused phaco tip may be used in soft and medium cataracts. As the timing of tip's change is a user-dependent procedure, a new single phaco tip

  10. Corneal Laceration

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    Full Text Available ... your vision. Privacy Policy Related People with Advanced Keratoconus May Have A Future Alternative to Full Corneal ... 2016 Corneal Collagen Cross-linking Approved to Treat Keratoconus in U.S. Aug 01, 2016 Firework Blinds Teenager, ...

  11. Corneal Laceration

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    Full Text Available ... lost sight from a corneal scar as a child. Now that I’m older, will a corneal transplant help me? May 15, 2015 Why Do My Eyes Burn After Inserting My Contacts? Feb 27, 2015 Dark ...

  12. Data on early postoperative changes in aqueous monocyte chemoattractant protein-1 levels after phacoemulsification.

    Science.gov (United States)

    Kawai, Motofumi; Inoue, Toshihiro; Yoshida, Akitoshi; Tanihara, Hidenobu

    2016-12-01

    The data presented in this article are related to the research article entitled "Elevated levels of monocyte chemoattractant protein-1 in the aqueous humor after phacoemulsification" (M. Kawai, T. Inoue, M. Inatani, N. Tsuboi, K. Shobayashi, A. Matsukawa, A. Yoshida, H, 2012) [1]. The mean (±SE) aqueous MCP-1 levels (pg/ml) were 31.2±12.5, 1931.2±910.7, 2172.2±1015.7, 3315.4 ±1535.8, 3015.9 ±914.4, 2709.0 ±738.7, 72.8 ±26.9, and 207.1±62.9 at 0, 3, 6, 12, 24, 48, 168, and 720 h after phacoemulsification, respectively. The immunohistochemical analysis showed a number of MCP-1 positive inflammatory cells in the anterior chamber and conjunctiva. There were some MCP-1 positive cells in the corneal endothelium.

  13. Corneal Abrasions

    Science.gov (United States)

    ... and lead to a serious condition called a corneal ulcer . That's why it's important to see a doctor to get a corneal abrasion checked out. What Causes a Corneal ... and land on your cornea, tears help to wash the particles away. Sometimes, ...

  14. Phacoemulsification conditions resulting in thermal wound injury.

    Science.gov (United States)

    Ernest, P; Rhem, M; McDermott, M; Lavery, K; Sensoli, A

    2001-11-01

    To determine and model the relationships between phacoemulsification conditions and viscoelastic agents that result in thermal wound injury. Animal laboratory, Irvine, California, USA. Mechanical and animal models, various wound sizes, phacoemulsification tips, and dispersive and cohesive viscoelastic agents were evaluated. Settings for phaco power, vacuum, and irrigation levels were controlled within a surgically relevant range. In the mechanical and animal models, incision temperature was assessed as a function of phacoemulsification parameters and time. In the animal model, wound damage was evaluated at the time of surgery. Induced time delays from the onset of phaco power to the onset of irrigation flow caused a thermal rise at the incision site. In these experiments, lack of irrigation and aspiration resulted in the greatest thermal rise and caused wound damage. Both the cohesive and dispersive viscoelastic agents were associated with a delay in the start of irrigation and aspiration, which resulted in similar maximum temperatures. Mathematical models were developed to estimate the maximum incision temperature from the phacoemulsification power, the duration (seconds) of occlusion, the tip gauge and type, and other phacoemulsification parameters. The models predict that under comparable conditions, occlusion with a viscoelastic agent will result in higher incision temperatures than occlusion with a balanced salt solution. Under comparable phacoemulsification conditions, both the cohesive and dispersive viscoelastic agents were associated with elevated temperatures that would be preventable by ensuring irrigation and aspiration flow before the onset of phacoemulsification power.

  15. Role of cavitation in the phacoemulsification process.

    Science.gov (United States)

    Zacharias, Jaime

    2008-05-01

    To determine the role of cavitational energy as a mechanism responsible for the emulsification of the lens during phacoemulsification. Clinica Ophthalmologica Pasteur, Santiago, Chile. Cavitation and its relationship to phacoemulsification power were documented using a combination of light sources, high-speed video recording techniques, and computerized control and by monitoring environmental pressure. The suppression of cavitation from the phaco process was achieved by building an environmental hyperbaric system capable of retaining the phacoemulsification system's ability to provide irrigation, aspiration, and vacuum necessary at standard and elevated pressures. The pressure level was controlled and monitored through a computer interface alongside the simultaneous video monitoring of cavitation bubble creation changes during pressure rise or fall. Last, evaluation and measurement of phacoemulsification was performed on real cataract fragments in the presence and absence of cavitation. Cavitation around the phaco tip mainly occurred at longitudinal ultrasonic power levels of 30% or more. Cavitation bubble formation was observed during the backstroke or as the tip moved away from the lens material and collapsed during the forward displacement of the phaco tip. Cavitation at any power level was successfully suppressed when the pressure in the hyperbaric chamber increased beyond 2.0 bar (29.1 psi) above atmospheric pressure. Phacoemulsification performance in the presence or absence of cavitation was comparable. This study found strong evidence that cavitation plays no role in phacoemulsification, leaving the jackhammer effect as the only important mechanism responsible for the lens-disrupting power of phacoemulsification.

  16. Metallic fragment deposits during phacoemulsification.

    Science.gov (United States)

    Martínez-Toldos, J J; Elvira, J C; Hueso, J R; Artola, A; Mengual, E; Barceló, A; Garcia, J; Martínez-Reina, M J

    1998-09-01

    To describe the nature and origin of foreign metallic intraocular bodies appearing after phacoemulsification. Department of Ophthalmology, University Hospital of San Juan, Alicante, Spain. Two metallic particles, 1 extracted during surgery and the other from a patient in whom surgery had been performed, were studied by scanning electronic microscopy and X-ray dispersive energy spectroscopy. Also evaluated were all metallic elements used in phacoemulsification including phaco tips, Sinskey hooks, and handpieces. A morphologic analysis at various magnifications was performed and the composition of the elements studied. Scanning electronic microscopy showed irregularities of the phaco tip and Sinskey hook after their use. Spectrographic analysis found that the phaco tip was mainly aluminum and titanium; the Sinskey hook, iron, chromium, cobalt, and nickel; the handpiece, iron, chromium, and nickel; and the 2 metallic particles, iron, chromium, and nickel, the same as the handpiece. The metallic particles extracted corresponded to those of the phaco handpiece. Vibration during prolonged use of the phacoemulsifier probably caused these particles to chip off the handpiece.

  17. Surgically induced astigmatism after phacoemulsification with and without correction for posture-related ocular cyclotorsion: randomized controlled study.

    LENUS (Irish Health Repository)

    Dooley, Ian

    2012-02-01

    PURPOSE: To report the impact of posture-related ocular cyclotorsion on one surgeon\\'s surgically induced astigmatism (SIA) results and the variance in SIA. SETTING: Institute of Eye Surgery, Whitfield Clinic, Waterford, Ireland. METHODS: This prospective randomized controlled study included eyes that had phacoemulsification with intraocular lens implantation. Eyes were randomly assigned to have (intervention group) or not have (control group) correction for posture-related ocular cyclotorsion. In the intervention group, the clear corneal incision was placed precisely at the 120-degree meridian with instruments designed to correct posture-related ocular cyclotorsion. In the control group, the surgeon endeavored to place the incision at the 120-degree meridian, but without markings. RESULTS: The intervention group comprised 41 eyes and the control group, 61 eyes. The mean absolute SIA was 0.74 diopters (D) in the intervention group and 0.78 D in the control group; the difference between groups was not statistically significant (P>.5, unpaired 2-tailed Student t test). The variance in SIA was 0.29 D(2) and 0.31 D(2), respectively; the difference between groups was not statistically significant (P>.5, unpaired F test). CONCLUSIONS: Attempts to correct for posture-related ocular cyclotorsion did not influence SIA or its variance in a single-surgeon series. These results should be interpreted with full appreciation of the limitations of currently available techniques to correct for posture-related ocular cyclotorsion in the clinical setting.

  18. New Management of Malignant Glaucoma by Phacoemulsification with Posterior Chamber Foldable Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    GeJian; GuoY

    1999-01-01

    Objective:To investigate the feasibility of phacoemulsification with posterior chamber foldable intraocular lens implantation in the management of malignant glaucoma. Patients and Methods:Fourteen patients with malignant glaucoma diagnosed in the Department of Glaucoma were enrolled in the study.12 patients developed malignant glaucoma after filtration surgery.1 developed after peripheral iridectomy.1 patient developed malignant glaucoma without any clear cause.Cataract phacoemulsification was performed.Posterior chamber intraocular foldable lens was implanted in 10 cases of patients.Results:All 14 patients were cured wiht normal intraocular pressure,normal anterior chamber depth and increased visual acuity.Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation is a good alternative in treating malignant glaucoma.

  19. Simultaneous Phacoemulsification and Graft Refractive Surgery in Penetrating Keratoplasty Eyes

    Science.gov (United States)

    Feizi, Sepehr; Zare, Mohammad; Einollahi, Bahram

    2011-01-01

    Purpose. To report outcomes of graft refractive surgery (GRS) along with clear-cornea phacoemulsification and intraocular lens (IOL) implantation in penetrating keratoplasty (PKP) eyes. Methods. Fourteen eyes of 13 patients who had received PKP underwent simultaneous GRS (relaxing incisions with or without counter-quadrant compression sutures) and clear-cornea phacoemulsification with IOL implantation. To calculate IOL power, preoperative keratometry readings and the SRK-T formula were used. Results. Mean patient age and follow-up period were 50.5 ± 14.4 years and 14.6 ± 7.1 months, respectively. A significant increase was observed in best spectacle-corrected visual acuity (from 0.55 ± 0.18 logMAR to 0.33 ± 0.18 logMAR, P = 0.001). There was a significant decrease in vector keratometric astigmatism by 6.22 D (P = 0.03). Spherical equivalent refraction was reduced from −3.31 ± 3.96 D to −1.69 ± 2.38 D (P = 0.02) which did not significantly differ from the target refraction (−0.76 ± 0.14 D, P = 0.20). No complications developed and all the grafts remained clear at the final examination. Conclusion. Simultaneous phacoemulsification and GRS is a safe and effective method to address post-PKP astigmatism and lens opacity. IOL power can be calculated from preoperative keratometry readings with an acceptable accuracy. However, patients should be informed about the possibility of high refractive errors postoperatively. PMID:24527227

  20. Iridectomy of the anterior iris stroma using the vitreocutter during phacoemulsification in patients with iridoschisis.

    Science.gov (United States)

    Ghanem, Vinícius Coral; Ghanem, Emir Amin; Ghanem, Ramon Coral

    2003-11-01

    We present a technique to manage iridoschisis. This technique for anterior iridectomy of the affected iris fibers avoids intraoperative obstruction of the phaco tip and prevents postoperative complications such as corneal decompensation and glaucoma. Before the capsulorhexis is created, a vitreocutter is inserted in the anterior chamber and used to cut the iris strands at the site of the iridoschisis, making an anterior sectorial stromal iridectomy and preserving the iris pigment epithelium. Phacoemulsification is then performed. After the pupil is constricted with carbacol, remnants of the loose anterior iris fibers are excised with the vitreocutter and the scleral incision is sutured.

  1. Comparison of 45-degree Kelman and 45-degree balanced phaco tip designs in torsional microcoaxial phacoemulsification.

    Science.gov (United States)

    Demircan, Süleyman; Ataş, Mustafa; Göktaş, Emre; Başkan, Burhan

    2015-01-01

    To compare the intraoperative performance and postoperative outcome after microcoaxial torsional phacoemulsification using either a Kelman or balanced phaco tip. Cataracts were treated using 2.2 mm microcoaxial torsional phacoemulsification using either a 45-degree mini-flared Kelman(®) or a 45-degree Intrepid(®) Balanced phaco tip. Intraoperative measurements included total ultrasound (US) time, cumulative dissipated energy (CDE), torsional US time, and balanced salt solution (BSS) use. The central endothelial cell density (ECD) and central corneal thickness (CCT) were evaluated preoperatively and postoperatively 1, 7, and 30d after surgery using noncontact specular microscopy. The 116 enrolled eyes (116 patients) were divided equally between the Kelman and balanced tip groups. Intraoperative measurements showed significantly less total US time, torsional US time, CDE, and BSS use in the balanced group than in Kelman group (Ptip provided more effective lens removal with less total US time, torsional time, CDE, and BSS use, as well as similar changes in ECD with a Kelman tip in all cataract grades. This special designed phaco tip for torsional phacoemulsification provides an alternative phaco tip for many surgeons' preference with straight phaco tip.

  2. Clinical experience of phacoemulsification for cataract patients with angle-closure glaucoma in 29 cases

    Directory of Open Access Journals (Sweden)

    Yong-Hui Gu

    2014-05-01

    Full Text Available AIM: To observe the clinical effect of phacoemulsification with foldable intraocular lens implantation on cataract with angle-closure glaucoma. METHODS: Twenty-nine cases(29 eyesof angle-closure glaucoma with cataract underwent phacoemulsification with foldable intraocular lens implantation, and the data of visual acuity, intraocular pressure, gonioscopy and complications after operation were statistically analyzed.RESULTS:Postoperatively, 28 eyes(96.5%visual acuity were improved. Intraocular pressure of 25 eyes(86.2%were maintained at a normal level without any IOP lowering drug, intraocular pressure of 3 eyes(10.3%were controlled by IOP lowering eye drops, intraocular pressure of 1 eye(3.5%returned to normal by trabeculectomy. The chamber depth of 29 eyes was increased. 8 eyes were suffered from mild corneal edema, and returned to normal after treatment. CONCLUSION: Characterized by decreasing intraocular pressure, opening anterior chamber, and raising visual acuity, phacoemulsification with foldable intraocular lens implantation is a good operative therapy for primary angle-closure glaucoma complicated with cataract with preoperative goniosynechia closed ≤270°.

  3. Vitreous loss during conversion from conventional extracapsular cataract extraction to phacoemulsification.

    Science.gov (United States)

    Ah-Fat, F G; Sharma, M K; Majid, M A; Yang, Y C

    1998-06-01

    To study the outcome of vitreous loss among senior surgeons converting from conventional extracapsular cataract extraction (ECCE) to phacoemulsification. A university teaching hospital in the United Kingdom. A retrospective analysis of 87 planned cataract extractions performed from January 1992 to December 1996 and complicated by vitreous loss was done. Outcome measures included postoperative complication rates and visual acuity. During the study, vitreous loss occurred in 39 patients having ECCE and in 48 having phacoemulsification; the latter group included 8 patients with dropped nucleus. Postoperative complications included cystoid macular edema (18.7% of phaco patients, 30.8% of ECCE patients), retinal detachment (2.1% of phaco patients, 5.1% of ECCE patients), and expulsive hemorrhage (5.1% of ECCE patients). Phaco patients had higher rates of postoperative corneal edema (27.1%) than ECCE patients (12.8%) and transient intraocular pressure elevation (33.3%) versus 20.5%) but were more likely to receive posterior chamber intraocular lenses (70.8% versus 35.9%; P = .0024, chi-square test). After excluding pre-existing diseases, 83.3% of phaco patients and 67.6% of ECCE patients achieved a visual acuity of 6/12 or better. With careful patient selection, experienced extracapsular surgeons converting to phacoemulsification can achieve favorable results even in the presence of complications such as vitreous loss or dropped nucleus.

  4. Clinical Observation of 126 Cases of Sutureless Phacoemulsification with PMMA Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    Yanshuang Yan; Zhengxing Mao

    2000-01-01

    Objective: To observe the safety and effect of sutureless phacoemulsification with PMMA intraocular lens (IOL) implantation.Methods: One-hundred and twenty-six cases (126 eyes) of sutureless phacoemulsification with PMMA intraocular lens (IOL) implantation were retrospected and evaluated. The surgeries were performed through a limbal tunnel incision. PMMA IOLs with 5.5mm or 6.0mm in diameter were implanted.Results: The follow-up was 3~20 months. Visual acuity of 0. 5 or better was obtained in 120 cases (95.2%), and that of 1.0 or better was obtained in 89 cases (70. 6% ).Intra-operative complications included posterior capsule rupture in 9 cases (7. 1% ) and iris injury in 7 cases(5.6% ). Postoperative complications included early corneal edema in 96 cases(76.2% ), transient intraocular pressure elevation in 5 cases(4. 3%),remnant of cortex in 1 case and leakage of incision in 1 case. M1 were properly managed with good results.Conclusion: Sutureless phacoemulsification with PMMA IOL implantation is safe even in grass-root hospitals where cataracts are harder.

  5. Corneal Laceration

    Science.gov (United States)

    ... drugs. These drugs thin the blood and may increase bleeding. After you have finished protecting the eye, see a physician immediately. Next Corneal Laceration Symptoms Related Ask an Ophthalmologist Answers I lost sight from a corneal scar as a child. Now that I’m older, ...

  6. Corneal Laceration

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    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration ... Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué Es una Laceración de la Córnea? Written ...

  7. Corneal Laceration

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    Full Text Available ... Health Find an Ophthalmologist Academy Store Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask ... Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration Sections What Is Corneal Laceration? ...

  8. Corneal Laceration

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    Full Text Available ... Health Find an Ophthalmologist Academy Store Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask ... Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration Sections What Is Corneal Laceration? ...

  9. Phacoemulsification in eyes with cataract and pseudoexfoliation syndrome

    Directory of Open Access Journals (Sweden)

    Servet Cetinkaya

    2016-06-01

    Full Text Available AIM: To evaluate the visual outcomes and intraoperative and postoperative complications of phacoemulsification surgery in patients with cataract and pseudoexfoliation syndrome(PEXand the usage of proper surgical techniques and appropriate devices intraoperatively.METHODS: Sixty-seven eyes of 53 patients with PEX and cataract who had undergone phacoemulsification and intraocular lens(IOLimplantation surgery were evaluated retrospectively. The mean age was 71.68±9.96(53-89y, and there were 24(45%males and 29(55%females. Nuclear, cortical, posterior subcapsular, and mature cataracts were all represented.RESULTS: Nuclear cataract was significantly more common than other types(P=0.00. The mean preoperative best corrected visual acuity(BCVAwas 0.99±0.30(SD(0.40-1.50logMAR, and the mean postoperative BCVA was 0.32±0.31(SD(0.00-1.00logMAR(P=0.00. Iris retractors were used in 12(18%eyes. Capsular tension ring(CTRimplantation was used in 15(22%eyes, it was planned in 8(12%and unplanned in 7(10%. Posterior capsule rupture occurred in 4(6%eyes, and vitreous loss occurred in 2(3%eyes. Anterior vitrectomy was performed in these 2 eyes. Conversion to extracapsular cataract extraction(ECCEwas needed in these 2(3%eyes due to large posterior capsular rupture. Persistent corneal edema was observed in 4(6%eyes, and anterior chamber reaction in 5(7%eyes. IOL dislocation occurred in 4(6%eyes, but repositioning was only needed in 1(1.5%eye. Posterior capsule opacification(PCOrequiring Nd:YAG laser capsulotomy developed in 13(20%eyes.CONCLUSION: Postoperative visual acuities of patients with cataract and PEX are satisfactory. However, intraoperative and postoperative complications like posterior capsule rupture, vitreous loss, conversion to ECCE, persistent corneal edema, anterior chamber reaction and IOL dislocation may be observed. To avoid these complications, proper surgical techniques and the use of appropriate devices intraoperatively are essential.

  10. Comparison of 45-degree Kelman and 45-degree balanced phaco tip designs in torsional microcoaxial phacoemulsification

    Directory of Open Access Journals (Sweden)

    Süleyman Demircan

    2015-12-01

    Full Text Available AIM: To compare the intraoperative performance and postoperative outcome after microcoaxial torsional phacoemulsification using either a Kelman or balanced phaco tip. METHODS: Cataracts were treated using 2.2 mm microcoaxial torsional phacoemulsification using either a 45-degree mini-flared Kelman® or a 45-degree Intrepid® Balanced phaco tip. Intraoperative measurements included total ultrasound (US time, cumulative dissipated energy (CDE, torsional US time, and balanced salt solution (BSS use. The central endothelial cell density (ECD and central corneal thickness (CCT were evaluated preoperatively and postoperatively 1, 7, and 30d after surgery using noncontact specular microscopy. RESULTS: The 116 enrolled eyes (116 patients were divided equally between the Kelman and balanced tip groups. Intraoperative measurements showed significantly less total US time, torsional US time, CDE, and BSS use in the balanced group than in Kelman group (P<0.05. The total US time, torsional US time, CDE, and BSS use were 17.45±14.53s, 16.63±13.97s, 6.38±5.26, and 48.21±17.21 mL in the Kelman group and 11.39 ± 9.60s, 10.90 ± 9.25s, 4.04 ± 3.42, and 41.36 ± 12.70 mL in the balanced group, respectively. CONCLUSION: Torsional phacoemulsification performed with a balanced tip provided more effective lens removal with less total US time, torsional time, CDE, and BSS use, as well as similar changes in ECD with a Kelman tip in all cataract grades. This special designed phaco tip for torsional phacoemulsification provides an alternative phaco tip for many surgeons' preference with straight phaco tip.

  11. Intraoperative performance and longterm outcome of phacoemulsification in age-related cataract.

    Directory of Open Access Journals (Sweden)

    Dholakia Sheena

    2004-01-01

    Full Text Available PURPOSE: To evaluate intraoperative performance and longterm surgical outcome after phacoemulsification of age-related cataracts. METHODS: Prospective, observational, non-comparative study of 165 consecutive eyes undergoing phacoemulsification with nuclear sclerosis Grade I to III (Scale I to V. Preoperative evaluation included specular microscopy. Phacoemulsification was performed by a single surgeon using a standardised surgical technique under topical anaesthesia. Intraoperatively, effective phaco time (EPT, wound site thermal injury (WSTI, serious complications (eg. vitreous loss, posterior capsule rupture, zonulolysis and intraoperative posterior capsule opacification (plaque were evaluated. Postoperatively, posterior capsule opacification (PCO, Neodymium:YAG (Nd:YAG laser posterior capsulotomy rate, corneal endothelial count, best corrected visual acuity and cystoid macular oedema were evaluated. Eyes were examined at 6 months and then yearly for 3 years. RESULTS: Mean ages of 78 males and 87 females were 59.12 +/- 8.56 and 58.34 +/- 7.45 years respectively. EPT was 36 +/- 19 seconds and WSTI occurred in 7 eyes (4.7%. No serious intraocular complications occurred. Intraoperative posterior capsule opacification (plaque was present in 21 eyes (13.93%. Postoperatively, PCO occurred in 8 eyes (4.84% and Nd:YAG laser posterior capsulotomy was performed in 3 eyes (1.8%. Endothelial cell loss was 7.1% at 3 years follow-up. At the end of 3 years follow-up, 146 eyes (88.89% maintained a best corrected visual acuity of > or = 6/12. Cystoid macular oedema did not occur in any eye at 1 and 6 months′ follow-up. CONCLUSION: PCO rates and endothelial cell loss were acceptable. Consistent and reproducible outcome can be obtained after phacoemulsification of age related cataracts (grade I to III.

  12. [Corneal sensibility following epikeratophakia].

    Science.gov (United States)

    Biermann, H; Grabner, G; Baumgartner, I; Reim, M

    1992-07-01

    The postoperative rate of reinnervation following corneal surgery is widely considered to be a useful indicator of the healing process. This study reports the corneal sensitivity of 14 patients following epikeratophakia for different indications (myopia, aphakia and keratoconus) after time periods ranging from 7 to 104 weeks. All transplants were clear at the time of measurement. A newly developed aesthesiometer (using a low electric current for stimulation) was employed. Nine positions on the operated eye were chosen for the measurements, five locations of the non-operated fellow eye served as controls. On the operated eye the corneal sensitivity peripheral to the trephination were significantly reduced at the 9 and 12 o'clock positions as compared to the other eye. The 3 and 6 o'clock locations showed no significant difference. On the epikeratophakia lenticule the sensitivity was significantly reduced at all points, the center showing the largest difference (p less than 0.001). No correlation with age, sex or the indication for the procedure was observed. Although there was a trend of a positive correlation between the postoperative time period and the central corneal sensitivity, the follow-up was too short to reach significant levels. The nearly complete lack of corneal sensitivity, particularly in the center of the transplant is therefore well compatible with its long-time survival, even when the lenticule has been prepared with the cryolathe and lyophilized for transportation.

  13. Pupil Dilation with Intracameral Epinephrine Hydrochloride during Phacoemulsification and Intraocular Lens Implantation

    Science.gov (United States)

    Yu, A-Yong; Guo, Hua; Wang, Qin-Mei; Bao, Fang-Jun; Huang, Jing-Hai

    2016-01-01

    Objective. To investigate mydriatic effect of intracamerally injected epinephrine hydrochloride during phacoemulsification and intraocular lens (IOL) implantation. Methods. Eighteen cataract patients for bilateral phacoemulsification were enrolled. To dilate pupil, one eye was randomly selected to receive intracamerally 1 mL epinephrine hydrochloride 0.001% for 1 minute after corneal incision (intracameral group), and the contralateral eye received 3 drops of compound tropicamide 0.5% and phenylephrine 0.5% at 5-minute intervals 30 minutes before surgery (topical group). Pupil diameters were measured before corneal incision, before ophthalmic viscoelastic device (OVD) injection, after OVD injection, before IOL implantation, and at the end of surgery. Results. At each time point, the mean pupil diameter in the intracameral group was 2.20 ± 0.08, 5.09 ± 0.20, 6.76 ± 0.19, 6.48 ± 0.18, and 5.97 ± 0.24 mm, respectively, and in the topical group it was 7.98 ± 0.15, 7.98 ± 0.15, 8.53 ± 0.14, 8.27 ± 0.16, and 7.93 ± 0.20 mm, respectively. The topical group consistently had larger mydriatic effects than the intracameral group (P < 0.05). The onset of mydriatic effect was rapid in the intracameral group. There was no difference in surgical performance or other parameters between groups. Conclusions. Intracameral epinephrine hydrochloride appears to be an alternative to the mydriatic modalities for phacoemulsification and IOL implantation. In comparison with topical mydriatics, intracameral epinephrine hydrochloride offers easier preoperative preparation, more rapid pupil dilation, and comparable surgical performance. PMID:26904274

  14. Clinical efficacy of Toric intraocular lens implantation for cataract patients with corneal astigmatism

    Directory of Open Access Journals (Sweden)

    Guo-Hua Deng

    2015-11-01

    Full Text Available AIM: To investigate the clinical efficacy of Toric intraocular lens(IOLimplantation for cataract patients with corneal astigmatism.METHODS: Thirty-eight patients(46 eyeswith corneal astigmatism undergone phacoemulsification and IOL implantation in our hospital from June 2013 to July 2014 were observed. Twenty cases(24 eyesreceived Toric IOL, 18 cases(22 eyesgot Acrysof IQ IOL. The clinical efficacy of the two groups was analyzed.RESULTS:The difference on visual acuity after surgery between the two groups was statistically significant(F=5.783, PPt=5.248, 2.573, 2.782; all PF=5.482, PPt=6.591, 3.287, 2.167; all PCONCLUSION: Phacoemulsification associated with Toric IOL implantation has good correction effect and prediction for cataract and corneal astigmatism patients, and can improve the visual activity significantly, so it is worthy of clinical application.

  15. Corneal Laceration

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    Full Text Available ... from Laundry Packets On the Rise Jun 30, 2017 People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation Nov 29, 2016 Combating Eye Injuries from Air Guns Aug 30, ...

  16. Corneal transplant

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    ... lenses to achieve the best vision. Laser vision correction may be an option if you have nearsightedness, ... Editorial team. Related MedlinePlus Health Topics Corneal Disorders Refractive Errors Browse the Encyclopedia A.D.A.M., Inc. ...

  17. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... Dangerous for Your Eyes Sep 20, 2017 Eye Injuries from Laundry Packets On the Rise Jun 30, ...

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... 27, 2015 Dark Spot in Vision After Blunt Trauma Dec 21, 2014 Pain a Year After Eyelid ...

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... and preserving your vision. Privacy Policy Related Eye Injuries from Laundry Packets On the Rise Jun 30, ...

  1. Corneal Laceration

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  2. Corneal Laceration

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    Full Text Available ... by something sharp flying into the eye. It can also be caused by something striking the eye ... If the corneal laceration is deep enough it can cause a full thickness laceration. This is when ...

  3. Corneal Laceration

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  4. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... 27, 2015 Dark Spot in Vision After Blunt Trauma Dec 21, 2014 Pain a Year After Eyelid ...

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

    Directory of Open Access Journals (Sweden)

    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

  6. A clinical comparison between DisCoVisc and 2% hydroxypropylmethylcellulose in phacoemulsification: a fellow eye study

    Directory of Open Access Journals (Sweden)

    Rodrigo F. Espíndola

    Full Text Available OBJECTIVE: This study sought to compare the effects and outcomes of two ophthalmic viscosurgical devices, 1.6% hyaluronic acid/4.0% chondroitin sulfate and 2.0% hydroxypropylmethylcellulose, during phacoemulsification. METHODS: This prospective, randomized clinical trial comprised 78 eyes (39 patients that received phacoemulsification performed by the same surgeon using a standardized technique. Patients were randomly assigned to receive either 1.6% hyaluronic acid/4.0% chondroitin sulfate or 2.0% hydroxypropylmethylcellulose on the first eye. The other eye was treated later and received the other viscoelastic agent. Preoperative and postoperative examinations (5, 24 and 48 hours; 7 and 14 days; 3 and 6 months included measurements of the total volume of the ophthalmic viscosurgical device, ultrasound and washout times to completely remove the ophthalmic viscosurgical device, intraocular pressure, central corneal thickness and best-corrected visual acuity. The corneal endothelial cell count was measured at baseline and at six months postoperatively. ClinicalTrials.gov: NCT01387620. RESULTS: There were no statistically significant differences between groups in terms of cataract density or ultrasound time. However, it took longer to remove 2.0% hydroxypropylmethylcellulose than 1.6% hyaluronic acid/ 4.0% chondroitin sulfate, and the amount of viscoelastic material used was greater in the 2.0% hydroxypropylmethylcellulose group. In addition, the best-corrected visual acuity was significantly better in the hyaluronic acid/ chondroitin sulfate group, but this preferable outcome was only observed at 24 hours after the operation. There were no statistically significant differences between the two ophthalmic viscosurgical devices regarding the central corneal thickness or intraocular pressure measurements at any point in time. The corneal endothelial cell count was significantly higher in the hyaluronic acid/chondroitin sulfate group. CONCLUSION: The

  7. Cataract Surgery with a Refractive Corneal Inlay in Place

    Directory of Open Access Journals (Sweden)

    N. R. Stojanovic

    2015-01-01

    Full Text Available Purpose. To present a case of cataract surgery performed in a patient with a refractive corneal inlay in place. Methods. A 48-year-old female patient presented to our institute with bilateral cataract. The patient had undergone refractive corneal inlay implantation three years ago in her right, nondominant eye for presbyopia correction. Biometry and intraocular lens (IOL power calculation were performed without removing the inlay. Phacoemulsification and IOL insertion were carried out in both eyes in a usual manner. Results. On day one postoperatively, the patient achieved binocular uncorrected distance visual acuity 20/20 and uncorrected near visual acuity J1. The vision remained stable during the one-year follow-up period. Conclusion. Cataract surgery was performed in a standard manner in a patient with Presbia Microlens corneal inlay in place. Visual outcomes for both near and distance vision were satisfactory.

  8. Turning the tide of corneal blindness.

    Science.gov (United States)

    Oliva, Matthew S; Schottman, Tim; Gulati, Manoj

    2012-01-01

    Corneal diseases represent the second leading cause of blindness in most developing world countries. Worldwide, major investments in public health infrastructure and primary eye care services have built a strong foundation for preventing future corneal blindness. However, there are an estimated 4.9 million bilaterally corneal blind persons worldwide who could potentially have their sight restored through corneal transplantation. Traditionally, barriers to increased corneal transplantation have been daunting, with limited tissue availability and lack of trained corneal surgeons making widespread keratoplasty services cost prohibitive and logistically unfeasible. The ascendancy of cataract surgical rates and more robust eye care infrastructure of several Asian and African countries now provide a solid base from which to dramatically expand corneal transplantation rates. India emerges as a clear global priority as it has the world's largest corneal blind population and strong infrastructural readiness to rapidly scale its keratoplasty numbers. Technological modernization of the eye bank infrastructure must follow suit. Two key factors are the development of professional eye bank managers and the establishment of Hospital Cornea Recovery Programs. Recent adaptation of these modern eye banking models in India have led to corresponding high growth rates in the procurement of transplantable tissues, improved utilization rates, operating efficiency realization, and increased financial sustainability. The widespread adaptation of lamellar keratoplasty techniques also holds promise to improve corneal transplant success rates. The global ophthalmic community is now poised to scale up widespread access to corneal transplantation to meet the needs of the millions who are currently blind.

  9. Turning the tide of corneal blindness

    Directory of Open Access Journals (Sweden)

    Matthew S Oliva

    2012-01-01

    Full Text Available Corneal diseases represent the second leading cause of blindness in most developing world countries. Worldwide, major investments in public health infrastructure and primary eye care services have built a strong foundation for preventing future corneal blindness. However, there are an estimated 4.9 million bilaterally corneal blind persons worldwide who could potentially have their sight restored through corneal transplantation. Traditionally, barriers to increased corneal transplantation have been daunting, with limited tissue availability and lack of trained corneal surgeons making widespread keratoplasty services cost prohibitive and logistically unfeasible. The ascendancy of cataract surgical rates and more robust eye care infrastructure of several Asian and African countries now provide a solid base from which to dramatically expand corneal transplantation rates. India emerges as a clear global priority as it has the world′s largest corneal blind population and strong infrastructural readiness to rapidly scale its keratoplasty numbers. Technological modernization of the eye bank infrastructure must follow suit. Two key factors are the development of professional eye bank managers and the establishment of Hospital Cornea Recovery Programs. Recent adaptation of these modern eye banking models in India have led to corresponding high growth rates in the procurement of transplantable tissues, improved utilization rates, operating efficiency realization, and increased financial sustainability. The widespread adaptation of lamellar keratoplasty techniques also holds promise to improve corneal transplant success rates. The global ophthalmic community is now poised to scale up widespread access to corneal transplantation to meet the needs of the millions who are currently blind.

  10. Corneal Transplantation

    DEFF Research Database (Denmark)

    Hjortdal, Jesper Østergaard

    Corneal transplantation has been performed for more than 100 years. Until 15 years ago the state-of-the art type of transplantation was penetrating keratoplasty, but since the start of this millennium, newly designed surgical techniques have developed considerably. Today, the vast majority of ker...

  11. Corneal Laceration

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration ... After Eyelid Scratch Jul 28, 2014 Leer en Español: ¿Qué Es una Laceración de la Córnea? Find ...

  12. Corneal topography

    DEFF Research Database (Denmark)

    Andersen, J.; Koch-Jensen, P.; Østerby, Ole

    1993-01-01

    The central corneal zone is depicted on keratoscope photographs using a small target aperture and a large object distance. Information on the peripheral area is included by employing a hemispherical target with a dense circular and radial pattern. On a 16 mm (R = 8 mm) reference steel sphere...

  13. Corneal chromoblastomycosis.

    Science.gov (United States)

    Barton, K; Miller, D; Pflugfelder, S C

    1997-03-01

    We sought to illustrate the difficulty in managing uncommon, pigmented mold-related corneal ulceration and to highlight the role of itraconazole in treating these patients. We describe the management and clinical course of a patient with a recurring corneal infection caused by Fonsecaea pedrosoi and discuss this experience in the light of existing literature on management of cutaneous chromoblastomycosis. A corneal ulcer caused by this organism healed initially on treatment with topical and systemic antifungal medication, but infection recurred in the deep stroma 4 months after cessation of therapy. After failure to respond to a further period of medical therapy, a small therapeutic penetrating keratoplasty was performed. Culture of a fibrinous membrane from the anterior iris surface demonstrated intraocular fungal infection, and postoperatively, an episode of marked fibrinous uveitis developed, suggesting the presence of viable intraocular fungal elements. A large penetrating keratoplasty was therefore performed with excision of involved iris in combination with extracapsular cataract extraction. F. pedrosoi was again cultured from the fibrinous membrane adherent to the iris and from the anterior lens capsule. Postoperatively the patient received a 5-month course of systemic itraconazole, and no further recurrences have been encountered after a further 2 months. F. pedrosoi is the organism most commonly isolated from the chronic cutaneous mycosis, chromoblastomycosis, and is relatively resistant to medical therapy. As has been reported for cutaneous disease, surgery in combination with systemic itraconazole may provide the best chance of cure in corneal chromoblastomycosis.

  14. Postoperative maintaining patients after a phacoemulsification

    Directory of Open Access Journals (Sweden)

    S. N. Akulov

    2013-01-01

    Full Text Available Purpose: Studying of efficiency and safety of application of «Sistаnе-gel» after a cataract phaсoemulsification for postoperative therapy of a syndrome of a dry eye was.Methods: 56 patients (56 eyes are surveyed. 26 of them (26 eyes have primary open-angle glaucoma and receive antiglaukomе preparations in instillations. Other 30 patients didn’t use any drops. To all patients the cataract phacoemulsification is executed. After operation applied standard antibacterial and anti-inflammatory therapy and conducted complex examination, including biomicroscopy,Shirmer’s test, Norn’s test, staining the anterior surface of the eye with Fluoresceine. Besides, patients answered the questions containingin a simple questionnaire.Results: Application of the preparation «Sistane-gel» showed its high efficiency and safety in treatment of a postoperative syndrome of a dry eye after a cataract phacoemulsification.Conclusion: Taking into account specifics of patients with a cataract (advanced age, existence of the somatic diseases, the changed hormonal background, reception of medicines, all of them can recommend application of sistant-gel for prevention and dry eye treatment after phacoemulsification. Especially it is necessary to pay attention to dry eye prevention at the patients who have glaucoma and constantly using hypotensive drops.

  15. Postoperative maintaining patients after a phacoemulsification

    Directory of Open Access Journals (Sweden)

    S. N. Akulov

    2014-07-01

    Full Text Available Purpose: Studying of efficiency and safety of application of «Sistаnе-gel» after a cataract phaсoemulsification for postoperative therapy of a syndrome of a dry eye was.Methods: 56 patients (56 eyes are surveyed. 26 of them (26 eyes have primary open-angle glaucoma and receive antiglaukomе preparations in instillations. Other 30 patients didn’t use any drops. To all patients the cataract phacoemulsification is executed. After operation applied standard antibacterial and anti-inflammatory therapy and conducted complex examination, including biomicroscopy,Shirmer’s test, Norn’s test, staining the anterior surface of the eye with Fluoresceine. Besides, patients answered the questions containingin a simple questionnaire.Results: Application of the preparation «Sistane-gel» showed its high efficiency and safety in treatment of a postoperative syndrome of a dry eye after a cataract phacoemulsification.Conclusion: Taking into account specifics of patients with a cataract (advanced age, existence of the somatic diseases, the changed hormonal background, reception of medicines, all of them can recommend application of sistant-gel for prevention and dry eye treatment after phacoemulsification. Especially it is necessary to pay attention to dry eye prevention at the patients who have glaucoma and constantly using hypotensive drops.

  16. [Computer-assisted phacoemulsification for hard cataracts].

    Science.gov (United States)

    Zemba, M; Papadatu, Adriana-Camelia; Sîrbu, Laura-Nicoleta; Avram, Corina

    2012-01-01

    to evaluate the efficiency of new torsional phacoemulsification software (Ozil IP system) in hard nucleus cataract extraction. 45 eyes with hard senile cataract (degree III and IV) underwent phacoemulsification performed by the same surgeon, using the same technique (stop and chop). Infiniti (Alcon) platform was used, with Ozil IP software and Kelman phaco tip miniflared, 45 degrees. The nucleus was split into two and after that the first half was phacoemulsificated with IP-on (group 1) and the second half with IP-off (group 2). For every group we measured: cumulative dissipated energy (CDE), numbers of tip closure that needed manual desobstruction the amount of BSS used. The mean CDE was the same in group 1 and in group 2 (between 6.2 and 14.9). The incidence of occlusion that needed manual desobstruction was lower in group 1 (5 times) than in group 2 (13 times). Group 2 used more BSS compared to group 1. The new torsional software (IP system) significantly decreased occlusion time and balanced salt solution use over standard torsional software, particularly with denser cataracts.

  17. Bilateral acute corneal calcification.

    Science.gov (United States)

    Freddo, T F; Leibowitz, H M

    1985-04-01

    A 38-year-old man with brittle, juvenile onset diabetes mellitus and bilateral severe dry eyes with recurrent corneal ulcers developed atypical band-shaped calcifications of both corneas during a 24-hour period. Serum calcium, phosphate, and carbon dioxide levels all were within normal limits. The patient was mildly uremic but was not in renal failure. When EDTA chelation failed to clear the deposits, partial keratectomies were performed in both eyes and the specimens were examined by light and electron microscopy, including energy dispersive x-ray analysis. Microscopic studies revealed an atypical calcific keratopathy which involved neither Bowman's layer nor the most superficial stromal lamellae. The deposits were confined to deeper lamellae in the anterior stroma and by electron microscopy were composed of extracellular crystalline aggregates. Energy dispersive x-ray analysis of these aggregates confirmed the presence of calcium and phosphate. Corneal dessication appeared to be a major contributing factor in the rapid formation of these deposits.

  18. Corneal collagen cross-linking

    Directory of Open Access Journals (Sweden)

    Jankov II Mirko

    2010-01-01

    Full Text Available Corneal collagen cross-linking (CXL with riboflavin and ultraviolet-A (UVA is a new technique of corneal tissue strengthening by using riboflavin as a photosensitizer and UVA to increase the formation of intra- and interfibrillar covalent bonds by photosensitized oxidation. Keratocyte apoptosis in the anterior segment of the corneal stroma all the way down to a depth of about 300 microns has been described and a demarcation line between the treated and untreated cornea has been clearly shown. It is important to ensure that the cytotoxic threshold for the endothelium has not been exceeded by strictly respecting the minimal corneal thickness. Confocal microscopy studies show that repopulation of keratocytes is already visible 1 month after the treatment, reaching its pre-operative quantity and quality in terms of functional morphology within 6 months after the treatment. The major indication for the use of CXL is to inhibit the progression of corneal ectasias, such as keratoconus and pellucid marginal degeneration. CXL may also be effective in the treatment and prophylaxis of iatrogenic keratectasia, resulting from excessively aggressive photoablation. This treatment has also been used to treat infectious corneal ulcers with apparent favorable results. Combination with other treatments, such as intracorneal ring segment implantation, limited topography-guided photoablation and conductive keratoplasty have been used with different levels of success.

  19. Use of pars plana vitrectomy with phacoemulsification in vitreous cavity to treat complete posterior dislocation of lens

    Directory of Open Access Journals (Sweden)

    Mutoh T

    2011-07-01

    Full Text Available Tetsuya Mutoh, Yukihiro Matsumoto, Makoto ChikudaDepartment of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, JapanBackground: The purpose of this study was to evaluate pars plana vitrectomy (PPV with phacoemulsification in the vitreous cavity for treatment of complete posterior dislocation of the lens without any damage to the lens capsule.Methods: We evaluated factors such as cause of dislocation, scleral fixation of an intraocular lens (IOL, preoperative and postoperative visual acuity, corneal endothelial cell density, and intraoperative and postoperative complications.Results: Displacement in the eleven eyes studied was mostly caused by ocular trauma and was idiopathic (four eyes each. Scleral fixation of the IOL was performed in seven of the eyes during first-time PPV. Visual acuity was improved in two eyes, unchanged in eight eyes, and worse in one eye. Mean corneal endothelial cell density was 2485 cells/mm2 preoperatively and 2301 cells/mm2 postoperatively. No significant differences were seen before and after the surgeries (P = 0.15, paired t-test. Intraoperative complications included retinal detachment and suprachoroidal hemorrhage in one eye each. The most common postoperative complication was transient ocular hypertension, which occurred in three eyes. IOL dislocation and vitreous incarceration of the anterior chamber in one eye required a second operation, while retinal detachment in one eye required a third operation.Conclusion: When treating a completely dislocated lens, prevention of retinal detachment which subsequently can affect the visual prognosis is the most important factor to be addressed after PPV with intravitreal phacoemulsification.Keywords: lens dislocation, pars plana vitrectomy, phacoemulsification in the vitreous cavity, retinal detachment

  20. Feline corneal disease.

    Science.gov (United States)

    Moore, Phillip Anthony

    2005-05-01

    The cornea is naturally transparent. Anything that interferes with the cornea's stromal architecture, contributes to blood vessel migration, increases corneal pigmentation, or predisposes to corneal edema, disrupts the corneas transparency and indicates corneal disease. The color, location, and shape and pattern of a corneal lesion can help in determining the underlying cause for the disease. Corneal disease is typically divided into congenital or acquired disorders. Congenital disorders, such as corneal dermoids are rare in cats, whereas acquired corneal disease associated with nonulcerative or ulcerative keratitis is common. Primary ocular disease, such as tear film instability, adenexal disease (medial canthal entropion, lagophthalmus, eyelid agenesis), and herpes keratitis are associated with the majority of acquired corneal disease in cats. Proliferative/eosinophilic keratitis, acute bullous keratopathy, and Florida keratopathy are common feline nonulcerative disorders. Nonprogressive ulcerative disease in cats, such as chronic corneal epithelial defects and corneal sequestration are more common than progressive corneal ulcerations.

  1. Evaluation of Anterior Segment Parameter Changes Using the Sirius after Uneventful Phacoemulsification

    Science.gov (United States)

    Şimşek, Ali; Çapkın, Musa; Bilak, Şemsettin; Güler, Mete; Reyhan, Ali Hakim

    2016-01-01

    Purpose To investigate changes in anterior chamber depth (ACD), corneal volume (CV), anterior chamber angle (ACA), anterior chamber volume (ACV), central corneal thickness (CCT), horizontal visible iris diameter (HVID), pupil diameter (PD), and intraocular pressure (IOP) after uneventful phacoemulsification cataract surgery with intraocular lens implantation. Methods A total of 132 eyes of 132 patients (87 men and 45 women) that underwent uneventful phacoemulsification cataract surgery and intraocular lens implantation were prospectively studied. The mean age of the patients was 63.68 ± 12.51 years. All patients were evaluated preoperatively and at 1 month postoperatively with the Sirius 3D Rotating Scheimpflug camera topography system. The ACD, CV, ACA, ACV, CCT, HVID, and PD measurements were recorded. IOP was measured using the Goldmann applanation tonometer, which was corrected for CCT of the Sirius device using Ehlers' formula. Results The preoperative mean ACD, ACV, ACA, CCT, CV, PD, HVID, and IOP were 2.79 ± 0.45 mm, 124.73 ± 25.72 mm3, 42.09 ± 7.490, 523.87 ± 41.97 microns, 55.37 ± 4.89 mm3, 3.98 ± 1.23 mm, 11.72 ± 0.67 mm, and 14.74 ± 2.59 mmHg, respectively. Three months postoperatively, the mean ACD, ACV, ACA, CCT, CV, PD, HVID, and IOP were 3.45 ± 0.6 mm, 162.52 ± 23.79 mm3, 51.46 ± 5.630, 526.21 ± 44.45 microns, 56.23 ± 5.12 mm3, 2.87 ± 0.45 mm, 11.91 ± 0.75 mm, and 12.02 ± 1.83 mmHg, respectively. There was a statistically significant increase in mean postoperative ACD, ACV, ACA, CV, and HVID compared with the corresponding preoperative values (p < 0.05). CCT remained stable after surgery. Postoperative PD and IOP were significantly decreased compared to corresponding preoperative values (p < 0.05). Conclusions Preoperative measurements by the Sirius 3D Rotating Scheimpflug camera topography system might help surgeons to predict postoperative changes resulting from phacoemulsification and intraocular lens implantation. This is a

  2. Clear & Simple

    Science.gov (United States)

    ... Cultural Respect Language Access Talking to Your Doctor Research Underway Plain Language Clear & Simple What is Clear & Simple? Clear & Simple ... schedule? A: Pretesting need not be an elaborate, time-consuming research project and depends on: How quickly you work, ...

  3. Learning phacoemulsification. Results of different teaching methods.

    Directory of Open Access Journals (Sweden)

    Hennig Albrecht

    2004-01-01

    Full Text Available We report the learning curves of three eye surgeons converting from sutureless extracapsular cataract extraction to phacoemulsification using different teaching methods. Posterior capsule rupture (PCR as a per-operative complication and visual outcome of the first 100 operations were analysed. The PCR rate was 4% and 15% in supervised and unsupervised surgery respectively. Likewise, an uncorrected visual acuity of > or = 6/18 on the first postoperative day was seen in 62 (62% of patients and in 22 (22% in supervised and unsupervised surgery respectively.

  4. Equine corneal stromal abscesses

    DEFF Research Database (Denmark)

    Henriksen, M. D. L.; Andersen, P. H.; Plummer, C. E.

    2013-01-01

    The last 30 years have seen many changes in the understanding of the pathogenesis and treatment of equine corneal stromal abscesses (SAs). Stromal abscesses were previously considered an eye problem related to corneal bacterial infection, equine recurrent uveitis, corneal microtrauma and corneal...

  5. Phacoemulsification efficiency with a radiused phaco tip.

    Science.gov (United States)

    Gupta, Isha; Zaugg, Brian; Stagg, Brian C; Barlow, William R; Pettey, Jeff H; Jensen, Jason D; Kirk, Kevin R; Olson, Randall J

    2014-05-01

    To evaluate radiused and nonradiused phacoemulsification tips to determine which tip is more efficient in removal of lens fragments using 3 ultrasound (US) modalities. John A. Moran Eye Center Laboratories, University of Utah, Salt Lake City, Utah, USA. Experimental study. Porcine lens nuclei were formalin-soaked for 2 hours or 3 hours and then divided into 2.0 mm cubes. Thirty-degree, 0.9 mm beveled radiused tips and nonradiused tips were used with torsional, transverse, and micropulsed US modalities. Bent tips were used with torsional and transversal US, and straight tips were used with micropulsed US. Efficiency (time to lens removal) and chatter (number of lens fragment repulsions from the tip) were determined. The mean phacoemulsification efficiency was statistically significantly decreased (increased time for removal) with the radiused tip compared with the nonradiused tip for torsional US only (2-hour soaked lenses: 2.14 seconds ± 1.94 [SD] versus 1.18 ± 0.69 seconds [P tip showed decreased efficiency with torsional US only. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Measuring performance in virtual reality phacoemulsification surgery

    Science.gov (United States)

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

    2008-02-01

    We have developed a virtual reality (VR) simulator for phacoemulsification surgery. The current work aimed at developing a relative performance index that characterizes the performance of an individual trainee. We recorded measurements of 28 response variables during three iterated surgical sessions in 9 experienced cataract surgeons, separately for the sculpting phase and the evacuation phase of phacoemulsification surgery and compared their outcome to that of a reference group of naive trainees. We defined an individual overall performance index, an individual class specific performance index and an individual variable specific performance index. We found that on an average the experienced surgeons performed at a lower level than a reference group of naive trainees but that this was particularly attributed to a few surgeons. When their overall performance index was further analyzed as class specific performance index and variable specific performance index it was found that the low level performance was attributed to a behavior that is acceptable for an experienced surgeon but not for a naive trainee. It was concluded that relative performance indices should use a reference group that corresponds to the measured individual since the definition of optimal surgery may vary among trainee groups depending on their level of experience.

  7. Induced astigmatism after diamond burr superficial keratectomy for recurrent corneal erosion.

    Science.gov (United States)

    Yoo, Janie H; Choi, David M

    2009-11-01

    To report a case of induced astigmatism after diamond burr superficial keratectomy (DBSK) for recurrent corneal erosion (RCE). Case report. Review of clinical findings in a 54-year-old women with ocular history of a scleral buckling procedure for a retinal detachment from blunt trauma and phacoemulsification with intraocular lens placement. The patient presented with RCE after trauma with a mascara brush to the OD and was treated with DBSK. Postoperatively, she developed significant astigmatism. In the third postoperative week after the DBSK procedure, the patient reported of worsening vision. On corneal topography, the patient was found to have 4 diopters of induced astigmatism. The astigmatic error was followed closely by serial corneal topography; a gradual decrease in the amount of astigmatism occurred over the course of 30 weeks. Forme fruste keratoconus was suspected in the patient's contralateral eye, based on corneal topographic analysis. Induced corneal astigmatism is a previously undescribed complication that can occur after DBSK. It is unclear whether the induced astigmatism in our patient was caused by the DBSK procedure alone or whether the patient had decompensated structural integrity from forme fruste keratoconus or blunt corneal trauma or both. The authors recommend that corneal topographic analysis be appropriately considered before DBSK for RCE and that corneal astigmatism be seen as a potential complication of the procedure.

  8. Curative effects of small incision cataract surgery versus phacoemulsification: a Meta-analysis

    Directory of Open Access Journals (Sweden)

    Chang-Jian Yang

    2013-08-01

    Full Text Available AIM: To evaluate the curative efficacy of small incision cataract surgery(SICSversus phacoemulsification(Phaco.METHODS: A computerized literature search was carried out in Chinese Biomedical Database(CBM, Wanfang Data, VIP and Chinese National Knowledge Infrastructure(CNKIto collect articles published between 1989-2013 concerning the curative efficacy of SICS versus Phaco. The studies were assessed in terms of clinical case-control criteria. Meta-analysis were performed to assess the visual acuity, the complications rates between SICS and Phaco 90 days after surgery. Treatment effects were measured as risk difference(RDbetween SICS and Phaco. Fixed and random effect models were employed to combine results after a heterogeneity test. RESULTS:A total of 8 studies were included in our Meta-analysis. At 90 days postoperative time, there were no significant differences between the two groups at the visual acuity >0.5(P=0.14; and no significant differences on the complications rates of corneal astigmatism, corneal edema, posterior capsular rupture and anterior iris reaction(P>0.05.CONCLUSION: These results suggest that there is no different on the curative effects of SICS and Phaco for cataract.

  9. Three methods for correction of astigmatism during phacoemulsification

    Directory of Open Access Journals (Sweden)

    Hossein Mohammad-Rabei

    2016-01-01

    Conclusion: There was no significant difference in astigmatism reduction among the three methods of astigmatism correction during phacoemulsification. Each of these methods can be used at the discretion of the surgeon.

  10. Application and experience of anterior vitrectomy in phacoemulsification

    Directory of Open Access Journals (Sweden)

    Xiao-Bo Zeng

    2016-02-01

    Full Text Available AIM: To observe and discuss the clinical application and effect of anterior vitrectomy in phacoemulsification for the treatment of vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection.METHODS:Retrospective analysis of 28 cases(35 eyeswith cataract in whom vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and intraocular lens implantation and anterior vitrectomy were performed was conducted. RESULTS:Anterior vitrectomy for timely and accurate treatment for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification was satisfied. CONCLUSION: Anterior vitrectomy has good curative effect for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and is effective with less severe complications.

  11. Refractive aim and visual outcome after phacoemulsification: A 2 ...

    African Journals Online (AJOL)

    2016-03-24

    Mar 24, 2016 ... Aim: To review the short‑term visual outcome of phacoemulsification in adults with uncomplicated ... social consequences.[2] In a ... visual impairment, respectively. ... skills and experience, who form the group practice, did the.

  12. Asteroid hyalosis removal during phacoemulsification: an anterior approach

    Directory of Open Access Journals (Sweden)

    Mohamed Anbar

    2017-01-01

    Removal of AH by means of anterior vitrectomy during phacoemulsification through a posterior capsulorhexis is safe and effective and enables the surgeon to treat undiagnosed missed retinal lesions that were not obvious preoperatively.

  13. 角膜地形图引导下白内障手术切口构建的变异对角膜散光影响%The Effect of the Corneal Astigmatism in Changed Cataract Surgery Incision with the Corneal Topography

    Institute of Scientific and Technical Information of China (English)

    刘文慧; 施彦; 李一壮

    2010-01-01

    Objective To observe the effect of the corneal astigmatism in cataract surgery incision which selected according to corneal topography to further reduce the preoperative corneal astigmatism. Meth-ods Computer-assisted corneal topography was used to examine the 126 eyes of 123 patients preoperatively.The cases were divided into 5 groups randomly. Group A: Manual small incision cataract surgery (MSICS) Group: Superior anti-bow sclera tunnel incision was made on 22 eyes of Group A. Group B: MSICS Group: The anti-bow sclera tunnel incision was made on the steepest meridian according to the corneal topography ex-amined preoperatively on 28 eyes. Group C: Phacoemulsification Group: Superior clear corneal incision was made on 24 eyes of group C. Group D: Phacoemulsification Group: The clear corneal incision was made on the steepest meridian according to the corneal topography examined preoperatively on 26 eyes. Group E: MSICS Group: incision was made on the steepest meridian according to the corneal topography The straight sclera tun-nel examined preoperatively on 26 eyes. The corneal topography at 1 day and 7 days after surgery was ob-served and recorded except for visual acuity and so on. Results ①Visual acuity: The differences were not sta-tistically significant among these groups which Visual acuity was above 0.5 after 1 day and 7 days except the one between Group B and Group E after 7 days. ②Astigmatism axis conversion: The conversions were not sig-nificant from Group A to Group D. There were 12 cases changed in Group E. ③Corneal astigmatism: In Group A, the differences were not statistically significant among pre-operation, 1 day and 7 days. In Group B, the val-ues of corneal astigmatism in 1 day after surgery were a little more decreased than pre-existing ones, but were statistically significant 7 days later. The values of Group C and D were a little greater in 1 day after surgery and reduced 7 days later, however the values of Group C were higher. In group E

  14. [Results of combined endotrabeculectomy and phacoemulsification surgery].

    Science.gov (United States)

    Novytskyy, I Ya; Novytskyy, M I

    2015-01-01

    to identify indications and evaluate the efficacy of combined endotrabeculectomy and phacoemulsification surgery. A total of 172 patients (193 eyes) with open-angle glaucoma and cataract were enrolled. Group 1 included 102 patients (118 eyes), who were considered surgical candidates due to decompensation of IOP, group 2--70 patients (75 eyes), in whom IOP control could only be achieved with a multidrug regimen (two or more ocular hypotensive medications). The mean preoperative IOP measured with Maklakov tonometer was 26.4 ± 1.8 mmHg in group 1 and 20.5 ± 1.7 mmHg in group 2. In 134 eyes the extent of retention of intraocular fluid was determined intraoperatively by provoking blood reflux into Schlemm's canal. In 6 out of 134 eyes (4.5%) Schlemm's canal was not at all filled with blood, which was considered a contraindication for endotrabeculectomy. Partial filling of Schlemm's canal with blood was observed in 26 out of 134 eyes (19.4%), complete--in 102 eyes (76.1%). All but 6 patients underwent endotrabeculectomy (ab interno trabecular excision with original forceps through the anterior chamber angle) combined with cataract phacoemulsification and intraocular lens implantation. In 11 out of 126 cases, insignificant bleeding occurred during sample acquisition. No other complications were registered. Six months after the surgery, IOP was reduced by the mean of 7.0 ± 0.6 mmHg (26.5% from the baseline) in group 1 and by 2.2 ± 0.2 mmHg (10.7% from the baseline) in group 2. The number of hypotensive medications by that time has been decreased from 2.3 ± 0.3 to 0.8 ± 0.2 in group 1 and from 1.6 ± 0.3 to 0.4 ± 0.1 in group 2. Combined endotrabeculectomy and phacoemulsification surgery is a pathogenically oriented procedure, which improves ocular hydrodynamics and has a significant hypotensive effect.

  15. Sudden corneal edema due to retained lens nuclear fragment presenting 8.5 years after cataract surgery.

    Science.gov (United States)

    Pandit, Rahul T; Coburn, Amy G

    2011-06-01

    A 79-year-old woman presented with a 1-week history of sudden onset of decreased vision, pain, and redness in the right eye. Ocular history included uneventful cataract surgery in both eyes more than 8 years prior to presentation. Slitlamp examination revealed significant corneal edema and mild iritis. Gonioscopy revealed a retained lens nuclear fragment in the inferior angle. Surgical removal of the fragment improved the patient's condition. The retained nuclear fragment presumably lodged behind the iris at the time of the initial surgery and spontaneously moved forward more than 8 years later. To our knowledge, this is the longest reported delay between phacoemulsification and presentation of a retained nuclear fragment. Before this case, retained nuclear fragments had been associated with complications within a year of surgery only. We recommend gonioscopy in cases of sudden-onset corneal edema extending to the inferior limbus in patients with a history of phacoemulsification.

  16. Corneal ulcers in horses.

    Science.gov (United States)

    Williams, Lynn B; Pinard, Chantale L

    2013-01-01

    Corneal ulceration is commonly diagnosed by equine veterinarians. A complete ophthalmic examination as well as fluorescein staining, corneal cytology, and corneal bacterial (aerobic) and fungal culture and sensitivity testing are necessary for all infected corneal ulcers. Appropriate topical antibiotics, topical atropine, and systemic NSAIDs are indicated for all corneal ulcers. If keratomalacia (melting) is observed, anticollagenase/antiprotease therapy, such as autologous serum, is indicated. If fungal infection is suspected, antifungal therapy is a necessity. Subpalpebral lavage systems allow convenient, frequent, and potentially long-term therapy. Referral corneal surgeries provide additional therapeutic options when the globe's integrity is threatened or when improvement has not been detected after appropriate therapy.

  17. Effect of lateral temporal corneal incision for intraocular pressure and tear film stability in cataract patients

    Directory of Open Access Journals (Sweden)

    Ying Wang

    2017-02-01

    Full Text Available AIM: To investigate therapeutic effect of lateral temporal corneal incision phacoemulsification combined with intraocular lens(IOLon cataract and its effect on intraocular pressure(IOPand tear film. METHODS: The clinical data of patients with cataract who received treatment in our hospital from March 2014 to December 2015 were retrospectively analyzed. According to the location of the incision, they were divided into temporal corneal incision group and upper corneal incision group. We observed the incidence of complications of the two groups, compared the intraocular pressure, visual acuity, refraction and tear film break-up time of the two groups before and after surgery. RESULTS: The operation time and postoperative pain score of the two groups had no significant difference(P>0.05. The IOP and visual acuity between the two groups before operation had no significant difference(P>0.05. At the intraocular pressure of the two groups was lower than that before operation, and the visual acuity was higher than before operation, and the changes of the anterior lateral incision group were more obvious(PPCONCLUSION: The temporal corneal incision phacoemulsification combined with intraocular lens implantation has a good therapeutic effect on cataract patients, can effectively improve the intraocular pressure and tear film stability, improve eye function, promote the recovery of the body after surgery.

  18. Er:YAG phacoemulsification with fiber

    Science.gov (United States)

    Cozean, Colette D.

    1994-07-01

    Forty years ago, a leading cataract surgeon in the United States announced, with an air of finality, that the "perfect operation' for cataract extraction had been developed.' He believed cataract surgeons had reached their zenith and that no more time should be wasted looking for alternatives or refinements. The procedure he was describing was an intracapsular cataract extraction. The cataract was delivered at that time with forceps, often with "just a little vitreous". Sutures were just beginning to be used, but weeks of postoperative immobilization were still the norm. Patients undergoing the procedure could look forward to a lifetime of visual impairment and to a loss of confidence and self-esteem brought about by both the functional impairment and the unflattering appearance of these spectacles. This "perfect operation" marked the end of the productive life for most individuals. With the introduction of the first ultrasonic phacoemulsification equipment in the 1970's and the development of small incision intraocular lenses in the 1980's, all of us have witnessed a remarkable leap in the evolution of cataract surgery. Like our colleague forty years ago, some of us think that we have reached a plateau, but this evolution will continue. What is needed in ophthalmic surgery today is a single, versatile, reliable, and inexpensive multipurpose device which can perform all these surgical functions with equivalent or superior results. Such a device would allow cost-conscious surgery facilities to offer a full range of state-of-the-art surgery, while purchasing only a single unit - a unit which would be no more expensive than existing phacoemulsification devices.

  19. Phacoemulsification after penetrating keratoplasty with autologous limbal transplant and amniotic membrane transplant in chemical burns

    Directory of Open Access Journals (Sweden)

    Arora Ritu

    2005-01-01

    Full Text Available We report a patient who had earlier penetrating keratoplasty with amniotic membrane transplant and autologous limbal cell transplant for chemical injury who underwent cataract surgery by phacoaspiration. A posterior limbal incision with corneal valve was made superotemporally with extreme caution to avoid damage to the limbal graft. Aspiration flow rates and vacuum were kept low to avoid any turbulence during surgery. A 6.0 mm optic diameter acrylic foldable intraocular lens was inserted in the bag. The patient achieved a best-corrected visual acuity of 6/12 at 10 months′ follow-up with a clear corneal graft. We conclude that caution during wound construction and phacoaspiration can help preserve corneal and limbal graft integrity in patients undergoing cataract surgery after corneal graft and limbal transplantation.

  20. Partial-thickness corneal tissue restoration after a chemical burn

    Directory of Open Access Journals (Sweden)

    Galan A

    2016-04-01

    Full Text Available Alessandro Galan, Anton Giulio Catania, Giuseppe Lo Giudice San Paolo Ophthalmic Center, San Antonio Hospital, Padova, Italy Purpose: We describe a case of full-thickness corneal restoration after an acute corneal burn with an acid agent. Methods: A 32-year-old male reported painful discomfort, redness, photophobia, and a decrease in visual acuity in the left eye after a unilateral burn with an acid agent. Slit-lamp examination revealed massive corneal melting involving necrotic sequestrum of the entire corneal surface. Surgical approach was carried out in order to preserve residual ocular tissues. Results: Extensive corneal–conjunctival layer curettage of the necrotic tissue was performed showing perfectly clear undamaged deep lamellar corneal layers. The patient underwent multilayered amniotic membrane transplantation and total capsular–conjunctival flap in order to preserve ocular tissue from further melting or corneal perforation. A complete and spontaneous “restitutio ad integrum” of the corneal layers was shown during the follow-up. The cornea was perfectly clear with restored normal anatomical architecture. Conclusion: In this case, a spontaneous full-thickness corneal tissue restoration occurred after an acute chemical burn. Studies about the mechanisms whereby different cells interact and replicate within the stroma may unveil the biology behind corneal regeneration and transparency. Keywords: amniotic membrane, chemical burn, corneal healing

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

    LENUS (Irish Health Repository)

    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.

  2. Outcomes of torsional microcoaxial phacoemulsification using tips with 30-degree and 45-degree aperture angles.

    Science.gov (United States)

    Helvacioglu, Firat; Sencan, Sadik; Yeter, Celal; Tunc, Zeki; Uyar, O Murat

    2014-03-01

    To compare the safety and efficacy of Ozil Intelligent Phaco torsional microcoaxial phacoemulsification surgeries performed using 30-degree and 45-degree aperture angled tips. Maltepe University School of Medicine Department of Ophthalmology, Istanbul, Turkey. Comparative case series. Eyes were assigned to 2.2 mm microcoaxial phacoemulsification using the torsional mode with a 45-degree (Group 1) or 30-degree (Group 2) aperture angled tip. A quick-chop surgical technique was used. The primary outcome measures were ultrasound time (UST), cumulative dissipated energy (CDE), longitudinal and torsional ultrasound (US) amplitudes, mean surgical time, mean balanced salt solution volume used, and mean central corneal thickness (CCT) changes. The mean UST, CDE, and longitudinal and torsional US amplitudes were 58.21 seconds ± 33.81 (SD), 7.74 ± 6.23, 0.45 ± 0.30, and 26.30 ± 12.60 in Group 1 and 63.83 ± 23.42 seconds, 12.36 ± 6.75, 0.23 ± 0.26, and 44.65 ± 14.38 in Group 2, respectively. The mean CDE and torsional amplitudes were significantly lower in Group 1 (P=.002 and P=.001, respectively). The mean balanced salt solution volume was 73.30 ± 19.87 cc in Group 1 and 74.30 ± 19.44 cc in Group 2 (P=.821). The mean CCT change was 52.40 ± 38.08 μm and 99.35 ± 47.14 μm, respectively (Ptip provided more effective lens removal with a lower CDE and less CCT change than a 30-degree aperture angled tip. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Corneal transplant - discharge

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000243.htm Corneal transplant - discharge To use the sharing features on this page, please enable JavaScript. You had a corneal transplant. Most of the tissue of your cornea (the ...

  4. Outcomes of Coaxial Micro-incision Phacoemulsification in Nanophthalmic Eyes:Report of Retrospective Case Series

    Institute of Scientific and Technical Information of China (English)

    Zi Ye; Zhaohui Li; Shouzhi He; Bing Chen; Xiaojuan Xing; Chunyan Ren

    2015-01-01

    Purpose:The surgical risk and complication rate after cataract surgery are extremely high in patients with nanophthalmos. This study is designed to compare the visual and refractive outcomes before and after coaxial micro-incision phacoemulsi-fication and evaluate postoperative complications. Methods:.Fifty nine patients (89 eyes) with axial length (AL)< 21 mm diagnosed with nanophthalmos were enrolled in this retrospective study. All patients underwent coaxial micro-inci-sion phacoemulsification and IOL implantation..The main outcome measures included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (A CA), intraocular pressure(IOP) and best corrected visual acu-ity (BCVA). Wilcoxon signed rank test or Mann-Whitney test, and Chi-square test and logistic regression analysis were per-formed for statistical tests as appropriate. Results:.The median AL was 19.63 mm...Sixty-six eyes (74.16%) had a history of surgical intervention. Postoperative ACD, ACV and ACA were increased significantly (all P<0.001), whereas postoperative IOP was decreased significantly. (P<0.001) after surgery. Previous surgical intervention was related to a reduction in the postoperative ACD and ACA (P<0.01), and both preoperative and postoperative IOP. (P<0.001). Postoperative BCVA was improved in 94.38% of the cases. Intraoperative complications mainly included iridoschisis (6 eyes, 6.74%). Early postoperative complications included tem-porary corneal edema (TCE) (23 eyes, 25.84%), anterior in-flammatory response (AIR)(19 eyes, 21.35%), cystoid mac-ular edema (CME) (14 eyes, 15.73%), and uveal effusion (4 eyes, 4.49%). Late postoperative complications included CME (8 eyes, 8.99%), uveal effusion (8 eyes, 8.99%), malignant glaucoma (2 eyes, 2.25%) and posterior capsular opacification (PCO) (10 eyes, 11.24%). The majority of complications (80%) were successfully resolved by pharma-cotherapy or operation. The risk of surgical complications was greater in patients

  5. Clear retainer

    Directory of Open Access Journals (Sweden)

    Priyakorn Chaimongkol

    2017-01-01

    Full Text Available A clear retainer is a removable retainer that is popular in the present day. Compared with conventional fixed and removable orthodontic retainers, it is a more esthetic, comfortable, and inexpensive appliance. Although several studies have been published about clear retainers, it could be difficult to interpret the results because of the variety of study designs, sample sizes, and research methods. This article is intended to compile the content from previous studies and discuss advantages, disadvantages, fabrication, insertion, and adjustment. Moreover, the effectiveness in maintaining dental position, occlusion, retention protocols, thickness, and survival rate of clear retainers is discussed.

  6. Refractive results after phacoemulsification and ECCE. A comparative study.

    Science.gov (United States)

    Dam-Johansen, M; Olsen, T

    1993-06-01

    The refractive results were evaluated in 79 patients undergoing cataract extraction by phacoemulsification using a 6-7 mm tunnel incision, and compared with a group of 77 patients undergoing planned extracapsular cataract extraction (ECCE) by the same surgeon. A mean increase in the keratometric cylinder of 0.05D and 0.52D was found in the phacoemulsification and the extracapsular cataract extraction group, respectively. This was significantly different from zero for the extracapsular cataract extraction group (p 0.05). By vector analysis, the mean surgically induced astigmatism was 0.91D and 1.36D in the phacoemulsification and the extracapsular cataract extraction group, respectively (p < 0.01). The IOL power prediction error (spectacle plane) was found to be 0.17D (+/- 0.69 SD) in the phacoemulsification group and 0.02 D (+/- 0.79 SD) in the extracapsular cataract extraction group, respectively. We conclude that phacoemulsification improves the surgical control of the refractive outcome of cataract surgery.

  7. Changes of the ocular surface and tear film after clear corneal incision phacoemulsification with different incision sizes%不同透明角膜切口白内障超声乳化术后眼表和泪膜的变化

    Institute of Scientific and Technical Information of China (English)

    李科; 林再雄; 李雷

    2016-01-01

    AIM:To study the changes of tear fiIm and ocuIar surface after cIear corneaI incision phacoemuIsification with different incision sizes. METHODS:Ninety patients (90 eyes) from May 2013 to May 2014 in our hospitaI were enroIIed. The patients were randomIy divided into two groups. Forty-five patients (45 eyes) in group A: coaxiaI 2. 2mm micro - incision phacoemuIsification cataract extraction and intraocuIar Iens(IOL) impIantation; forty-five patients (45 eyes) in group B: the conventionaI coaxiaI 3. 0mm smaII incision phacoemuIsification cataract extraction and IOL impIantation. The dry eye symptom ( DES) score, break up time ( BUT ) , Schirmer’s I test ( SIt ) and corneaI fIuorescein staining ( CFS ) score were assessed preoperativeIy and postoperativeIy. RESULTS: At 10, 20 and 30d postoperativeIy, the DES score in two groups increased, the DES score of group B was significantIy higher than those of group A and the differences were statisticaIIy significant ( t= -9. 501,-10. 070,-7. 961; aII P0. 05). The DES score, BUT, SIt and CFS score in group B showed statisticaIIy significant differences ( t=7. 321, 4. 071, 3. 620, 4. 214;aII P0.05);B组患者的DES评分、BUT、SⅠt和CFS评分与术前相比差异明显,具有统计学意义( t=7.321、4.071、3.620、4.214,均P<0.05)。结论:白内障超声乳化术角膜切口大小对术后眼表和泪膜的变化具有一定的影响,切口小的能有效降低手术对患者眼表所造成的损伤,且术后早期对泪膜和眼表的影响比较小。

  8. SNOW CLEARING

    CERN Multimedia

    Groupe de Transport/Transport Group

    1999-01-01

    In order to facilitate snow-clearing operations, which commence at 4.30 every morning, drivers of CERN vehicles are kindly requested to group their cars together in the car parks. This will greatly help us in our work. Thank you for your co-operation.Transport Group / ST-HMTel. 72202

  9. Indocyanine green staining for the triple corneal procedure.

    Science.gov (United States)

    Kobayashi, Akira; Segawa, Yoji; Nishimura, Akira; Shirao, Yutaka; Sugiyama, Kazuhisa

    2004-01-01

    In the triple corneal procedure, successful completion of capsulorhexis is of the utmost importance. Another use of indocyanine green dye for better visualization of the anterior lens capsule of mature cataract during the triple corneal procedure is described. Four consecutive patients (mean age, 69.5 years) with both mature cataracts and corneal opacity underwent the triple corneal procedure. After trephination of the recipient cornea, the anterior capsule of the lens was stained with indocyanine green. A continuous curvilinear capsulorhexis (CCC) was performed, after which conventional triple corneal procedures were followed. In all four cases, this technique markedly improved visualization of the lens capsule and resulted in successful and easy manipulation of the CCC and subsequent removal of residual lens cortex. Staining of the anterior capsule of mature cataract in the triple corneal procedure clearly defines the border of the capsule, thus allowing easy and complete execution of CCC.

  10. Avoiding iris trauma from phacoemulsification in eyes with iridoschisis.

    Science.gov (United States)

    Rozenberg, Israel; Seabra, Fabíola P

    2004-04-01

    Iridoschisis is a rare condition frequently associated with age-related cataract. Phacoemulsification can be difficult to perform in these eyes, as the detached iris fibrils that are typically present free float in the anterior chamber and are attracted to the phaco tip and the irrigation/aspiration handpiece port. We describe a technique for performing phacoemulsification in eyes with iridoschisis. In this technique, iris fibrils are held in place by 2 ophthalmic viscosurgical devices (OVDs) that are injected into the inferior portion of the anterior chamber. An elliptical capsulorhexis is made and limited to the superior half of the pupil for additional stability of the anterior chamber during surgery. The nucleus is chopped with a phaco chopper and a bent-tip, 22-gauge needle. Most of the phacoemulsification is performed under the anterior capsule. The iris comes into contact with the OVDs only and has no mechanical trauma.

  11. [Patient's pain feeling and surgeon's comfort--ECCE versus phacoemulsification].

    Science.gov (United States)

    Kałuzny, Jakub J; Eliks, Iwona; Mierzejewski, Andrzej; Kałuzny, Bartłomiej

    2004-01-01

    To compare patient's pain and surgeon's comfort during ECCE performed under retrobulbar anesthesia and phacoemulsification under topical anesthesia. 120 patients scheduled for planned routine cataract extraction were divided in 2 groups: group 1-60 eyes, ECCE under retrobulbar anesthesia and group II-60 eyes, phacoemulsification under topical anesthesia. Immediately after operation patients were asked, to answer questions about their feeling during surgery. Simultaneously, the surgeon filled up the questionnaire, concerning patients behavior during the entire procedure. Statistically significant higher level of pain was reported in group I (ECCE). The most painful moment of the procedure was retrobulbar injection. During surgery pain feeling in both groups was similar. Both types of anesthesia provided very good level of surgeon's comfort. The longer operation, the higher level of pain and lower surgeon's comfort were reported in both groups. Patients having ECCE performed under retrobulbar anesthesia reported more pain comparing to phacoemulsification under topical anesthesia. Both anesthesia methods provided high level of surgeon's comfort.

  12. Phacoemulsification in Patients with Secondary Glaucoma Caused by Uveitis

    Institute of Scientific and Technical Information of China (English)

    Mingkai Lin; Jian Ge; Yizhi Liu; Yuqing Lan; Yehong Zhou

    2001-01-01

    Purposes: To evaluate the effect of phacoemulsification in the patients with uveitis,secondary glaucoma and complicated cataract. Methods: Phacoemulsification and implantation of a foldable intraocular len was performed in 12 patients(13 eyes) with uveitis, secondary glaucoma and complicated cataract. The complications, intraocular pressures (IOP), and visual acuity were observed postoperatively. Results: No severe complication was found in the patients postoperatively or within the operation procedure. The visual acuity was improved after the operation ( P < 0.05) .The intraocular pressures and/or the number of antiglaucoma medications reduced in 3months of the follow-up time. Conclusion: phacoemulsification is the best way to treat the patients with secondary glaucoma and complicated cataract caused by uveitis. Eye Science 2001; 17: 8 ~ 10.

  13. Clinical observation on lidocaine's application in phacoemulsification as surface anesthesia

    Directory of Open Access Journals (Sweden)

    Yong Liu

    2013-08-01

    Full Text Available AIM: To evaluate the effect of surface anesthesia for phacoemulsification using 20g/L lidocaine.METHODS: There were 1 850 patients(2 600 eyeswho underwent phacoemulsification via surface anesthesia using 20g/L lidocaine. The analgesic effect was observed. RESULTS: Totally 93% of 1 850 patients had not any pain during the surgery, a nice analgesic effect was showed, there was no complications duo to anaesthesia. Seven percent of all patients felt swelling pain during surgery but could tolerate. The naked or corrected visual acuity of 89.4% eyes was ≥0.6 one month after surgery.CONCLUSION: Surface anesthesia of using 20g/L lidocaine is safe and painless for phacoemulsification.

  14. Phaco-emulsification causes the formation of cavitation bubbles.

    Science.gov (United States)

    Svensson, B; Mellerio, J

    1994-09-01

    There have been reports of complications arising from damage to non-lenticular ocular tissue during the increasingly popular procedure of cataract extraction with phaco-emulsification. One cause of this damage might be the formation of cavitation bubbles. Such bubbles are known to produce free radicals and shock waves. This paper demonstrates directly the formation of cavitation bubbles at the tip of the phaco-probe. It also shows the importance of a smooth probe profile in reducing bubble formation. Recommendations are made for probe and tip design and for the use of minimum power during the surgical procedure of phaco-emulsification.

  15. Outcomes of a Management Strategy in Eyes with Corneal Irregularity and Cataract

    Science.gov (United States)

    Shetty, Rohit; Paryani, Mukesh

    2016-01-01

    Purpose. To evaluate the outcomes of a management strategy in patients with irregular corneas and cataract. Methods. Six eyes of four patients presented for cataract surgery with irregular corneas following corneal refractive surgery. Topoguided ablation regularised the cornea, followed by phacoemulsification and intraocular lens implantation. Zonal keratometric coefficient of variation (ZKCV) measured structural changes and visual quality metrics measured functional improvement. Results. The mean duration after corneal refractive surgery was 7.83 ± 2.40 years. The logmar uncorrected distance visual acuity (0.67 ± 0.25) and the corrected distance visual acuity (0.38 ± 0.20) improved to 0.34 ± 0.14 and 0.18 ± 0.10, respectively. The changes in the standard deviations of the zonal keratometry values and the ZKCV were statistically significant in the 2, 3, and 4 mm zones. The changes in the Strehl ratio (ANOVA p = 0.043) were also statistically significant. Conclusions. Corneal regularisation followed by phacoemulsification resulted in lower residual refractive error with improved visual quality metrics. This strategy is a viable option in patients with symptomatic cataracts and irregular corneas. PMID:27563677

  16. Toric Intraocular Lens Implantation for Correction of Astigmatism in Cataract Patients with Corneal Ectasia

    Directory of Open Access Journals (Sweden)

    Efstratios A. Parikakis

    2013-11-01

    Full Text Available Our purpose was to examine the long-term efficacy of toric intraocular lens (IOL implantation in cataract patients with high astigmatism due to corneal ectasia, who underwent phacoemulsification cataract surgery. Five eyes of 3 cataract patients with topographically stable keratoconus or pellucid macular degeneration (PMD, in which phacoemulsification with toric IOL implantation was used to correct high astigmatism, are reported. Objective and subjective refraction, visual acuity measurement and corneal topography were performed in all cases before and after cataract surgery. In all cases, there was a significant improvement in visual acuity, as well as refraction, which remained stable over time. Specifically, in subjective refraction, all patients achieved visual acuity from 7/10 to 9/10 with up to -2.50 cyl. Corneal topography also remained stable. Postoperative follow-up was 18-28 months. Cataract surgery with toric IOL implantation seems to be safe and effective in correcting astigmatism and improving visual function in cataract patients with topographically stable keratoconus or PMD.

  17. Pain relief with intracameral mepivacaine during phacoemulsification

    Science.gov (United States)

    Malecaze, F.; Deneuville, S.; Julia, B.; Daurin, J.; Chapotot, E.; Grandjean, H.; Arne, J.; Rascol, O.

    2000-01-01

    AIM—To assess the efficacy and safety of an intraoperative intracameral injection of mepivacaine, administered when patients experienced pain during the course of cataract surgery under topical anaesthesia.
METHODS—This is a prospective placebo controlled double masked randomised clinical trial. 50 eyes were included; 25 receiving the active compound and 25 receiving placebo. Mepivacaine (2%, 0.4 ml) or placebo was administered intraoperatively under the iris of the patients who experienced pain during the course of phacoemulsification in spite of previous topical anaesthesia. Efficacy was evaluated by the patients themselves using a five point subjective pain rating scale, the Keele verbal pain chart. Safety was measured by assessing intraocular inflammation (clinical evaluation and laser flare meter), intraocular pressure, and endothelial cell count.
RESULTS—The pain rating score significantly diminished after intracameral injection in the mepivacaine group (mean 3.0 (95% CI 2.6-3.4) v 0.8 (0.3-1.3), p<10−4)) while remaining unchanged in the placebo group (2.9 (2.6-3.2) v 2.9 (2.5-3.3)), the mean reduction in pain score being significantly different between the two groups (p<10−4). There was no indication of increased postoperative ocular inflammation, intraocular pressure change, or endothelial cell loss.
CONCLUSIONS—These results suggest that it may not be necessary to systematically add intracameral anaesthesia with topical anaesthesia for cataract surgery. An intraoperative intracameral injection, performed only in patients who happen to suffer during surgery, is safe and effective.

 PMID:10655193

  18. Corneal mucus plaques.

    Science.gov (United States)

    Fraunfelder, F T; Wright, P; Tripathi, R C

    1977-02-01

    Corneal mucus plaques adhered to the anterior corneal surface in 17 of 67 advanced cases of keratoconjunctivitis sicca. The plaques were translucent to opaque and varied in size and shape, from multiple isolated islands to bizarre patterns involving more than half the corneal surface. Ultrastructurally, they consisted of mucus mixed with desquamated degenerating epithelial cells and proteinaceous and lipoidal material. The condition may be symptomatic but can be controlled and prevented in most cases by topical ocular application of 10% acetylcysteine.

  19. Influence of the combined surgery of phacoemulsification and intraocular lens implantation through different incisions on tear film stability%不同切口方式白内障超声乳化联合人工晶状体植入术后泪膜稳定性研究

    Institute of Scientific and Technical Information of China (English)

    刘湘萍; 刘向东

    2012-01-01

    目的 观察两种不同切口晶状体超声乳化联合人工晶状体植入术后泪膜稳定性的变化.方法 选择术前无干眼症老年性白内障74例(74眼),随机分组:A组37例行角膜缘切口超声乳化联合人工晶状体植入术;B组37例行透明角膜切口超声乳化联合人工晶状体植入术.观察分析术前、术后1d、7d、14 d、30 d、90 d的干眼自觉症状、基础泪液分泌试验(SIt)、泪膜破裂时间(BUT)和角膜荧光素染色情况.结果 两组术后干眼自觉症状评分增大、基础泪液分泌量升高、泪膜破裂时间缩短、角膜荧光素染色明显增加,与术前比较差异有统计学意义(P<0.05);术后组间比较差异也有统计学意义(P<0.05).结论 晶状体超声乳化联合人工晶状体植入术对泪膜稳定性有影响,相对于角巩膜缘切口,透明角膜切口超声乳化联合人工晶状体植入术术后短期泪膜稳定性差.%Objective To explore the changes of tear film after the combined surgery of phacoemulsification and intraocular lens (IOL) implantation through two different incisions.Methods Preoperatively,74 age-related cataract cases (74 eyes) without dry eye syndrome were randomly divided into two groups.Thirty-seven eyes of 37 cases were enrolled in group A,they were treated with corneoscleral incision,and 37 cases (37 eyes) in group B treated with clear corneal incision.Subjective score for dryness,Schirmer I test(SIt),tear film break-up time (BUT) and corneal fluorescein staining were evaluated preoperatively and 1,7,14,30 and 90 days postoperatively.Results Decline of BUT and increase of SIt,corneal fluorescein staining and subjective score for dryness were observed postoperatively,which showed statistically significant difference when compared with the preoperative (P < 0.05),and there was significant difference between two groups after surgery (P < 0.05).Conclusion The short-term stability of tear film was worse after the combined

  20. Characterization of Corneal Indentation Hysteresis.

    Science.gov (United States)

    Ko, Match W L; Dongming Wei; Leung, Christopher K S

    2015-01-01

    Corneal indentation is adapted for the design and development of a characterization method for corneal hysteresis behavior - Corneal Indentation Hysteresis (CIH). Fourteen porcine eyes were tested using the corneal indentation method. The CIH measured in enucleated porcine eyes showed indentation rate and intraocular pressure (IOP) dependences. The CIH increased with indentation rate at lower IOP ( 25 mmHg). The CIH was linear proportional to the IOP within an individual eye. The CIH was positively correlated with the IOP, corneal in-plane tensile stress and corneal tangent modulus (E). A new method based on corneal indentation for the measurement of Corneal Indentation Hysteresis in vivo is developed. To our knowledge, this is the first study to introduce the corneal indentation hysteresis and correlate the corneal indentation hysteresis and corneal tangent modulus.

  1. Pars Plana Vitrectomy and Intravitreal Phacoemulsification for Dropped Nuclei

    Directory of Open Access Journals (Sweden)

    Khalil Ghasemi Falavarjani

    2012-01-01

    Full Text Available Purpose: To report the outcomes of pars plana vitrectomy (PPV and intravitreal phacoemulsification in patients with dropped nuclei/nuclear fragments following complicated cataract surgery. Methods: In this retrospective case series, charts of patients who had undergone PPV and intravitreal phacoemulsification for removal of dislocated nuclei/lens fragments were reviewed. After standard PPV, a conventional phacoemulsification probe with an amputated sleeve was used for grasping and emulsifying the nucleus/nuclear fragments in mid/anterior vitreous cavity. Pre- and postoperative visual acuity, and intra- and postoperative complications were recorded. Results: A total of 22 patients with mean age of 71.1΁8.2 years were studied. Mean interval between complicated cataract surgery and PPV was 26.6΁36.5 (range: 0-120 days. Patients were followed for a mean of 105.5΁57.5 days. Preoperatively, best corrected visual acuity was 2.4΁0.6 logMAR which was improved to 1.4΁0.6 logMAR at final follow-up (P<0.001. Intraoperative complications included iatrogenic peripheral retinal breaks in three eyes. Postoperative complications consisted of epiretinal membrane formation in one eye, hypotony in one eye, and medically-controlled glaucoma in 2 eyes. Conclusion: In this series, PPV and intravitreal phacoemulsification using a conventional phacoemulsification probe in patients with dropped nuclei/nuclear fragments following complicated cataract surgery resulted in visual improvement without any complications directly attributable to the probe.

  2. Comparação entre a dor provocada pela facoemulsificação com anestesia tópica e a pela infiltração peribulbar sem sedação Comparison between the pain induced by phacoemulsification with topical anesthesia and by peribulbar anesthesia without sedation

    Directory of Open Access Journals (Sweden)

    Roberto Pinto Coelho

    2005-02-01

    patients. The same surgeon performed peribulbar infiltrations and surgeries. The phacoemulsifications were done using clear corneal approach followed by in-the-bag intraocular lens implantation. Pain comparison between the two groups was performed by the non-parametrical U Mann-Whitney test. RESULTS: The distribution of the pain scores of the patients who underwent cataract extraction with topical anesthesia ranged from 0 to 5 (median value = 2. The scores of the patients who underwent peribulbar infiltration ranged from 0 to 7 (median value = 3. The mean rank of the group of patients who had surgery with topical anesthesia (15.78 was significantly different from the mean rank of the patients who received peribulbar anesthesia (25.98 (p=0.0057. CONCLUSION: Without sedation, the pain induced by phacoemulsification with topical anesthesia was milder than the pain induced by peribulbar infiltration.

  3. 超声乳化术不同切口对白内障患者泪膜稳定性的影响%Effects of different phacoemulsification incisions on the tear film stability

    Institute of Scientific and Technical Information of China (English)

    孟逸芳

    2016-01-01

    目的:观察超声乳化手术不同切口对白内障患者泪膜稳定性的影响。  方法:随机抽取2014-01/2015-09我院行白内障超声乳化手术的患者108例144眼,分成两组:A 组行透明角膜切口(52例74眼);B 组行巩膜隧道切口(56例70眼)。两组患者保持相同的切口宽度。观察手术前1d,手术后1d,1、3wk,1、3mo 眼部情况,记录患者干眼症状和泪膜破裂时间(break-up time,BUT)。  结果:白内障患者在进行超声乳化手术后1d、1wk,A 组干眼症状评分要小于 B 组,差异有显著统计学意义( t =-6.199、-2.871,P0.05);术后1d、术后1wk、术后3wk B 组的 BUT 较 A 组长,对比有统计学差异(t =-3.718、-2.342、-2.506,P0.05)。  结论:白内障超声乳化手术的两种不同切口对泪膜稳定性的影响仅在术后短期内存在差异;而术后1mo 后无明显差异。另外行透明角膜切口对泪膜稳定性的影响要大于行巩膜隧道切口,但干眼症状评分要明显小于行巩膜隧道切口。%AIM: To investigate the effects of different phacoemulsification incision for tear film stability in cataract patients. METHODS: From January 2014 to September 2015, 108 patients (144 eyes) who underwent cataract surgery were divided into two groups: group A with clear corneal incision ( 52 cases with 74 eyes), group B with scleral tunnel incision (56 cases with 70 eye). Two groups of patients were taken the same incision width. Symptoms of dry eye and tear film break - up time ( BUT) were observed 1d before and 1d, 1, 3wk, 1 and 3mo postoperatively. RESULTS:After performing cataract phacoemulsification 1d, 1wk, symptoms score of dry eye of group A was less than that of group B, the difference was statistically significant (t = -6. 199, -2. 871, P0. 05); at postoperative 1d, 1 and 3wk, BUT of group B was better than those of group A, there were a statistically significant differences ( t = - 3. 718, -2. 342,-2. 506, P0. 05).CONCLUSION

  4. Current status of corneal xenotransplantation.

    Science.gov (United States)

    Kim, Mee Kum; Hara, Hidetaka

    2015-11-01

    Corneal allo-transplantation is a well-established technique to treat corneal blindness. However, the limited availability of human donors demands the exploration of alternative treatments such as corneal xenotransplantation (e.g., pigs as donors) and bioengineered corneas. Since the first attempt of corneal xenotransplantation using a donor pig cornea in 1844, great advances have been made in the development of genetically-engineered pigs, effective immunosuppressive protocols and the establishment of guidelines for the conduction of clinical trials. We highlight immunological and physio-anatomical barriers of corneal xenotransplantation, recent progress of corneal xenotransplantation in non-human-primates studies, and regulatory guidelines to conduct clinical trials for corneal xenotransplantation.

  5. 白内障小瞳孔下超声乳化联合人工晶状体植入%The effect of phacoemulsification through a small pupil and intraocular lens implantation

    Institute of Scientific and Technical Information of China (English)

    郭哲锋; 原文新; 潘秀红

    2013-01-01

    Objective To observe the clinical effect of phacoemulsification through a small pupil and intraocular lens implantation.Methods Forty-two eyes of 38 patients accept phacoemulsification with intraocular lens implantation in treatment of small pupil cataract patients.Among them,14 eyes with posterior synechia after glaucoma surgery,6 eyes with small pupil caused by trauma,4 eyes without complications (All of the patients age≥71).After glaucoma surgery by using foldable IOL implantation with clear corneal incision,26 eyes implanted heparin surface modified intraocular lens with straight scleral tunnel incision,other 2 eyes implanted foldable lens.Postoperative follow-up 1-3months.Results The number of the preoperative uncorrected visual acuity (UCVA) or best-corrected visual acuity (BCVA) ≤ 0.3,Postoperativerly,the UCVA or BCVA ≥0.6 after the first week and first monthe were achieved in 31 eyes(73.8%)and 34 eyes(81.0%) >0.8 were achieved in 19 eyes(45.2%) after the first week.the pupil nearly circular or oval were achieved in 36 eyes,irregular pupil were achieved in 6 eyes.Part of the patient's pupil is larger in diameter than the preoperative.Conclusion The operation of phacoemulsification through a small pupil and intraocular lens implantation is complicated,prevention and treatment of the complications is very important.%目的 观察白内障在小瞳孔下超声乳化联合人工晶状体植入术的临床疗效.方法 采用超声乳化白内障摘出联合人工晶状体植入术治疗小瞳孔白内障38例(42眼).青光眼术后虹膜后粘连14眼,陈旧性虹膜炎虹膜后粘连18眼,外伤导致瞳孔不能散大6眼,无外伤或虹膜粘连瞳孔不能散大者4眼(均≥71岁).青光眼术后者采用透明角膜切口植入折叠人工晶状体,26眼采用巩膜隧道切口植入肝素表面处理的硬质人工晶状体,其余2眼也植入折叠人工晶状体.术后随访1~3个月.结果 术前裸眼视力或矫正视力均≤0.3,

  6. Corneal blindness and xenotransplantation.

    Science.gov (United States)

    Lamm, Vladimir; Hara, Hidetaka; Mammen, Alex; Dhaliwal, Deepinder; Cooper, David K C

    2014-01-01

    Approximately 39 million people are blind worldwide, with an estimated 285 million visually impaired. The developing world shoulders 90% of the world's blindness, with 80% of causative diseases being preventable or treatable. Blindness has a major detrimental impact on the patient, community, and healthcare spending. Corneal diseases are significant causes of blindness, affecting at least 4 million people worldwide. The prevalence of corneal disease varies between parts of the world. Trachoma, for instance, is the second leading cause of blindness in Africa, after cataracts, but is rarely found today in developed nations. When preventive strategies have failed, corneal transplantation is the most effective treatment for advanced corneal disease. The major surgical techniques for corneal transplantation include penetrating keratoplasty (PK), anterior lamellar keratoplasty, and endothelial keratoplasty (EK). Indications for corneal transplantation vary between countries, with Fuchs' dystrophy being the leading indication in the USA and keratoconus in Australia. With the exception of the USA, where EK will soon overtake PK as the most common surgical procedure, PK is the overwhelming procedure of choice. Success using corneal grafts in developing nations, such as Nepal, demonstrates the feasibility of corneal transplantation on a global scale. The number of suitable corneas from deceased human donors that becomes available will never be sufficient, and so research into various alternatives, for example stem cells, amniotic membrane transplantation, synthetic and biosynthetic corneas, and xenotransplantation, is progressing. While each of these has potential, we suggest that xenotransplantation holds the greatest potential for a corneal replacement. With the increasing availability of genetically engineered pigs, pig corneas may alleviate the global shortage of corneas in the near future.

  7. DEPLOYMENT OF SIX SIGMA METHODOLOGY IN PHACOEMULSIFICATION CATARACT SURGERY

    Directory of Open Access Journals (Sweden)

    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.

  8. New phacoemulsification tip with a grooved, threaded-tip construction.

    Science.gov (United States)

    Watanabe, Akinari

    2011-07-01

    To visually compare ultrasonic tip vibrations between a phaco tip with internal grooves (threaded tip) and a standard phaco tip during continuous-mode ultrasound (US) using ultra-high-speed digital video imaging. Watanabe Eye Clinic, Hyogo, Japan. Experimental study. The threaded tip was constructed by creating grooves inside a standard phaco tip using a screw. An ultra-high-speed digital video camera was used to record the image during continuous-mode US. Samples used in the test chamber during phacoemulsification included a piece of chestnut as a representative human lens sample and actual human lens fragments. Ultra-high-speed digital images showed that the threaded tip created a larger amount of cavitation than the standard phaco tip during US oscillation. Phacoemulsification of the sample using the standard phaco tip produced a chattering motion, making it difficult to maintain a steady tip position. The threaded tip produced little chattering motion, making it relatively easy to maintain a steady tip position. Once a piece of sample was gripped by the threaded tip, it was shaved and aspirated into the threaded tip without chattering motion. The mean effective phacoemulsification time (EPT) of the threaded tip was significantly shorter than that of the normal phaco tip (6.0 seconds ± 1.9 [SD] versus 15.4 ± 1.3 seconds; P=.002). The threaded tip created larger amounts of cavitation and had strong destructive and holding power. This threaded construction is simple to produce and appears to be very effective for phacoemulsification. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Viral contamination during sequential phacoemulsification surgeries in an experimental model

    Directory of Open Access Journals (Sweden)

    Roberto Pinto Coelho

    2012-06-01

    Full Text Available PURPOSE: To determine the incidence of Piry virus contamination among surgical instruments used with disposable accessories for phacoemulsification during sequential surgeries. METHODS: An experimental model was created with 4 pigs' eyes that were contaminated with Piry virus and 4 pigs' eyes that were not contaminated. Phacoemulsification was performed on the eyes, alternating between the contaminated and non-contaminated eyes. From one surgery to another, the operating fields, gloves, scalpel, tweezers, needles, syringes, tips and bag collector from the phacoemulsification machine were exchanged; only the hand piece and the irrigation and aspiration systems were maintained. RESULTS: In the collector bag, three samples from the contaminated eyes (3/4 were positive, and two samples from the non-contaminated (2/4 eyes were also positive; at the tip, one sample from the contaminated eyes (1/4 and two samples of the non-contaminated eyes (2/4 yielded positive results. In the irrigation system, one sample from a non-contaminated eye (1/4 was positive, and in the aspiration system, two samples from contaminated eyes (2/4 and two samples from non-contaminated eyes (2/4 were positive. In the gloves, the samples were positive in two samples from the non-contaminated eyes (2/4 and in two samples from the contaminated eyes (2/4. In the scalpel samples, three contaminated eyes (3/4 and none of the non-contaminated eyes (0/4 were positive; finally, two samples from the anterior chambers of the non-contaminated eyes gathered after surgery were positive. CONCLUSIONS: In two non-contaminated eyes, the presence of genetic material was detected after phacoemulsification surgery, demonstrating that the transmission of the genetic material of the Piry virus occurred at some point during the surgery on these non-contaminated eyes when the hand piece and irrigation and aspiration systems were reused between surgeries.

  10. Phacoemulsification in hard cataracts: the "chop, trip and free" technique

    OpenAIRE

    José Marcos S. Gonçalves

    2004-01-01

    Very hard cataracts continue to be a challenge to phacoemulsification due to the difficulty in breaking the nucleus and also in separating the broken nucleus from the adjacent epinucleus. The present technique is the presentation of a surgical maneuver which uses the Nagahara chopper and the phaco tip to divide the nucleus (including the epinucleus) as a whole and then emulsify it using little time and not very much phaco power.

  11. Foveal thickness after phacoemulsification as measured by optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Gerasimos Th Georgopoulos

    2008-08-01

    Full Text Available Gerasimos Th Georgopoulos, Dimitrios Papaconstantinou, Maria Niskopoulou, Marilita Moschos, Ilias Georgalas, Chrysanthi KoutsandreaGlaucoma Department, Medical School, Athens University, Athens, GreeceBackground: Despite a significant body of research, no consistency on postoperative foveal thickness as measured by optical coherence tomography (OCT, can be recorded. The purpose of our study was to evaluate the effect of uncomplicated cataract surgery in the thickness of the retina in the foveal area during the early postoperative period.Methods: In a prospective study, 79 eyes were assessed by OCT, on day 1, and weeks 2 and 4 after uncomplicated phacoemulsification with intraocular lens implantation in the Athens University Clinic. The outcome measure was the thickness of the retina in the foveal area.Results: The thickness of the retina preoperatively is significantly smaller (150.4 ± 18.8 (p < 0.05 than the thickness of the retina on day 1 (171.8 ± 21 and week 2 (159.7 ± 19 and returned to the initial levels on week 4 (152 ± 17.1. The estimated correlation coefficients between preoperative and postoperative thickness of the retina were significant (p < 0.05. Conversely, no association was found between postoperative visual acuity and thickness of the retina, neither between the phacoemulsification energy and retinal thickness. Operation time, although inversely related with postoperative visual acuity, was not associated with the thickness of the retina.Conclusions: Following phacoemulsification, an increase in the foveal thickness was detected in the early postoperative period, quantified and followed up by OCT. The foveal thickness returned to the preoperative level, 1 month following surgery in our study. No association was shown between intraoperative parameters and increased postoperative retinal thickness.Keywords: optical coherence tomography, phacoemulsification, retinal thickness

  12. Peripheral radial chop technique for phacoemulsification of hard cataracts

    Institute of Scientific and Technical Information of China (English)

    LI Shao-wei; XIE Li-xin; SONG Zhen-hua; MENG Li; JIANG Jian

    2007-01-01

    Background Phacoemulsification yields successful outcomes in eyes with standard cataract. Though techniques have been improved, it is still challenging to perform phacoemulsification in cases of hard cataracts for difficulty in nuclear management and much more complications. This study aimed at describing and evaluating the efficacy and safety of a peripheral radial chop technique to remove hard cataracts.Methods In this prospective study conducted between January 2003 and January 2004, 107 consecutive eyes with hard cataract underwent modified phacoemulsification surgery with peripheral radial chop technique by the Bausch & Lomb Millennium phacoemulsifier with preset parameters of power less than 30%; vaccum, 150 mmHg; and bottle height,85 cm when a DP8145 phaco tip was used, and vaccum, 380 mmHg; bottle height, 95 cm when a DP8245 phaco tip was used.Results The mean ultrasonic power was 14.7% (range 9% to 19%), ultrasonic time was 1.98 minutes (range 1.55 to 3.18 minutes). At 1, 7 and 30 days postoperatively, the eyes with uncorrected visual acuity 0.5 or better accounted for 76.42%, 87.16% and 90.67% respectively. At 1 month, the endothelial cell loss rate was 9.74% (range 8% to 17%). There were 6 cases of posterior capsule rupture in an early period of study. No serious intraoperative or postoperative complications were noted.Conclusions The peripheral radial chop technique was effective without serious complications in hands of an experienced surgeon.

  13. [Improvement of Phaco Tip Geometry During Torsional Phacoemulsification].

    Science.gov (United States)

    Vetter, Jan Markus; Wirbelauer, Christopher

    2017-06-09

    Background Advanced cataract with hard lens nuclei frequently challenge the ophthalmologic surgeon when doing phacoemulsification. In the present study, we examined the effect of a new phaco tip design during cataract surgery. Patients and Methods 100 patients were assigned to two groups. In group 1 (50 patients), the Kelman(®) tip design (Alcon) was used during phacoemulsification, while in group 2 (50 patients), the Intrepid(®) Balanced Tip was applied. Trypan blue was used in both groups, if necessary, to stain the anterior lens capsule prior to capsulorhexis. Results Preoperative visual acuity was 0.11 ± 0,16 (decimal equivalent; means ± standard deviation) in the Kelman tip group and 0.10 ± 0.14 in the Intrepid Balanced Tip group (p > 0,05). Applied cumulative displaced energy was 43.38 ± 21.84 s% in the Kelman tip group and 21.55 ± 13.25 s% in the Intrepid Balanced Tip group (p phaco tip design has led to a significant reduction in ultrasound energy required to successfully perform phacoemulsification in medium to hard lenses. Georg Thieme Verlag KG Stuttgart · New York.

  14. Peripheral radial chop technique for phacoemulsification of hard cataracts.

    Science.gov (United States)

    Li, Shao-wei; Xie, Li-xin; Song, Zhen-hua; Meng, Li; Jiang, Jian

    2007-02-20

    Phacoemulsification yields successful outcomes in eyes with standard cataract. Though techniques have been improved, it is still challenging to perform phacoemulsification in cases of hard cataracts for difficulty in nuclear management and much more complications. This study aimed at describing and evaluating the efficacy and safety of a peripheral radial chop technique to remove hard cataracts. In this prospective study conducted between January 2003 and January 2004, 107 consecutive eyes with hard cataract underwent modified phacoemulsification surgery with peripheral radial chop technique by the Bausch & Lomb Millennium phacoemulsifier with preset parameters of power less than 30%; vaccum, 150 mmHg; and bottle height, 85 cm when a DP8145 phaco tip was used, and vaccum, 380 mmHg; bottle height, 95 cm when a DP8245 phaco tip was used. The mean ultrasonic power was 14.7% (range 9% to 19%), ultrasonic time was 1.98 minutes (range 1.55 to 3.18 minutes). At 1, 7 and 30 days postoperatively, the eyes with uncorrected visual acuity 0.5 or better accounted for 76.42%, 87.16% and 90.67% respectively. At 1 month, the endothelial cell loss rate was 9.74% (range 8% to 17%). There were 6 cases of posterior capsule rupture in an early period of study. No serious intraoperative or postoperative complications were noted. The peripheral radial chop technique was effective without serious complications in hands of an experienced surgeon.

  15. Clinical observation of torsional phacoemulsification for a beginner

    Directory of Open Access Journals (Sweden)

    Qiong Lei

    2013-09-01

    Full Text Available AIM: To observe the clinical security of torsional phacoemulsification for a beginner.METHODS: The clinical data of 200 eyes who accepted torsional phacoemulsification by a beginner from February 2012 to March 2013 were reviewed. The operation complications were analyzed and the postoperative effect was assessed.RESULTS: There was no collapse of the anterior chamber during operation. When the last nuclear was removed the surge occurred mildly. Posterior capsular rupture happened in 8 eyes, 5 eyes' intraocular lens#IOL#implanted in sclera sulcus after anterior vitrectomy, 3 eyes' IOL in bag without vitreous outflow. One eye without continuous curvilinear capsulotomy was transferred to the superior doctor for extracapsular cataract extraction#ECCE#. One eye with the loose zonular fiber was implanted a capsular tension ring by the superior doctor. Seven cases need suture because of short sclera tunnel incisions. Uncorrected visual acuity a week after operation: 2 eyes#1%#CONCLUSION: The technique of torsional phacoemulsification is safe and effective for a beginner.

  16. Refractive corneal surgery - discharge

    Science.gov (United States)

    Nearsightedness surgery - discharge; Refractive surgery - discharge; LASIK - discharge; PRK - discharge ... You had refractive corneal surgery to help improve your vision. This surgery uses a laser to reshape your cornea. It corrects mild-to-moderate nearsightedness, ...

  17. Equine corneal surgery and transplantation.

    Science.gov (United States)

    Denis, Heidi M

    2004-08-01

    Corneal disease is common in equine ophthalmology and requires vigilant monitoring and appropriate therapy to optimize the outcome. Many equine corneal diseases, particularly those that progress rapidly, may benefit from surgical intervention. These include descemetoceles, deep corneal lacerations and ulcers, corneal perforation/iris prolapse, ulcerative keratitis, corneal stromal abscesses, and corneoscleral neoplasia. Indications for corneal transplantation include optical, tectonic, therapeutic, and cosmetic purposes. Corneal transplantation is most often implemented in equine patients for tectonic and therapeutic reasons when a cornea is compromised by corneal stromal abscess, iris prolapse, or neoplasia. This article provides an outline of when to consider surgical intervention for corneal disease, the procedures available and expected outcomes, and how appropriate early surgical intervention can dramatically improve the end result.

  18. Corneal Viscoelastic Properties from Finite-Element Analysis of In Vivo Air-Puff Deformation

    Science.gov (United States)

    Kling, Sabine; Bekesi, Nandor; Dorronsoro, Carlos; Pascual, Daniel; Marcos, Susana

    2014-01-01

    Biomechanical properties are an excellent health marker of biological tissues, however they are challenging to be measured in-vivo. Non-invasive approaches to assess tissue biomechanics have been suggested, but there is a clear need for more accurate techniques for diagnosis, surgical guidance and treatment evaluation. Recently air-puff systems have been developed to study the dynamic tissue response, nevertheless the experimental geometrical observations lack from an analysis that addresses specifically the inherent dynamic properties. In this study a viscoelastic finite element model was built that predicts the experimental corneal deformation response to an air-puff for different conditions. A sensitivity analysis reveals significant contributions to corneal deformation of intraocular pressure and corneal thickness, besides corneal biomechanical properties. The results show the capability of dynamic imaging to reveal inherent biomechanical properties in vivo. Estimates of corneal biomechanical parameters will contribute to the basic understanding of corneal structure, shape and integrity and increase the predictability of corneal surgery. PMID:25121496

  19. Central corneal abscess.

    Science.gov (United States)

    van Bijsterveld, O P

    1976-05-01

    Central corneal abscess developed in the experimental animal after inoculation of biologically active staphylococcal strains in a paracentral epithelial lesion of the cornea. These abscesses did not ulcerate, developed only with high inocula, occurred more frequently in immunized rabbits. A serpiginous type of ulceration did not develop at the site of the initial epithelial lesion nor at any other place in the cornea. Histologically, the lesions consisted of densely packed polymorphonuclear leukocytes between the corneal lamellae.

  20. Effects of diabetic keratopathy on corneal optical density, central corneal thickness, and corneal endothelial cell counts.

    Science.gov (United States)

    Gao, Feng; Lin, Tao; Pan, Yingzhe

    2016-09-01

    Diabetic keratopathy is an ocular complication that occurs with diabetes. In the present study, the effect of diabetic keratopathy on corneal optical density, central corneal thickness, and corneal endothelial cell count was investigated. One hundred and eighty diabetic patients (360 eyes) were enrolled in the study during the period from March, 2012 to March, 2013. The patients were divided into three age groups: 10 years, with 60 patients per group (120 eyes). During the same period, 60 healthy cases (120 eyes) were selected and labeled as the normal control group. The Pentacam was used to measure the corneal optical density, and central corneal thickness. Specular microscopy was used to examine the corneal endothelial cell density. The coefficient of partial correlation was used to control age and correlate the analysis between the corneal optical density, corneal endothelial cell density, and central corneal thickness. The stage of the disease, the medial and intimal corneal optical density and central corneal thickness was analyzed in the diabetes group. The corneal optical density in the diabetes group increased compared with that of the normal control group. The medial and intimal corneal optical density and central corneal thickness were positively correlated with the course of the disease. However, the corneal endothelial cell density was not associated with the course of diabetes. There was a positive association between the medial and intimal corneal optical density and central corneal thickness of the diabetic patients. In conclusion, the results of the present study show that medial and intimal corneal optical density and central corneal thickness were sensitive indicators for early diabetic keratopathy.

  1. Double fluid pump system in phacoemulsification for hard nuclear cataract%双泵液流系统在硬核超声乳化手术中的应用

    Institute of Scientific and Technical Information of China (English)

    夏建平; 张繁友; 祁媛媛; 崔明月; 陈丽娜; 徐东风

    2014-01-01

    目的 探讨双泵液流系统在硬核超声乳化手术中的临床效果.方法 对116例(116眼)Ⅳ~Ⅴ级硬核白内障手术中应用双泵套包系统完成超声乳化,蠕动泵模式下超声乳化,文氏泵模式下注吸,植入折叠人工晶状体.观察手术时间及术后并发症.结果 双泵液流系统的应用明显缩短硬核超声乳化手术时间,手术时间3 min20s~5 min56s,人工晶状体植入率100%,术后角膜内皮水肿者占15%,3d内完全消退,房水闪光轻度,3d内房水清澈.结论 在硬核白内障的超声乳化手术中应用双泵液流系统减少角膜内皮的热损伤,减轻硬核超声乳化术后并发症,是一种高频率、高质量的超声乳化手术的应用方法.%Objective To explore the clinical efficacy of double fluid pump system in phacoemulsification for hard nuclear cataract.Methods 116 eyes of 116 cases of cataract with grade Ⅳ or Ⅴ hard nuclei were treated by phacoemulsification combined with intraocular lens implantation under double fluid pump system.The phacoemulsification was performed with peristaltic pump,and irrigation and aspiration was done with Venturi pump.The operational duration and postoperative complications were observed.Results With double fluid pump system,the average operational duration was from 3min and 20s to 5min and 56s,which was shorter than the traditional phacoemulsification.The rate of intraocular lens implantation was 100%.There were 15% patients with corneal endothelial edema after the surgery,which disappeared within 3 days.The slight aqueous flare was disappeared within 3 days.Conclusion Phacoemulsification for hard nuclear cataract with double fluid pump system is a high-efficiency and high-quality method,which can decrease the thermal damage to the corneal endothelia and reduce postoperative complications.

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

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit;

    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....

  3. A corneal mold to restore normal corneal dimensions.

    Science.gov (United States)

    Swinger, C A; Kornmehl, E W; York, S; Forman, J S

    1986-01-01

    A corneal mold is described that provides an MK corneal button of normal thickness and curvature from an edematous, post-mortem button. The uniform, processed tissue can then be used for experimental refractive surgery.

  4. Corneal Topography Analysis of Stromal Corneal Dystrophies

    OpenAIRE

    Kocluk, Yusuf; Yalniz-Akkaya, Zuleyha; Burcu, Ayse; Ornek, Firdevs

    2015-01-01

    Objective: The aim was to compare the corneal topography and tomography parameters of macular corneal dystrophy (MCD), granular corneal dystrophy (GCD) and lattice corneal dystrophy (LCD) patients obtained by Scheimpflug imaging system. Methods: The charts, photographs and topography images of patients were reviewed retrospectively. This study included 73 eyes of 73 patients (28 MCD, 20 GCG and 25 LCD patients). Topography images were obtained by Pentacam (Oculus Optikgerate, Wetzlar, Germany...

  5. Ocular hypertension after intravitreal triamcinolone with vitrectomy and phacoemulsification

    Directory of Open Access Journals (Sweden)

    Parke III DW

    2012-06-01

    Full Text Available D Wilkin Parke III, Robert A Sisk, Samuel K Houston, Timothy G MurrayDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USAObjective: To evaluate the effect of adjunctive intravitreal triamcinolone (IVTA on intraocular pressure (IOP in the setting of combined vitrectomy with phacoemulsification.Design: Retrospective case series.Participants: One hundred thirty-one consecutive eyes undergoing nonemergent vitrectomy with phacoemulsification and IVTA were reviewed and included in the analysis. All 131 eyes received 4 mg IVTA at the end of surgery.Methods: Pre- and postoperative IOP, use of pressure-lowering medications, and rate of glaucoma surgery were analyzed. Pre-operative risk factors were analyzed.Main outcome measures: IOP, glaucoma medications, or glaucoma surgery.Results: Secondary ocular hypertension (defined as IOP ≥25 mmHg was found in 28 eyes (21%, the majority during postoperative day 1 only. Twelve eyes (9% had an elevated IOP measurement noted at a visit after the first postoperative day. Five (4% had an IOP rise of ≥10 mmHg over baseline at any time after postoperative day 1. Six (5% required glaucoma medications. One eye required a glaucoma drainage implant for diabetic neovascular angle closure glaucoma, and one eye required enucleation for intractable neovascular glaucoma due to radiation retinopathy. Elevated postoperative IOP was statistically associated with higher baseline IOP and presence of preoperative glaucoma.Conclusions: Therapeutic intravitreal triamcinolone with combined vitrectomy and phacoemulsification causes infrequent and usually mild secondary ocular hypertension. Secondary ocular hypertension is associated with preoperative glaucoma and high IOP.Keywords: glaucoma, cataract, inflammation

  6. Determining the local origin of hydroxyl radical generation during phacoemulsification.

    Science.gov (United States)

    Aust, Steven D; Terry, Scott; Hebdon, Thomas; Gunderson, Broc; Terry, Michael; Dimalanta, Ramon

    2011-06-01

    To determine the local origin of hydroxyl radicals during phacoemulsification using an ultrasonic phacoemulsification device that includes longitudinal and torsional modalities. Chemistry and Biochemistry Department, Utah State University, Logan, Utah, USA. Experimental study. Experiments were conducted using the Infiniti Vision System and Ozil handpiece. Hydroxyl radical concentrations during longitudinal and torsional phacoemulsification were quantitated as malondialdehyde (MDA) determined spectrophotometrically using the deoxyribose assay. The difference between the total concentration found in the aspirated solution at steady-state concentrations and the pre-aspirate levels deductively determined the concentration of MDA formed along the interior of the sonicating tip. The time to reach 50% of steady state as a function of reaction vessel volume was determined. The mean maximum for torsional ultrasound at 100% amplitude was 7.70 nM ± 0.38 (SD), 91.1% of which was generated outside the tip. During longitudinal ultrasound at 100% power, MDA concentration in the aspirated solution was 29.5 ± 0.3 nM, 71.6% of which was generated outside the tip. The time (seconds) to reach 50% of maximum for longitudinal ultrasound using 5 mL, 10 mL, and 20 mL reaction vessels was 12.6 ± 1.5, 21.0 ± 1.5, and 25.3 ± 3.4, respectively. Although a significantly greater proportion of the hydroxyl radicals generated during ultrasound modality were formed outside the phaco tip (91.1% torsional; 71.6% longitudinal), torsional ultrasound generated only about one-fourth the amount of MDA as longitudinal ultrasound in total and about one-third that generated outside the tip (7.02 nM versus 21.1 nM). No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Bent versus straight tips in micropulsed longitudinal phacoemulsification.

    Science.gov (United States)

    Stagg, Brian C; Gupta, Isha; Cahoon, Judd; Ronquillo, Cecinio; Shi, Dallas; Zaugg, Brian; Gardiner, Gareth; Barlow, William R; Pettey, Jeff H; Aabid Farukhi, M; Jensen, Jason; Olson, Randall J

    2015-10-01

    The aim of this study was to evaluate bent and straight phacoemulsification tips to determine which tip is more efficient in removal of lens fragments, using micropulsed longitudinal ultrasound in phacoemulsification. In vitro laboratory study. The John A. Moran Eye Center Laboratories, University of Utah, Salt Lake City, Utah, was the study setting. Pig lenses hardened in a manner comparable with dense human cataracts were cut into 2-mm cubes and removed with micropulsed longitudinal ultrasound using settings previously shown to be optimally efficient (6 milliseconds on and 6 milliseconds off for a bent tip). To verify this time as most efficient for a straight tip, we also tested times of 5, 6, and 7 milliseconds time on and off. The tips were either straight or with a 20-degree bend. Twenty cubes were used for each comparative run. For the straight tip, 6 milliseconds on (1.56 ± 0.815 seconds) was significantly more efficient than 7 milliseconds on (2.45 ± 1.56 seconds, p = 0.001) and not significantly more efficient than 5 milliseconds on (1.69 ± 0.86 seconds, p = 0.43). Five milliseconds off time (1.45 ± 0.76s) was more efficient than 6 milliseconds (2.06 ± 1.37 seconds, p = 0.004) and 7 milliseconds off (2.18 ± 1.24s, p = 0.001). The straight tip was more efficient than the bent tip (1.38 ± 0.83 versus 2.93 ± 2.14 seconds, p = 0.006). Results are contrary to accepted common belief. Micropulsed longitudinal phacoemulsification is more efficient with a straight rather than a bent tip. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  8. A Case of Branch Retinal Artery Occlusion following Uneventful Phacoemulsification

    Directory of Open Access Journals (Sweden)

    Daniel Dragnev

    2013-03-01

    Full Text Available We would like to present a case of branch retinal artery occlusion following uneventful phacoemulsification, possibly caused by sub-Tenon's anaesthesia. There were no predisposing general health problems. There are two possible mechanisms: (1 mechanical effect of the bolus anaesthetic; (2 pharmacologically mediated changes in the vascular calibre. The latter mechanism is much more probable, because of the vasoconstrictive properties of both medications used. This is the first reported case of branch retinal artery occlusion after sub-Tenon's anaesthesia with preservative-free medications.

  9. Using corneal topography design personalized cataract surgery programs

    Directory of Open Access Journals (Sweden)

    Jin-Ou Huang

    2014-08-01

    Full Text Available AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment. METHODS: Totally 202 cases(226 eyescataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed. RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3.0mm sclera tunnel incision group there were no statistically significance difference. After 55.8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced. CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

  10. Persistent corneal edema secondary to presumed dead adult filarial worm in the anterior chamber

    Directory of Open Access Journals (Sweden)

    Basak Samar

    2007-01-01

    Full Text Available We present three cases of persistent corneal edema secondary to presumed dead adult filarial worms lying in the anterior chamber with their attachment to the endothelium. Two of them were initially diagnosed as descemet′s fold with corneal edema. Two patients underwent penetrating keratoplasty and in one case, surgical removal was partly possible with clearing of cornea.

  11. Corneal stroma microfibrils

    KAUST Repository

    Hanlon, Samuel D.

    2015-03-01

    Elastic tissue was first described well over a hundred years ago and has since been identified in nearly every part of the body. In this review, we examine elastic tissue in the corneal stroma with some mention of other ocular structures which have been more thoroughly described in the past. True elastic fibers consist of an elastin core surrounded by fibrillin microfibrils. However, the presence of elastin fibers is not a requirement and some elastic tissue is comprised of non-elastin-containing bundles of microfibrils. Fibers containing a higher relative amount of elastin are associated with greater elasticity and those without elastin, with structural support. Recently it has been shown that the microfibrils, not only serve mechanical roles, but are also involved in cell signaling through force transduction and the release of TGF-β. A well characterized example of elastin-free microfibril bundles (EFMBs) is found in the ciliary zonules which suspend the crystalline lens in the eye. Through contraction of the ciliary muscle they exert enough force to reshape the lens and thereby change its focal point. It is believed that the molecules comprising these fibers do not turn-over and yet retain their tensile strength for the life of the animal. The mechanical properties of the cornea (strength, elasticity, resiliency) would suggest that EFMBs are present there as well. However, many authors have reported that, although present during embryonic and early postnatal development, EFMBs are generally not present in adults. Serial-block-face imaging with a scanning electron microscope enabled 3D reconstruction of elements in murine corneas. Among these elements were found fibers that formed an extensive network throughout the cornea. In single sections these fibers appeared as electron dense patches. Transmission electron microscopy provided additional detail of these patches and showed them to be composed of fibrils (~10nm diameter). Immunogold evidence clearly

  12. Multi-dimension Aspiration Control Mode in Phacoemulsification

    Institute of Scientific and Technical Information of China (English)

    Xiangqun Wang; Mingguang He; Junwen Zeng

    2005-01-01

    Purpose: Multi-dimension aspiration control mode was put forward in this study.Accuracy of multi-dimension aspiration control model was compared to simple traditional pedal control model.Methods: Induced by high aspiration pressure (200~250 mmHg), hard nucleus (≥Grade Ⅲ ) of senile cataract was chopped before phacoemulsification in 170 patients (174 eyes). Ninety-one patients (94 eyes) accepted multi-dimension aspiration control model in which aspiration direction, distance and targets prevention were adjusted by phaco-tip besides traditional pedal control. Another 79 patients (80 eyes) were compared as reviewed group, aspiration of which was controlled simply by traditional pedal control. Postcapsular rupture rates (PCRR) were compared between two groups.Results: Multi-dimension control model could make the terminal effects cooperate with phacoemulsification more precisely and protect post capsular from damage (x2 =5.41, P < 0.02).Conclusion: Multi-dimension control model could improve the accuracy of aspiration effects and protect postcapsular from damage.

  13. Changes of Blood Aqueous Barrier after Phacoemulsification in Rabbits

    Institute of Scientific and Technical Information of China (English)

    Lixia Luo; Yizhi Liu; Xinyu Zhang; Yuhua Liu

    2003-01-01

    Purpose: To evaluate the function and the morphological changes of the blood aqueousbarrier (BAB) after phacoemulsification and to provide the physiological mechanism ofBAB dysfunction.Methods: Phacoemulsification was performed on 12 rabbit eyes. Aqueous humor wasabstracted and the concentrations of aqueous humor protein were examined preoperativelyand on postoperative days 1, 7, 14, 21, 30 with Lowry. After the iris and the ciliarybody were removed from the rabbit eyes, we selected lanthanum nitrate as a tracer,then ultrastructural changes of BAB were investigated with transmission electronmicroscopy.Results: Highly statistically significant differences (P < 0.05) were found betweenpreoperative aqueous humor protein concentration and those measured on days 1, 7, 14,2 1and 30 after surgery. Under transmission electron microscopy, a part of the endothelialcells and BAB damaged as shown by the leakage of lanthanum tracing into intravesselsthrough the broad space were observed.Conclusion: The results suggest that there is a blood aqueous barrier breakdown afterphacoemulsification. The morphological basis of BAB damage is the reversible opening oftight junctions between endothelial cells.

  14. Determining optimal ultrasound off time with micropulse longitudinal phacoemulsification.

    Science.gov (United States)

    Jensen, Jason D; Kirk, Kevin R; Gupta, Isha; Ronquillo, Cecinio; Farukhi, M Aabid; Stagg, Brian C; Pettey, Jeff H; Olson, Randall J

    2015-02-01

    To evaluate the optimum off time for the most efficient removal of lens fragments using micropulse ultrasound (US). John A. Moran Eye Center Laboratories, University of Utah, Salt Lake City, Utah, USA. Experimental study. Porcine lens nuclei were soaked in formalin for 2 hours and then cut into 2.0 mm cubes using the Signature US machine with a bent 0.9 mm phaco tip with a 30-degree bevel. The on time was 7 milliseconds (ms), and the off time was varied from 2 to 20 ms in 2 ms steps. Phacoemulsification efficiency (time for fragment removal) and chatter (number of times the fragment bounced from the tip) were measured. A nonsignificant linear increase in efficiency was observed with 2 to 6 ms of off time (R(2) = .87, P = .24). A significant linear decrease in efficiency was observed with 6 to 20 ms (R(2) = .74, P = .006). With micropulse longitudinal US, 6 to 7 ms of off time was as efficient as shorter off times; longer off times (8 to 20 ms) showed decreased efficiency. Chatter was minimal and statistically similar throughout. To maximize phacoemulsification US efficiency, an off-time setting of 6 ms is recommended. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  15. Phacoemulsification versus small incision cataract surgery in patients with uveitis

    Directory of Open Access Journals (Sweden)

    Rahul Bhargava

    2015-10-01

    Full Text Available AIM: To compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS in patients with uveitic cataract.METHODS:In aprospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI. A P value of <0.05 was considered statistically significant.RESULTS:One hundred and twenty-six of 139 patients (90.6% completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1 or inability implant an intraocular lens (IOL because of insufficient capsular support following posterior capsule rupture (n=5. There was significant improvement in vision after both the procedures (paired t-test; P<0.001. On first postoperative day, uncorrected distance visual acuity (UDVA was 20/63 or better in 31 (47% patients in Phaco group and 26 (43.3% patients in SICS group (P=0.384. The mean surgically induced astigmatism (SIA was 0.86±0.34 dioptres (D in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002. At 6mo, corrected distance visual acuity (CDVA

  16. A Rabbit Model Study to Determine the Efficacy of a Prototype Corneal Endothelium Protector during Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Annabel C. Y. Chew

    2017-01-01

    Full Text Available Purpose. We evaluated the efficacy and safety of a mechanical device, the P-chute, in corneal endothelium preservation during phacoemulsification in a rabbit model. Methods. Twenty-four rabbits were randomly assigned into 2 groups. One eye of each rabbit underwent phacoemulsification that simulated the removal of a dense nucleus, with or without the P-chute. Serial slit-lamp examinations, anterior segment optical coherence tomography (ASOCT scans, and specular microscopy were performed. Three rabbits from each group were sacrificed on postoperative days (PODs 1, 5, 7, and 14. Histological analysis of the corneas was performed. Results. There was a trend towards lesser endothelial cell loss for the P-chute group at POD1 (4.9% versus 12.5%, p=0.53, POD5 (10.4% versus 12.2%, p=0.77, and POD7 (10.5% versus 17.2%, p=0.52. There was no significant difference in the corneal thickness (p=>0.05 between the 2 groups. The insertion of the device was challenging. The use of the P-chute only added an extra 15% to the surgical time. Conclusions. There was a trend towards better endothelium preservation with the P-chute even though the results were not statistically significant. We believe that the device could be useful in certain surgical situations. Further work is needed to improve the device insertion.

  17. SURGICAL AND VISUAL OUTCOME OF PHACOEMULSIFICATION SURGERY (ROUTINE AND MICRO - PHACO (BIMANUAL PHACO: A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Sudha

    2015-03-01

    Full Text Available Cataract surgery has evolved over the past few decades with progressive decrease in the size of the incision. Originally from 12 mm intracapsular incision to bimanual phacoemulsification (Micro - Phaco that has incision size of just 700 microns. In the pres ent comparative PROSPECTIVE study best corrected visual acuity postoperatively and surgically induced astigmatism were compared in routine Phacoemulsification technique and bimanual phaco (Micro - Phaco 60 eyes were studied. There was no statistically signi ficant difference in postoperative best corrected visual acuity (BCVA of patients operated with Micro - Phaco or routine Phacoemulsification. There was difference in surgically induced astigmatism (SIA ; average SIA in microphaco was 0.5972 as against 0.832 8 in routine Phacoemulsification.

  18. Corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis

    Directory of Open Access Journals (Sweden)

    Li-Dong Yang

    2013-08-01

    Full Text Available AIM: To investigate the clinical effect of corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis.METHODS: There were 168 cases suffered keratomycosis that the focus located shallow of the cornea and was not obvious to drug, who registered in our hospital from March 2005 to June 2010. In surgery we removed plate layer to cormea clear, the region was greater than focus for 0.5mm,then we injected fluconazole which is 2g/L density in corneal stroma to make the edema area greater than Removal of area for 0.5mm. At last we took pedicle conjunctival flap to cover the plant bed by continuous suture. Postoperative day use drug to drop eye and to observe that whether recurrent of the keratomycosis and how was the edema degrade, the blood supply of conjunctival graft pieces, how about the stimulating signs of the surgery eye, the vision.RESULTS: The improvement rate was 96.2% after surgery for seven days and the cure rate was 95.5% after surgery for one months. We found in 157 eyes accepted trigeminy surgery there were 6 eyes recurrence and the recurrence rate was 3.8%. The mean time of corneal stromal edema faded away was 13.4 hours. After surgery for one month there were 39 eyes(24.8%whose vision removed than preoperative, there were 91 eyes(58.0%whose vision were same as preoperative and there were 27 eyes(17.2%whose vision lower than preoperative. In these operations the loss ratio of corneal endothelium was from 0%-8%, the mean was 2.9%. The irritative symptoms postoperative were mild for 87%, moderate for 10% and severe for 3%. By this surgery the mean length of stay was 7.3 days so the mean hospitalization expenses only were 2160 RMB. Three months after surgery, 4 cases were slight corneal ectasia.CONCLUSION: This operation combined corneal layer plate removal, Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis which was in

  19. Corneal Neurotoxicity Due to Topical Benzalkonium Chloride

    OpenAIRE

    Sarkar, Joy; Chaudhary, Shweta; Namavari, Abed; Ozturk, Okan; Chang, Jin-Hong; Yco, Lisette; Sonawane, Snehal; Khanolkar, Vishakha; Hallak, Joelle; Jain, Sandeep

    2012-01-01

    Topical application of benzalkonium chloride (BAK) to the eye causes dose-related corneal neurotoxicity. Corneal inflammation and reduction in aqueous tear production accompany neurotoxicity. Cessation of BAK treatment leads to recovery of corneal nerve density.

  20. Genetics of corneal endothelial dystrophies

    Indian Academy of Sciences (India)

    Chitra Kannabiran

    2009-12-01

    The corneal endothelium maintains the level of hydration in the cornea. Dysfunction of the endothelium results in excess accumulation of water in the corneal stroma, leading to swelling of the stroma and loss of transparency. There are four different corneal endothelial dystrophies that are hereditary, progressive, non-inflammatory disorders involving dysfunction of the corneal endothelium. Each of the endothelial dystrophies is genetically heterogeneous with different modes of transmission and/or different genes involved in each subtype. Genes responsible for disease have been identified for only a subset of corneal endothelial dystrophies. Knowledge of genes involved and their function in the corneal endothelium can aid understanding the pathogenesis of the disorder as well as reveal pathways that are important for normal functioning of the endothelium.

  1. Complication rates of phacoemulsification and manual small-incision cataract surgery at Aravind Eye Hospital.

    Science.gov (United States)

    Haripriya, Aravind; Chang, David F; Reena, Mascarenhas; Shekhar, Madhu

    2012-08-01

    To analyze the rate of intraoperative complications, reoperations, and endophthalmitis with phacoemulsification, manual small-incision cataract surgery (SICS), and large-incision extracapsular cataract extraction (ECCE). Aravind Eye Hospital, Madurai, India. Retrospective cohort study. This study comprised consecutive cataract surgeries performed during a 12-month period. All surgical complications and endophthalmitis cases were tabulated and analyzed for each of 4 surgeon groups (staff, fellows, residents, visiting trainees). Within each surgeon group, complication rates with phacoemulsification, manual SICS, and ECCE were compared. The surgical distribution was 20,438 (26%) phacoemulsification, 53,603 (67%) manual SICS, and 5736 (7%) ECCE. The overall intraoperative complication rate was 0.79% for staff, 1.19% for fellows, 2.06% for residents, and 5% for visiting trainees. Extracapsular cataract extraction had the highest overall rate of surgical complications (2.6%). The overall complication rate was 1.01% for manual SICS and 1.11% for phacoemulsification. However, the combined complication rate for trainees was significantly higher with phacoemulsification (4.8%) than with manual SICS (1.46%) (P<.001). The corrected distance visual acuity was better than 6/12 in 96% after phacoemulsification complications and 89% after manual SICS complications (P<.001). There were 27 cases (0.04%) of endophthalmitis but no statistical differences between surgical methods or surgeon groups. For staff surgeons experienced with both phacoemulsification and manual SICS, intraoperative complication rates were comparably low. However, for trainee surgeons, the complication rate was significantly higher with phacoemulsification, suggesting that manual SICS may be a safer initial procedure to learn for inexperienced cataract surgeons in the developing world. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS

  2. Corneal Asphericity and IOL Power Calculation in Eyes With Aspherical IOLs.

    Science.gov (United States)

    Savini, Giacomo; Hoffer, Kenneth J; Barboni, Piero; Schiano Lomoriello, Domenico; Ducoli, Pietro

    2017-07-01

    Given that a previous study found that corneal asphericity influences the refractive outcome of intraocular lens (IOL) power calculation by means of thin-lens formulas in eyes with spherical IOLs, the authors aimed to verify whether such influence can also be observed in eyes with aspherical IOLs. In this retrospective comparative case series, IOL power was calculated with the Haigis, Hoffer Q, Holladay 1, and SRK/T formulas in two groups of eyes undergoing phacoemulsification and implantation of an aspherical IOL (Acrysof SN60WF; Alcon Laboratories, Inc., Fort Worth, TX). For each formula, the refractive prediction error was calculated once the constants had been optimized. Biometric data were obtained by partial coherence interferometry in one group and immersion ultrasound biometry and corneal topography in the other. Corneal asphericity was assessed by two different corneal topographers in the optical biometry group (Magellan; Nidek, Gamagori, Japan) and ultrasound biometry group (Keratron, Optikon 2000 Spa, Rome, Italy). The mean Q-value was -0.12 ± 0.08 in the optical biometry group (n = 51) and -0.22 ± 0.14 in the ultrasound biometry group (n = 79). In both groups, linear regression disclosed a statistically significant correlation between the Q-value and the prediction error (the only exception being the SRK/T formula). More negative Q-values were correlated to a positive prediction error, indicating a myopic outcome for prolate corneas. However, the correlation coefficients were lower than those previously reported for spherical IOLs. Corneal asphericity also influences the refractive outcomes of IOL power calculation by thinlens formulas when aspherical IOLs are implanted, although this influence is exerted to a lesser degree compared to spherical IOLs. [J Refract Surg. 2017;33(7):476-481.]. Copyright 2017, SLACK Incorporated.

  3. Outcomes of manual extracapsular versus phacoemulsification cataract extraction by beginner resident surgeons.

    Science.gov (United States)

    Meeks, Landen A; Blomquist, Preston H; Sullivan, Brian R

    2013-11-01

    To evaluate the safety and efficacy of phacoemulsification cataract extraction and manual extracapsular cataract extraction (ECCE) performed by beginning resident surgeons. Dallas Veterans Affairs Medical Center, Dallas, Texas, USA. Retrospective cohort study. A review was performed of each resident's series of initial cataract surgery procedures as a late first-year or second-year resident. Data were collected for cases performed over almost a 6-year period during which initially the first primary surgeon cases were ECCE and later, the first primary surgeon cases were phacoemulsification. For each case, the following data were gathered: technique of cataract extraction, laterality, resident, vitreous loss or dropped nucleus, placement of posterior chamber intraocular lens (IOL), and need for reoperation within 90 days of surgery. Complications occurred in 6 (2.5%) of 244 cases in which phacoemulsification was performed by a beginner resident primary surgeon and in 7 (4.1%) of 172 cases in which ECCE was used (P=.40). Posterior chamber IOLs were placed in all but 2 phacoemulsification cases and 4 ECCE cases (P=.24). Moreover, 3 cases in the phacoemulsification group and 1 case in the ECCE group required a reoperation within 90 days (P=.65). Phacoemulsification cataract extraction can be taught safely and effectively to residents with no cataract surgery experience as a primary surgeon. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Corneal blindness: prevention, treatment and rehabilitation

    Directory of Open Access Journals (Sweden)

    Matthew J Burton

    2009-12-01

    Full Text Available Blindness from corneal disease is a major ophthalmic public health problem. There are three important elements to addressing corneal blindness: prevention, treatment, and rehabilitation.

  5. Phacoemulsification versus phacoemulsification with micro-bypass stent implantation in primary open-angle glaucoma: randomized double-masked clinical trial.

    Science.gov (United States)

    Fea, Antonio M

    2010-03-01

    To compare phacoemulsification alone and phacoemulsification with micro-bypass stent implantation in eyes with primary open-angle glaucoma. Instituto di Fisiopatologia Clinica, Clinica Oculistica, Universita' di Torino, Torino, Italy. In this prospective double-masked randomized clinical trial, patients had phacoemulsification alone (control group) or phacoemulsification with iStent implantation (combined group). Primary outcomes were intraocular pressure (IOP) and reduction in medication use over 15 months and IOP after a 1-month washout of ocular hypotensive agents (ie, 16 months postoperatively). The baseline IOP was similar between groups (combined group: 17.9 mm Hg +/- 2.6 [SD]; control group: 17.3 +/- 3.0 mm Hg) (P = .512). Three patients in the control group were lost to follow-up. The mean IOP was 14.8 +/- 1.2 mm Hg in the combined group and 15.7 +/- 1.1 mm Hg in the control group at 15 months and 16.6 +/- 3.1 mm Hg and 19.2 +/- 3.5 mm Hg, respectively, after washout; the IOP was statistically significantly lower in the combined group than in the control group at both time points (P = .031 and P = .042, respectively). At 15 months, the mean number of medications was lower in the combined group than in the control group (0.4 +/- 0.7 and 1.3 +/- 1.0, respectively; P = .007), as was the proportion of patients on ocular hypotensive medication (33% and 76%, respectively). Phacoemulsification with stent implantation was more effective in controlling IOP than phacoemulsification alone; the safety profiles were similar. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Intraocular pressure following ECCE, phacoemulsification, and PC-IOL implantation.

    Science.gov (United States)

    Kooner, K S; Cooksey, J C; Perry, P; Zimmerman, T J

    1988-09-01

    Abnormal intraocular pressure (IOP), either transient or permanent, may follow extracapsular cataract extraction (ECCE) with phacoemulsification (PE) and posterior chamber intraocular lens (PC-IOL) implantation. We retrospectively studied IOP measurements at different intervals post ECCE and PE in 242 eyes of 211 patients: 105 males, 106 females, 198 Caucasians and 13 blacks. Elevated IOP (greater than 23 mm Hg) was observed in 20 eyes (8.2%). Only two patients (0.8%) had persistent (greater than 3 months) IOP elevation and needed antiglaucoma therapy. Six more eyes (2.5%), however, developed glaucoma after 1 year. Hence, the incidence of secondary pseudophakic glaucoma at the conclusion of this study was 3.3%. No patient required laser or other mechanical surgery for IOP control. ECCE and PE with PC-IOL does not appear to adversely affect IOP. Patients, however, must be followed closely, as some may develop glaucoma months after surgery.

  7. Comparison of two different ultrasound methods of phacoemulsification.

    Science.gov (United States)

    Helvacioglu, Firat; Yeter, Celal; Sencan, Sadik; Tunc, Zeki; Uyar, O Murat

    2014-08-01

    To compare the safety and efficacy of microcoaxial phacoemulsification surgeries performed with the OZil Intelligent Phaco torsional mode (Alcon Laboratories, Inc., Fort Worth, USA) and combined torsional/longitudinal ultrasound mode using 45 degree aperture angled tips. Prospective randomized clinical trial. setting: Maltepe University, Istanbul. patient population: Eighty eyes of 80 cataract patients were randomly assigned to 2.2 mm microcoaxial phacoemulsification using the OZil Intelligent Phaco torsional mode (Group 1) or combined torsional/longitudinal ultrasound mode (Group 2). observation procedure: Intraoperative fluid and energy usage and postoperative examinations were evaluated. main outcome measures: Ultrasound time, cumulative dissipated energy, longitudinal and torsional ultrasound amplitudes, mean operation time, mean volume of fluid used, and surgical complications. Both groups included 40 eyes. Mean ultrasound time, cumulative dissipated energy, and longitudinal and torsional ultrasound amplitudes in Group 1 were 58.21±33.81 seconds, 7.74±6.23, 0.45±0.30, and 26.30±12.60%, respectively, and these parameters in Group 2 were 64.75±30.23 seconds, 12.61±6.21, 26.32±5.85, and 40.98±8.33%, respectively. Cumulative dissipated energy and longitudinal and torsional amplitudes were found to be significantly lower in Group 1 (P=.001, Ptip, the OZil Intelligent Phaco torsional mode provided more effective lens removal than the combined torsional/longitudinal ultrasound mode, with a lower cumulative dissipated energy and volume of fluid used. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Phacoemulsification and foldable IOL implantation with limbal tunnel incision%角膜缘隧道切口白内障超声乳化折叠式人工晶体植入术

    Institute of Scientific and Technical Information of China (English)

    吴勇; 黄振平; 曹春林; 薛春燕

    2001-01-01

    目的:评价角膜缘隧道切口的白内障超声乳化折叠式人工晶体植入术的效果。方法:对66例(72眼)老年性、并发性、外伤性白内障采用3.2 mm角膜缘隧道切口,行白内障超声乳化并植入折叠式人工晶体,观察手术前后视力、角膜曲率、角膜地形图的变化。结果:术后1天、1周、1个月的视力达0.5以上者分别占69.4%、80.6%和86.1%,术后1周平均散光为(1.85±0.89)D,比术前增加0.30 D(P0.05,角膜地形图显示已恢复术前状态。结论:角膜缘隧道切口的白内障超声乳化折叠式人工晶体植入术能简化手术步骤,术后视力恢复快,炎症反应轻,具有早期恢复至术前眼屈光状态的优势。%Objectives: To evaluate the efficacy of phacoemulsification and foldable IOL implantation with limbal tunnel incision. Methods: A 3.2mm limbal tunnel incision was made on 72 eyes of 66 patients with senile, complicated and traumatic cataract. Phacoemulsification and foldable IOL implantation was performed. Visual acuity, corneal curvature and corneal topography were measured after the surgery.  Results: One day, one week and one month after the surgery, visual acuity exceeded 0.5 in 69.4%, 80.6%,86.1% of the patients respectively. One week after the surgery, the mean astigmatism was (1.85±0.89)D(P0.05,corneal topography had recovered.  Conclusions: Phacoemulsification and foldable IOL implantation with limbal tunnel incision have comparatively simple, with less postoperative inflammation and faster recovery of visual acuity.

  9. Clinical effects of conjunctival sac flushing using different concentration of povidoneiodine on corneal epithelium before cataract surgeries

    Directory of Open Access Journals (Sweden)

    Xue-Lian Gu

    2015-10-01

    Full Text Available AIM:To determine the most optimal concentration of the safe usage of povidone-iodine(PVP-Iin the flushing to disinfect the conjunctive sac before cataract surgeries, in order to provide a scientific basis for clinical eye surgery work.METHODS:Sixty-two patients with phacoemulsification and intraocular lens implantation in our hospital from October 2012 to October 2014 were randomly divided into 0.25g/L PVP-I group(Ⅰand 5g/L PVP-I group(Ⅱ. Sterilizing effect and the complications postoperative were analyzed.RESULTS:The sterilizing effects of the two groups after flushing conjunctiva sac using different concentrations of PVP-I were both remarkable, but the difference between the two groups was not statistically significant(P>0.05. No endophthalmitis occurred in the two groups. Observing the corneal condition after rinsing, no severe conjunctival hyperemia, corneal edema and other serious complications occurred. There was slightly punctate corneal epithelial shedding in groupⅡ, and the difference was statistically significant(PPCONCLUSION:Using 0.25g/L PVP-I in the conjunctiva sac rinsing before surgeries can inhibit the growth of bacteria in the conjunctival sac, reduce the impact on the corneal epithelium thereby reducing the incidence of postoperative complications and the positive rate of bacterial culture, increasing the comfort degree of patients, bringing a better area for the surgeries.

  10. Corneal injection track: an unusual complication of intraocular lens implantation and review

    Institute of Scientific and Technical Information of China (English)

    Julie; Y.C.Lok; Alvin; L.Young

    2015-01-01

    Phacoemulsification is the main gold standard for cataract operation in the developed world together with foldable intraocular lens(IOL) implantation by injection,allowing for stable wound construction and less postoperative astigmatism. It is a safe procedure with high success rate with the advancement in machines,improvement of IOL injection systems and further maturation of surgeons’ techniques. Despite the large number of operations performed every day, foldable IOL injection leading to an intra-stromal corneal track is a very rare complication. We report a case of this unusual finding in a 70-year-old gentleman who has undergone cataract operation in November 2011 in our hospital and will review on the complications related to foldable IOL injection.

  11. Comparison of cumulative dissipated energy between the Infiniti and Centurion phacoemulsification systems

    Directory of Open Access Journals (Sweden)

    Chen M

    2015-07-01

    Full Text Available Ming Chen,1 Erik Anderson,2 Geoffrey Hill,3 John J Chen,4 Thomas Patrianakos2 1Department of Surgery, University of Hawaii, Honolulu, HI, 2Department of Ophthalmology, John H Stroger, Jr Hospital of Cook County, Chicago, IL, 3Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, 4Biostatistics Core, John A Burns School of Medicine, University of Hawaii, Honolulu, HI, USA Purpose: To compare cumulative dissipated energy between two phacoemulsification machines. Setting: An ambulatory surgical center, Honolulu, Hawaii, USA. Design: Retrospective chart review. Methods: A total of 2,077 consecutive cases of cataract extraction by phacoemulsification performed by five surgeons from November 2012 to November 2014 were included in the study; 1,021 consecutive cases were performed using the Infiniti Vision System, followed by 1,056 consecutive cases performed using the Centurion Vision System. Results: The Centurion phacoemulsification system required less energy to remove a cataractous lens with an adjusted average energy reduction of 38% (5.09 percent-seconds (P<0.001 across all surgeons in comparison to the Infiniti phacoemulsification system. The reduction in cumulative dissipated energy was statistically significant for each surgeon, with a range of 29%–45% (2.25–12.54 percent-seconds (P=0.005–<0.001. Cumulative dissipated energy for both the Infiniti and Centurion systems varied directly with patient age, increasing an average of 2.38 percent-seconds/10 years. Conclusion: The Centurion phacoemulsification system required less energy to remove a cataractous lens in comparison to the Infiniti phacoemulsification system. Keywords: phacoemulsification, cumulative dissipated energy, Centurion Vision System, Infiniti Vision System

  12. Resolution of persistent corneal erosion after administration of topical rebamipide.

    Science.gov (United States)

    Kashima, Tomoyuki; Akiyama, Hideo; Miura, Fumihide; Kishi, Shoji

    2012-01-01

    Rebamipide is an antiulcer agent used to treat gastric ulcer and gastritis. Biological effects of rebamipide include cytoprotection, wound healing, and anti-inflammatory properties that are known to be universal for a variety of tissues in addition to gastrointestinal mucosa. The therapeutic effects of rebamipide eye drops are due to its ability to increase corneal and conjunctival mucin-like substances and improve corneal and conjunctival injury in vivo. In this paper, we report a case of Sjögren's syndrome with complete disappearance of corneal erosion after administration of rebamipide eye drops. This was observed even though corneal erosion had not improved for 6 months after punctal occlusion surgery. The patient was a 33-year-old female, diagnosed with Sjögren's syndrome by a salivary gland biopsy. The corneal and conjunctival surfaces were filled with dense erosions, which did not improve with topical drugs. Punctal plugs were applied several times; however, the plugs were repeatedly shed. All four puncta of both eyelids were surgically occluded, and both corneal and conjunctival erosion was clearly improved. However, the erosion in the inferior cornea of both eyes had not improved for 6 months after surgery. We used the newly approved topical rebamipide for treatment of this patient. The corneal erosion gradually improved and completely disappeared 4 weeks after administration of the drug. Dry eye sensation disappeared at the same time. Both membrane-associated mucin and secreted mucin in the ocular surface are thought to be essential for maintenance of the tear film. Induction of mucin from ocular surface epithelium could be an effective treatment in cases of dry eye caused by mucin deficiency. Through its various mechanisms, rebamipide improves ocular surface conditions. To our knowledge, this is the first clinical case report using rebamipide ophthalmic solution. This drug may provide a novel approach to treat drying diseases of the eye.

  13. Corneal Densitometry for Quantification of Corneal Deposits in Monoclonal Gammopathies.

    Science.gov (United States)

    Enders, Philip; Holtick, Udo; Schaub, Friederike; Tuchscherer, Armin; Hermann, Manuel M; Scheid, Christoph; Cursiefen, Claus; Bachmann, Björn O

    2017-04-01

    To assess the capability of Scheimpflug-based densitometry of the cornea to quantify light chain deposits in patients with active monoclonal gammopathies. This is a case-control study in which data from a leading tertiary university center in myeloma care were analyzed. Ten eyes of 5 patients with monoclonal gammopathy and 26 eyes of 13 healthy controls undergoing clinical evaluation and Scheimpflug-based measurements were included in the study. The main outcome measures were densitometry data of the 4 corneal layers-anterior layer (AL), central layer (CL), posterior layer, and total layer (TL)-in 4 different annuli (central annular zone 0-2 mm, intermediate annular zone 2-6 mm, peripheral annular zone 6-10 mm, and total annular zone 0-12 mm). In 8 eyes of 4 patients with IgG-based gammopathy, corneal light backscatter was highest in the AL and decreased with increasing corneal depth. The peripheral annular zone showed a higher densitometry value compared with the corneal center. Compared with healthy controls, the AL (P < 0.001), the CL (P < 0.001), and the TL (P < 0.001) had significantly higher corneal light backscatter in patients with gammopathy in the total and the peripheral annular zones. In one patient with predominantly IgA-based disease, corneal light backscatter was not elevated. Scheimpflug-based densitometry of the cornea is able to quantify opacification by immunoglobulin G light chain deposits in monoclonal gammopathies. This noninvasive technique can complement presently used in vivo confocal microscopy and corneal photography to objectivize corneal changes. Densitometry might allow monitoring of corneal immunoglobulin deposits in follow-up examinations.

  14. Corneal epithelial bullae after short-term wear of small diameter scleral lenses.

    Science.gov (United States)

    Nixon, Alex D; Barr, Joseph T; VanNasdale, Dean A

    2017-04-01

    Complications of scleral lens wear are not well documented or understood. While multiple studies focus on oxygen transmission during scleral lens wear and associated corneal swelling, little is known about the effects of varying scleral lens fitting relationships, especially when there is corneal interaction. Scleral lenses, by convention, are designed to completely clear the corneal surface and rest on the conjunctival and scleral tissue. However, some designs maximize oxygen transmission by reducing the lens diameter, thickness, and recommended corneal clearance.While the modifications increase oxygen transmission in any scleral lens design, they also distribute the lens mass closer to the limbus and make visualization of corneal clearance, especially narrow in the limbal region, more difficult. The sequelae from mechanical interaction between scleral lenses and the ocular surface, in particular the cornea, remain uncertain. This case series will describe corneal epithelial bullae, molding, and epithelial erosions as unintended scleral lens complications. These corneal changes corresponded to areas of contact lens-corneal bearing confirmed utilizing a combined scanning laser ophthalmoscopy (SLO) and anterior segment OCT. This case series will discuss epithelial bullae detection, their etiology, and suggestions for application of this information into scleral lens fitting protocols. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  15. INTRAOCULAR LENS POSITION IN COMBINED PHACOEMULSIFICATION AND VITREORETINAL SURGERY.

    Science.gov (United States)

    Ozates, Serdar; Kiziltoprak, Hasan; Koc, Mustafa; Uzel, Mehmet Murat; Teke, Mehmet Yasin

    2017-10-09

    To assess the decentration and angle of tilt of the intraocular lens (IOL) according to the intravitreal tamponade types used in combined phacoemulsification and vitreoretinal surgery. This prospective and randomized clinical study involved 73 eyes of 69 patients who underwent combined vitreoretinal surgery. Eyes with intravitreal tamponades formed the study group and eyes without intravitreal tamponades formed the control group. The study group was further divided into silicone oil and gas tamponade subgroups. Cross-sectional IOL images were captured using a Pentacam HR (Oculus, Germany) and tilt and decentration were calculated with Adobe Photoshop software (Adobe, San Jose, CA). The mean angle of tilt and decentration at the vertical meridian were significantly higher in both tamponade groups than in the control group (P 0.05). When comparing the silicone oil and gas tamponade subgroups, no significant differences were noted on the position of IOL at both meridians (P > 0.05 for all). Intravitreal tamponades have an important effect on the position of IOL in combined vitreoretinal surgery. Silicone oil and gas tamponades may induce postoperative tilt and decentration of one-piece acrylic IOLs.

  16. Combined Idiopathic Macular Hole Vitrectomy with Phacoemulsification without Face-Down Positioning

    Directory of Open Access Journals (Sweden)

    Fumihiko Yagi

    2012-01-01

    Full Text Available Purpose. To evaluate the outcome of combined vitrectomy with phacoemulsification without postoperative face-down positioning for idiopathic macular holes (MHs. Design. Retrospective, observational case series. Participants. Forty-two eyes of 42 patients with MH. Methods. We studied 42 eyes of 42 cases followed up for 6 months postoperatively. MH closure rate and preoperative and postoperative visual acuity (VA were evaluated. Main Outcome Measures. MH closure rate and VA were evaluated after combined vitrectomy with phacoemulsification without postoperative face-down positioning. Results. Of the 42 holes, 40 (95.2% were initially closed, and the final closure rate was 100%. Compared with preoperative VA, the mean VA was significantly improved at 1 month and the improvement was maintained for at least 6 months postoperatively. Conclusions. Combined vitrectomy with phacoemulsification without postoperative face-down positioning produced favorable anatomic and functional results for MH repair. Improvement in VA can be expected for up to at least 6 months postoperatively.

  17. The Changes of Quality of Life in the Patients after Phacoemulsification with Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    Jiewei Liu; Jingjing Xu; Mingguang He

    2004-01-01

    Purpose: To investigate the improvement and maintenance of the quality of life in the patients after phacoemulsification with intraocular lens implantation.Methods :The study population consisted of 116 patients receiving phacoemulsification with intraocular lens implantation. They were interviewed using the quality of life questionnaire, and the clinical outcomes were evaluated before surgery and at 1 week, 1month, 3 months, 6 months after surgery respectively.Results:Patients reported similar scores of quality of life and all the four subscales among 1-week, 1-month , 3-month and 6-month follow-up visit after surgery, all of which were higher than the scores before surgery.Conclusion: Patients receiving phacoemulsification reported rapid improvement in quality of life after surgery, and the quality of life scores were not changed significantly from 1week to 6 months after surgery.

  18. Risk factors for intra-operative complications during phacoemulsification performed by residents.

    Science.gov (United States)

    Lomi, Neiwete; Sharma, Reetika; Khokhar, Sudarshan; Dada, Tanuj; Vanathi, Murugesan; Agarwal, Tushar

    2016-06-01

    The purpose of this study was to determine the risk factors for occurrence of intra-operative complications during phacoemulsification performed by residents. One hundred fifty patients with cataract who underwent phacoemulsification by residents, with an experience of five or more phacoemulsification surgery, at a tertiary care centre were included in this study. The pre-operative data of these patients were collected from the hospital records. Surgeons were interviewed immediately after the surgery regarding the surgeon experience, phacoemulsification technique, machine factors, and intra-operative complications. Statistical analysis was done to determine pre-operative and intra-operative risk factors. The overall surgical complication rate in resident-performed phacoemulsification was 37 % of which major and minor complications were 21 and 16 %, respectively. Success in terms of placement of intraocular lens in capsular bag was 84 %. The most common major and minor complications found were posterior capsular tear and irregular capsulorhexis, respectively. Systemic and ocular features of patients as well as type of machine (longitudinal versus torsional longitudinal) had no significant association in terms of complication rate. Increase in success rate was seen with increase in semester and number of surgeries performed. Patient factors including general physical condition, systemic diseases, and anatomical factors do not influence success in resident-performed phacoemulsification. With increase in semester of residents, there is a significant decrease in intra-operative complications. Minor complications in the beginning of case lead to increase in major complications later on during the case and decrease in success rate by junior-semester residents.

  19. [Methods for sealing of corneal perforations].

    Science.gov (United States)

    Samoilă, O; Totu, Lăcrămioara; Călugăru, M

    2012-01-01

    A variety of corneal pathology can lead to corneal ulcers and perforations. A deep corneal ulcer may need surgical treatment to allow good volume restoration and reepithelisation. Corneal perforation must be sealed and when the perforation is large, the task of repairing the defect can be underwhelming. The elegant solution is the corneal transplant, but this is not always readily available, especially in undeveloped countries. We present here two cases with different solutions to seal the perforated cornea: the first one has a large peripheral defect and it is successfully sealed with scleral patch and the second one is central with small perforation and is successfully sealed with multilayered amniotic membrane. Both cases are followed for over 12 months and demonstrate good corneal restoration (both on clinical examination and corneal topography). Sclera and amniotic membrane can be used to seal corneal defects when corneal transplant is not readily available.

  20. Corneal collagen crosslinking: a systematic review.

    Science.gov (United States)

    Sorkin, Nir; Varssano, David

    2014-01-01

    Keratoconus (KCN) is an ectatic disorder with progressive corneal thinning and a clinical picture of corneal protrusion, progressive irregular astigmatism, corneal fibrosis and visual deterioration. Other ectatic corneal disorders include: post-LASIK ectasia (PLE) and pellucid marginal degeneration (PMD). Corneal crosslinking (CXL) is a procedure whereby riboflavin sensitization with ultraviolet A radiation induces stromal crosslinks. This alters corneal biomechanics, causing an increase in corneal stiffness. In recent years, CXL has been an established treatment for the arrest of KCN, PLE and PMD progression. CXL has also been shown to be effective in the treatment of corneal infections, chemical burns, bullous keratopathy and other forms of corneal edema. This is a current review of CXL - its biomechanical principles, the evolution of CXL protocols in the past, present and future, indications for treatment, treatment efficacy and safety.

  1. Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    Schulze SD

    2015-11-01

    Full Text Available Stephan D Schulze,1 Thomas Bertelmann,1 Irena Manojlovic,2 Stefan Bodanowitz,2 Sebastian Irle,3 Walter Sekundo11Department of Ophthalmology, Philipps University of Marburg, Marburg, 2Private Practice and Ambulatory Surgical Center, Bremen, 3Freelance Statistician, Friedberg, GermanyPurpose: To evaluate whether the use of balanced salt solution (BSS or an ophthalmic viscoelastic device (OVD during hydrophilic acrylic intraocular lens (IOL implantation variously impacts corneal endothelial cell characteristics in eyes undergoing uneventful phacoemulsifications.Methods: Prospective nonrandomized observational clinical trial. Patients were assigned either to the BSS plus® or to the OVD Z-Celcoat™ group depending on the substance used during IOL implantation. Corneal endothelium cell characteristics were obtained before, 1 week, and 6 weeks after surgery. Intraoperative parameters (eg, surgery time, phacoemulsification energy were recorded.Results: Ninety-seven eyes were assigned to the BSS plus and 86 eyes to the Z-Celcoat group. Preoperative corneal endothelium cell density (ECD and endothelium cell size were 2,506±310 cells/mm2/2,433±261 cells/mm2 and 406±47 µm2/416±50 µm2 (P=0.107/P=0.09. After 1 and 6 weeks, ECD decreased and endothelium cell size increased significantly in both groups (each P<0.001 without significant differences between both groups (each P>0.05. Irrigation–aspiration suction time (30.3±16.6 versus 36.3±14.5 seconds and overall surgical time (7.2±1.2 versus 8.0±1.4 minutes were significantly longer in the OVD Z-Celcoat group (each P<0.001. No complications or serious side effects occurred.Conclusion: Implantation of a hydrophilic acrylic IOL under BSS infusion seems to be a useful and faster alternative in experienced hands without generating higher ECD loss rates.Keywords: phacoemulsification, ophthalmic viscoelastic device, endothelial cell density, IOL

  2. Corneal Topographic Changes After Eyelid Ptosis Surgery.

    Science.gov (United States)

    Savino, Gustavo; Battendieri, Remo; Riso, Monica; Traina, Salvatore; Poscia, Andrea; DʼAmico, Giovanni; Caporossi, Aldo

    2016-04-01

    To evaluate the corneal topography and the topographic changes after ptosis surgery on patients affected by congenital and acquired blepharoptosis. Twenty eyes of 17 patients affected by acquired and congenital ptosis underwent surgical correction through anterior levator complex tightening. Computerized tomography (Syrius Sistem; CSO) was used to analyze any change in corneal astigmatism (CYL), simulated keratometry, anterior corneal symmetry index front, apical keratometry front, and central corneal thickness. Visual acuity, margin reflex distance, and levator function were also measured. After surgical ptosis repair, corneal topography demonstrated a reduction in average keratometry of 0.15 ± 0.47 diopters (D) and in corneal astigmatism of 0.26 ± 1.12 D. Significant differences were found in apical keratometry front (-1.84 ± 1.76 D) and in best-corrected visual acuity (-0.18 ± 0.06 logMAR) in the postoperative examinations. Central corneal thickness did not show significant differences between preoperative and postoperative examinations. Postoperative topographic maps showed a reduction of symmetry index front (0.10 ± 0.64 D). Eyelid ptosis modifies anterior corneal surface inducing refractive errors and modifying corneal astigmatism in patients, thus affecting the quality of vision. The surgical correction of blepharoptosis induces anterior corneal surface modification, restoring corneal symmetry and regular corneal astigmatism. Postoperative corneal topography showed normal corneal contours.

  3. Patching for corneal abrasion.

    Science.gov (United States)

    Lim, Chris H L; Turner, Angus; Lim, Blanche X

    2016-07-26

    Published audits have demonstrated that corneal abrasions are a common presenting eye complaint. Eye patches are often recommended for treating corneal abrasions despite the lack of evidence for their use. This systematic review was conducted to determine the effects of the eye patch when used to treat corneal abrasions. The objective of this review was to assess the effects of patching for corneal abrasion on healing and pain relief. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2016), EMBASE (January 1980 to May 2016), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to May 2016), System for Information on Grey Literature in Europe (OpenGrey) (January 1995 to May 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 9 May 2016. We also searched the reference lists of included studies, unpublished 'grey' literature and conference proceedings and contacted pharmaceutical companies for details of unpublished trials. We included randomised and quasi-randomised controlled trials that compared patching the eye with no patching to treat simple corneal abrasions. Two authors independently assessed the risk of bias and extracted data. Investigators were contacted for further information regarding the quality of trials. The primary outcome was healing at 24, 48 and 72 hours while secondary outcomes included measures of pain, quality of life and adverse effects. We graded the certainty of the evidence using GRADE. We included 12 trials which

  4. SURGICALLY INDUCED ASTIGMATISM AFTER IMPLANTATION OF FOLDABLE AND NON - FOLDABLE LENSES IN CATARACT SURGERY BY PHACOEMULSIFICATION

    Directory of Open Access Journals (Sweden)

    Vikas

    2015-01-01

    Full Text Available This prospective comparative study included 300 matched patients of different grades of senile cataract. All of them willfully underwent phacoemulsification at the hands of a single experienced surgeon, performing with a single and individual technique {Woodcutter’s technique 1 }; half of them were implanted with a foldable intraocular lens and the other half with a non - foldable PMMA intraocular lens. All the patients undergoing phacoemulsification had an improvement in vision. There was no statistically significant difference in the surgically induced astigmatism after implanting foldable or non - foldable IOL

  5. Clinical study on tear film changes after phacoemulsification combined with intraocular lens implantation%白内障超声乳化联合人工晶状体植入术后泪膜功能变化

    Institute of Scientific and Technical Information of China (English)

    庄栗; 黄金土

    2009-01-01

    目的 探讨白内障超声乳化联合人工晶状体植入术对泪膜功能的影响.方法 随机抽取2007年1月至2008年1月行白内障超声乳化联合人工晶状体植入术的患者75例(75眼),术前、术后1 d、1周、2周及1个月行干眼症状评分、角膜荧光素染色、泪膜破裂时间(breaking-up time,BUT)和基础泪液分泌实验(Schier-met test,STT)检查.利用统计学软件SPSS 16.0进行数据分析.结果 与术前相比,术后1 d、1周及2周的BUT明显缩短,干眼症状评分及角膜荧光素染色等级明显增高,差异有统计学意义(P0.05).结论 白内障超声乳化联合人工晶状体植入术后短期内影响患者的泪膜功能,1个月后基本恢复正常.%Objective To investigate the tear film changes after phacoemulsification combined with intraocular lens implantation. Methods Seventy-five patients (75 eyes) with cataract who had undergone phacoemulsification com-bined with intraocular lens implantation from Jan 2007 to Jan 2008 were concluded in the study. Subjective scores for dry-hesS,COrneal fluorescein staining,tear break-up time and Schiermer test values were measured preoperatively and 1 day and 7,14,30 days postoperatively. Data were analyzed by SPSS 16.0. Results At 1 day and 7,14 days postoperatively, the mean tear break-up time all reduced greatly, but the grades of subjective score for dryness and corneal fluorescein stai-ning increased significantly (P 0. 05). Conclusions Phacoemulsification combined with intraecular lens implantation might relate to the changes of postoperative tear film stability in a short term, which would recover 1 month later. (Chin J Ophthalmol and Otorhinolaryngol,2009 ,9 :225-227)

  6. Cataract surgery in a patient with severe chronic iritis and corneal endothelial damage.

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    Yasukawa, T; Suga, K; Yokoo, N; Asada, S

    1998-07-01

    We report a patient with broad anterior synechias and corneal endothelial damage. The patient had chronic iritis and cataracts secondary to chronic iritis in both eyes. Because the right eye had broad anterior synechias and severe corneal endothelial damage, extracapsular cataract extraction and intraocular lens implantation were performed through the basal iris. Good postoperative visual acuity was obtained. The cornea showed little trauma from the surgery and remained clear 36 months postoperatively.

  7. Clinical study of 23G vs 20G vitreous surgery combined with phacoemulsification and IOL implantation for macular epiretinal membrane with cataract

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    Rui Wang

    2017-10-01

    Full Text Available AIM: To evaluate the effects of 23G vs 20G pars plana vitrectomy(PPVcombined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation for macular epiretinal membrane with cataract. METHODS: Totally 45 eyes of 45 patients with macular epiretinal membrane and cataract were enrolled in this retrospective non-randomized controlled clinical study. All eyes were treated with PPV combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation. There were 20 eyes in 23G PPV group, and 25 eyes in 20G PPV group. The best corrected visual acuity(BCVA, intraocular pressure(IOP, counting of corneal endothelial cells(CECand central retinal thickness(CRTwere examined before surgery. BCVA results were converted to the logarithm of the minimum angle of resolution(LogMARvisual acuity. All operations were performed by the same doctor. Operation time for vitrectomy and membrane peeling, average ultrasound energy(AVEand effective phacoemulsification time(EPTwere recorded. BCVA and CRT were observed postoperatively at 30d and 90d, counting of CEC was observed postoperatively at 90d. IOP was observed postoperatively at 1d and 7d.RESULTS: The mean operation time for vitrectomy were 12.57±1.35min in 23G group and 17.30±1.19min in 20G group. The difference was statistically significant(t=-12.488, Pt=-0.68,-1.186,-0.737,P=0.500, 0.242,0.465. On 1d after surgery, IOP in 23G group was lower than that in 20G group, the difference was statistically significant(t=-2.345, P=0.024. The BCVA and CRT of the two groups both improved after operations. There were no statistically significant differences between two groups in terms of IOP, BCVA, and CRT(F=0.465, 1.895, 0.689; P=0.499, 0.176, 0.411. IOP, BCVA and CRT were significant statistical different in different time-point within each group(F=291.245, 103.06, 665.402, PF=13.245, PF=1.212, 2.293; P=0.283, 0.129. The counting CEC in 23G group was more

  8. Effects of vitamin B12 on the corneal nerve regeneration in rats.

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    Romano, Maria Rosaria; Biagioni, Francesca; Carrizzo, Albino; Lorusso, Massimo; Spadaro, Angelo; Micelli Ferrari, Tommaso; Vecchione, Carmine; Zurria, Monia; Marrazzo, Giuseppina; Mascio, Giada; Sacchetti, Benedetto; Madonna, Michele; Fornai, Francesco; Nicoletti, Ferdinando; Lograno, Marcello Diego

    2014-03-01

    The study was designed to investigate the effects of a new ophthalmic solution containing 0.05% vitamin B12 0.05% on corneal nerve regeneration in rats after corneal injury. Eyes of anesthetized male Wistar rats were subjected to corneal injury by removing the corneal epithelium with corneal brush (Algerbrush). After the epithelial debridement, the right eye of each animal received the instillation of one drop of the ophthalmic solution containing vitamin B12 0.05% plus taurine 0.5% and sodium hyaluronate 0.5% four time per day for 10 or 30 days. Left eyes were used as control and treated with solution containing taurine 0.5% and sodium hyaluronate 0.5% alone following the same regimen. Fluorescein staining by slit-lamp and morphological analysis was used to determine corneal wound healing. Immunohistochemistry, immunoblot and confocal microscopy were used to examine corneal re-innervation. Slit-lamp and histological analyses showed that re-epithelization of the corneas was accelerated in rats treated with vitamin B12. A clear-cut difference between the two groups of rats was seen after 10 days of treatment, whereas a near-to-complete re-epithelization was observed in both groups at 30 days. Vitamin B12 treatment had also a remarkable effect on corneal re-innervation, as shown by substantial increased in the expression of neurofilament 160 and β-III tubulin at both 10 and 30 days. The presence of SV2A-positive nerve endings suggests the presence of synapse-like specialized structures in corneal epithelium of the eye treated with vitamin B12. Our findings suggest that vitamin B12 treatment represents a powerful strategy to accelerate not only re-epithelization but also corneal re-innervation after mechanical injury.

  9. Stroke dynamics and frequency of 3 phacoemulsification machines.

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    Tognetto, Daniele; Cecchini, Paolo; Leon, Pia; Di Nicola, Marta; Ravalico, Giuseppe

    2012-02-01

    To measure the working frequency and the stroke dynamics of the phaco tip of 3 phacoemulsification machines. University Eye Clinic of Trieste, Italy. Experimental study. A video wet fixture was assembled to measure the working frequency using a micro camera and a micropulsed strobe-light system. A different video wet fixture was created to measure tip displacement as vectorial movement at different phaco powers using a microscopic video apparatus. The working frequency of the Infiniti Ozil machine was 43.0 kHz in longitudinal mode and 31.6 kHz in torsional mode. The frequency of the Whitestar Signature machine was 29.0 kHz in longitudinal mode and 38.0 kHz with the Ellips FX handpiece. The Stellaris machine had a frequency of 28.8 kHz. The longitudinal stroke of the 3 machines at different phaco powers was statistically significantly different. The Stellaris machine had the highest stroke extent (139 μm). The lateral movement of the Infiniti Ozil and Whitestar Signature machines differed significantly. No movement on the y-axis was observed for the Infiniti Ozil machine in torsional mode. The elliptical path of the Ellips FX handpiece had different x and y components at different phaco powers. The 3 phaco machines performed differently in terms of working frequency and stroke dynamics. The knowledge of the peculiar lateral and elliptical path strokes of Infiniti and Whitestar Signature machines may allow the surgeon to fully use these features for lens removal. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  10. Step-by-step phacoemulsification training program for ophthalmology residents

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    Wang Yulan

    2013-01-01

    Full Text Available Aims: The aim was to analyze the learning curve of phacoemulsification (phaco performed by residents without experience in performing extra-capsular cataract extraction (ECCE in a step-by-step training program (SBSTP. Materials and Methods: Consecutive surgical records of phaco performed from March 2009 to Sept 2011 by four residents without previous ECCE experience were retrospectively reviewed. The completion rate of the first 30 procedures by each resident was calculated. The main intraoperative phaco parameter records for the first 30 surgeries by each resident were compared with those for their last 30 surgeries. Intraoperative complications in the residents′ procedures were also recorded and analyzed. Results: A total of 1013 surgeries were performed by residents. The completion rate for the first 30 phaco procedures was 79.2 μ 5.8%. The main reasons for halting the procedure were as follows: Anterior capsule tear, inability to crack the nucleus, and posterior capsular rupture during phaco or cortex removal. Cumulative dissipated energy of phaco power used during the surgeries was significantly less in the last 30 cases compared with the first 30 cases (30.10 μ 17.58 vs. 55.41 μ 37.59, P = 0.021. Posterior capsular rupture rate was 2.5 μ 1.2% in total (10.8 μ 4.2% in the first 30 cases and 1.7 μ 1.9% in the last 30 cases, P = 0.008; a statistically significant difference. Conclusion:The step-by-step training program might be a necessary process for a resident to transit from dependence to a self-supported operator. It is also an essential middle step between wet lab training to performing the entire phaco procedure on the patient both effectively and safely.

  11. Corneal stromal dystrophies: a clinical pathologic study

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    Elvira Barbosa Abreu

    2012-12-01

    Full Text Available INTRODUCTION: Corneal dystrophy is defined as bilateral and symmetric primary corneal disease, without previous associated ocular inflammation. Corneal dystrophies are classified according to the involved corneal layer in superficial, stromal, and posterior dystrophy. Incidence of each dystrophy varies according to the geographic region studied. PURPOSE: To evaluate the prevalence of stromal corneal dystrophies among corneal buttons specimens obtained by penetrating keratoplasty (PK in an ocular pathology laboratory and to correlate the diagnosis with patient age and gender. METHODS: Corneal button cases of penetrating keratoplasty from January-1996 to May-2009 were retrieved from the archives of The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry, Montreal, Canada. The cases with histopathological diagnosis of stromal corneal dystrophies were stained with special stains (Peroxid acid Schiff, Masson trichrome, Congo red analyzed under polarized light, and alcian blue for classification and correlated with epidemiological information (age at time of PK and gender from patients' file. RESULTS: 1,300 corneal buttons cases with clinical diagnose of corneal dystrophy were retrieved. Stromal corneal dystrophy was found in 40 (3.1% cases. Lattice corneal dystrophy was the most prevalent with 26 cases (65%. Nineteen were female (73.07% and the PK was performed at average age of 59.3 years old. Combined corneal dystrophy was found in 8 (20% cases, 5 (62.5% of them were female and the average age of the penetrating keratoplasty was 54.8 years old. Granular corneal dystrophy was represented by 5 (12.5% cases, and 2 (40% of them were female. Penetrating keratoplasty was performed at average age of 39.5 years old in granular corneal dystrophy cases. Macular corneal dystrophy was present in only 1 (2.5% case, in a 36 years old female. CONCLUSION: Systematic histopathological approach and evaluation, including special stains in all stromal

  12. Evaluation of Factors Limiting Corneal Donation.

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    Röck, Daniel; Wude, Johanna; Yoeruek, Efdal; Bartz-Schmidt, Karl Ulrich; Röck, Tobias

    2016-11-15

    BACKGROUND This study aimed to investigate factors limiting corneal donation at the University Hospital Tübingen. MATERIAL AND METHODS We retrospectively studied all hospital deaths from January 2012 to December 2015, considering each deceased patient as a potential corneal donor. During this period an ophthalmic resident managed corneal donor procurement on a full-time basis. Various factors limiting corneal donation were examined. RESULTS Among the 3412 deaths, 2937 (86.1%) displayed nonfulfillment of corneal donation. Consent for corneal donation was obtained in 475 cases (13.9%). The mean annual corneal donation rate was 13.9 donors per 100 deaths (range: 11.2-17.8). The leading causes of nonfulfillment of corneal donations were refusal to donate (49.8%, 1698 cases) and medical contraindications (23.6%, 805 cases). After next-of-kin interview of 2173 potential donors (109 potential donors were excluded because of logistical problems), willingness to participate in corneal donation was present in 475 cases (21.9%), whereas in 1698 cases (78.1%) corneal donation was refused. CONCLUSIONS Our study showed refusal to donate is the most important factor limiting corneal donation. It seems that increasing the knowledge of people about corneal donation through public education and media are necessary to address the corneal shortage.

  13. Corneal Biomechanical Findings in Contact Lens Induced Corneal Warpage

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    Letafatnejad, Mojgan; Beheshtnejad, Amir Hooshang; Ghaffary, Seyed Reza; Hassanpoor, Narges; Yaseri, Mehdi

    2016-01-01

    Purpose. To evaluate the difference in biomechanical properties between contact lens induced corneal warpage and normal and keratoconic eyes. Method. Prospective observational case control study, where 94 eyes of 47 warpage suspicious and 46 eyes of 23 keratoconic patients were included. Warpage suspected cases were followed until a definite diagnosis was made (warpage, normal, or keratoconus). Results. 44 eyes of 22 patients had contact lens related corneal warpage. 46 eyes of 23 people were diagnosed as nonwarpage normal eyes. 46 eyes of 23 known keratoconus patients were included for comparison. The mean age of the participants was 23.8 ± 3.8 years, and 66.2% of the subjects were female. The demographic and refractive data were not different between warpage and normal groups but were different in the keratoconus group. The biomechanical properties (corneal hysteresis or CH and corneal resistance factor or CRF) were different with the highest value in the warpage group followed by normal and keratoconus groups. CRF was 10.08 ± 1.75, 9.23 ± 1.22, and 7.38 ± 2.14 and CH was 10.21 ± 1.57, 9.59 ± 1.21, and 8.69 ± 2.34 in the warpage, normal, and keratoconus groups, respectively. Conclusion. Corneal biomechanics may be different in people who develop contact lens induced warpage. PMID:27688908

  14. Reconstruction of Rabbit Corneal Layer Composed of Corneal Fibroblasts and Corneal Epithelium on the Lyophilized Amniotic Membrane

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Many researchers have employed the cryopreserved amniotic membrane(CAM) and corneal epithelial cells in the treatment of a severely damaged burned cornea, with corneal epithelial cells cultured on an amniotic membrane (AM). The lyophilized amniotic membrane (LAM) has a higher graft take and a longer shelf life; it is easier to store and safer because of gamma irradiation. Two Teflon rings(Ahn's supporter) were made for culturing the cells on the LAM, and were then used to support the LAM. To reconstruct a corneal layer composed of corneal fibroblasts and epithelium, the corneal fibroblasts were first cultivated on the stromal side of LAM for five days, followed by epithelial cells culture on the epithelial side, by using the air-liquid interface culture. The reconstructed corneal layer composed of corneal fibroblasts and corneal epithelial cells has a much healthier basal layer of corneal epithelium than the reconstructed corneal epithelium, which was got by using only corneal epithelial cells, and resembles the epithelium of normal corneas, without the horny layer. Thus, the reconstruction of the corneal layer by using a LAM is considered to be a good in vitro model, not only for its application in toxicological test kits, but also for transplantation in patients with a severely damaged cornea.

  15. Comparison of phacoemulsification parameters effect on macular thickness changes after uneventful phacoemulsification in diabetic and non-diabetic patients

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    Ayse Gul Kocak Altintas

    2016-02-01

    Full Text Available AIM: To evaluate the effect of phacoemulsification(phacoparameters in micropulse phaco-tecnology with chamber stabilization environment(CASEand increased control and efficiency(ICEmode on central foveal thickness(CFTchanges after uneventful cataract surgery in normal and diabetic patients without retinopathy.METHODS: In this prospective study a total of 120 patients consist of 60 patients with type 2 diabetes mellitus as a diabetic group(DGwithout retinopathy and 60 normal subjects as a control group(CGwho underwent uneventful phaco were evaluated. Intraoperative phacoemulsification parameters including phaco time(PT, and effective phaco time(EPTwere recorded. The CFT measurements were performed preoperatively, at 1 and 3mo postoperatively. The CFT differences were calculated in each exam.RESULTS:The mean PT in DG was 1.40±0.43min and it was 1.44±0.32min in CG, the difference was not significant(P=0.85. The mean EPT was 20.12±8.82s and 19.24±9.02s in DG and CG respectively which was statistically insignificant(P=0.964. The mean preoperative CFT was 218.4±12.0 μm in DG and 222.1±16.6 μm in CG which was not statistically different(P=0.168. The mean increment of CFT in DG was 30.3±37.2 μm at 1mo postoperatively, while it was 13.1±12.5 μm in CG. Even the CFT increments were significant in both groups at 1mo postoperatively, it was statistically higher in DG than that of CG(P=0.001. The average CFT increment at 3mo postoperatively comparing to preoperative level was 12.5±12.4 μm and 4.6±9.7 μm in DG and CG respectively. The increment of CFT was significantly higher in DG than that of CG(P=0.00. But the comparison of the mean CFTs changes from postoperative 1mo and 3mo in both DG and CG, significant decrements were observed in each group(P=0.00 and P=0.03 respectively.CONCLUSION: The significant increment of CFT following uneventful phaco. With the similar phaco parameters were observed in both normal and diabetic subjects. The CFT

  16. Visual outcome following posterior capsule rupture during phacoemulsification in a tertiary care hospital in Malaysia.

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    Thevi, T; Sahoo, S

    2016-04-01

    To analyse the visual outcomes of cases with posterior capsule rupture (PCR) compared to those without PCR following phacoemulsification. The occurrence of posterior capsule rupture during phacoemulsification surgery for cataract can have serious implications in the visual recovery. However, recognition of PCR and proper management can yield a successful visual outcome. This study analysed the visual outcomes of cases with PCR compared to those without PCR. This is a case-control study. All patients who underwent cataract surgery from 2011 to 2012 in Hospital Melaka were traced from the National Eye Database (NED) of Malaysia. The visual outcomes were classified as good, borderline and poor as per WHO guidelines. The data was analysed with SPSS version 12 IBM. Out of 80.4% (2519) of eyes that had undergone phacoemulsification (PHACO) type of surgery, 3.06% (77 cases) had posterior capsule rupture complication. There was no significant difference in the visual outcome of borderline between cases with PCR and cases without PCR (Odds Ratio (OR) 0.989; 95% Confidence Interval (CI) 0.382- 2.560). However, cases with PCR were significantly less likely to have good vision compared to those without PCR (OR 0.335; 95% CI 0.157-0.714). The study reveals that a significant number of patients without PCR had good vision, whereas those with PCR did not get good vision. We would like to suggest meticulous care during phacoemulsification surgery to avoid PCR in order to obtain good visual outcomes.

  17. Phacoemulsification in cases of pseudoexfoliation using in situ nuclear disassembly without nuclear rotation.

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    Mahdy, Mohamed A E S

    2012-05-01

    The purpose was to assess the safety and frequency of intraoperative complications of phacoemulsification using an in situ nuclear disassembly technique in pseudoexfoliation (PEX) cases. The work was done in Rustaq Hospital, Rustaq, Sultanate of Oman. This prospective, interventional, noncomparative study included 103 cases of cataract with pseudoexfoliation that underwent phacoemulsification with in situ nuclear disassembly using Alcon Infinity machine with Ozil handpeice and Kelman-style 45° phacoemulsification tip. Of the 103 cases, 55 males (53.4%) and 48 (46.6%) females, one case developed posterior capsular rupture, and four cases developed zonular dehiscence that was partial in three cases and >180° in one case only. The best corrected visual acuity (BCVA) 4 weeks postoperatively using logMAR notation was as follows: 66 cases (65.1%) had BCVA of 0.30 or better (logMAR notation), and 37 cases (35.9%) had BCVA of 0.48 or less. Safe and efficient phacoemulsification without nuclear rotation could be achieved in cases pseudoexfoliation in which zonular weakness is a concern by utilizing the versatility of Kelman style phaco tip to do lateral sweep sculpting and in situ cracking techniques. It prevents zonular stress by avoiding manipulation or rotation of the nucleus in cases.

  18. Dye-enhanced cataract surgery. Part 2: learning critical steps of phacoemulsification.

    Science.gov (United States)

    Werner, L; Pandey, S K; Escobar-Gomez, M; Hoddinott, D S; Apple, D J

    2000-07-01

    To use capsule dyes to enhance visualization to learn and perform various critical steps of the phacoemulsification procedure in a laboratory setting using postmortem human eyes. Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. Indocyanine green 0.5% (ICG) and trypan blue 0.1% were used to enhance visualization for performing critical steps of phacoemulsification in 8 human eyes obtained postmortem. All eyes were prepared according to the Miyake-Apple posterior video technique. After a continuous curvilinear capsulorhexis (CCC) was made, the dyes were used to enhance visualization for hydrodissection, hydrodelineation, and various maneuvers for nuclear emulsification and cortical cleanup. In 8 eyes, all the aforementioned steps were performed without using dye (control group). Both dyes helped enhance visualization during the critical steps of phacoemulsification. The use of a dye solution instead of balanced salt solution (BSS) for hydrodissection/delineation helped localize the complete plane of cleavage between the capsule and cortex and the nucleus-epinucleus complex. During various nuclear sculpting maneuvers, the use of dye helped visualization of the position of the phaco tip and its relation to the posterior capsule. It also helped localize remaining cortical fibers, facilitating complete cleaning of the capsular bag. Dye-enhanced cataract surgery was useful in learning various critical steps of phacoemulsification in a wet laboratory setting.

  19. Ultrasonic-generated fluid velocity with Sovereign WhiteStar micropulse and continuous phacoemulsification.

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    Steinert, Roger F; Schafer, Mark E

    2006-02-01

    To evaluate and compare ultrasonic turbulence created by conventional and micropulse ultrasound technology. Sonora Medical Systems, Longmont, Colorado, USA. A high-resolution digital ultrasound probe imaged the zone around a phacoemulsification tip. Doppler analysis allowed determination of flow. The fluid velocity was measured at 4 levels of ultrasound power at a constant flow, comparing the ultrasonic conditions of continuous energy to WhiteStar micropulses. In addition to the normal baseline irrigation and aspiration, fluid movement was detected directly below the phaco tip, produced by a nonlinear effect known as acoustic streaming. Acoustic streaming increased with increased phacoemulsification power for both conditions. At each of the 4 levels of power, fluid velocity away from the tip was less with micropulse technology than with continuous phacoemulsification. The demonstrated decrease in acoustic streaming flow away from the phaco tip with Sovereign WhiteStar micropulse technology compared to conventional ultrasound provides an objective explanation for clinical observations of increased stability of nuclear fragments at the tip and less turbulence in the anterior chamber during phacoemulsification. This methodology can be used to examine and compare fluid flow and turbulence under a variety of clinically relevant conditions.

  20. Phacoemulsification in cases of pseudoexfoliation using in situ nuclear disassembly without nuclear rotation

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    Mohamed A. E. S. Mahdy

    2012-01-01

    Conclusion: Safe and efficient phacoemulsification without nuclear rotation could be achieved in cases pseudoexfoliation in which zonular weakness is a concern by utilizing the versatility of Kelman style phaco tip to do lateral sweep sculpting and in situ cracking techniques. It prevents zonular stress by avoiding manipulation or rotation of the nucleus in cases.

  1. Dry eye following phacoemulsification surgery and its relation to associated intraoperative risk factors

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    P K Sahu

    2015-01-01

    Conclusion: Phacoemulsification surgery is capable of inducing dry eye, and patients should be informed accordingly prior to surgery. The clinician should also be cognizant that increased CDE can induce dry eyes even in eyes that were healthy preoperatively. In addition, intraoperative exposure to the microscopic light should be minimized.

  2. Resolution of persistent corneal erosion after administration of topical rebamipide

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    Kashima T

    2012-08-01

    Full Text Available Tomoyuki Kashima,1,2 Hideo Akiyama,1 Fumihide Miura,2 Shoji Kishi11Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan; 2Department of Ophthalmology, Saku Central Hospital, Saku, JapanAbstract: Rebamipide is an antiulcer agent used to treat gastric ulcer and gastritis. Biological effects of rebamipide include cytoprotection, wound healing, and anti-inflammatory properties that are known to be universal for a variety of tissues in addition to gastrointestinal mucosa. The therapeutic effects of rebamipide eye drops are due to its ability to increase corneal and conjunctival mucin-like substances and improve corneal and conjunctival injury in vivo. In this paper, we report a case of Sjögren's syndrome with complete disappearance of corneal erosion after administration of rebamipide eye drops. This was observed even though corneal erosion had not improved for 6 months after punctal occlusion surgery. The patient was a 33-year-old female, diagnosed with Sjögren's syndrome by a salivary gland biopsy. The corneal and conjunctival surfaces were filled with dense erosions, which did not improve with topical drugs. Punctal plugs were applied several times; however, the plugs were repeatedly shed. All four puncta of both eyelids were surgically occluded, and both corneal and conjunctival erosion was clearly improved. However, the erosion in the inferior cornea of both eyes had not improved for 6 months after surgery. We used the newly approved topical rebamipide for treatment of this patient. The corneal erosion gradually improved and completely disappeared 4 weeks after administration of the drug. Dry eye sensation disappeared at the same time. Both membrane-associated mucin and secreted mucin in the ocular surface are thought to be essential for maintenance of the tear film. Induction of mucin from ocular surface epithelium could be an effective treatment in cases of dry eye caused by mucin deficiency. Through its various

  3. Corneal biomechanics: a review.

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    Piñero, David P; Alcón, Natividad

    2015-03-01

    Biomechanics is often defined as 'mechanics applied to biology'. Due to the variety and complexity of the behaviour of biological structures and materials, biomechanics is better defined as the development, extension and application of mechanics for a better understanding of physiology and physiopathology and consequently for a better diagnosis and treatment of disease and injury. Different methods for the characterisation of corneal biomechanics are reviewed in detail, including those that are currently commercially available (Ocular Response Analyzer and CorVis ST). The clinical applicability of the parameters provided by these devices are discussed, especially in the fields of glaucoma, detection of ectatic disorders and orthokeratology. Likewise, other methods are also reviewed, such as Brillouin microscopy or dynamic optical coherence tomography and others with potential application to clinical practice but not validated for in vivo measurements, such as ultrasonic elastography. Advantages and disadvantages of all these techniques are described. Finally, the concept of biomechanical modelling is revised as well as the requirements for developing biomechanical models, with special emphasis on finite element modelling.

  4. Corneal Decompensation after Selective Laser Trabeculoplasty

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    Ahmet Ozkok

    2014-01-01

    Full Text Available A 64-year-old Caucasian man referred for decreased vision after selective laser trabeculoplasty (SLT. Slit lamp examination revealed diffuse corneal edema. Despite intensive topical treatment including steroids, corneal edema did not resolve; on the contrary, it advanced to bullous keratopathy. Corneal edema after SLT is an exceptionally rare complication and in all of the previous reports edema resolved with medical treatment. To the best of our knowledge, this is the first report presenting persistent corneal edema after SLT.

  5. Progress of research on corneal collagen cross-linking for corneal melting

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    Ke-Ren Xiao

    2016-06-01

    Full Text Available Corneal collagen cross-linking(CXLcould increase the mechanical strength, biological stability and halt ectasia progression due to covalent bond formed by photochemical reaction between ultraviolet-A and emulsion of riboflavin between collagen fibers in corneal stroma. Corneal melting is an autoimmune related noninfectious corneal ulcer. The mechanism of corneal melting, major treatment, the basic fundamental of ultraviolet-A riboflavin induced CXL and the clinical researches status and experiment in CXL were summarized in the study.

  6. Ocular dimensions, corneal thickness, and corneal curvature in quarter horses with hereditary equine regional dermal asthenia.

    Science.gov (United States)

    Badial, Peres R; Cisneros-Àlvarez, Luis Emiliano; Brandão, Cláudia Valéria S; Ranzani, José Joaquim T; Tomaz, Mayana A R V; Machado, Vania M; Borges, Alexandre S

    2015-09-01

    The aim of this study was to compare ocular dimensions, corneal curvature, and corneal thickness between horses affected with hereditary equine regional dermal asthenia (HERDA) and unaffected horses. Five HERDA-affected quarter horses and five healthy control quarter horses were used. Schirmer's tear test, tonometry, and corneal diameter measurements were performed in both eyes of all horses prior to ophthalmologic examinations. Ultrasonic pachymetry was performed to measure the central, temporal, nasal, dorsal, and ventral corneal thicknesses in all horses. B-mode ultrasound scanning was performed on both eyes of each horse to determine the dimensions of the ocular structures and to calculate the corneal curvature. Each corneal region examined in this study was thinner in the affected group compared with the healthy control group. However, significant differences in corneal thickness were only observed for the central and dorsal regions. HERDA-affected horses exhibited significant increases in corneal curvature and corneal diameter compared with unaffected animals. The ophthalmologic examinations revealed mild corneal opacity in one eye of one affected horse and in both eyes of three affected horses. No significant between-group differences were observed for Schirmer's tear test, intraocular pressure, or ocular dimensions. Hereditary equine regional dermal asthenia-affected horses exhibit decreased corneal thickness in several regions of the cornea, increased corneal curvature, increased corneal diameter, and mild corneal opacity. Additional research is required to determine whether the increased corneal curvature significantly impacts the visual accuracy of horses with HERDA. © 2014 American College of Veterinary Ophthalmologists.

  7. Acute corneal hydrops in keratoconus

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    Prafulla K Maharana

    2013-01-01

    Full Text Available Acute corneal hydrops is a condition characterized by stromal edema due to leakage of aqueous through a tear in descemet membrane. The patient presents with sudden onset decrease in vision, photophobia, and pain. Corneal thinning and ectasias combined with trivial trauma to the eye mostly by eye rubbing is considered as the underlying cause. With conservative approach self-resolution takes around 2 to 3 months. Surgical intervention is required in cases of non-resolution of corneal edema to avoid complications and for early visual rehabilitation. Intracameral injection of air or gas such as perflouropropane is the most common surgical procedure done. Recent investigative modality such as anterior segment optical coherence tomography is an extremely useful tool for diagnosis, surgical planning, and postoperative follow up. Resolution of hydrops may improve the contact lens tolerance and visual acuity but most cases require keratoplasty for visual rehabilitation.

  8. Posterior Corneal Surface Stability after Femtosecond Laser-Assisted Keratomileusis

    Directory of Open Access Journals (Sweden)

    Carlo Cagini

    2015-01-01

    Full Text Available The purpose of this study was to evaluate posterior corneal surface variation after femtosecond laser-assisted keratomileusis in patients with myopia and myopic astigmatism. Patients were evaluated by corneal tomography preoperatively and at 1, 6, and 12 months. We analyzed changes in the posterior corneal curvature, posterior corneal elevation, and anterior chamber depth. Moreover, we explored correlation between corneal ablation depth, residual corneal thickness, percentage of ablated corneal tissue, and preoperative corneal thickness. During follow-up, the posterior corneal surface did not have a significant forward corneal shift: no significant linear relationships emerged between the anterior displacement of the posterior corneal surface and corneal ablation depth, residual corneal thickness, or percentage of ablated corneal tissue.

  9. Application of phaco prechop with phaco chop technique in phacoemulsification

    Directory of Open Access Journals (Sweden)

    Wei Liu

    2014-03-01

    Full Text Available AIM:To compare two phaco techniques, namely phaco prechop with phaco chop and divide and conquer, and to discuss the technical advantages of phaco prechop with phaco chop METHODS:The study included 131 patients(156 eyeswith age-related cataract eyes divided into 2 groups, group A including 68 patients(82 eyes, in which phaco prechop with phaco chop was performed, and group B including 63 patients(74 eyes, in which divide and conquer was performed. The mean parameters including average power(AP, U/S time, accumulated energy complex parameter(AECP, mean endothelial cell count, mean endothelial cell loss, intraoperative complications, postoperative uncorrected visual acuity(UCVAat 1d and 1wk, and corneal edema were reported in the two groups both preoperative and postoperative.RESULTS:The subgroups with same grade of lens nucleus hardness were compared. Parameters such as AP, U/S time, AECP in group A were significantly less than those in group B. Postoperative corneal clarity and UCVA at 1d in group A was better than that in group B. No significant difference was found in UCVA at 1wk after operation between the two groups. The difference in mean endothelial cell count at 3mo postoperative between the two groups was statistically insignificant(P>0.05, however the difference in endothelial cell loss at 3mo postoperatively between the two groups was statistically significant(PCONCLUSION:Compare with divide and conquer, phaco prechop with phaco chop utilized less phaco time, energy, and the rate of endothelial cell loss at 3mo postoperatively, and better early postoperative uncorrected visual acuity.

  10. Correlations between corneal and total wavefront aberrations

    Science.gov (United States)

    Mrochen, Michael; Jankov, Mirko; Bueeler, Michael; Seiler, Theo

    2002-06-01

    Purpose: Corneal topography data expressed as corneal aberrations are frequently used to report corneal laser surgery results. However, the optical image quality at the retina depends on all optical elements of the eye such as the human lens. Thus, the aim of this study was to investigate the correlations between the corneal and total wavefront aberrations and to discuss the importance of corneal aberrations for representing corneal laser surgery results. Methods: Thirty three eyes of 22 myopic subjects were measured with a corneal topography system and a Tschernig-type wavefront analyzer after the pupils were dilated to at least 6 mm in diameter. All measurements were centered with respect to the line of sight. Corneal and total wavefront aberrations were calculated up to the 6th Zernike order in the same reference plane. Results: Statistically significant correlations (p corneal and total wavefront aberrations were found for the astigmatism (C3,C5) and all 3rd Zernike order coefficients such as coma (C7,C8). No statistically significant correlations were found for all 4th to 6th order Zernike coefficients except for the 5th order horizontal coma C18 (p equals 0.003). On average, all Zernike coefficients for the corneal aberrations were found to be larger compared to Zernike coefficients for the total wavefront aberrations. Conclusions: Corneal aberrations are only of limited use for representing the optical quality of the human eye after corneal laser surgery. This is due to the lack of correlation between corneal and total wavefront aberrations in most of the higher order aberrations. Besides this, the data present in this study yield towards an aberration balancing between corneal aberrations and the optical elements within the eye that reduces the aberration from the cornea by a certain degree. Consequently, ideal customized ablations have to take both, corneal and total wavefront aberrations, into consideration.

  11. A new, band-shaped and whorled microcystic dystrophy of the corneal epithelium.

    Science.gov (United States)

    Lisch, W; Steuhl, K P; Lisch, C; Weidle, E G; Emmig, C T; Cohen, K L; Perry, H D

    1992-07-15

    Five family members and three unrelated patients (four women, four men, 23 to 71 years old) had a dystrophy of the corneal epithelium. Direct slit-lamp examination showed bilateral or unilateral, gray, band-shaped, and feathery opacities that sometimes appeared in whorled patterns. Retroillumination showed intraepithelial, densely crowded, clear microcysts. Light and electron microscopy disclosed diffuse vacuolization of the cytoplasm of epithelial cells in the affected area. Visual acuity was so reduced in three patients that abrasion of the corneal epithelium was performed. The corneal abnormalities recurred within months, with the same reduction in visual acuity as before. The corneal opacities were progressive in two patients but diminished noticeably in another after he began using a hard contact lens. We found no other ophthalmic irregularities or associated systemic abnormalities and no indication of drug-induced keratopathy.

  12. The Preliminary Experimental Study of Induced Differentiation of Embryonic Stem Cells into Corneal Epithelial Cells

    Institute of Scientific and Technical Information of China (English)

    Ling Yu; Jian Ge; Zhichong Wang; Bing Huang; Keming Yu; Chongde Long; Xigu Chen

    2001-01-01

    Purpose:To study preliminarily induced differentiation of embryonic stem cells intocorneal epithelial cells in vitro.Methods: Murine embryonic stem cells were co-cultured with Rabbit limbal cornealepithelial cells in Transwell system to induce differentiation. Mophological andimmunohistochemical examination were implemented.Results: The induced cells from embryonic stem cells have an epithelial appearance.The cells formed a network and were confluent into film gradually after beingco-cultured with rabbit limbal corneal epithelial cells for 24 ~ 96 hours. The cells rangedmosaic structure and localized together with clear rim. Most of the cells showedpolygonal appearance. Transmission electron microscope showed lots of microvilli on thesurface of induced cells and tight junctions between them. These epithelial-like cellsexpressed the corneal epithelial cell specific marker cytokeratin3/cytokeratinl2.Conclusion: The potential mechanism of the differentiation of murine embryonic stemcells into corneal epithelial cells induced by limbal corneal epithelial cell-derivedinducing activity is to be further verified.

  13. Combined 30-degree bevel up and down technique against 0-degree phaco tip for phacoemulsification surgery of hard cataracts

    National Research Council Canada - National Science Library

    Joshi RS; Muley SJ

    2017-01-01

    ...) as phaco parameters with 0- and 30-degree phaco tip. Patients and methods: This prospective, interventional and observational case series included 294 patients scheduled for cataract removal by phacoemulsification technique...

  14. The incidence of ptosis following extracapsular and phacoemulsification surgery: comparison of two prospective studies and review of the literature.

    Science.gov (United States)

    Puvanachandra, Narman; Hustler, Adam; Seah, Lay Leng; Tyers, Anthony G

    2010-12-01

    We prospectively compared 120 patients who underwent either phacoemulsification or extracapsular cataract (ECCE) surgery to establish the incidence of postoperative ptosis between the two techniques. Of the 120 patients, 60 underwent ECCE (unpublished data 1989) and 60 had phacoemulsification. Data was collected prospectively on upper and lower margin reflex distance, upper lid skin crease and levator function, preoperatively and 6 weeks postoperatively. Photographs were taken pre and postoperatively and examined by a blinded observer. At 6 weeks, ptosis was present in 18% of ECCE patients compared with 0% in the phacoemulsification group. By changing from ECCE to phacoemulsification the incidence of postoperative ptosis has reduced. The possibility to induce postoperative ptosis remains, potential mechanisms are discussed.

  15. Progress in corneal wound healing.

    Science.gov (United States)

    Ljubimov, Alexander V; Saghizadeh, Mehrnoosh

    2015-11-01

    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β (TGF-β) system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal

  16. Progress in corneal wound healing

    Science.gov (United States)

    Ljubimov, Alexander V.; Saghizadeh, Mehrnoosh

    2015-01-01

    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal epithelium, and

  17. [Corneal manifestations in systemic diseases].

    Science.gov (United States)

    Zarranz Ventura, J; De Nova, E; Moreno-Montañés, J

    2008-01-01

    Systemic diseases affecting the cornea have a wide range of manifestations. The detailed study of all pathologies that cause corneal alteration is unapproachable, so we have centered our interest in the most prevalent or characteristic of them. In this paper we have divided these pathologies in sections to facilitate their study. Pulmonar and conective tissue (like colagen, rheumatologic and idiopathic inflamatory diseases), dermatologic, cardiovascular, hematologic, digestive and hepatopancreatic diseases with corneal alteration are described. Endocrine and metabolic diseases, malnutrition and carential states are also studied, as well as some otorhinolaryngologic and genetic diseases that affect the cornea. Finally, a brief report of ocular toxicity induced by drugs is referred.

  18. Fully automated corneal endothelial morphometry of images captured by clinical specular microscopy

    Science.gov (United States)

    Bucht, Curry; Söderberg, Per; Manneberg, Göran

    2010-02-01

    The corneal endothelium serves as the posterior barrier of the cornea. Factors such as clarity and refractive properties of the cornea are in direct relationship to the quality of the endothelium. The endothelial cell density is considered the most important morphological factor of the corneal endothelium. Pathological conditions and physical trauma may threaten the endothelial cell density to such an extent that the optical property of the cornea and thus clear eyesight is threatened. Diagnosis of the corneal endothelium through morphometry is an important part of several clinical applications. Morphometry of the corneal endothelium is presently carried out by semi automated analysis of pictures captured by a Clinical Specular Microscope (CSM). Because of the occasional need of operator involvement, this process can be tedious, having a negative impact on sampling size. This study was dedicated to the development and use of fully automated analysis of a very large range of images of the corneal endothelium, captured by CSM, using Fourier analysis. Software was developed in the mathematical programming language Matlab. Pictures of the corneal endothelium, captured by CSM, were read into the analysis software. The software automatically performed digital enhancement of the images, normalizing lights and contrasts. The digitally enhanced images of the corneal endothelium were Fourier transformed, using the fast Fourier transform (FFT) and stored as new images. Tools were developed and applied for identification and analysis of relevant characteristics of the Fourier transformed images. The data obtained from each Fourier transformed image was used to calculate the mean cell density of its corresponding corneal endothelium. The calculation was based on well known diffraction theory. Results in form of estimated cell density of the corneal endothelium were obtained, using fully automated analysis software on 292 images captured by CSM. The cell density obtained by the

  19. A clinical comparison between DisCoVisc and 2% hydroxypropylmethylcellulose in phacoemulsification: a fellow eye study

    OpenAIRE

    Espíndola, Rodrigo F.; Castro, Emerson F.S.; Marcony R. Santhiago; Newton Kara-Junior

    2012-01-01

    OBJECTIVE: This study sought to compare the effects and outcomes of two ophthalmic viscosurgical devices, 1.6% hyaluronic acid/4.0% chondroitin sulfate and 2.0% hydroxypropylmethylcellulose, during phacoemulsification. METHODS: This prospective, randomized clinical trial comprised 78 eyes (39 patients) that received phacoemulsification performed by the same surgeon using a standardized technique. Patients were randomly assigned to receive either 1.6% hyaluronic acid/4.0% chondroitin sulfate o...

  20. Anterior Chamber Contamination at the Conclusion of Phacoemulsification

    Directory of Open Access Journals (Sweden)

    Mohammad-Reza Soleimani

    2008-12-01

    Full Text Available

    PURPOSE: To evaluate anterior chamber aspirates at the conclusion of phacoemulsification and intraocular lens implantation (PE+IOL for bacterial and fungal contamination. METHODS: We prospectively evaluated 80 eyes of 80 patients undergoing routine PE+IOL by performing bacterial and fungal culture on aspirates obtained from the anterior chamber at the end of the surgery. RESULTS: Anterior chamber fluid aspirates were positive for bacteria in 5 eyes (6.33% with coagulase-negative staphylococcus being the most common organism (three eyes. No instance of positive fungus culture was observed. One of the culture-positive eyes developed postoperative uveitis which resolved during a week of treatment with topical corticosteroids and antibiotics.  None of the eyes developed endophthalmitis. CONCLUSION: In the current series, the rate of anterior chamber contamination by bacteria at the end of phacoemulsification was in the lower range reported by previous studies.  

  1. Corneal Regeneration After Photorefractive Keratectomy: A Review.

    Science.gov (United States)

    Tomás-Juan, Javier; Murueta-Goyena Larrañaga, Ane; Hanneken, Ludger

    2015-01-01

    Photorefractive keratectomy (PRK) remodels corneal stroma to compensate refractive errors. The removal of epithelium and the ablation of stroma provoke the disruption of corneal nerves and a release of several peptides from tears, epithelium, stroma and nerves. A myriad of cytokines, growth factors, and matrix metalloproteases participate in the process of corneal wound healing. Their balance will determine if reepithelization and stromal remodeling are appropriate. The final aim is to achieve corneal transparency for restoring corneal function, and a proper visual quality. Therefore, wound-healing response is critical for a successful refractive surgery. Our goal is to provide an overview into how corneal wounding develops following PRK. We will also review the influence of intraoperative application of mitomycin C, bandage contact lenses, anti-inflammatory and other drugs in preventing corneal haze and post-PRK pain. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  2. Clear cell chondrosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, R.; David, R.; Cierney, G. III

    1985-01-01

    The clinical, radiologic, and histopathologic features of three cases of clear cell chondrosarcoma are described. On radiographs, this rather benign-appearing tumor resembles a chondroblastoma when it occurs at the end of a long bone, and may occasionally show a calcified matrix. However, it has distinctive tumor cells with a centrally placed vesicular nucleus surrounded by clear cytoplasm. The lesion has a low-grade malignancy and is amenable to en bloc surgical resection, which results in a much better prognosis than that of conventional chondrosarcoma.

  3. Changing Indications and Surgical Techniques for Corneal Transplantation Between 2004 and 2009 at a Tertiary Referral Center

    Science.gov (United States)

    Zare, Mohammad; Javadi, Mohammad A.; Einollahi, Bahram; Karimian, Farid; Rafie, Ali R. B.; Feizi, Sepehr; Azimzadeh, Ahmad

    2012-01-01

    Purpose: The aim of this study is to report the indications, techniques, and clinical outcomes of corneal transplantation and investigate any changing trends in surgical techniques over a 6 year period. Materials and Methods: Records of patients who had undergone any kind of corneal transplantation at Labbafinejad Medical Center, Tehran, Iran, from January 2004 to December 2009 were reviewed to determine the indications and types of corneal transplantation. Postoperative best-corrected visual acuity, refractive error, graft clarity, and complications were reported. Results: During this period, 1859 eyes of 1624 patients with a mean age of 41.3 ± 21.3 years underwent corneal transplantation. The most common indication was keratoconus (38.4%) followed by aphakic/pseudophakic bullous keratopathy (11.7%), previous failed grafts (10.6%), infectious corneal ulcers (10.1%), non-herpetic corneal scars (7.6%), trachoma keratopathy (4.7%), stromal corneal dystrophies (4.6%), post-herpetic corneal scar (3.7%), Fuchs’ endothelial dystrophy (0.8%), and congenital hereditary endothelial dystrophy (0.4%). Techniques of corneal transplantation included penetrating keratoplasty (PKP; 70.9%), deep anterior lamellar keratoplasty (DALK; 20.1%), conventional lamellar keratoplasty (LKP; 4.4%), and Descemet's stripping automated endothelial keratoplasty (DSAEK; 2.3%). Over the study period, there was a significant increase in the relative frequency of infectious corneal ulcers, failed grafts, and trachoma keratopathy. Additionally, a significant reduction was observed in PKP and LKP procedures, and volume of DALK and DSAEK increased significantly. At final follow-up, 69.0% of grafts were clear in the PKP group. This figure was 82.6%, 82.7%, and 97.6% in the DALK, LKP, and DSAEK groups, respectively. Conclusion: Keratoconus was the most common indication and PKP was the most prevalent technique used for corneal transplantation. However, significant changes in the indications and

  4. Changing indications and surgical techniques for corneal transplantation between 2004 and 2009 at a tertiary referral center

    Directory of Open Access Journals (Sweden)

    Mohammad Zare

    2012-01-01

    Full Text Available Purpose: The aim of this study is to report the indications, techniques, and clinical outcomes of corneal transplantation and investigate any changing trends in surgical techniques over a 6 year period. Materials and Methods: Records of patients who had undergone any kind of corneal transplantation at Labbafinejad Medical Center, Tehran, Iran, from January 2004 to December 2009 were reviewed to determine the indications and types of corneal transplantation. Postoperative best-corrected visual acuity, refractive error, graft clarity, and complications were reported. Results: During this period, 1859 eyes of 1624 patients with a mean age of 41.3 ± 21.3 years underwent corneal transplantation. The most common indication was keratoconus (38.4% followed by aphakic/pseudophakic bullous keratopathy (11.7%, previous failed grafts (10.6%, infectious corneal ulcers (10.1%, non-herpetic corneal scars (7.6%, trachoma keratopathy (4.7%, stromal corneal dystrophies (4.6%, post-herpetic corneal scar (3.7%, Fuchs′ endothelial dystrophy (0.8%, and congenital hereditary endothelial dystrophy (0.4%. Techniques of corneal transplantation included penetrating keratoplasty (PKP; 70.9%, deep anterior lamellar keratoplasty (DALK; 20.1%, conventional lamellar keratoplasty (LKP; 4.4%, and Descemet′s stripping automated endothelial keratoplasty (DSAEK; 2.3%. Over the study period, there was a significant increase in the relative frequency of infectious corneal ulcers, failed grafts, and trachoma keratopathy. Additionally, a significant reduction was observed in PKP and LKP procedures, and volume of DALK and DSAEK increased significantly. At final follow-up, 69.0% of grafts were clear in the PKP group. This figure was 82.6%, 82.7%, and 97.6% in the DALK, LKP, and DSAEK groups, respectively. Conclusion: Keratoconus was the most common indication and PKP was the most prevalent technique used for corneal transplantation. However, significant changes in the indications

  5. Corneal surface reconstruction - a short review

    Directory of Open Access Journals (Sweden)

    Madhavan H N

    2009-01-01

    Full Text Available Cornea is the clear, dome-shaped surface that covers the front of the eye and when damage due to burns or injury and several other diseases, stem cells residing in its rim called "limbus" are stimulated to multiply to support growth of new epithelial cells over its surface. If this ready source of stem cells is damaged or destroyed the natural repair is not possible and such a condition is known as corneal limbal stem cell deficiency (CLSCD disease. Stem cell transplant helps such persons to regenerate the corneal surface. Human corneal limbal stem cell transplantation is at present an established procedure with reasonable good clinical outcome particularly when autologous limbal epithelial tissue from a fellow unaffected eye is used. 1, 2 A major concern related to the autograft is the possibility of CLSCD at the donor site, 3 techniques that allowed the expansion of a small limbal biopsy in the laboratory using cell cultures that could be then transplanted to the affected eye have been developed ,4, 5 Human amniotic membrane (HAM is used as a scaffold for both culturing the human limbal epithelial cells and for ocular surface reconstruction with the cultured limbal epithelial cells. 4-7 However, researchers have used alternative scaffolds like collagen 8, fibrin gel 9 and cross-linked gel of fibronectin and fibrin. 10 All these are biological materials and also need for animal 3T3 feeder layer for stem cell cultures. The properties of HAM are unique including antiadhesive effects, bacteriostatic effects, wound protection, pain reduction, and improvement of epithelialization and characteristically lacking imunogenicity. The use of amniotic membrane transplantation (AMT to treat ocular surface abnormalities was first reported by Graziella Pellegrini, chief of stem cell laboratory at Giovanni Paolo Hospital in Venice, Italy, who was the first to demonstrate the limbal stem cell transplant in 1997. Amniotic membrane has been successfully used in

  6. Topography-guided phacoemulsification surgery on type 2 diabetic patients with age-related cataract%角膜地形图引导超声乳化治疗2型糖尿病年龄相关性白内障

    Institute of Scientific and Technical Information of China (English)

    易昀敏; 易敬林; 邵毅; 余瑶; 王慧珍; 龚菊梅; 高桂平

    2011-01-01

    Objective To observe the corneal astigmatism and tear film stability of type 2 diabetic patients with age related cataract and astigmatism after phacoemulsification surgery guided by corneal topography. Methods 80 patients with type 2 diabetic age-related cataract and astigmatism were randomly divided into two groups;group A was treated by tra ditional superior corneal incision phacoemulsification surgery and IOL implantation, group B was treated by corneal topogra phy guiding incision phacoemulsification surgery and IOL implantation. Topography tests and tear film function were per formed at 1 week and 3 months postoperative. Results For corneal vertical Jc and horizon astigmatism P, there was signifi cance statistically at preoperative and I week postoperative in group A(P0. 01 ), however, there was significance statistically at preoperative and 1 week, 3 months postoperative in group B(P <0. 01) ; when compared with group A. Group B had longer time of BUT al 1 week postoperative(P <0.05) , 3 months after surgery, the BUT of two groups return to the preoperative level. Con dusion Topography-guided phacoemulsification surgery and IOL implantation is a more favorable solution for type 2 dia betic patients with age-related cataract and astigmatism,which can correct the cornea] astigmatism, stabilize the tear film and therefore improve the visual quality.%目的 观察角膜地形图引导超声乳化治疗2型糖尿病年龄相关性白内障患者角膜散光及泪膜稳定性.方法 术前存在角膜散光的2型糖尿病年龄相关性白内障患者80例(80眼),随机分为A、B组,各40例(40眼).A组采用常规上方透明角膜切口行超声乳化白内障吸除联合人工晶状体(IOL)植入术,B组在角膜地形图引导下作切口行超声乳化白内障吸除联合IOL植入术,术后1周及3个月复查角膜地形图并观察泪膜改变情况.结果 角膜垂直散光失量Jo和水平散光失量P,A组术前与术后1周相比,P<0.01,与术后3

  7. Corneale crosslinking voor progressieve keratoconus

    NARCIS (Netherlands)

    Wisse, Robert P L; Soeters, Nienke; Godefrooij, Daniel A.; De Koning-Tahzib, Nayyirih G.

    2016-01-01

    Keratoconus is a corneal disease with onset typically occurring during puberty or early adulthood. The cornea progressively thins and acquires a cone-like shape which negatively affects visual acuity. In the early stages, visual acuity can be corrected with glasses or contact lenses. In more

  8. Corneale crosslinking voor progressieve keratoconus

    NARCIS (Netherlands)

    Wisse, Robert P L; Soeters, Nienke; Godefrooij, Daniel A.; De Koning-Tahzib, Nayyirih G.

    2016-01-01

    Keratoconus is a corneal disease with onset typically occurring during puberty or early adulthood. The cornea progressively thins and acquires a cone-like shape which negatively affects visual acuity. In the early stages, visual acuity can be corrected with glasses or contact lenses. In more advance

  9. Terahertz sensing of corneal hydration.

    Science.gov (United States)

    Singh, Rahul S; Tewari, Priyamvada; Bourges, Jean Louis; Hubschman, Jean Pierre; Bennett, David B; Taylor, Zachary D; Lee, H; Brown, Elliott R; Grundfest, Warren S; Culjat, Martin O

    2010-01-01

    An indicator of ocular health is the hydrodyanmics of the cornea. Many corneal disorders deteriorate sight as they upset the normal hydrodynamics of the cornea. The mechanisms include the loss of endothelial pump function of corneal dystophies, swelling and immune response of corneal graft rejection, and inflammation and edema, which accompany trauma, burn, and irritation events. Due to high sensitivity to changes of water content in materials, a reflective terahertz (300 GHz and 3 THz) imaging system could be an ideal tool to measure the hydration level of the cornea. This paper presents the application of THz technology to visualize the hydration content across ex vivo porcine corneas. The corneas, with a thickness variation from 470 - 940 µm, were successfully imaged using a reflective pulsed THz imaging system, with a maximum SNR of 50 dB. To our knowledge, no prior studies have reported on the use of THz in measuring hydration in corneal tissues or other ocular tissues. These preliminary findings indicate that THz can be used to accurately sense hydration levels in the cornea using a pulsed, reflective THz imaging system.

  10. Snow-clearing operations

    CERN Multimedia

    EN Department

    2010-01-01

    To facilitate snow clearing operations, which commence at 4.30 in the morning, all drivers of CERN cars are kindly requested to park them together in groups. This will help us greatly assist us in our work. Thank-you for your help. Transport Group / EN-HE Tel. 72202

  11. Management of corneal bee sting

    Directory of Open Access Journals (Sweden)

    Razmjoo H

    2011-12-01

    Full Text Available Hassan Razmjoo1,2, Mohammad-Ali Abtahi1,2,4, Peyman Roomizadeh1,3, Zahra Mohammadi1,2, Seyed-Hossein Abtahi1,3,41Medical School, Isfahan University of Medical Sciences (IUMS; 2Ophthalmology Ward, Feiz Hospital, IUMS; 3Isfahan Medical Students Research Center (IMSRC, IUMS; 4Isfahan Ophthalmology Research Center (IORC, Feiz Hospital, IUMS, Isfahan, IranAbstract: Corneal bee sting is an uncommon environmental eye injury that can result in various ocular complications with an etiology of penetrating, immunologic, and toxic effects of the stinger and its injected venom. In this study we present our experience in the management of a middle-aged male with a right-sided deep corneal bee sting. On arrival, the patient was complaining of severe pain, blurry vision with acuity of 160/200, and tearing, which he had experienced soon after the injury. Firstly, we administered conventional drugs for eye injuries, including topical antibiotic, corticosteroid, and cycloplegic agents. After 2 days, corneal stromal infiltration and edema developed around the site of the sting, and visual acuity decreased to 100/200. These conditions led us to remove the stinger surgically. Within 25 days of follow-up, the corneal infiltration decreased gradually, and visual acuity improved to 180/200. We suggest a two-stage management approach for cases of corneal sting. For the first stage, if the stinger is readily accessible or primary dramatic reactions, including infiltration, especially on the visual axis, exist, manual or surgical removal would be indicated. Otherwise, we recommend conventional treatments for eye injuries. Given this situation, patients should be closely monitored for detection of any worsening. If the condition does not resolve or even deteriorates, for the second stage, surgical removal of the stinger under local or generalized anesthesia is indicated.Keywords: bee sting, stinger, cornea, removal, management, surgery

  12. Clinical applications of corneal confocal microscopy

    Directory of Open Access Journals (Sweden)

    Mitra Tavakoli

    2008-06-01

    Full Text Available Mitra Tavakoli1, Parwez Hossain2, Rayaz A Malik11Division of Cardiovascular Medicine, University of Manchester and Manchester Royal Infirmary, Manchester, UK; 2University of Southampton, Southampton Eye Unit, Southampton General Hospital, Southampton, UKAbstract: Corneal confocal microscopy is a novel clinical technique for the study of corneal cellular structure. It provides images which are comparable to in-vitro histochemical techniques delineating corneal epithelium, Bowman’s layer, stroma, Descemet’s membrane and the corneal endothelium. Because, corneal confocal microscopy is a non invasive technique for in vivo imaging of the living cornea it has huge clinical potential to investigate numerous corneal diseases. Thus far it has been used in the detection and management of pathologic and infectious conditions, corneal dystrophies and ecstasies, monitoring contact lens induced corneal changes and for pre and post surgical evaluation (PRK, LASIK and LASEK, flap evaluations and Radial Keratotomy, and penetrating keratoplasty. Most recently it has been used as a surrogate for peripheral nerve damage in a variety of peripheral neuropathies and may have potential in acting as a surrogate marker for endothelial abnormalities.Keywords: corneal confocal microscopy, cornea, infective keratitis, corneal dystrophy, neuropathy

  13. Pupil dilation with intracameral lidocaine during phacoemulsification: Benefits for the patient and surgeon

    Directory of Open Access Journals (Sweden)

    Nikeghbali Aminollah

    2008-01-01

    Full Text Available Topical and/or intracameral administration of anticholinergic and/or sympathomimetic mydriatic agents which are usually used for pupillary dilation during cataract surgery, have some disadvantages such as slow onset of dilation and adverse ocular and systemic effects. We evaluated intracameral injection of preservative-free 1% lidocaine without using any preoperative or intraoperative mydriatics to induce pupil dilation in 31 consecutive eyes scheduled for phacoemulsification cataract extraction and intraocular lens implantation. Pupil diameter was measured before and 90 sec after intracameral lidocaine injection. After intracameral lidocaine injection, the mean pupil diameter was significantly greater than the baseline measurement (P< 0.001. No additional mydriatics were needed up to the end of the operations. Intracameral preservative-free lidocaine 1% has a rapid and effective mydriasis that could be a safe alternative to topical and intracameral mydriatics in phacoemulsification.

  14. Comparing the intraoperative complication rate of femtosecond laser-assisted cataract surgery to traditional phacoemulsification

    Institute of Scientific and Technical Information of China (English)

    Ming; Chen; Christian; Swinney; Mindy; Chen

    2015-01-01

    AIM: To compare the complication rate of femtosecond laser-assisted cataract surgery(FLACS) and traditional phacoemulsification for the first 18 mo of FLACS use at a private surgical center in Hawaii.METHODS: A retrospective chart review was conducted from January 2012 to June 2013. The first 273 consecutive eyes receiving FLACS and 553 eyes receiving traditional phacoemulsification were examined.All surgeries were performed at a single surgical center in Hawaii. The presence of intraoperative complications was used as the main outcome measure. Approval was obtained from the institutional review board of the University of Hawaii.RESULTS: The overall complication rate for FLACS was 1.8%, while that of the traditional procedure was5.8%(P <0.05). A majority of the surgeons(80%) had a lower complication rate while using FLACS.CONCLUSION: FLACS is comparable in safety, if not safer, than traditional cataract surgery when performed by qualified cataract surgeons on carefully selected patients.

  15. Phacoemulsification without hydrodissection: Semi-crater and split technique.

    Science.gov (United States)

    Soda, Mitsutaka; Yaguchi, Shigeo

    2015-06-01

    We present a semi-crater sculpting and split technique for simple nucleus removal and hydrodissection-free phacoemulsification. In this technique, the crater sculpting is done in half the nucleus only and emulsified before nucleus rotation. The remaining half of the nucleus is freed from the capsule and then rotated to the opposite side of the phaco tip and emulsified. This technique can be easily performed without hydrodissection because emulsifying half the nucleus creates a free space. It was used in 19 198 eyes between 2000 and 2013 and enabled stable phacoemulsification, regardless of the surgeon's experience. The technique prevents hydrodissection-related complications, such as posterior capsule rupture caused by high intraocular pressure changes, and reduces the stress on the zonule during nucleus rotation. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Comparing the intraoperative complication rate of femtosecond laser-assisted cataract surgery to traditional phacoemulsification

    Directory of Open Access Journals (Sweden)

    Ming Chen

    2015-02-01

    Full Text Available AIM: To compare the complication rate of femtosecond laser-assisted cataract surgery (FLACS and traditional phacoemulsification for the first 18mo of FLACS use at a private surgical center in Hawaii. METHODS: A retrospective chart review was conducted from January 2012 to June 2013. The first 273 consecutive eyes receiving FLACS and 553 eyes receiving traditional phacoemulsification were examined. All surgeries were performed at a single surgical center in Hawaii. The presence of intraoperative complications was used as the main outcome measure. Approval was obtained from the institutional review board of the University of Hawaii. RESULTS: The overall complication rate for FLACS was 1.8%, while that of the traditional procedure was 5.8% (PCONCLUSION: FLACS is comparable in safety, if not safer, than traditional cataract surgery when performed by qualified cataract surgeons on carefully selected patients.

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

    Science.gov (United States)

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

    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, 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 (P = 0.16). Both groups, achieved similar best corrected visual acuity (P = 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. PMID:22523646

  19. First report of acute postoperative endophthalmitis caused by Rothia mucilaginosa after phacoemulsification

    Directory of Open Access Journals (Sweden)

    Pablo Álvarez-Ramos

    2016-03-01

    Full Text Available We aimed at reporting the first case of rapidly progressive acute postoperative endophthalmitis after phacoemulsification cataract surgery in an immunocompetent patient caused by Rothia mucilaginosa. An immunocompetent patient manifested endophthalmitis signs 48 hours after an uncomplicated cataract surgery by phacoemulsification. A bacteria of the family Micrococcaceae was cultured in the vitreous biopsy, namely R. mucilaginosa. The patient did not show a favorable clinical response after vitrectomy and systemic, intravitreal, and topical fortified antibiotics. The patient’s eye was very painful, and consequently, it deemed necessary to perform an evisceration. R. mucilaginosa may be an aggressive etiologic agent for postoperative endophthalmitis. Although the isolated R. mucilaginosa was susceptible to empirical treatment, it was impossible to control the infection with standard treatment, probably due to its ability to create a biofilm around the intraocular lens.

  20. Blood pressure change during phacoemulsification and femtosecond laser-assisted cataract surgery

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    Hung-Yuan Lin

    2016-11-01

    Full Text Available AIM: To evaluate blood pressure (BP changes during phacoemulsification (PC and femtosecond laser (FSL-assisted cataract surgery. METHODS: A retrospective chart review was performed for all patients who received traditional phacoemulsification surgery (PC group and FSL-assisted cataract surgery (FS group from July 2013 to December 2014. Totally 206 eyes from 133 patients receiving the two types of procedures were included. Patient characteristics (age, gender, and hypertension history, pre- and post-operative BPs were collected. RESULTS: The pro-operative systolic and diastolic BPs (mm Hg were 124.89±20.48 vs 126.98±16.85, and 71.88±9.81 vs 73.56±10.03, in PC and FS groups, respectively. While the post-operative systolic and diastolic BPs (mm Hg were 130.13±22.59 vs 134.77±17.52, and 73.41±11.62 vs 78.89±12.2, in PC and FS groups, respectively. Paired-sample t-tests showed obvious systolic and diastolic BP elevations in FS group after surgery (P=0.001 and 0.007 and no reliability in PC group (P=0.094 and 0.359. A linear regression model revealed systolic and diastolic BP elevations, which were related to longer surgical times for FS group (P=0.008 and 0.021. Age, gender, and hypertension history were not correlated with blood pressure elevation in either group. CONCLUSION: BP increases but at a limited level after FSL-assisted cataract surgery compared to traditional phacoemulsificationKEYWORDS: cataract surgery; blood pressure; femtosecond-assisted cataract surgery; phacoemulsification

  1. Combined intravitreal bevacizumab with phacoemulsification in visually significant cataract and visually significant exudative maculopathy

    Directory of Open Access Journals (Sweden)

    Ahmad Mansour

    2011-01-01

    Full Text Available Purpose : We investigated the visual outcome of combined phacoemulsification with intravitreal bevacizumab, in eyes with dense cataract and visually significant exudative maculopathy. Materials and Methods : Prospective longitudinal pilot study of consecutive patients treated by two surgeons in 2006, using intravitreal bevacizumab at the end of phacoemulsification. The historical control group consisted of consecutive subjects with exudative maculopathy and dense cataract treated by the same surgeons with the help of phacoemulsification without intravitreal bevacizumab prior to 2006. Results : Thirty-one treated patients had the mean (SD logMar best corrected visual acuity improving from - 1.48 (0.50 preoperatively to - 0.67 (0.38 in the first postoperative week ( p < 0.001, to - 0.64 (0.40 in the first postoperative month ( p < 0.001, and to - 0.62 (0.42 ( p < 0.001 on the last follow-up (mean 4.2 months, range 1 - 9 months. Fourteen control patients had the mean (SD logMar best corrected visual acuity improving from - 1.78 (0.79 preoperatively, to - 0.91 (0.53 in the first postoperative week ( p < 0.001, to - 0.86 (0.45 in the first postoperative month ( p < 0.001, and to - 0.90 (0.47 ( p < 0.001 on the last follow- up (mean 19.6 months, range 1 - 49 months. Initial visual acuities, final visual acuities, and percentage of visual improvement at one month were all not significantly better in the intervention compared to the control group at one month. In the study group, the fovea was flattened at the one-month follow-up, by 90-diopter slit lamp examination and / or Optical coherence tomography. Conclusion : The combination of intravitreal bevacizumab and phacoemulsification is beneficial for maximal visual rehabilitation in the first postoperative month.

  2. Phacoemulsification Surgery in Eyes with Neovascular Age-Related Macular Degeneration

    Science.gov (United States)

    Papavasileiou, Evangelia; Kumar, Balakrishna Vineeth; Prasad, Som

    2014-01-01

    Purpose. To evaluate the visual outcomes and effect of phacoemulsification surgery on the progression of neovascular age-related macular degeneration (AMD). Methods. Retrospective, noncomparative, and interventional case series. Thirty eyes from 29 subjects with neovascular AMD treated with intravitreal antivascular endothelial growth factor (VEGF) injections who underwent phacoemulsification and had a postsurgery follow-up of 6 months were included. LogMAR best corrected visual acuity (BCVA) was assessed preoperatively; 1 month, 3 months, and 6 months postoperatively; and finally at the last visit. The frequency of anti-VEGF therapy, calculated as the number of intravitreal injections per month, and central macular thickness (CMT) before and after cataract surgery were determined. Results. Median (range) logMAR BCVA was 0.69 (0.16 to 1.32) preoperatively; 0.55 (−0.04 to 1.32) at 1 month, 0.52 (−0.1 to 1.32) at 3 months, and 0.50 (0.0 to 1.32) at 6 months postoperatively; and 0.6 (0.0 to 1.4) at final visit (P = 0.0011). There was no difference in the frequency of anti-VEGF injections between the immediate 6 months before and after phacoemulsification, which was equal to 0.1667 injections per month (P = 0.6377). Median CMT measured 203 μm preoperatively, which temporarily increased to 238 μm at 1 month after surgery (P = 0.0093) and then spontaneously returned to baseline, measuring 212.5 μm at 3 months postoperatively (P = 0.3811). Conclusion. Phacoemulsification surgery significantly improved vision in patients with neovascular AMD, with no increased need for anti-VEGF injections to keep the macula dry postoperatively. PMID:24719771

  3. Phacoemulsification without preoperative topical mydriatics: Induction and sustainability of mydriasis with intracameral mydriatic solution

    Directory of Open Access Journals (Sweden)

    Sanjiv K Gupta

    2014-01-01

    Full Text Available Context: Intracameral mydriatic solution can eliminate the disadvantages of repeated eye drop instillation regimen and provide adequate mydriasis for phacoemulsification with added advantages. Aims: Evaluating the role of intracameral irrigating solution (0.5% lignocaine + 0.001% epinephrine in initiating and maintaining the pupillary mydriasis during phacoemulsification. Secondary aims were to observe the effect of surgical time, nucleus density and ultrasound time on mydriasis during the procedure. Settings and Design: The study is a prospective interventional case series, conducted at tertiary care institution. Materials and Methods: Thirty patients underwent phacoemulsification under topical anesthesia for visually significant cataract. Pupillary dilatation was achieved by intracameral irrigation of mydriatic solution alone. Pupillary diameter was measured serially during surgery and ultrasound time and total surgical time were noted. Statistical Analysis Used: Paired samples student-t test was done to compare means. Spearman correlation coefficient was used to study the effect of various parameters on mydriasis. Results: Thirty eyes completed the study. The pupil size increased from 2.1 mm (Range 2-3.5 mm SD ± 0.32 to 6.9 mm (Range 5-9 mm SD ± 1.02 in 30 seconds time after intracameral mydriatic solution delivery, and was 7.0 mm (Range 3.5 - 9 mm SD ± 0.20 at the end of surgery. Duration of surgery, grade of nucleus and ultrasound time had statistically insignificant effect on mydriasis. Conclusions: Intracameral solution containing 0.5% lignocaine and 0.001% epinephrine provides rapid mydriasis which is adequate for safe phacoemulsification and is unaffected by other parameters.

  4. Visual outcome after corneal transplantation for corneal perforation and iris prolapse in 37 horses

    DEFF Research Database (Denmark)

    Henriksen, Michala de Linde; Plummer, C. E.; Mangan, B.;

    2012-01-01

    We wanted to investigate the visual outcome of horses presented with iris prolapse and treated with corneal transplantation.......We wanted to investigate the visual outcome of horses presented with iris prolapse and treated with corneal transplantation....

  5. "Double bubble" deep anterior lamellar keratoplasty for management of corneal stromal pathologies.

    Science.gov (United States)

    Jhanji, Vishal; Beltz, Jacqueline; Sharma, Namrata; Graue, Enrique; Vajpayee, Rasik B

    2011-08-01

    'Big Bubble' deep anterior lamellar keratoplasty (DALK) is becoming an accepted corneal transplantation technique for keratoconus and other anterior stromal corneal pathologies that spare the Descemet's membrane (DM) and endothelium. However, it is not always possible to conclusively recognise formation and identification of the 'Big Bubble'. We describe the surgical technique of DALK called 'Double Bubble' technique that allows the surgeon to definitely and immediately identify the formation of an adequate big bubble. DALK was performed using the 'Double Bubble' technique in twelve eyes of twelve patients with corneal stromal pathologies (keratoconus, 9 eyes; macular corneal dystrophy, 2 eyes; postinfectious keratitis corneal stromal scar, 1 eye) at the Royal Victorian Eye and Ear Hospital, Melbourne. Big bubble was successfully formed in 10 eyes. Maximum-depth deep lamellar keratoplasty was performed in two eyes. There were no instances of intraoperative perforation of the DM. All grafts were clear at last follow-up. Best-corrected visual acuity of ≥20/40 was achieved in all the cases at last follow-up (6-12 months). 'Double Bubble' DALK helps in identification of the big bubble and has the potential to increase the success of standard 'Big Bubble' DALK in patients with corneal stromal pathologies sparing the DM and endothelium.

  6. Small Incision Non-phacoemulsification Cataract Surgery Clinical Effect Analysis of Hard Nucleus Cataract%小切口非超声乳化白内障手术治疗硬核白内障的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    殷先第

    2015-01-01

    Objective To explore the clinical effect of smal incision non-phacoemulsification cataract surgery in the hard nuclear cataract treatment.Methods Choose 76 cases of our hospital's hard nuclear cataract patients,divided into control group and experimental group in lots of ways, control group treated by conventional incision cataract extracapsular extraction, and the experimental treated by smal incision non phacoemulsification cataract surgery, the treatment effects were analyzed.Results The experimental group after treatment in patients with corneal luminosity and the incidence of complications was better than the control group patients, the results were statisticaly significant (P<0.05).ConclusionSmal incision non-phacoemulsification cataract surgery in treatment of hard nuclear cataract ,the effect is remarkable.%目的:探究硬核白内障治疗中采用小切口非超声乳化白内障手术的临床效果。方法选择我院收治的硬核白内障患者76例,采用抽签的方式将其分为对照组和实验组,对照组治疗方式为常规切口白内障囊外摘除术,而实验组治疗方式为小切口非超声乳化白内障手术,将治疗效果进行对比分析。结果治疗后实验组患者的角膜散光度及并发症发生率明显优于对照组患者,差异P<0.05。结论在硬核白内障治疗中采用小切口非超声乳化白内障手术方式,效果显著。

  7. [Neurotrophic keratopathy--studies on substance P and the clinical significance of corneal sensation].

    Science.gov (United States)

    Nishida, T; Nakamura, M; Konma, T; Ofuji, K; Nagano, K; Tanaka, T; Enoki, M; Reid, T W; Brown, S M; Murphy, C J; Mannis, M J

    1997-12-01

    Neurotrophic keratopathy, which often follows damage to the trigeminal nerve, is clinically characterized by various types of epithelial disorders and melting of corneal stroma. To understand both the pathology of neurotrophic keratopathy and the physiological significance of corneal sensation, we investigated both the cellular and molecular functions of a sensory neurotransmitter, substance P, in corneal epithelial cells. Our findings prompted us to try a new mode of treatment for neurotrophic keratopathy. Substance P, a member of the tachykinin family, is an 11-amino-acid peptide. In an organ culture system using rabbit corneas, substance P alone had no effect on corneal epithelial migration. In the presence of insulin-like growth factor-1 (IGF-1), however, substance P synergistically facilitated corneal epithelial migration in proportion to the concentration of substance P or of IGF-1. Other neurotransmitters (acetylcholine, norepinephrine, serotonin etc.) or tachykinins (neurokinin A, eledoisin etc.) did not show this synergistic effect with IGF-1. Among receptors for the tachykinin family (NK-1, NK-2, or NK-3) only the NK-1 receptor system was involved in the synergistic effect of substance P and IGF-1 on corneal epithelial migration. IGF-1 affected neither the binding constant nor the number of sites of substance P receptors in corneal epithelial cells, suggesting that the synergistic effect was not regulated at the receptor level. Various extracellular signals activate the intracellular signal transduction system, thus amplifying specific biological functions. We found that the addition of inhibitors of protein kinase C or tyrosine kinase clearly inhibited the synergistic effect of substance P and IGF-1 on corneal epithelial migration, demonstrating that protein kinase C and tyrosine kinase are involved in the synergistic effect. During corneal epithelial wound healing, epithelial cells must attach to a provisional, extracellular fibronectin matrix. We

  8. Effect of phacoemulsification, intraocular lens implantation, and trabeculectomy on angle-closure glaucoma merged with cataract

    Institute of Scientific and Technical Information of China (English)

    Qun Wu; Li-Li Hao; Wen-Xuan Tao; Chun-Xiang Liu

    2016-01-01

    Objective:To explore the clinical effect of phacoemulsification, intraocular lens implantation, and trabeculectomy in the treatment of angle-closure glaucoma merged with cataract. Methods:A total of 80 patients with angle-closure glaucoma merged with cataract who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and randomized into the observation group and the control group. The patients in the control group were given phacoemulsification and intraocular lens implantation. On this basis, the patients in the observation group were given trabeculectomy. The vision, intraocular pressure, central anterior chamber depth, and visual field before operation, 1 week, 1 month, and 3 months after operation in the two groups were detected.Results: In the control group, 1 month after operation, while in the observation group, 1 week after operation, the vision was significantly improved, the intraocular pressure was significantly reduced, the central anterior chamber depth was significantly increased, and the average visual field defect value and average standard deviation value were significantly improved when compared with before operation (P<0.05); moreover, the improved degree in the observation group was significantly superior to that in the control group (P<0.05).Conclusions:Phacoemulsification, intraocular lens implantation, and trabeculectomy in the treatment of angle-closure glaucoma merged with cataract can effectively increase the central anterior chamber depth, reduce the intraocular pressure, and improve the vision; therefore, it deserves to be widely recommended in the clinic.

  9. Visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery

    Institute of Scientific and Technical Information of China (English)

    Wei-Qi; Chen; Vishal; Jhanji; Hao-Yu; Chen; Gui-Hua; Zhang; Ping; Hou

    2014-01-01

    AIM:To investigate the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery.METHODS:In this prospective case series, consecutive patients who underwent combined phacoemulsification and pars plana vitrectomy(PPV) under sub-Tenon anesthesia between October 2008 and September 2009 were enrolled. The patients were asked whether they could see the light of the operating microscope or not between various surgical steps with their contralateral eye being covered.RESULTS:A total of 163 eyes of 163 patients were enrolled in this study. After their contralateral eyes were covered, 152(93.3%) patients said that they could not see any light at least during one of the surgical steps. All eyes recovered to at least light perception on the first postoperative day. The incidence of no light perception during the surgery was not related to demographic factors, including age, gender, or type of ocular diseases.CONCLUSION:The incidence of no light perception during combined phacoemulsification and vitrectomy under sub-Tenon anesthesia was high in our study.Patients should be duly informed about this temporary but potential intraoperative event.

  10. Myopic shift of clinical refraction following cataract phacoemulsification with IOL implantation in an avitreal eye

    Directory of Open Access Journals (Sweden)

    E. N. Panteleev

    2013-01-01

    Full Text Available Purpose: Propose a correction of IOL power calculation for the cases of cataract phacoemulsification after preceding subtotal vitrectomy.Methods: The study enrolled 32 cases (32 patients cataract phacoemulsification with IOL implantation after subtotal vitrectomy.Patient age averaged 48±3 years. In all cases, the elastic IOLs were implanted with the value of the constant A from 118.0 to 119.0. Termevaluation of clinical refraction after phacoemulsification surgery was on average 3 months. A retrospective analysis was performed of refractive outcomes using the inverse method of calculation.Results: In a retrospective analysis, the error calculated IOL power by an average of 0.8 D, which leads to a shift in clinical refraction towards myopia. IOL after surgery avitreal eye on the average is closer to the top of the cornea by 0.5 mm, relative to the standard situation. Conclusion: For preoperative IOL power calculations after subtotal vitrectomy A-constant can be modified as follows: Am = A-0.9.

  11. Myopic shift of clinical refraction following cataract phacoemulsification with IOL implantation in an avitreal eye

    Directory of Open Access Journals (Sweden)

    E. N. Panteleev

    2014-07-01

    Full Text Available Purpose: Propose a correction of IOL power calculation for the cases of cataract phacoemulsification after preceding subtotal vitrectomy.Methods: The study enrolled 32 cases (32 patients cataract phacoemulsification with IOL implantation after subtotal vitrectomy.Patient age averaged 48±3 years. In all cases, the elastic IOLs were implanted with the value of the constant A from 118.0 to 119.0. Termevaluation of clinical refraction after phacoemulsification surgery was on average 3 months. A retrospective analysis was performed of refractive outcomes using the inverse method of calculation.Results: In a retrospective analysis, the error calculated IOL power by an average of 0.8 D, which leads to a shift in clinical refraction towards myopia. IOL after surgery avitreal eye on the average is closer to the top of the cornea by 0.5 mm, relative to the standard situation. Conclusion: For preoperative IOL power calculations after subtotal vitrectomy A-constant can be modified as follows: Am = A-0.9.

  12. Dynamic thermal imaging control of an eye in postoperative period after cataract phacoemulsification

    Directory of Open Access Journals (Sweden)

    N.R. Lopatinskaya

    2010-06-01

    Full Text Available The research goal is to study the impact of various schemes of antibacterial therapy in the postoperative period in patients after cataract phacoemulsification with distant thermography. Under observation there were 68 patients with cortical initial cataract. All patients were subjected to cataract phacoemulsification. Patients were divided into 2 groups: 34 patients of the first group after the operation dropped into the operated eye medication «Oftaquiks» 1 drop 5 times a day for one day before surgery and for 5 days postoperatively. 34 patients from the second group as an antibacterial drug received medication "Cipromed" in a similar way. Inflammatory reaction in postoperative period in the first group was not evident. In the second group the presence of inflammatory reaction of various degrees was revealed. Period of its reduction was 6,3 ± 2 days. The temperature difference between the non-operated and operated eye in the 3d day in most cases was less than 1 day after surgery. In the first group of patients the average temperature difference in the 3d day after surgery was 0.35 ± 0.21 ° C, and in the second group of patients - 1.3±0.83°C. Advantages of dynamic thermal imaging method for monitoring the state of the eye, including the analysis of time dependencies of temperature in the process of natural load test, which allows to select the optimal drug correction of postoperative cataract pha-coemulsification were revealed

  13. Comparison of outcomes following combined ECCE-trabeculectomy versus phacoemulsification-trabeculectomy.

    Science.gov (United States)

    Tous, Horacio M; Nevárez, Juan

    2006-12-01

    To analyze and compare the main outcomes between trabeculectomies combined with extracapsular cataract extraction (ECCE) versus those with phacoemulsification (Phaco). The authors retrospectively reviewed one surgeon's 357 consecutive cases (475 eyes) of combined cataract extraction, intraocular lens implantation and Mitomycin enhanced trabeculectomy. Patients were divided into two groups, those who underwent extracapsular cataract extraction (80 eyes) and those having phacoemulsification (395 eyes). Analysis of postoperative visual acuity, intraocular pressure (IOP), number of glaucoma medications, postoperative adverse events and additional procedures required, was done. Minimum follow-up was 12 months with an average of 53 months. There was no significant difference (p = 1.000) between the groups in terms of visual acuity improvement rate, 66% (ECCE) versus 59% (Phaco). Postoperatively IOP with both techniques fell significantly (p ECCE vs. 14.1 mmHg Phaco, p = 1.0000). Postoperative pressure spikes occurred in 6% versus 10% (p = 0.3995) of the eyes. No significant difference (55% ECCE versus 63% Phaco, p = 0.1674) between the two groups in terms of glaucoma medication reduction was found. The total number of postoperative complications (89% versus 68.5%) were significantly higher (p = 0.0001) in the ECCE-group, as well as the total number of eyes which required further interventions (86% versus 64%, p = 0.0001). Both combined surgery techniques are effective and yielded similar long-term results. However phacoemulsification can decrease the post operative complications associated with this surgery.

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

    Directory of Open Access Journals (Sweden)

    Shu Tian

    2015-01-01

    Full Text Available 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 static images, complicated background, unexpected noise, and varied information are always introduced in dynamic videos of the surgery. Here we develop a VidEo-Based Intelligent Recognitionand Decision (VEBIRD system, which breaks new ground by providing a generic framework for automatically tracking the operation process and classifying the cataract grade in microscope videos of the phacoemulsification cataract surgery. VEBIRD comprises a robust eye (iris detector with randomized Hough transform to precisely locate the eye in the noise background, an effective probe tracker with Tracking-Learning-Detection to thereafter track the operation probe in the dynamic process, and an intelligent decider with discriminative learning to finally recognize the cataract grade in the complicated video. Experiments with a variety of real microscope videos of phacoemulsification verify VEBIRD’s effectiveness.

  15. Determination of corneal image-forming properties from corneal topography.

    Science.gov (United States)

    Maloney, R K; Bogan, S J; Waring, G O

    1993-01-01

    Keratometry provides useful information about the cornea's image-forming properties, such as corneal astigmatism, but is inaccurate on irregular corneas. Quantitative corneal topographic information is now obtainable on irregular corneas, but is difficult for the clinician to interpret. We developed a method to determine the spherical power, astigmatism, and topographic irregularity of a cornea by finding the best-fit spherocylinder that was closest to its measured topography. Keratometric measurements and two videokeratographs were gathered prospectively on 262 normal and abnormal corneas. The best-fit measurements of spherical power, astigmatism, and topographic irregularity were reproducible with one standard deviation of 0.75 diopter or better; agreement with keratometric measurements in normal eyes was good (0.60 diopter or better). Topographic irregularity averaged 0.1 diopter on precision spheres, 0.4 diopter on 146 normal eyes, 0.8 diopter on 29 eyes after radial keratotomy, 2.0 diopters on 58 eyes after penetrating keratoplasty, and 3.0 diopters on 29 eyes with advanced keratoconus. We conclude the following: basic corneal image-forming properties can be measured from videokeratographs; the properties can be determined, by our methods, on irregular corneas in which keratometry is unreliable; and topographic irregularity provides a measure of irregular astigmatism.

  16. Clearing the Big Smog

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Beijing is trying to clean up its sky with a new standard for vehicle emissions From March 1,Beijing has imple- mented a new stricter vehicle emission standard that could lead to cleaner air,but also force thousands of cars off the road. StandardⅣ,the latest in a series of measures aimed at clearing the per- sistent smog,will match the current standard of the European Union. All the new light petro vehicles that are on sale in the Beijing market shall

  17. Immunoglobulins in granular corneal dystrophy Groenouw type I

    DEFF Research Database (Denmark)

    Møller, H U; Bojsen-Møller, M; Schrøder, H D

    1993-01-01

    Three patients with granular corneal dystrophy Groenouw type I underwent corneal grafting, and cryostat sections of the corneal buttons were examined immunohistochemically for immunoglobulins. Positive results were obtained for IgG, Kappa-, and Lambda chains with immunofluorescence technique...

  18. Polar Value Analysis of Corneal Astigmatism in Intrastromal Corneal Ring Segment Implantation

    OpenAIRE

    Chang Rae Rho; Min-Ji Kim; Choun-Ki Joo

    2016-01-01

    Purpose. To evaluate surgically induced astigmatism (SIA) and the average corneal power change in symmetric intrastromal corneal ring segment (ICRS) implantation. Methods. The study included 34 eyes of 34 keratoconus patients who underwent symmetric Intacs SK ICRS implantation. The corneal pocket incision meridian was the preoperative steep meridian. Corneal power data were obtained before and 3 months after Intacs SK ICRS implantation using scanning-slit topography. Polar value analysis was ...

  19. [Regeneration and fibrosis of corneal tissues].

    Science.gov (United States)

    Simirskiĭ, V N

    2014-01-01

    In this review, the features of the regeneration of corneal tissue and its disorders leading to the development of fibrosis are considered. The data on the presence of stem (clonogenic) cell pool in the corneal tissues (epithelium, endothelium, stroma) are given; these cells can serve as a source for regeneration of the tissues at injury or various diseases. The main steps of regeneration of corneal tissues and their disorders that lead to outstripping proliferation of myofibroblasts and secretion of extracellular matrix in the wound area and eventually cause the formation of connective tissue scar and corneal opacity are considered. Particular attention is given to the successes of translational medicine in the treatment of corneal tissue fibrosis. The methods of cell therapy aimed at the restoration of stem cell pool of corneal tissues are the most promising. Gene therapy provides more opportunities; one of its main objectives is the suppression of the myofibroblast proliferation responsible for the development of fibrosis.

  20. Ascorbic acid levels of aqueous humor of dogs after experimental phacoemulsification.

    Science.gov (United States)

    De Biaggi, Christianni P; Barros, Paulo S M; Silva, Vanessa V; Brooks, Dennis E; Barros, Silvia B M

    2006-01-01

    Phacoemulsification has been successfully employed in humans and animals for lens extraction. This ultrasonic extracapsular surgical technique induces hydroxyl radical formation in the anterior chamber, which accumulates despite irrigation and aspiration. In this paper we determined the total antioxidant status of aqueous humor after phacoemulsification by measuring aqueous humor ascorbic acid levels. Mixed-breed dogs (n = 11; weighing about 10 kg) with normal eyes as determined by slit-lamp biomicroscopy, applanation tonometry, and indirect ophthalmoscopy had phacoemulsification performed in one eye with the other eye used as a control. Samples of aqueous humor were obtained by anterior chamber paracentesis before surgery and at days 1, 2, 3, 7, and 15 after surgery. Total aqueous humor antioxidant status was inferred from the capacity of aqueous humor to inhibit free radical generation by 2,2-azobis (2-amidopropane) chlorine. Ascorbic acid concentrations were measured by high-pressure liquid chromatography with UV detection. Protein content was determined with the biuret reagent. Statistical analysis was performed by anova followed by the paired t-test. Total antioxidant capacity was reduced from 48 to 27 min during the first 24 h with a gradual increase thereafter, remaining statistically lower than the control eye until 7 days postoperatively. Reduced levels of ascorbic acid followed this reduction in antioxidant capacity (from 211 to 99 microm after 24 h), remaining lower than the control eye until 15 days postoperatively. Protein concentration in aqueous humor increased from 0.62 mg/mL to 30.8 mg/mL 24 h after surgery, remaining statistically lower than the control eye until 15 days postoperatively. Paracentesis alone did not significantly alter the parameters measured. These results indicate that after phacoemulsification, the aqueous humor ascorbic acid levels and antioxidant defenses in aqueous humor are reduced, indirectly corroborating free radical

  1. Obtaining corneal tissue for keratoplasty.

    Science.gov (United States)

    Navarro Martínez-Cantullera, A; Calatayud Pinuaga, M

    2016-10-01

    Cornea transplant is the most common tissue transplant in the world. In Spain, tissue donation activities depend upon transplant coordinator activities and the well-known Spanish model for organ and tissue donation. Tissue donor detection system and tissue donor evaluation is performed mainly by transplant coordinators using the Spanish model on donation. The evaluation of a potential tissue donor from detection until recovery is based on an exhaustive review of the medical and social history, physical examination, family interview to determine will of the deceased, and a laboratory screening test. Corneal acceptance criteria for transplantation have a wider spectrum than other tissues, as donors with active malignancies and infections are accepted for kearatoplasty in most tissue banks. Corneal evaluation during the whole process is performed to ensure the safety of the donor and the recipient, as well as an effective transplant. Last step before processing, corneal recovery, must be performed under standard operating procedures and in a correct environment. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  2. A native-like corneal construct using donor corneal stroma for tissue engineering.

    Directory of Open Access Journals (Sweden)

    Jing Lin

    Full Text Available Tissue engineering holds great promise for corneal transplantation to treat blinding diseases. This study was to explore the use of natural corneal stroma as an optimal substrate to construct a native like corneal equivalent. Human corneal epithelium was cultivated from donor limbal explants on corneal stromal discs prepared by FDA approved Horizon Epikeratome system. The morphology, phenotype, regenerative capacity and transplantation potential were evaluated by hematoxylin eosin and immunofluorescent staining, a wound healing model, and the xeno-transplantation of the corneal constructs to nude mice. An optically transparent and stratified epithelium was rapidly generated on donor corneal stromal substrate and displayed native-like morphology and structure. The cells were polygonal in the basal layer and became flattened in superficial layers. The epithelium displayed a phenotype similar to human corneal epithelium in vivo. The differentiation markers, keratin 3, involucrin and connexin 43, were expressed in full or superficial layers. Interestingly, certain basal cells were immunopositive to antibodies against limbal stem/progenitor cell markers ABCG2 and p63, which are usually negative in corneal epithelium in vivo. It suggests that this bioengineered corneal epithelium shared some characteristics of human limbal epithelium in vivo. This engineered epithelium was able to regenerate in 4 days following from a 4mm-diameter wound created by a filter paper soaked with 1 N NaOH. This corneal construct survived well after xeno-transplantation to the back of a nude mouse. The transplanted epithelium remained multilayer and became thicker with a phenotype similar to human corneal epithelium. Our findings demonstrate that natural corneal stroma is an optimal substrate for tissue bioengineering, and a native-like corneal construct has been created with epithelium containing limbal stem cells. This construct may have great potential for clinical use in

  3. Emulsification action of longitudinal and torsional ultrasound tips and the effect on treatment of the nucleus during phacoemulsification.

    Science.gov (United States)

    Miyoshi, Teruyuki; Yoshida, Hironori

    2010-07-01

    To compare the results of emulsification of test materials when applying torsional and longitudinal emulsification tips as well as to define emulsification and determine how it occurs by examining the effect of phacoemulsification. Miyoshi Eye Hospital, Fukuyama, Japan. An ultra-high-speed digital video camera was used to record emulsification of chestnuts and human nuclei in a test chamber, simulating real phacoemulsification. The treatment of the nucleus as a result of phacoemulsification was analyzed visually. Visual comparison of video data showed that the test chamber materials were completely desiccated by the torsional phaco device. Longitudinal phacoemulsification resulted in cutting and coring of the test chamber materials, but not total disruption. Visual comparisons showed that complete obliteration and desiccation of the nucleus, or emulsification, occurs only with torsional phacoemulsification. These observations open the way to understanding the best approach to new tip design and surgical strategy development. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Protective Effects of Trehalose on the Corneal Epithelial Cells

    Directory of Open Access Journals (Sweden)

    Pasquale Aragona

    2014-01-01

    Full Text Available Purpose. Aim of the present work was to evaluate the effects of the trehalose on the corneal epithelium undergoing alcohol delamination. Methods. Twelve patients undergoing laser subepithelial keratomileusis (LASEK were consecutively included in the study. The right eyes were pretreated with 3% trehalose eye drops, whilst left eyes were used as control. Epithelial specimens were processed for cells vitality assessment, apoptosis, and light and transmission electron microscopy; a morphometric analysis was performed in both groups. Results. In both trehalose-untreated eyes (TUE and trehalose-treated eyes (TTE, the percentage of vital cells was similar and no apoptotic cells were observed. In TUE, the corneal epithelium showed superficial cells with reduced microfolds, wing cells with vesicles and dilated intercellular spaces, and dark basal cells with vesicles and wide clefts. In TTE, superficial and wing cells were better preserved, and basal cells were generally clear with intracytoplasmatic vesicles. The morphometric analysis showed statistically significant differences between the two groups: the TTE epithelial height was higher, the basal cells showed larger area and clearer cytoplasm. The distribution of desmosomes and hemidesmosomes was significantly different between the groups. Conclusions. Trehalose administration better preserved morphological and morphometric features of alcohol-treated corneal epithelium, when compared to controls.

  5. Experiment Study of Effect of Perfiuorohexyloctane on Corneal Endothelial Cells

    Institute of Scientific and Technical Information of China (English)

    Xiaoyan Ding; Chunfang Li; Lin Lu; Guanguang Feng; Huling Zheng

    2001-01-01

    Purpose: To investigate the effect of Perfluorohexyloctane (F6H8)on corneal endothelial celIs(CEC) of rabbit eyes. Methods: Fifteen New Zealand white rabbits were devided into two groups:experimental group(F6H8) and control group(BSS) . All rabbits underwent anterior chamber injection of 0. 15ml F6H8 or BSS. Slit-lamp biomicroscopy and corneal endothelium photography were performed pre-operatively and postoperatively. Histopathological examination and Transmission electron microscopy(TEM) were done after the rabbits were sacrificed. Results: All the corneas were clear. Since 4 weeks after operation, the endothelial cells were markedly irregular in size and shape and the number of endothelial cells was markedly decreased. Multilayered retrocorneal membranes (RCM)grew gradually 2 weeks after surgery. Vacuolar degeneration was seen in some endothelial cells. Nuclear degeneration and edema of plasma were seen in TEM. Conclusion: Corneal endothelial cell degenerated after contacting with F6H8 for 2 ~4weeks. As a silicone solvent, it should be removed completely after injection. We don't recommend it to be used as a new intraocular temponade. Eye Science 2001: 17:21 ~ 26.

  6. Corneal Transplants - an overview with an emphasis on legal aspects and current scenario in Mauritius

    Directory of Open Access Journals (Sweden)

    Dr. Arun Kumar Agnihotri

    2007-07-01

    Full Text Available A healthy cornea is an essential component of clear vision. Any condition that distorts the clarity of the cornea to a greater extent has to be treated by keratoplasty. This article discusses by large about the various aspects of corneal transplants like modes of storage and their legal aspects with an emphasis on the scenario in Mauritius.

  7. Corneal tomography and biomechanics in primary pterygium.

    Science.gov (United States)

    Vanathi, M; Goel, Sahil; Ganger, Anita; Agarwal, Tushar; Dada, T; Khokhar, Sudarshan

    2017-05-13

    To study the Scheimpflug's imaging and corneal biomechanics in primary pterygium. A prospective observational study of 55 patients with unilateral primary nasal pterygium was done. The normal fellow eyes of patients with pterygium were taken as controls. Clinical parameters noted included visual acuity, values of corneal curvature by doing Scheimpflug imaging, wavefront aberrations in terms of higher and lower-order aberrations and corneal hysteresis (CH) as well as corneal resistance factor (CRF) values by using ocular response analyzer. Of the total 55 patients, mean age was 43.0 + 11.4 years (range: 20-72 years). Mean LogMar uncorrected visual acuity in pterygium eyes and control eyes was 0.21 + 0.20 and 0.12 + 0.15, respectively (p = 0.016). On Scheimpflug imaging the mean anterior corneal curvature values (Ka1/Ka2 D) were 41.09 + 3.38/44.33 + 2.29 in pterygium eyes, 43.13 + 1.79/43.98 + 2.17 in control eyes (p  0.05). Analysis of corneal aberrations showed significantly higher corneal wavefront aberrations in pterygium eyes. Highest correlation of corneal astigmatism was noted with corneal area encroached by pterygium (ρ = 0.540 for LOA and 0.553 for HOA) and distance from pupillary center (ρ = 0.531 for LOA and 0.564 for HOA). Corneal biomechanical parameters including CH and CRF were found to be lower in the pterygium eyes, though not statistically significant (p value 0.60 and 0.59, respectively). Pterygium leads to deterioration of visual performance not only by causing refractive and topographic changes but also by causing a significant increase in corneal wavefront aberrations.

  8. Consciousness CLEARS the mind.

    Science.gov (United States)

    Grossberg, Stephen

    2007-11-01

    A full understanding of consciousness requires that we identify the brain processes from which conscious experiences emerge. What are these processes, and what is their utility in supporting successful adaptive behaviors? Adaptive Resonance Theory (ART) predicted a functional link between processes of Consciousness, Learning, Expectation, Attention, Resonance and Synchrony (CLEARS), including the prediction that "all conscious states are resonant states". This connection clarifies how brain dynamics enable a behaving individual to autonomously adapt in real time to a rapidly changing world. The present article reviews theoretical considerations that predicted these functional links, how they work, and some of the rapidly growing body of behavioral and brain data that have provided support for these predictions. The article also summarizes ART models that predict functional roles for identified cells in laminar thalamocortical circuits, including the six layered neocortical circuits and their interactions with specific primary and higher-order specific thalamic nuclei and nonspecific nuclei. These predictions include explanations of how slow perceptual learning can occur without conscious awareness, and why oscillation frequencies in the lower layers of neocortex are sometimes slower beta oscillations, rather than the higher-frequency gamma oscillations that occur more frequently in superficial cortical layers. ART traces these properties to the existence of intracortical feedback loops, and to reset mechanisms whereby thalamocortical mismatches use circuits such as the one from specific thalamic nuclei to nonspecific thalamic nuclei and then to layer 4 of neocortical areas via layers 1-to-5-to-6-to-4.

  9. Changes in high order aberrations of anterior and posterior surfaces of cornea before and after phacoemulsification%超声乳化白内障吸除术后角膜前后表面高阶像差的变化

    Institute of Scientific and Technical Information of China (English)

    王娟; 汤欣; 张帅; 李丽华

    2008-01-01

    posterior surface of cornea were measured before and after phacoemulsification surgery on 51 eyes of 45 patients.Monofocal foldable IOLs were implanted afterphacoemulsification through a clear-cornea,3.2 mm incision without suture.Patients were observed 1 day before surgery,and at 7 days,1 month and 3 months after surgery.HOAs included the total high order aberration(tHOA),spherical aberration(SA),coma,trefoil,3rd,4th,5 th,6th order aberrations.Root-mean-square(RMS)values of HOAs were obtained with 3 mm and 6 mm aperture using corneal topography of Pentacam pre-and postoperatively,and were divided into 3 mm and 6 mm aperture groups.Aberrations were compared in each eye using repeated measures and the optical changes induced by surgery were investigated.Results The total HOA of the anterior surface increased slightly from a mean of(0.289±0.171)μm preoperatively to(0.312±0.158)μm postoperatively with 3 mm aperture;and(0.980±0.215)μm preoperatively to(1.054±0.308)μm postoperatively with 6 mm aperture,respectively.The increase was not statistically significant(F=1.55,P=0.22),and the changing trend of the total HOA was similar between the two groups of 3 mm and 6 mm aperture(F=0.95,P=0.42).The changes of other HOAs were similar to the total HOA pre-and postoperative.The total HOA of the posterior surface increased significantly from(0.548±0.220)μm preoperatively to(0.661±0.275)μm postoperatively with 3 mm aperture,and(1.780±0.453)μm preoperatively to(1.945±0.532)μm postoperatively with 6 mm aperture.The increase was statistically significant(F=15.83,P=0.00).The changing trend of the total HOA showed statistically difference between these two groups(F=12.46,P=0.00).The changes of other HOAs were similar to the total HOA pre-and postoperatively.Conclusions Phacoemulsification cataract surgery does not systematically degrade the optical quality of the anterior corneal surface.However,it introduces significant changes in most HOAs of the posterior surface of cornea

  10. Corneal laceration caused by river crab

    Directory of Open Access Journals (Sweden)

    Vinuthinee N

    2015-01-01

    Full Text Available Naidu Vinuthinee,1,2 Anuar Azreen-Redzal,1 Jaafar Juanarita,1 Embong Zunaina2 1Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Setar, 2Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia Abstract: A 5-year-old boy presented with right eye pain associated with tearing and photophobia of 1-day duration. He gave a history of playing with a river crab when suddenly the crab clamped his fingers. He attempted to fling the crab off, but the crab flew and hit his right eye. Ocular examination revealed a right eye corneal ulcer with clumps of fibrin located beneath the corneal ulcer and 1.6 mm level of hypopyon. At presentation, the Seidel test was negative, with a deep anterior chamber. Culture from the corneal scrapping specimen grew Citrobacter diversus and Proteus vulgaris, and the boy was treated with topical gentamicin and ceftazidime eyedrops. Fibrin clumps beneath the corneal ulcer subsequently dislodged, and revealed a full-thickness corneal laceration wound with a positive Seidel test and shallow anterior chamber. The patient underwent emergency corneal toileting and suturing. Postoperatively, he was treated with oral ciprofloxacin 250 mg 12-hourly for 1 week, topical gentamicin, ceftazidime, and dexamethasone eyedrops for 4 weeks. Right eye vision improved to 6/9 and 6/6 with pinhole at the 2-week follow-up following corneal suture removal. Keywords: corneal ulcer, pediatric trauma, ocular injury

  11. Corneal staining after treatment with topical tetracycline

    NARCIS (Netherlands)

    R. Lapid-Gortzak; C.P. Nieuwendaal; A.R. Slomovic; L. Spanjaard

    2006-01-01

    Purpose: The purpose of this paper is to report a case of corneal staining after treatment with topical tetracycline. Methods: A patient with crystalline keratopathy caused by Streptococcus viridans after corneal transplantation was treated topically with tetracycline eye drops, based on results of

  12. Corneal cellular proliferation and wound healing

    OpenAIRE

    Gan, Lisha

    2000-01-01

    Background. Cellular proliferation plays an important role in both physiological and pathological processes. Epithelial hyperplasia in the epithelium, excessive scar formation in retrocorneal membrane formation and neovascularization are examples of excessive proliferation of cornea cells. Lack of proliferative ability causes corneal degeneration. The degree of proliferative and metabolic activity will directly influence corneal transparency and very evidently refractive res...

  13. Corynebacterium macginleyi isolated from a corneal ulcer

    Directory of Open Access Journals (Sweden)

    Kathryn Ruoff

    2010-02-01

    Full Text Available We report the isolation of Corynebacterium macginleyi from the corneal ulcer culture of a patient, later enrolled in the Steroids for Corneal Ulcer Trial (SCUT. To our knowledge this is the first published report from North America of the recovery of C. macginleyi from a serious ocular infection.

  14. Dorsally located corneal dermoid in a cat

    Directory of Open Access Journals (Sweden)

    Alexander J LoPinto

    2016-04-01

    Full Text Available Case summary A 2-month-old, male kitten was presented for evaluation of unilateral blepharospasm and epiphora involving the right eye. Ocular examination revealed conjunctivitis, a superficial corneal ulcer, reflex anterior uveitis and a haired mass within the dorsal cornea of the right eye. The mass was subsequently removed surgically via a lamellar keratectomy. Histologic evaluation of the mass via light microscopy revealed it to be comprised of normal-haired skin with mild inflammation. One week after surgical removal and medical management of the corneal ulcer, all ocular clinical signs had resolved with minimal corneal scarring. On re-examination 6 months following surgical excision of the mass, the kitten was noted to be comfortable with no significant corneal scarring. Relevance and novel information To our knowledge, this is the first case report of a dorsally located corneal dermoid in a cat.

  15. Corneal Topographical Changes Flollowing Strabismus Surgery

    Institute of Scientific and Technical Information of China (English)

    MaiGH; WangZ

    1999-01-01

    Purpose:To study corneal topographical changes after strabismus surgery.Methods:Computer-aided corneal topography was used in 43 strabismus patients(45 eyes)one or two days prior to and six or seven ays after strabismus surgery.The spherical and cylindrical equivalents were calculated based on the simulated keratometry.Results:After the surgery,only the changes at 3mm in the inferior quadrant were statistically significant.The changes at 3mm in the rest quadrants and the changes at 7mm were no significant.Significant changes in spherical equivalent were found post-operatively.neither the horizontal nor the verical meridional equivalent showed significant changes after surgery.Conclusions:The results of corneal topographical changes following strabismus surgery in our preliminary study indicated the little effect of strabismus surgery on corneal curvature and corneal astigmatism.

  16. Corneal neovascularization and contemporary antiangiogenic therapeutics.

    Science.gov (United States)

    Hsu, Chih-Chien; Chang, Hua-Ming; Lin, Tai-Chi; Hung, Kuo-Hsuan; Chien, Ke-Hung; Chen, Szu-Yu; Chen, San-Ni; Chen, Yan-Ting

    2015-06-01

    Corneal neovascularization (NV), the excessive ingrowth of blood vessels from conjunctiva into the cornea, is a common sequela of disease insult that can lead to visual impairment. Clinically, topical steroid, argon laser photocoagulation, and subconjunctival injection of bevacizumab have been used to treat corneal NV. Sometimes, the therapies are ineffective, especially when the vessels are large. Large vessels are difficult to occlude and easily recanalized. Scientists and physicians are now dedicated to overcoming this problem. In this article, we briefly introduce the pathogenesis of corneal NV, and then highlight the existing animal models used in corneal NV research-the alkali-induced model and the suture-induced model. Most of all, we review the potential therapeutic targets (i.e., vascular endothelial growth factor and platelet-derived growth factor) and their corresponding inhibitors, as well as the immunosuppressants that have been discovered in recent years by corneal NV studies.

  17. 小切口非超声乳化白内障治疗硬核白内障的临床效果观察%Clinical effect observation of small incision non phacoemulsification cataract extraction in the treatment of hard nucleus cataract

    Institute of Scientific and Technical Information of China (English)

    孙光涛

    2016-01-01

    Objective:To investigate the effect of small incision non phacoemulsification cataract extraction in the treatment of hard nucleus cataract.Methods:92 patients with hard nuclear cataract were selected.They were divided into the study group and the control group with 46 cases in each according to the random number method.The control group were treated with the conventional incision extracapsular cataract extraction surgery.The research group take small incision non phacoemulsification cataract extraction and intraocular lens implantation treatment.Results:After the treatment,the corneal flash degree of the study group was significantly lower than that of the control group(P<0.05);the incidence of complications in the study group was significantly lower than that of the control group(P<0.05).Conclusion:The effect fo small incision non phacoemulsification cataract surgery in the treatment of hard nucleus cataract is significantly,and improve the corneal flash degree effectively,reduce the incidence of complications.%目的:探讨小切口非超声乳化白内障治疗硬核白内障的效果。方法:收治硬核白内障患者92例,通过随机数字法将其分成研究组和对照组各46例,对照组采取常规切口白内障囊外摘除术治疗,研究组采取小切口非超声乳化白内障治疗。结果:治疗后,研究组角膜闪光度数明显比对照组低(P<0.05);研究组并发症发生率明显低于对照组(P<0.05)。结论:硬核白内障患者采取小切口非超声乳化白内障手术治疗,效果显著,能有效改善角膜闪光度数,降低并发症发生率。

  18. Corneal Regeneration by Deep Anterior Lamellar Keratoplasty (DALK Using Decellularized Corneal Matrix.

    Directory of Open Access Journals (Sweden)

    Yoshihide Hashimoto

    Full Text Available The purpose of this study is to demonstrate the feasibility of DALK using a decellularized corneal matrix obtained by HHP methodology. Porcine corneas were hydrostatically pressurized at 980 MPa at 10°C for 10 minutes to destroy the cells, followed by washing with EGM-2 medium to remove the cell debris. The HHP-treated corneas were stained with H-E to assess the efficacy of decellularization. The decellularized corneal matrix of 300 μm thickness and 6.0 mm diameter was transplanted onto a 6.0 mm diameter keratectomy wound. The time course of regeneration on the decellularized corneal matrix was evaluated by haze grading score, fluorescein staining, and immunohistochemistry. H-E staining revealed that no cell nuclei were observed in the decellularized corneal matrix. The decellularized corneal matrices were opaque immediately after transplantation, but became completely transparent after 4 months. Fluorescein staining revealed that initial migration of epithelial cells over the grafts was slow, taking 3 months to completely cover the implant. Histological sections revealed that the implanted decellularized corneal matrix was completely integrated with the receptive rabbit cornea, and keratocytes infiltrated into the decellularized corneal matrix 6 months after transplantation. No inflammatory cells such as macrophages, or neovascularization, were observed during the implantation period. The decellularized corneal matrix improved corneal transparency, and remodelled the graft after being transplanted, demonstrating that the matrix obtained by HHP was a useful graft for corneal tissue regeneration.

  19. Comparison of intracameral dexamethasone and intracameral triamcinolone acetonide injection at the end of phacoemulsification surgery

    Directory of Open Access Journals (Sweden)

    Sirel Gur Gungor

    2014-01-01

    Full Text Available Purpose: To compare the results of intracameral dexamethasone and intracameral triamcinolone acetonide injection in patients that underwent cataract surgery with phacoemulsification. Materials and Methods: Sixty eyes of 60 patients that underwent cataract surgery with phacoemulsification were randomized into two groups. Preoperative visual acuity of all patients was 0.5 or lower and intraocular pressures were under 21mmHg. After surgery, eyes in group 1 (30 eyes were injected with 0.4 mg/0.1 ml dexamethasone into the anterior chamber, and eyes in group 2 (30 eyes were injected with 2 mg/0.05 ml triamcinolone acetonide into the anterior chamber. All eyes received standard postoperative prednisolone acetate and moxifloxacin eye drops. The biomicroscopic evaluation, visual acuity, and intraocular pressure measurements were done at baseline (preoperatively and on postoperative days 1, 7 and 30. Results: There were no statistically significant differences in mean visual acuity, the amount of anterior cells and flare between the two groups (P ≥ 0.05. Mean intraocular pressure values at postoperative first day were significantly higher in group 2 than in group 1 (P = 0.009. The mean intraocular pressures on days 7 and 30 after surgery were not statistically different between the two groups (P ≥ 0.05. Conclusions: Intracameral dexamethasone and intracameral triamcinolone acetonide were similarly effective in controlling postoperative inflammation following phacoemulsification. However, the intraocular pressures on postoperative first day were higher in patients receiving intracameral triamcinolone acetonide. The highest intraocular pressure in triamcinolone acetonide group was 24 mmHg, and stabilized in a few days, therefore using triamcinolone acetonide may impose a minimal risk to patients. Nevertheless, intracameral dexamethasone seems to be a better alternative to apply at the end of surgery to suppress the inflammation during the first 24 hours.

  20. OUTCOME OF PHACOEMULSIFICATION WITH INTRAOCULAR LENS IMPLANTATION IN PATIENTS WITH HIGH MYOPIA

    Directory of Open Access Journals (Sweden)

    Sunil

    2015-11-01

    Full Text Available : OBJECTIVE: To evaluate the visual and refractive outcomes of phacoemulsification with intraocular lens (IOL implantation in highly myopic eyes and to assess the intraoperative and postoperative complications. SETTINGS: Tertiary care Centre Ranchi, India. METHODS: Consecutive patients with high myopia were retrospectively studied for outcomes and complications after phacoemulsification and IOL implantation. RESULTS: The study included 125 eyes of 89 patients (53 females and 36 males with a mean age of 56.01±9.51 years and mean follow-up of 19.45±4.07 months. The mean axial length was 29.58±2.57mm and power of the IOL ranged from −4.00 D to + 17.00 D. The mean preoperative logMAR Best corrected visual acuity (BCVA was 0.82±0.26 which improved to 0.38±0.29 at one month and to 0.43±0.33 at last follow-up, the improvement in vision was statistically significant (P<0.0001, paired t test. Postoperatively, 80 eyes (64% had a BCVA between 0.00 logMAR (20/20 and 0.30 logMAR (20/40. Pre-existing myopic chorioretinal degeneration (13.6% was most common factor causing decreased visual acuity. The mean spherical equivalent at one month postoperative was -0.06±1.28 D. The complications included posterior capsule rupture (5.6%, zonular dehiscence (1.6%, retinal detachment (1.6%, cystoid macular edema (8.8% and posterior capsule opacifications (10.4%. CONCLUSIONS: Phacoemulsification with intraocular lens implantation is a safe and effective procedure to improve patients visual acuity in those with high myopia.

  1. Evaluation of Ex-PRESS implantation combined with phacoemulsification in primary angle-closure glaucoma

    Science.gov (United States)

    Liu, Bing; Guo, Da-Dong; Du, Xiu-Juan; Cong, Chen-Yang; Ma, Xiao-Hua

    2016-01-01

    Abstract To evaluate the safety and efficacy of Ex-PRESS (R50) implantation combined with phacoemulsification in primary angle-closure glaucoma (PACG) patients with cataract. Twenty-four eyes of 24 patients with unregulated PACG underwent combined cataract and glaucoma surgery. After phacoemulsification and intraocular lens implantation, the Ex-PRESS (R-50) was inserted into the anterior chamber under a scleral flap. The intraocular pressure (IOP), best corrected visual acuity (BCVA), number of medications, and complications were recorded preoperatively as well as postoperatively on day 7 and at 1, 3, 6, and 12 months. The mean follow-up was 16.4 ± 2.5 months (range 14–21 months) and the mean age of the patients was 64.7 ± 6.8 years (range 56–78 years). The mean IOP was 20.4 ± 5.4 mm Hg preoperatively and decreased to 10.2 ± 2.8, 13.1 ± 2.7, 14.9 ± 4.1, 14.3 ± 3.9, and 14.0 ± 3.6 mm Hg on day 7 and at 1, 3, 6, and 12 months after surgery (all P < 0.005). At 12 months, the mean BCVA was 0.62 ± 0.33 and the number of medications was 0.3 ± 0.6. Most of complications were resolved spontaneously and conservatively. The Ex-PRESS implantation combined with phacoemulsification cataract extraction is safe and effective for reducing IOP and antiglaucoma medications in PACG patients with cataract. PMID:27603352

  2. Effect of phacoemulsification combined with intraocular lens implantation on diabetic cataract treatment

    Institute of Scientific and Technical Information of China (English)

    Wei Gao; Chao Zhang; Li Jia; Hong Tang

    2016-01-01

    Objective:To observe the effect of phacoemulsification combined with intraocular lens implantation on inflammatory factors, oxidative stress reaction and the hemorheology in patients with diabetic cataract, for helping clinical treatment of patients with diabetic cataract. Methods: A total of 160 diabetic cataract patients in our hospital were selected and randomly divided into observation group and control group, each group were 80 cases, control group was treated with conventional therapy, observation group was treated with phacoemulsification combined with intraocular lens implantation based on conventional therapy, the changes of inflammatory factors, oxidative stress reaction and the hemorheology were detected before and after treatment.Results: The difference of inflammatory factors, oxidative stress reaction and the hemorheology in the two groups before treatment was not statistically significant (P>0.05). Inflammatory factors (IL-2, IL-6, hs-CRP and TNF-α), MDA in both groups after treatment significantly increased compared with that before treatment.; oxidative stress reaction parameters (CAT, SOD, GSH-Px), hemorheology parameters (WHV, WLV, PV) in both groups after treatment significantly decreased compared with that before treatment. Changes in PCV and FIB in two groups after treatment was not statistically significant compared with that before treatment (P>0.05). MDA, Inflammatory factors (IL-2, IL-6, , hs-CRP and TNF-α) and hemorheology parameters (WHV, WLV, PV) in observation group after treatment decreased more significantly than that in control group (P0.05). Conclusions:Phacoemulsification combined with intraocular lens implantation could improve inflammatory factors, oxidative stress reaction parameters and hemorheology parameters in diabetic cataract patients, and help clinical treatment of diabetic cataract patients.

  3. Impact of low versus high fluidic settings on the efficacy and safety of phacoemulsification.

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    Schriefl, Sabine M; Stifter, Eva; Menapace, Rupert

    2014-09-01

      To compare intraoperative efficiency and postoperative outcomes of cataract surgery with low and high fluidic settings.   In this prospective, randomized, single-blinded study, 114 eyes of 57 patients were operated with low fluidic settings for one eye (group I) and high fluidic settings for the other eye (group II). Efficiency was judged as metred surgery time, effective phacoemulsification time (EPT) and the amount of balanced salt solution used. Visual outcome and endothelial cell count were determined 1 week and 18 months postoperatively.   The overall effective phacoemulsification energy was statistically significantly lower (p = 0.003) in group II than in group I. Conquest of the nuclei was achieved with about two-thirds of the energy needed in group I, with 6.59 ± 4.79 effective ultrasound energy compared with 3.99 ± 3.18 (p = 0.001). Overall, about 12% more solution was used in group II than in group I. Median visual acuity was 1.0 for both groups 18 months after surgery. The mean endothelial cell loss was 5.0% in eyes in group I compared with 6.3% in eyes in group II (p > 0.5).   Switching from low fluidic settings with a conventional coaxial 20G phacoemulsification tip to higher fluidic settings with a microcoaxial phaco tip statistically significantly decreases EPT. As only marginally more solution was used with the higher aspiration flow, occlusion must be accomplished more often with high than with low fluidics. Aspiration of the quadrants was therefore more efficient with high fluidic settings. The enhanced pump speed did not result in more tissue damage. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  4. Bead-flow pattern: quantitation of fluid movement during torsional and longitudinal phacoemulsification.

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    de Castro, Luis E Fernández; Dimalanta, Ramon C; Solomon, Kerry D

    2010-06-01

    To develop a bead-flow pattern for visualizing and comparatively quantifying fluid movement using a torsional or longitudinal ultrasound (US) phaco handpiece. Magill Laser Center, Medical University of South Carolina, Charleston, South Carolina, USA. Visualization and quantification of intraocular fluid dynamics were evaluated by injecting neutrally buoyant, collagen-coated polystyrene beads (diameter, 125 to 212 microm) into the phacoemulsification irrigation flow. Using the anterior chamber of a cadaver or porcine eye or a laboratory test chamber, the bead-flow pattern was video recorded. Qualitative comparisons between longitudinal and torsional phacoemulsification were made using video-processing software to track the beads frame by frame. The time (quantitative) required to aspirate a bolus of beads from the anterior chamber (clearance time) was measured and compared between the 2 modalities. Aspiration efficiency was calculated to compare operating conditions in a test chamber using high-speed videography; conditions included irrigation/aspiration (I/A) only (0% power) and clinically relevant fluidic parameters and power modulations with torsional, longitudinal, or a combination of powers applied. Qualitative and quantitative analyses of the fluidic patterns of bead flow in the peripheral anterior chamber and near the aspirating tip opening indicated that torsional fluidics behave closer to the I/A-only configuration than longitudinal phacoemulsification, with the latter repelling more bead material in front of the aspiration tip. Bead clearance time was approximately 50% faster with torsional than with longitudinal US, regardless of the power setting. Bead flow-pattern evaluation is a feasible approach to future studies of fluid movement in the anterior chamber. (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. Outcomes of torsional microcoaxial phacoemulsification performed by 12-degree and 22-degree bent tips.

    Science.gov (United States)

    Helvacioglu, Firat; Yeter, Celal; Tunc, Zeki; Sencan, Sadik

    2013-08-01

    To compare the safety and efficacy of Ozil Intelligent Phaco torsional microcoaxial phacoemulsification surgeries performed with 12-degree and 22-degree bent tips using the Infiniti Vision System. Maltepe University School of Medicine Department of Ophthalmology, Istanbul, Turkey. Comparative case series. Eyes were assigned to 2.2 mm microcoaxial phacoemulsification using the torsional mode with a 22-degree bent tip (Group 1) or a 12-degree bent tip (Group 2). The primary outcome measures were ultrasound time (UST), cumulative dissipated energy (CDE), longitudinal and torsional ultrasound (US) amplitudes, mean surgical time, mean volume of balanced salt solution used, and surgical complications. Both groups included 45 eyes. The mean UST, CDE, longitudinal US amplitude, and torsional US amplitude were 65 seconds ± 27.23 (SD), 11.53 ± 6.99, 0.22 ± 0.26, and 42.86 ± 15.64, respectively, in Group 1 and 84 ± 45.04 seconds, 16.68 ± 10.66, 0.48 ± 0.68, and 46.27 ± 14.74, respectively, in Group 2. The mean UST, CDE, and longitudinal amplitudes were significantly lower in Group 1 (P=.003, P=.008, and P=.022, respectively). The mean volume of balanced salt solution was 73.33 ± 28.58 cc in Group 1 and 82.08 ± 26.21 cc in Group 2 (P=.134). Torsional phacoemulsification performed with 22-degree bent tips provided more effective lens removal than 12-degree bent tips, with a lower UST and CDE. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Outcome of Phacoemulsification in patients with and without Pseudoexfoliation syndrome in Kashmir

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    Sufi Aalia R

    2012-06-01

    Full Text Available Abstract Background The aim of the study is to compare the outcome of phacoemulsification in patients with and without pseudoexfoliation syndrome in Kashmir. Methods 200 patients were prospectively evaluated and divided into 2 groups. Group 1 comprised 100 cases with pseudoexfoliation and Group 2 (control 100 cases without pseudoexfoliation. Phacoemulsification with posterior chamber intraocular lens implantation was performed by 3 surgeons. Intraoperative and postoperative observations were made in both the groups at regular intervals upto 6 months. A chi square test was used for statistical analysis. Results Patients with pseudoexfoliation were significantly older (P = 0.000, had harder cataract(P = 0.030 and smaller mean pupil diameter(P = 0.000 than the control group. Intraoperative complications were comparable between the 2 groups except the occurrence of zonular dehiscence which was seen in 7% patients of Group 1 compared to 0% in Group 2. Higher postoperative inflammatory response was seen in Group 1(P = 0.000. Decrease in intraocular pressure (IOP at all postoperative measurements was more in Group 1(P = 0.000. The visual acuity was better in the control group in the early postoperative period (P = 0.029, however the final visual acuity at 6 months was comparable between the 2 groups. Conclusions Phacoemulsification in presence of pseudoexfoliation necessitates appropriate surgical technique to avoid intraoperative complications. Pseudoexfoliation is associated with higher inflammatory response, significant postoperative IOP drop and satisfactory visual outcome.

  7. Efficacy of intraoperative vancomycin in irrigating solutions on aqueous contamination during phacoemulsification

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    Srinivasan Renuka

    2008-01-01

    Full Text Available Purpose: To study the efficacy of adding vancomycin in irrigating solutions, in comparison to topical antibiotic given preoperatively for a day, during phacoemulsification, in reducing the anterior chamber (AC contamination. Settings and Design: This was a prospective, interventional, hospital-based study. Materials and Methods: This was a study involving 400 eyes of 400 paitens, undergoing routine phacoemulsification between January 2004 and June 2006. The patients were non-randomly assigned to two groups: Group 1 included 180 patients, who received topical ciprofloxacin eye-drops (four-hourly for a day preoperatively and Group 2 included 220 patients, who underwent phacoemulsification with vancomycin (20 µg/ml in the irrigating solution. Anterior chamber aspirate obtained at the end of the surgery was sent for microbial workup. The number of positive cultures in both the groups was determined. Statistical analysis: This was performed using Chi-square test. Results: Aqueous samples showed microbial growth in 38 (21.1% out of 180 eyes in Group 1 and in 17 (7.7% out of 220 eyes in Group 2 ( P = 0.001. Coagulase-negative staphylococcus was the most common organism in both the groups. Aqueous samples from four eyes in group 1 showed multiple organisms, while none of the sample from group 2 showed more than one organism. None of the eyes in either group showed fungal contamination. One patient in Group 1 developed endophthalmitis, and the causative organism was Alcaligenes faecalis. All patients were followed up for a minimum of six months (range: 6 to 14 months and mean: 9.3 months. Conclusion: Addition of vancomycin in irrigating solutions is more efficacious in reducing AC contamination in comparison to topical antibiotic administered a day preoperatively.

  8. Intracapsular dexamethasone implant in patients undergoing phacoemulsification and intraocular lens implantation

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    Lucas Monferrari Monteiro Vianna

    2013-08-01

    Full Text Available PURPOSE: To relate the outcomes of 7 eyes of 7 patients in which a dexamethasone 0.7 mg implant (Ozurdex® was placed inside the capsule bag after phacoemulsification and intraocular lens (IOL implantation and compare with the fellow eyes, that were operated by the same technique and received dexamethasone eyedrops in the post-operatory. METHODS: Report review of 7 eyes of 7 patients who received dexamethasone 0.7 mg implant after phacoemulsification and IOL, comparing them to the fellow eyes. All the patients underwent bilateral cataract surgery, with one month interval, by the same technique and by experienced surgeons, without complications. Post operatory medication consisted of moxifloxacin eye drops for all the 14 eyes and topic dexamethasone for the 7 eyes that did not received the implant. RESULTS: Nuclear cataract classification (according to LOCS III was 3.28 ± 0.69 in the implant eye group and 3.14 ± 0.83 in the fellow eye group. Postoperative best spectacle correct visual acuity (BSCVA was 0.85 ± 0.12 and 0.87 ± 0.13, respectively in the implant and fellow eye groups. The intraocular pressure remained stable and similar to the pre-operative measurements. Anterior chamber reaction and cornea edema were similar in both groups in the follow-up. Two of the four no sutured pellet migrated to the anterior chamber during the first post-operative week and had to be repositioned. Another no sutured pellet dislocated and remained partially inside the capsule bag. The 3 patients with IOL haptic-sutured pellet had no complications. CONCLUSIONS: In the present study, dexamethasone 0.7mg implant were effective in controlling the inflammation after phacoemulsification and IOL implantation, with no significant side effects.

  9. New Management of Angle-closure Glaucoma by Phacoemulsification with Foldable Posterior Chamber Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    Jian Ge; Yan Guo; Yizhi Liu; Mingkai Lin; Yehong Zhuo; Bing Chen; Xiuqi Chen

    2000-01-01

    Objective: To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens (PC-IOL) implantation. Design: Retrospective, noncontrolled interventional case series.Participants: In 36 eyes with angle-closure glaucoma (ACG), there were 18 eyes with primary acute angle-closure glaucoma (PACG), 14 eyes with primary chronic angle-closure glaucoma (PCCG), 3 eyes with secondary acute angle-closure glaucoma (SACG) and 1 eye with secondary chronic angle-closure glaucoma (SCCG).Intervention: Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures: Postoperative visual acuity, IOP, axial anterior chamber depth.Results: After a mean postoperative follow-up time of 8.81 ± 7.45 months, intraocular pressure was reduced from a preoperative mean of 23.81 ± 17.84 mmHg to a postoperative mean of 12.54 ± 4. 73 mmHg ( P = 0. 001 ). Mean anterior chamber depth was 1.75 ± 0.48 mm preoperatively and 2.29 ± 0.38 mm postoperatively ( P = 0. 000).Best spectacle-corrected visual acuity in 36 eyes ranged from 0. 01 to 0. 7 (20/200 to 20/30) postoperatively, which was better than preoperative VA ranging from hand movement to 0.4 (20/50) ( P= 0. 000).Conclusion: Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma. Eye Science 2000; 16:22 ~ 28.

  10. New Management of Angle-closure Glaucoma by Phacoemulsification with Folable Posterior Chamber Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    JianGE; YanGuo; 等

    2002-01-01

    Objective:To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens (PC-IOIL)implantation.Design:Retrospective,noncontrolled interventional case series.Participants:In 36 eyes with angle -closure glaucoma(ACG).there were 18eyes with primary acute angle-closure glaucoma(PACG),14 eyes with primary chonic angle -closure glaucoma(PCCG),3 eyes with secondary acute angle-closure glaucoma (SACG) and 1 eye with secondary chronic angle -closure glaucoma(SCCG).Intervention:Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures:Postoperative visual acuity,IOP,axial anterior chamber depth.Results:After a mean postoperative follow -time of 8.81±7.45 months,intraocular pressure was reduced from a preoperative mean of 23.81±17.84 mmHg to a postoperative mean of 12.54±4.73mmHg(P=0.001).Mean anterior chamber depth was 1.75±0.48 mm preoiperatively and 2.29±0.38mm postoperatively(P-0.000).Best spectacle-corrected visual acuity in 36 eyes ranged from 0.01 to 0.7(20/200 to 20/30)postoperatively,which was better than preoperative VA ranging from hand movement to 0.4(20/50)(P=0.000).Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma.Eye Science2000;16:22-28.

  11. A Case Report of Severe Corneal Toxicity following 0.5% Topical Moxifloxacin Use

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    A.P. Vignesh

    2015-02-01

    Full Text Available Moxifloxacin is a widely used topical antibiotic in various bacterial infections of the eye. Its safety and efficacy have been proved by many studies. We report a case of a rare adverse effect following its use. A 10-year-old female who had presented with acute bacterial conjunctivitis in both eyes with no corneal involvement was started on preservative-free 0.5% topical moxifloxacin four times a day. The child developed a severe form of corneal toxicity in both eyes with circumcorneal congestion and corneal edema following its use. The child's visual acuity had dropped from 20/20 to 20/400 in both the eyes. Topical moxifloxacin was discontinued, following which the cornea cleared dramatically and the visual acuity became normal. This case indicates that though rare, topical moxifloxacin can cause severe keratitis and that more studies need to be conducted to evaluate its safety.

  12. First Identification of a Triple Corneal Dystrophy Association: Keratoconus, Epithelial Basement Membrane Corneal Dystrophy and Fuchs' Endothelial Corneal Dystrophy

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    Cosimo Mazzotta

    2014-09-01

    Full Text Available Purpose: To report the observation of a triple corneal dystrophy association consisting of keratoconus (KC, epithelial basement membrane corneal dystrophy (EBMCD and Fuchs' endothelial corneal dystrophy (FECD. Methods: A 55-year-old male patient was referred to our cornea service for blurred vision and recurrent foreign body sensation. He reported bilateral recurrent corneal erosions with diurnal visual fluctuations. He underwent corneal biomicroscopy, Scheimpflug tomography, in vivo HRT confocal laser scanning microscopy and genetic testing for TGFBI and ZEB1 mutations using direct DNA sequencing. Results: Biomicroscopic examination revealed the presence of subepithelial central and paracentral corneal opacities. The endothelium showed a bilateral flecked appearance, and the posterior corneal curvature suggested a possible concomitant ectatic disorder. Corneal tomography confirmed the presence of a stage II KC in both eyes. In vivo confocal laser scanning microscopy revealed a concomitant bilateral EBMCD with hyperreflective deposits in basal epithelial cells, subbasal Bowman's layer microfolds and ridges with truncated subbasal nerves as pseudodendritic elements. Stromal analysis revealed honeycomb edematous areas, and the endothelium showed a strawberry surface configuration typical of FECD. The genetic analysis resulted negative for TGFBI mutations and positive for a heterozygous mutation in exon 7 of the gene ZEB1. Conclusion: This is the first case reported in the literature in which KC, EBMCD and FECD are present in the same patient and associated with ZEB1 gene mutation. The triple association was previously established by means of morphological analysis of the cornea using corneal Scheimpflug tomography and in vivo HRT II confocal laser scanning microscopy.

  13. Analysis of dry eye after phacoemulsification in patients of renal transplantation%肾移植患者白内障超声乳化术后干眼临床分析

    Institute of Scientific and Technical Information of China (English)

    武劲圆; 孙丰源; 唐东润; 张蕊

    2013-01-01

    目的 分析肾移植术后患者行超声乳化白内障吸出术后泪液及泪膜的变化,探讨其干眼问题.方法 采用非随机病例对照研究设计.肾移植组白内障患者26例(34眼)及单纯年龄相关性白内障患者(对照组)33例(40眼),分别于超声乳化联合人工晶状体(IOL)植入术前术后不同时间,以干眼调查问卷的方式获得患者的主觉症状并进行评分,同时行泪膜破裂时间(BUT)、基础泪液分泌试验(SIt)、角膜荧光素染色检查,对两组患者的上述检测指标进行比较.结果 肾移植组术后干眼症状的评分及角膜荧光素染色(FL),泪膜破裂时间(BUT)明显重于对照组,总体差异均有统计学意义(P<0.05).但术后3个月FL与术前比较差异无统计学意义(P>0.05).结论 肾移植患者术后泪膜功能较差,是干眼症的易患人群,行超声乳化术后干眼症状较单纯年龄相关性白内障患者更明显.%Objective To analyze the change of tear film after phacoemulsification in patient with renal transplantation and discuss the problem of dry eye.Methods A non-randomized cases-controlled study was designed.26 cataract patients with renal transplantation (the experimental group) (34 eyes) and matched 33 patients (40 eyes) with age-related cataract(control group) were included in this study.Before and after different time phacoemulsification and IOL implantation respectively was performed on the all patients,dry eye-related symptom was surveyed and scored by questionnaire,and tear film break-up time (BUT),Schirmer I test (SIt) and corneal fluorescein (FL) were examined.Results The experimental group is significantly heavier than control group obviously postoperatively in patients with dry eye symptom score,FL,BUT,the overall differences were statistically significant(P < 0.05),but after 3 months FL preoperatively with no significant difference (P > 0.05).Conclusion Tear film function of renal transplantation patients is poor after

  14. Estudio comparativo de la pérdida celular endotelial entre las técnicas de facoemulsificación por ultrachop y prechop Comparative study of the endothelial cell loss between the ultrachop and the prechop phacoemulsification techniques

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    Zucell Ana Veitía Rovirosa

    2010-01-01

    Full Text Available OBJETIVO: Comparar la pérdida celular endotelial en los pacientes operados de catarata mediante facoemulsificación por ultrachop y prechop. MÉTODOS: Se realizó un estudio observacional descriptivo prospectivo de 120 pacientes (ojos atendidos en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" operados de catarata mediante facoemulsificación por ultrachop y prechop en el período comprendido de noviembre 2006 a julio 2008 a los que se les realizó microscopia endotelial antes y después de la cirugía con el objetivo de determinar las alteraciones del endotelio corneal ocasionadas por ella. Se analizaron las variables edad, alteraciones endoteliales, tiempo efectivo de facoemulsificación y agudeza visual. La información se procesó a través de frecuencias absolutas, relativas, media y prueba T de Student. RESULTADOS: Se encontró que predominaron los pacientes entre 60 y 87 años; existió pérdida celular proporcional al aumento de la edad y al tiempo efectivo de facoemulsificación. Se produjo aumento del polimegatismo en relación con el tiempo efectivo de facoemulsificación en el grupo operado mediante ultrachop y no fue significativa la modificación del pleomorfismo en ambos grupos. La agudeza visual con corrección mejoró en más de cuatro líneas en la escala de Snellen equivalente a 25 VAR en la escala de Logmar. La presencia de alteraciones endoteliales no influyó en el resultado visual posoperatorio. CONCLUSIONES: Este estudio permite al cirujano del segmento anterior establecer un pronóstico antes de efectuar la cirugía, por lo que su realización en el preoperatorio constituye un pilar fundamental antes de su ejecución.OBJECTIVE: To compare the endothelial cell loss in patients operated on from cataracts through ultrachop and prechop phacoemulsification. METHOD: A prospective observational study of 120 patients (eyes treated at the Ocular Microsurgery Center in «Ramón Pando

  15. Factors Affecting Corneal Hysteresis in Taiwanese Adults

    Institute of Scientific and Technical Information of China (English)

    Jia-Kang Wang; Tzu-Lun Huang; Pei-Yuan Su; Pei-Yao Chang

    2015-01-01

    Purpose: To investigate the correlation of various corneal hysteresis (CH) factors in Chinese adults. Methods: From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the study. Goldmann-correlated intraocular pressure (IOPG) and CH were measured using an ocular response analyzer (ORA). Central corneal thickness was measured using the ORA’s in-tegrated handheld ultrasonic pachymeter. The IOLMaster was used to obtain the ocular biometric measurements including axial length, anterior chamber depth, and keratometric values. The Pearson correlation coefficient was used to test correla-tions between CH and quantitative factors. The chi-square test was used to detect differences in categorical values. Results: Longer axial length (P=0.0001), lower IOPG (P=0.03), older age(P=0.003),and thinner central corneal thick-ness (P=0.0001) were significantly associated with lower CH. The anterior chamber depth (P=0.34), gender (P=0.23), and corneal curvature (P=0.18) had no relationship to CH. Conclusion:Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measure-ment of corneal biomechanical properties in Chinese adults. But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.

  16. Corneal sensitivity in five horse breeds

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    Eunice Santos de Andrade

    Full Text Available ABSTRACT: This study aimed to determine and compare corneal sensitivity values in different regions of the cornea in five horse breeds. One hundred and forty five healthy horses, adults of both sexes, of the following breeds - Arabian horse (AH; n=20, Mangalarga Marchador (MM; n=50, Pure Blood Lusitano (PBL; n=35, Quarter Horse (QH; n=20, Brazilian Sport Horse (BSH; n=20-were investigated. Corneal touch threshold (CTT was measured with a Cochet-Bonnet esthesiometer in five different corneal regions. Measurements of the median central CTT were: 4.50±0.50cm (AH, 3.50±0.56cm (MM, 3.00±0.25cm (PBL, 2.50±0.44cm (QH and 2.50±0.00cm (BSH. The central region was the most sensitive and the dorsal region the least sensitive corneal region for all breeds. CTT values differed for corneal regions and horse breeds. The CTT values were different among the corneal regions and the horse breeds. Arabian horses presented higher sensitivity values being the most sensitive in all of the corneal regions.

  17. Corneal topographic changes following retinal surgery

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    Pandey RM

    2004-08-01

    Full Text Available Abstract Background To study the effect of retinal/ vitreoretinal surgeries on corneal elevations. Methods Patients who underwent retinal/ vitreoretinal surgeries were divided into 3 groups. Scleral buckling was performed in 11 eyes (Group 1. In 8 (25% eyes, vitreoretinal surgery was performed along with scleral buckling (Group 2. In 12 eyes, pars plana vitrectomy was performed for vitreous hemorrhage (Group 3. An encircling element was used in all the eyes. The parameters evaluated were best-corrected visual acuity (BCVA, change in axial length, and corneal topographic changes on Orbscan topography system II, preoperative and at 12 weeks following surgery. Results There was a statistically significant increase in anterior corneal elevation in all the three groups after surgery (p = 0.003, p = 0.008 & p = 0.003 respectively. The increase in posterior corneal elevation was highly significant in all the three groups after surgery (p = 0.0000, p = 0.0001 & p = 0.0001 respectively. The increase in the posterior corneal elevation was more than the increase in the anterior elevation and was significant statistically in all the three groups (group I: p = 0.02; group II: p = 0.01; group III: p = 0.008. Conclusions Retinal/ vitreoretinal surgeries cause a significant increase in the corneal elevations and have a greater effect on the posterior corneal surface.

  18. Riboflavin-ultraviolet a corneal cross-linking for keratoconus

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    El-Raggal Tamer

    2009-01-01

    Full Text Available Purpose: To evaluate the safety, efficacy of riboflavin-ultraviolet A irradiation (UVA corneal cross-linking and present refractive changes induced by the treatment in cases of keratoconus. Materials and Methods: The study includes 15 eyes of 9 patients with keratoconus with an average keratometric (K reading less than 54 D and minimal corneal thickness greater than 420 microns. The corneal epithelium was removed manually within the central 8.5 mm diameter area and the cornea was soaked with riboflavin eye drops (0.1% in 20% dextran t-500 for 30 minutes followed by exposure to UVA radiation (365 nm, 3 mW/cm 2 for 30 minutes. During the follow-up period, uncorrected visual acuity (UCVA, best spectacle-corrected visual acuity (BSCVA, manifest refraction, slit lamp examination and topographic changes were recorded at the first week, first month, 3 and 6 months. Results: There was statistically significant improvement of UCVA from a preoperative mean of 0.11 ± 0.07 (range 0.05-0.3 to a postoperative mean of 0.15 ± 0.06 (range 0.1-0.3 (P < 0.05. None of the eyes lost lines of preoperative UCVA but 1 eye lost 1 line of preoperative BSCVA. The preoperative mean K of 49.97 ± 2.81 D (range 47.20-51.75 changed to 48.34 ± 2.64 D (range 45.75-50.40. This decrease in K readings was statistically significant (P < 0.05. All eyes developed minimal faint stromal haze that cleared in 14 eyes within 1 month. In only 1 eye, this resulted in a very faint corneal scar. Other sight threatening complications were not encountered in this series. Progression of the original disease was not seen in any of the treated eyes within 6 months of follow-up. Conclusion: Riboflavin-UVA corneal cross-linking is a safe and promising method for keratoconus. Larger studies with longer follow up are recommended.

  19. Improved sampling and analysis of images in corneal confocal microscopy.

    Science.gov (United States)

    Schaldemose, E L; Fontain, F I; Karlsson, P; Nyengaard, J R

    2017-05-26

    Corneal confocal microscopy (CCM) is a noninvasive clinical method to analyse and quantify corneal nerve fibres in vivo. Although the CCM technique is in constant progress, there are methodological limitations in terms of sampling of images and objectivity of the nerve quantification. The aim of this study was to present a randomized sampling method of the CCM images and to develop an adjusted area-dependent image analysis. Furthermore, a manual nerve fibre analysis method was compared to a fully automated method. 23 idiopathic small-fibre neuropathy patients were investigated using CCM. Corneal nerve fibre length density (CNFL) and corneal nerve fibre branch density (CNBD) were determined in both a manual and automatic manner. Differences in CNFL and CNBD between (1) the randomized and the most common sampling method, (2) the adjusted and the unadjusted area and (3) the manual and automated quantification method were investigated. The CNFL values were significantly lower when using the randomized sampling method compared to the most common method (p = 0.01). There was not a statistical significant difference in the CNBD values between the randomized and the most common sampling method (p = 0.85). CNFL and CNBD values were increased when using the adjusted area compared to the standard area. Additionally, the study found a significant increase in the CNFL and CNBD values when using the manual method compared to the automatic method (p ≤ 0.001). The study demonstrated a significant difference in the CNFL values between the randomized and common sampling method indicating the importance of clear guidelines for the image sampling. The increase in CNFL and CNBD values when using the adjusted cornea area is not surprising. The observed increases in both CNFL and CNBD values when using the manual method of nerve quantification compared to the automatic method are consistent with earlier findings. This study underlines the importance of improving the analysis of the

  20. Comparison of clinical efficacy between phacoemulsification and small incision extracapsular cataract extraction for senile cataract%超声乳化术与小切口囊外摘除术对老年白内障疗效的比较

    Institute of Scientific and Technical Information of China (English)

    李勇; 岳章显; 徐海龙; 刘钊臣

    2014-01-01

    AIM:To evaluate the clinical therapeutic effects of senile cataract on phacoemulsification and small incision cataract surgery and the influence of corneal endothelium. METHODS: A retrospective analysis was performed in 296 cases of senile cataract in our hospital from Jan.2009 to Jan.2013 in the "Cataract extraction project".One hundred and forty cases underwent phacoemulsification treatment, whereas 156 cases received small incision extracapsular cataract extraction.The therapeutic efficacy and effects on corneal endothelial cells of the two groups were compared. RESULTS: After 3d operation, the visual acuity and corneal astigmatism in phacoemulsification group were much better than that in small incision cataract surgery group (P0.05). CONCLUSION: Both phacoemulsification and small incision extracapsular cataract extraction are effective methods of treatment of cataract.However, the method of small incision cataract surgery is more economic, and it is valuable in primary hospital and the “Cataract extraction project”.%目的:评价超声乳化术和小切口非超声乳化囊外摘除术对老年性白内障患者的临床疗效差异以及对角膜内皮细胞的影响情况。  方法:回顾性分析我院2009-01/2013-01收治的白内障复明工程患者296例,其中140例患者采用超声乳化白内障吸出术治疗,156例患者采用小切口白内障囊外摘除术治疗。分析比较两组患者治疗效果的差异以及术后角膜内皮细胞的变化情况。  结果:术后3d超声乳化组患者视力和散光度均优于小切口非超声乳化组(P<0.05);两组患者手术前后角膜内皮细胞的损伤程度差异有统计学意义(P<0.05),而术后1,3 mo视力情况和散光度以及术中、术后并发症差异无明显统计学差异(P>0.05)。  结论:小切口非超声乳化囊外摘除术和超声乳化术治疗白内障疗效基本相当,但其有着

  1. Differences between real and predicted corneal shapes after aspherical corneal ablation

    Science.gov (United States)

    Anera, Rosario G.; Villa, César; Jiménez, José R.; Gutiérrez, Ramón; Jiménez del Barco, Luis

    2005-07-01

    We study the differences between real and expected corneal shapes, using an aspherical ablation algorithm with a known equation and avoiding the limitation imposed by most studies of refractive surgery in which the ablation equations are not known. We have calculated the theoretical corneal shape predicted by this algorithm, comparing this shape with the real corneal topography. The results indicate that the deviations that appear in the corneal shape are significant for visual performance and for the correction of eye aberrations. If we include in this analysis the effect of reflection losses and nonnormal incidence on the cornea, we can reduce corneal differences, but they will remain significant. These results confirm that it is essential to minimize corneal differences to achieve effective correction in refractive surgery.

  2. Clinical study of intelligent phacoemulsification for hard nucleus cataract extraction%智能超声应用于硬核白内障手术的临床研究

    Institute of Scientific and Technical Information of China (English)

    孙存; 接英; 张建强

    2016-01-01

    目的:观察 Infiniti 超声乳化系统中智能超声( intelligent phacoemulsification,IP)应用于硬核白内障手术的有效性和安全性。  方法:前瞻性随机研究,选择年龄相关性白内障Ⅳ~Ⅴ级核患者92例92眼,随机分为两组,非 IP 组43例43眼, IP 组49例49眼,分别在 IP-OFF 和 IP-ON 的模式下进行超声乳化白内障手术。术中记录两组超声乳化时间(ultrasound time, UST )和累积释放能量( cumulative dissipated energy,CDE)。术后第1、7d,3mo 检查最佳矫正视力(best corrected visual acuity,BCVA),观察角膜水肿情况。术后第7d,3mo 检查术眼的角膜中央内皮细胞密度和六角形细胞比例。  结果:IP 组的 UST 为48.79依7.13s,非 IP 组为52.51依9.64s,两组比较差异有统计学意义(P =0.030),CDE 在IP 组为(14.29依2.77)%,低于非 IP 组的(15.78依3.73)%,两组比较差异有统计学意义(P =0.026)。术后第1d,IP 组角膜水肿评分平均为2.61依0.64分,低于非 IP 组2.98依0.77分,两组比较差异有统计学意义(P =0.021);IP 组79%术眼 BCVA>0.1,高于非 IP 组56%术眼 BCVA>0.1,两组比较差异无统计学意义(P =0.066),但有一定的临床意义。术后7d 患者角膜水肿减轻,视力迅速提高,差异无统计学意义。术后7d 角膜中央内皮细胞密度 IP 组为2586.26依154.71个/ mm2,高于非 IP 组的2497.95依211.48个/ mm2,且差异有统计学意义( P =0.029);六角形细胞比例 IP 组为(48.33依8.69)%,高于非 IP 组的(44.19依9.48)%,两组比较差异有统计学意义(P=0.030)。  结论:在硬核白内障手术中,IP 设置有机结合两种超声模式的优势,安全高效地减少对角膜内皮的损伤,有助于患者术后早期恢复视力。%AIM: To compare the efficiency and safety of torsional phacoemulsification with or without intelligent phacoemulsification ( IP ) software in hard nucleus cataract extraction. METHODS: Ninety two eyes with Ⅳ - Ⅴ grades cataracts were

  3. Morphological evaluation of normal human corneal epithelium

    DEFF Research Database (Denmark)

    Ehlers, Niels; Heegaard, Steffen; Hjortdal, Jesper

    2010-01-01

    PURPOSE: The human corneal epithelium is usually described as a 50-µm-thick layer of regular stratified squamous non-keratinized cells with a thickness of 5-7 cells. The purpose of this study is systemically to revisit the histopathological appearance of 100 corneas. METHODS: 5-µm-thick sections...... in Bowman's membrane. No intraepithelial microcysts, as found in Meesmann corneal dystrophy, were observed. CONCLUSION: The total corneal thickness was higher than reported in in vivo studies and with a wider variation. This may be an effect of uncontrolled swelling and dehydration during preparation...

  4. Polar Value Analysis of Corneal Astigmatism in Intrastromal Corneal Ring Segment Implantation

    Science.gov (United States)

    Rho, Chang Rae; Kim, Min-Ji

    2016-01-01

    Purpose. To evaluate surgically induced astigmatism (SIA) and the average corneal power change in symmetric intrastromal corneal ring segment (ICRS) implantation. Methods. The study included 34 eyes of 34 keratoconus patients who underwent symmetric Intacs SK ICRS implantation. The corneal pocket incision meridian was the preoperative steep meridian. Corneal power data were obtained before and 3 months after Intacs SK ICRS implantation using scanning-slit topography. Polar value analysis was used to evaluate the SIA. Hotelling's trace test was used to compare intraindividual changes. Results. Three months postoperatively, the combined mean polar value for SIA changed significantly (Hotelling's T2 = 0.375; P = 0.006). The SIA was 1.54 D at 99° and the average corneal power decreased significantly by 3.8 D. Conclusion. Intacs SK ICRS placement decreased the average corneal power and corneal astigmatism compared to the preoperative corneal power and astigmatism when the corneal pocket incision was made at the preoperative steep meridian. PMID:27795856

  5. Polar Value Analysis of Corneal Astigmatism in Intrastromal Corneal Ring Segment Implantation

    Directory of Open Access Journals (Sweden)

    Chang Rae Rho

    2016-01-01

    Full Text Available Purpose. To evaluate surgically induced astigmatism (SIA and the average corneal power change in symmetric intrastromal corneal ring segment (ICRS implantation. Methods. The study included 34 eyes of 34 keratoconus patients who underwent symmetric Intacs SK ICRS implantation. The corneal pocket incision meridian was the preoperative steep meridian. Corneal power data were obtained before and 3 months after Intacs SK ICRS implantation using scanning-slit topography. Polar value analysis was used to evaluate the SIA. Hotelling’s trace test was used to compare intraindividual changes. Results. Three months postoperatively, the combined mean polar value for SIA changed significantly (Hotelling’s T2=0.375; P=0.006. The SIA was 1.54 D at 99° and the average corneal power decreased significantly by 3.8 D. Conclusion. Intacs SK ICRS placement decreased the average corneal power and corneal astigmatism compared to the preoperative corneal power and astigmatism when the corneal pocket incision was made at the preoperative steep meridian.

  6. Laser Scanning In Vivo Confocal Microscopy of Clear Grafts after Penetrating Keratoplasty

    Science.gov (United States)

    Wang, Dai; Song, Peng; Wang, Shuting; Sun, Dapeng; Wang, Yuexin; Zhang, Yangyang

    2016-01-01

    Purpose. To evaluate the changes of keratocytes and dendritic cells in the central clear graft by laser scanning in vivo confocal microscopy after penetrating keratoplasty (PK). Methods. Thirty adult subjects receiving PK at Shandong Eye Institute and with clear grafts and no sign of immune rejection after surgery were recruited into this study, and 10 healthy adults were controls. The keratocytes and dendritic cells in the central graft were evaluated by laser scanning confocal microscopy, as well as epithelium cells, keratocytes, corneal endothelium cells, and corneal nerves (especially subepithelial plexus nerves). Results. Median density of subepithelial plexus nerves, keratocyte density in each layer of the stroma, and density of corneal endothelium cells were all lower in clear grafts than in controls. The dendritic cells of five (16.7%) patients were active in Bowman's membrane and stromal membrane of the graft after PK. Conclusions. Activated dendritic cells and Langerhans cells could be detected in some of the clear grafts, which indicated that the subclinical stress of immune reaction took part in the chronic injury of the clear graft after PK, even when there was no clinical rejection episode. PMID:27034940

  7. Laser Scanning In Vivo Confocal Microscopy of Clear Grafts after Penetrating Keratoplasty

    Directory of Open Access Journals (Sweden)

    Dai Wang

    2016-01-01

    Full Text Available Purpose. To evaluate the changes of keratocytes and dendritic cells in the central clear graft by laser scanning in vivo confocal microscopy after penetrating keratoplasty (PK. Methods. Thirty adult subjects receiving PK at Shandong Eye Institute and with clear grafts and no sign of immune rejection after surgery were recruited into this study, and 10 healthy adults were controls. The keratocytes and dendritic cells in the central graft were evaluated by laser scanning confocal microscopy, as well as epithelium cells, keratocytes, corneal endothelium cells, and corneal nerves (especially subepithelial plexus nerves. Results. Median density of subepithelial plexus nerves, keratocyte density in each layer of the stroma, and density of corneal endothelium cells were all lower in clear grafts than in controls. The dendritic cells of five (16.7% patients were active in Bowman’s membrane and stromal membrane of the graft after PK. Conclusions. Activated dendritic cells and Langerhans cells could be detected in some of the clear grafts, which indicated that the subclinical stress of immune reaction took part in the chronic injury of the clear graft after PK, even when there was no clinical rejection episode.

  8. Risk Factors for Posterior Capsule Rupture and Vitreous Loss during Phacoemulsification

    Science.gov (United States)

    Zare, Mohammad; Javadi, Mohammad-Ali; Einollahi, Bahram; Baradaran-Rafii, Ali-Reza; Feizi, Sepehr; Kiavash, Victoria

    2009-01-01

    Purpose To determine the rate and risk factors of vitreous loss during phacoemulsification in patients with cataracts operated by ophthalmology residents and fellows at Labbafinejad Medical Center. Methods This prospective descriptive study included consecutive patients with cataracts undergoing phacoemulsification over a one year period. All patients were operated under local or general anesthesia using the divide and conquer technique. Preoperatively, all patients underwent a complete ocular examination including measurement of visual acuity, slitlamp biomicroscopy, intraocular pressure measurement, and dilated funduscopy. Main outcome measures included the rate of posterior capsular rupture and vitreous loss as well as associated risk factors such as surgical experience, ocular and systemic conditions, and type and severity of the cataract. Results Overall, 767 eyes of 767 patients with mean age of 63.7±10.3 (range, 25–91) years were operated. The overall rate of vitreous loss was 7.9% which was 5-fold greater in the hands of residents as compared to fellows. Among different factors, older age, female sex, small pupil, small capsulorrhexis, presence of pseudoexfoliation, and high myopia were significantly associated with vitreous loss. The highest rate of vitreous loss occurred in patients with dense nuclear cataracts. Conclusion Considering the higher rate of vitreous loss in patients operated by ophthalmology residents; patients with known risk factors for vitreous loss should better be operated by more experienced surgeons. PMID:23198076

  9. Double extra sharp chopper increase efficacy of phacoemulsification for hard mature cataract surgery.

    Science.gov (United States)

    Simanjuntak, Gilbert W S; Tan, Jannes F; Mailangkay, H H B

    2010-01-01

    To assess the efficacy and safety of a modified double extra sharp chopper for removal of hard cataracts. Prospective non-comparative interventional clinical study. Forty eyes from 25 patients with hard mature cataract grades 3-4. The pre-modified Koch chopper was sharpened under the slit lamp to become extra sharp at the tip and inside the edge and 2 mm in length. Patients with hard mature cataract grades 3-4 (grade 4 being the hardest) underwent phacoemulsification by single surgery and were analyzed prospectively. The mean effective phaco time was 23.73 +/- 5.75 seconds. Minimal power was facilitated by using horizontal chopping using a self-made double extra sharp chopper. No resistance was encountered while moving the chopper, regardless of cataract persistency. Preoperative BCVA were count fingers (47%), hand movement (35%), and light perception (18%). Postoperative BCVA on day 1and day 7 were 0.57 and 0.95, respectively. There was no difference of effective phaco time among nuclear hardness (P = 0.467), which represent the effectiveness of the extra sharp chopper. The double extra sharp chopper facilitated a safe and rapid visual rehabilitation and maximal subject comfort when doing phacoemulsification for hard mature cataracts.

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

    Directory of Open Access Journals (Sweden)

    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. Outcomes and complications after phacoemulsification in retinoblastoma patients with cataract after radiation treatment.

    Science.gov (United States)

    Velásquez-Aguilar, M; Matiz-Moreno, H; Amato-Almanza, M; Chen-López, C Y; Márquez-García, G; Ramírez-Ortiz, M A

    2017-04-01

    To describe the visual outcome and complications associated with phacoemulsification in patients with bilateral retinoblastoma (Rb), with lens opacification secondary to external beam radiotherapy. A descriptive study was performed on patients with Rb, treated in Federico Gomez Children's Hospital, Mexico, from January 1997 to August 2015, with external beam radiotherapy eye salvaging. Statistical analysis was performed using Stata 10. A total of 15 patients were included. The mean age at phacoemulsification was 7.5 years. Mean preoperative visual acuity was 1.0LogMAR (range 0.4-1.6), and the mean postoperative visual acuity was 0.7LogMAR (range 0.1-1.6). Twelve patients had visual improvement (P<.05). The visual acuity decreased in one patient with vitreous haemorrhage and secondary glaucoma, and 2 patients with exudative maculopathy secondary to radiation. Mean follow up was 46 months and not a single patient showed tumour re-activation. Cataract surgery produces a statistically significant improvement in visual acuity. These patients have increased risk for eye complications in the mid- and long-term. It is important to conduct a close follow up due to reactivation of tumour. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. A comparative study of complications of cataract surgery with phacoemulsification in eyes with high and normal axial length

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2015-01-01

    Conclusion: The outcome of this meta-analysis indicated there is no difference between phacoemulsification and SICS for BCVA and UCVA of 6/18 and 6/60. Endothelial cell loss and intraoperative and postoperative complications were similar between procedures. SICS resulted in statistically greater astigmatism and UCVA of 6/9 or worse, however, near UCVA was better.

  14. Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction

    Directory of Open Access Journals (Sweden)

    Prabhasawat P

    2012-09-01

    Full Text Available Pinnita Prabhasawat,1 Pattama Ekpo,2 Mongkol Uiprasertkul,3 Suksri Chotikavanich,1 Nattaporn Tesavibul11Department of Ophthalmology, 2Department of Immunology, 3Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandPurpose: To investigate the clinical outcomes of cultivated corneal limbal epithelial transplantation (CLET using human amniotic membrane for corneal limbal stem-cell deficiency.Methods: Prospective, noncomparative case series. Eighteen patients (19 eyes with severe ocular surface diseases were chosen to undergo CLET using human amniotic membrane. Twelve eyes received auto-CLET, and seven eyes received allo-CLET. Clinical outcomes of corneal surface epithelialization, conjunctivalization, inflammation, visual acuity, graft status, and complications were observed.Results: Corneal epithelium cultivated on amniotic membrane (two to four layers was positive for molecular markers p63, ABCG2, CK3, and CK12. The mean patient age was 44.7 ± 15.2 years. A successful clinical outcome, defined as corneal epithelialization without central conjunctivalization or severe inflammation, was obtained in 14 (73.7% of 19 eyes (mean follow-up 26.1 ± 13.5 months; range 6–47. A histopathologic success, defined as absence of goblet cells at the central cornea, was achieved in 12 (63.2% eyes. Clinical failures occurred in five (26.3% of 19 eyes, and histopathologic failures occurred in seven (36.8% of 19 eyes. Survival analysis at 1 year showed that the clinical success rate was 77.9% and the pathological success rate was 72.3%. Fourteen of 19 (73.7% eyes had visual acuity improvements after CLET. Six cases underwent penetrating keratoplasty; five of these grafts remained clear after 20.4 ± 6.9 months (range, 12–31 of follow-up. Complications included infectious keratitis (three cases and recurrent symblepharon (one case. All complicated cases had lid abnormalities. Factors affecting the final clinical

  15. Surgical compensation of presbyopia with corneal inlays.

    Science.gov (United States)

    Konstantopoulos, Aris; Mehta, Jodhbir S

    2015-05-01

    Presbyopia, the physiological change in near vision that develops with ageing, gradually affects individuals older than 40 years and is a growing cause of visual disability due to ageing demographics of the global population. The routine use of computers and 'smartphones', combined with the affluence of the 'baby boomers' generation has set high standards for near vision correction. Corneal inlays are a relatively new treatment modality that is effective at compensating for presbyopia. The dimensions of these devices vary from 2 to 3.8 mm in diameter and 5 to 32 μm in thickness. They are implanted in the anterior corneal stroma of the non-dominant eye, most commonly, in a femtosecond laser created corneal pocket. They improve near vision by increasing the depth of focus, creating a hyper-prolate region of increased central cornea power or providing a refractive add power. This article reviews the literature on the efficacy and safety of corneal inlays.

  16. Conjunctival intraepithelial neoplasia with corneal furrow degeneration

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2014-01-01

    Full Text Available A 68-year-old man presented with redness of left eye since six months. Examination revealed bilateral corneal furrow degeneration. Left eye lesion was suggestive of conjunctival squamous cell carcinoma, encroaching on to cornea. Anterior segment optical coherence tomography (AS-OCT confirmed peripheral corneal thinning. Fluorescein angiography confirmed intrinsic vascularity of lesion. Patient was managed with "no touch" surgical excision, dry keratectomy without alcohol, cryotherapy, and primary closure. Pathologic examination of removed tissue confirmed clinical diagnosis. Management of this particular case required modification of standard treatment protocol. Unlike the alcohol-assisted technique of tumor dissection described, ethyl alcohol was not used for risk of corneal perforation due to underlying peripheral corneal thinning. Likewise, topical steroids were withheld in the post-operative period. Three weeks post-operatively, left eye was healing well. Hence, per-operative usage of absolute alcohol and post-operative use of topical steroids may be best avoided in such eyes.

  17. First report of evaluation of K-M media: A new corneal preservation medium

    Directory of Open Access Journals (Sweden)

    Desai Beena

    2007-01-01

    Full Text Available Purpose: To analyze the outcome of keratoplasty performed using Kalevar-Majumdar (K-M media, a new synthetic viscous medium for preservation of the cornea. Materials and Methods: The K-M media-preserved donor eye balls were kept in a bottle in a refrigerator at 4° C till the corneas were used. Forty-eight consecutive keratoplasty cases of pseudophakic bullous keratopathy with vision less than counting fingers at one meter and operated by a single surgeon have been analyzed. Corneal donor button of 7.5 mm was used on the 7.0 mm recipient bed in all cases. Surgery was done with a standard technique. All the cases were examined daily for the first week and at the end of one month for graft clarity, epithelial defect and stromal edema. Results: The K-M media-preserved corneal grafts remained clear at the end of the first week in 95.8% (46 of 48 cases and at the end of one month in 93.7% (45 of 48 cases. Donor epithelial haze cleared in 24h in all cases. The stromal edema got cleared in the majority (91.7%, 44 of 48 within 24h. Epithelial defect was seen in only 10.4% (five cases. There was no primary graft failure. Conclusion: K-M medium, a new viscous, synthetic corneal preservation medium, is a safe (no primary donor failure alternative to conventional liquid corneal preservation media. K-M media-preserved eyes appear to have better preserved corneal epithelium with faster achievement of graft clarity postoperatively.

  18. Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical center: a clinical audit

    Directory of Open Access Journals (Sweden)

    Chen M

    2014-02-01

    Full Text Available Ming Chen,1 Kara C LaMattina,2 Thomas Patrianakos,2 Surendar Dwarakanathan2 1Department of Surgery, Division of Ophthalmology, University of Hawaii, Honolulu, HI, USA; 2Division of Ophthalmology, John H Stroger, Jr Hospital of Cook County, Chicago, IL, USA Purpose: To compare the complication rate of posterior capsule rupture (PCR with vitreous loss during phacoemulsification at an ambulatory surgical center with published results as a clinical audit for quality control. Methods: A retrospective chart review of 3,339 consecutive patients who underwent routine phacoemulsification by four experienced private practice surgeons from January 1, 2011 to June 30, 2012 at The Surgical Suites, Honolulu, HI, USA. All cases with PCR and vitreous loss were identified and selected for the study. Risk factors of this complication were further examined. Data were sent to John H Stroger Jr Hospital of Cook County, Division of Ophthalmology, for literature review, analysis, and write-up. Results: Twenty-three of the 3,339 cases incurred PCR and vitreous loss during phacoemulsification, for an incidence rate of 0.68%. Miosis, shallow chamber, restlessness, pseudoexfoliation syndrome, floppy iris syndrome, and zonulopathy were the main causes. In addition, surgeon volume (number of cases was inversely correlated with PCR. Conclusion: The rate of PCR with vitreous loss during phacoemulsification in this study may be lower than other published results done at academic centers. However, there was no compatible study available for comparison, as existing studies performed at academic centers included resident cases. This study identified risk factors for PCR/vitreous loss both preoperatively and postoperatively that may assist in application of preventive measures to decrease rates of PCR/vitreous loss. Keywords: phacoemulsification complications, posterior capsule rupture, vitreous loss, vitrectomy, miosis, pseudoexfoliation, floppy iris syndrome, zonulopathy

  19. Corneal topography and soft contact lens fit.

    Science.gov (United States)

    Young, Graeme; Schnider, Cristina; Hunt, Chris; Efron, Suzanne

    2010-05-01

    To determine which ocular topography variables affect soft contact lens fit. Fifty subjects each wore three pairs of soft lenses in random succession (Vistakon Acuvue 2, Vistakon Acuvue Advance, Ciba Vision Night & Day), and various aspects of lens fit were evaluated. The steeper base curves of each type were worn in one eye and the flatter base curves in the other eye. Corneal topography data were collected using a Medmont E300 corneal topographer (Camberwell, Australia). Corneal curvature, shape factor (SF), and corneal height were measured over a 10 mm chord and also over the maximum measurable diameter. These were measured in the horizontal, vertical, steepest, and flattest meridians. With each lens type, the steeper base curve provided the best fit on the greatest proportion of eyes and the significant differences in various aspects of fit were noted between base curves. For each lens type, there was no significant difference in mean K-reading between those eyes best fit with the steeper base curve and those eyes best fit with the flatter base curve. Two of the lenses showed a positive correlation between centration and horizontal corneal height (maximum), whereas one lens showed a negative correlation between centration and horizontal SF (SF = e). Several lenses showed a positive correlation between post-blink movement and horizontal or vertical corneal SF. The measurement of corneal topography using current Placido disc instrumentation allows a better prediction of soft lens fit than by keratometry, but it is not reliable enough to enable accurate selection of the best fitting base curve. Some correlations are evident between corneal measurements; however, trial fitting remains the method of choice for selection of soft lens base curve.

  20. Serological profile of candidates for corneal donation

    OpenAIRE

    Adroaldo Lunardelli; Richard Beraldini Alvarenga; Maria Luiza Assmann; Dário Eduardo de Lima Brum; Mirna Adolfina Barison

    2014-01-01

    Objetive: The purpose of this study is to map the serological profile of candidates to corneal donation at Irmandade Santa Casa de Misericórdia de Porto Alegre, identifying the percentage of disposal by serology and the marker involved. Methods: There have been analised – retrospectively – the results of serology of all corneal donors, made between the period of 1st january 2006 and 31st december 2012. Data analised were related to age, gender and the results of serology pert...

  1. Asphericity analysis using corneal wavefront and topographic meridional fits

    Science.gov (United States)

    Arba-Mosquera, Samuel; Merayo-Lloves, Jesús; de Ortueta, Diego

    2010-03-01

    The calculation of corneal asphericity as a 3-D fit renders more accurate results when it is based on the corneal wavefront aberrations rather than on the corneal topography of the principal meridians. A more accurate prediction could be obtained for hyperopic treatments compared to myopic treatments. We evaluate a method to calculate corneal asphericity and asphericity changes after refractive surgery. Sixty eyes of 15 consecutive myopic patients and 15 consecutive hyperopic patients (n=30 each) are retrospectively evaluated. Preoperative and 3-month-postoperative topographic and corneal wavefront analyses are performed using corneal topography. Ablations are performed using a laser with an aberration-free profile. Topographic changes in asphericity and corneal aberrations are evaluated for a 6-mm corneal diameter. The induction of corneal spherical aberrations and asphericity changes correlates with the achieved defocus correction. Preoperatively as well as postoperatively, asphericity calculated from the topography meridians correlates with asphericity calculated from the corneal wavefront in myopic and hyperopic treatments. A stronger correlation between postoperative asphericity and the ideally expected/predicted asphericity is obtained based on aberration-free assumptions calculated from corneal wavefront values rather than from the meridians. In hyperopic treatments, a better correlation can be obtained compared to the correlation in myopic treatments. Corneal asphericity calculated from corneal wavefront aberrations represents a 3-D fit of the corneal surface; asphericity calculated from the main topographic meridians represents a 2-D fit of the principal corneal meridians. Postoperative corneal asphericity can be calculated from corneal wavefront aberrations with higher fidelity than from corneal topography of the principal meridians. Hyperopic treatments show a greater accuracy than myopic treatments.

  2. Bromfenac 0.09% bioavailability in aqueous humor, prophylactic effect on cystoid macular edema, and clinical signs of ocular inflammation after phacoemulsification in a Mexican population

    Directory of Open Access Journals (Sweden)

    Palacio C

    2016-01-01

    Full Text Available Claudia Palacio,1 Lourdes Fernández De Ortega,2 Francisco R Bustos,3 Eduardo Chávez,4 Aldo A Oregon-Miranda,5 Arieh R Mercado-Sesma5 1Anterior Segment Department, Fundación Hospital Nuestra Señora de la Luz, México City, México; 2Anterior Segment Department, Asociación Para Evitar la Ceguera en México, Hospital Dr Luis Sánchez Bulnes, México; 3Anterior Segment Department, Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México; 4Anterior Segment Department, Instituto de Oftalmología, Fundación de Asistencia Privada Conde de Valenciana, IAP, México; 5Clinical Research Department, Laboratorios Sophia, SA de CV, Zapopan, Jalisco, México Purpose: The purpose of this study was to evaluate the aqueous humor bioavailability and clinical efficacy of bromfenac 0.09% vs nepafenac on the presence of cystoid macular edema (CME after phacoemulsification.Material and methods: A Phase II, double-blind, masked, active-controlled, multicenter, clinical trial of 139 subjects, randomized to either a bromfenac 0.09% ophthalmic solution (n=69 or nepafenac 0.1% (n=70. Subjects instilled a drop three times a day for a period of 30 days. Follow-up visits were on days 2, 7, 15, 30, and 60. Biomicroscopy, clinical ocular signs, and assessment of posterior segment were performed. The primary efficacy endpoints included the presence of CME evaluated by optical coherence tomography. Safety evaluation included intraocular pressure, transaminase enzymes, lissamine green, and fluorescein stain.Results: The demographic and efficacy variables were similar between groups at baseline. The presence of pain, photophobia, conjunctival hyperemia, chemosis, cellularity, and corneal edema disappeared by day 30 in both groups. The central retinal thickness did not show significant changes after treatment when compared to baseline as follows: in the bromfenac group (247.2±32.9 vs 252.0±24.9 µm; P=0.958 and in nepafenac group (250.8±34

  3. Update on pathologic diagnosis of corneal infections and inflammations

    Directory of Open Access Journals (Sweden)

    Geeta K Vemuganti

    2011-01-01

    Full Text Available One of the most frequent types of corneal specimen that we received in our pathology laboratory is an excised corneal tissue following keratoplasty. Several of these cases are due to corneal infections or the sequelae, like corneal scar. Advances in the histological and molecular diagnosis of corneal infections and inflammations have resulted in rapid and accurate diagnosis of the infectious agent and in the overall understanding of the mechanisms in inflammatory diseases of the cornea. This review provides an update of histopathological findings in various corneal infections and inflammations.

  4. The Effect of Contact Lens Usage on Corneal Biomechanical Parameters in Keratoconus Patients

    Directory of Open Access Journals (Sweden)

    Ali Bülent Çankaya

    2012-05-01

    Full Text Available Pur po se: To determine and compare the corneal biomechanical properties in keratoconus patients using rigid gas permeable contact lenses and keratoconus patients who do not use contact lenses. Ma te ri al and Met hod: The study consisted of 70 healthy controls (Group A, 27 ketatoconus subjects who do not use contact lens (Group B and 36 rigid gas permeable contact lens using keratoconic patients (Group C. Corneal viscoelastic parameters were measured with an Ocular response analyzer (ORA. Central corneal thickness was measured with an ultrasonic pachymeter. The differences in ORA parameters between the groups were compared. Re sults: The mean corneal hysteresis (CH in Groups A, B, and C were 10.3±1.5 mm Hg, 7.8±1.4 mm Hg, and 7.4±1.2 mm Hg, respectively. The differences in mean CH between Group A and the other two groups were statistically significant (p<0.01 for both comparisons, but no statistically significant difference was found between groups B and C in terms of mean CH (p=0.61. The mean corneal resistance factor (CRF was 10.7±1.9 in Group A compared with 6.6±1.6 in Group B and 6.1±1.5 in Group C. The differences in mean CRF between Group A and the other two groups were statistically significant (p<0.01 for both comparisons. There was no significant difference in CRF between the keratoconus eyes with or without rigid gas permeable contact lens usage (p=0.57. Dis cus si on: Our results suggest that ORA-generated parameters may be different in subjects with keratoconus. Corneal biomechanical parameters did not demonstrate a clear trend of change with rigid gas permeable contact lens usage. (Turk J Ophthalmol 2012; 42: 197-201

  5. Survival and integration of tissue-engineered corneal stroma in a model of corneal ulcer.

    Science.gov (United States)

    Zhang, Chao; Nie, Xin; Hu, Dan; Liu, Yuan; Deng, Zhihong; Dong, Rui; Zhang, Yongjie; Jin, Yan

    2007-08-01

    Tissue-engineered replacement of diseased or damaged tissue has become a reality for some types of tissue, such as skin and cartilage. Tissue-engineered corneal stroma represents a promising concept to overcome the limitations of cornea replacement with allograft. In this study, porcine cornea was decellularized by a series of extraction methods, and the in vivo biocompatibility of the scaffold was measured subcutaneously in rabbits (n = 8). These were not acutely rejected and no abscesses were observed by hematoxylin and eosin staining at the 8th week, indicating that the scaffolds had good biocompatibility. To investigate the potential value of clinical applications, rabbit stromal keratocytes were implanted onto decellularized scaffolds to fabricate tissue-engineered corneal stroma. Allograft, tissue-engineered corneal stroma, or scaffolds were implanted into a model of corneal ulcer. The survival and reconstruction of corneal transplantation were morphologically evaluated by light and electron microscopy until the 32nd week after implantation. Experiments involving transplantation indicated that the epithelial and stromal defect healed quickly, with improvement in corneal clarity. The integration of the graft was accompanied by neurite ingrowth from the host tissue. By 16 weeks after transplantation, the cornea had gradually regained an intact state similar to that of normal cornea. Our results demonstrate that the tissue-engineered corneal stroma with allogenetic cells is a promising therapeutic method for corneal injury.

  6. Optical Coherence Tomography Findings in Anterior Chamber Ointment Globule after Phacoemulsification

    Directory of Open Access Journals (Sweden)

    Ahmad M. Mansour

    2015-12-01

    Full Text Available We present 2 cases of anterior chamber ointment with evidence of progressive endothelial cell loss. In both cases, an anterior segment optical coherence tomography (OCT was similar to an OCT of a tobramycin-dexamethasone ointment placed on a pen tip. An anterior segment OCT also demonstrated the direct contact of the globule with the corneal endothelium. A gas chromatography/mass spectrometry analysis documented the similarity to tobramycin-dexamethasone ointment in 1 case. Anterior segment OCT can help in confirming the diagnosis. Corneal endothelial injury is a continuous process, and its clinical manifestation is related to the size of the globule, the initial endothelium count, and the duration of ointment contact, which is related to supine positioning. It is advisable to avoid ointments in the immediate postoperative period, especially in corneal wounds larger than 3 mm.

  7. Toxic Anterior Segment Syndrome following Phacoemulsification Secondary to Overdose of Intracameral Gentamicin

    Directory of Open Access Journals (Sweden)

    Yaran Koban

    2014-01-01

    Full Text Available Objective. To report a case of toxic anterior segment syndrome (TASS that was caused by inadvertent anterior chamber and cornea stromal injection with high dose gentamicin following cataract surgery. Methods. Case report. Results. We report a 72-year-old female patient who developed TASS that was caused by high dose gentamicin (20 mg/0.5 mL, which was inadvertently used during the formation of the anterior chamber and hydration of the corneal incision. Unlike previous cases, hyphema and hemorrhagic fibrinous reaction were seen in the anterior chamber. Despite treatment, bullous keratopathy developed and penetrating keratoplasty was performed. The excised corneal button was sent for histopathological examination. Conclusions. Subconjunctival gentamicin is highly toxic to the corneal endothelium and anterior chamber structures. Including it on the surgical table carries a potentially serious risk for contamination of the anterior chamber.

  8. Toxic Anterior Segment Syndrome following Phacoemulsification Secondary to Overdose of Intracameral Gentamicin

    Science.gov (United States)

    Koban, Yaran; Genc, Selim; Cagatay, Halil Huseyin; Ekinci, Metin; Gecer, Melin; Yazar, Zeliha

    2014-01-01

    Objective. To report a case of toxic anterior segment syndrome (TASS) that was caused by inadvertent anterior chamber and cornea stromal injection with high dose gentamicin following cataract surgery. Methods. Case report. Results. We report a 72-year-old female patient who developed TASS that was caused by high dose gentamicin (20 mg/0.5 mL), which was inadvertently used during the formation of the anterior chamber and hydration of the corneal incision. Unlike previous cases, hyphema and hemorrhagic fibrinous reaction were seen in the anterior chamber. Despite treatment, bullous keratopathy developed and penetrating keratoplasty was performed. The excised corneal button was sent for histopathological examination. Conclusions. Subconjunctival gentamicin is highly toxic to the corneal endothelium and anterior chamber structures. Including it on the surgical table carries a potentially serious risk for contamination of the anterior chamber. PMID:25574173

  9. Influence of uncomplicated phacoemulsification on central macular thickness in diabetic patients: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jianping Liu

    Full Text Available To evaluate the effect of uncomplicated phacoemulsification on central macular thickness (CMT and best corrected visual acuity (BCVA in both diabetic patients without diabetic retinopathy (DR and diabetic patients with mild to moderate non-proliferative diabetic retinopathy (NPDR.Potential prospective observational studies were searched through PubMed and EMBASE. Standardized mean difference (SMD and 95% confidence interval (CI for changes in CMT and BCVA were evaluated at postoperative 1, 3 and 6 months. The pooled effect estimates were calculated in the use of a random-effects model.A total of 10 studies involving 190 eyes of diabetic patients without diabetic retinopathy and 143 eyes of diabetic patients with NPDR were identified. CMT values demonstrated a statistically significant increase after uncomplicated phacoemulsification at 1 month (SMD, -0.814; 95%CI, -1.230 to -0.399, 3 months (SMD, -0.565; 95%CI, -0.927 to -0.202 and 6 months (SMD, -0.458; 95%CI, -0.739 to -0.177 in diabetic patients with NPDR. There was no statistical difference in CMT values at postoperative 1 month (SMD, -1.206; 95%CI, -2.433 to 0.021and no statistically significant increase in CMT values at postoperative3 months (SMD, -0.535; 95%CI, -1.252 to 0.182 and 6 months (SMD, -1.181; 95%CI, -2.625 to 0.263 in diabetic patients without DR.BCVA was significantly increased at postoperative 1 month (SMD, 1.149; 95%CI, 0.251 to 2.047; and SMD,1.349; 95%CI, 0.264 to 2.434, respectively and 6 months (SMD, 1.295; 95%CI, 0.494 to 2.096; and SMD, 2.146; 95%CI, 0.172 to 4.120, respectively in both diabetic patients without DR and diabetic patients with NPDR. Sensitivity analysis showed that the results were relatively stable and reliable.Uncomplicated phacoemulsification in diabetic patients with mild to moderate NPDR seemed to influence significantly the subclinical thickening of the macular zones at postoperative 1, 3 and 6 months compared with diabetic patients without DR

  10. Ultrasound biomicroscopy confirmation of corneal overriding due to improper suturing of full-thickness corneal laceration

    Directory of Open Access Journals (Sweden)

    Murat Kucukevcilioglu

    2014-12-01

    Full Text Available We herein present a case with corneal overriding due to improper suturing of a full-thickness corneal laceration. There was a 2.5-mm difference between horizontal and vertical white-to-white measurements in the cornea. However, slit lamp examination failed to demonstrate the exact architecture of the laceration. Ultrasound biomicroscopy defined the wound edges thoroughly and confirmed the presence of corneal overriding. Six weeks after suture enhancement, the abnormal oval appearance of the cornea was absent and correct apposition of the corneal edges was seen on ultrasound biomicroscopy. Ultrasound biomicroscopy can be used in preoperative surgical planning of cases with complicated corneal lacerations. It can be used to adjust and enhance wound architecture in eyes with penetrating injury.

  11. Pseudolentogenic astigmatic effect of multifocal intraocular lenses: non-corneal ocular residual astigmatism (N-CORA) as a new parameter in astigmatic change analysis.

    Science.gov (United States)

    Frings, Andreas; Steinberg, Johannes; Druchkiv, Vasyl; Linke, Stephan J; Katz, Toam

    2017-08-01

    This study was initiated to introduce the term non-corneal ocular residual astigmatism (N-CORA) as a new parameter in astigmatic change analysis after implantation of two different types of non-toric, multifocal intraocular lenses (MIOL). Seventy-two eyes from 72 consecutive patients after MIOL surgery were studied in terms of a retrospective, cross-sectional data analysis. Two types of spherical MIOL were used. Surgical technique in all patients was a 2.4-mm incision phacoemulsification, performed by one surgeon. To investigate the magnitude and axis of astigmatic changes, the true corneal astigmatism and Alpins vector method were applied. There were no statistically significant between-group differences related to the preoperative refraction or ocular residual astigmatism (ORA). After surgery, the mean refractive surgically induced astigmatism (RSIA) and the topographic SIA (TSIA) did not differ significantly between the lenses. The magnitude and orientation of ORA and N-CORA changed after surgery. There are no statistically significant differences in postoperative ORA in magnitude or axis when implanting different types of MIOL. The similarity of N-CORA between both MIOL types shows that both diffractive and refractive asymmetric MIOLs with plate haptics have the same pseudolentogenic astigmatic effect which could be presented in terms of the newly introduced parameter N-CORA.

  12. Media Language, Clear or Obscure

    DEFF Research Database (Denmark)

    Jakobsen, Bjarne le Fevre; Ejstrup, Michael

    2015-01-01

    Abstract— Be clear, not obscure. One of the four maxims for optimal communication is that it is essential to develop proficiency in being concise and clear. The question is whether this is really a good idea in all contexts. There is some evidence to the contrary. Undoubtedly, we have many contex...... for the survival of free speech....

  13. Tomographic corneal profile analysis of central toxic keratopathy after LASIK.

    Science.gov (United States)

    Sikder, Shameema; Khalifa, Yousuf M; Neuffer, Marcus C; Moshirfar, Majid

    2012-01-01

    To describe a case of bilateral central toxic keratopathy (CTK) in a post-laser in situ keratomileusis-treated patient using tomographic methods for more than a 1-year follow-up. Case report and literature review. Tomographic analysis of a patient with bilateral CTK revealed flattening of the anterior cornea curvature and thinning at the level of anterior stromal bed, with minimal changes of the posterior curvature. A thin central flap was also noted on optical coherence tomography (OCT). Over the course of a year, the patient's hyperopic shift resolved with steepening of the anterior curvature and concomitant thickening of the flap and stromal bed. Using Scheimpflug imaging and Visante OCT, we demonstrated that the hyperopia that accompanies CTK is related to anterior corneal curvature changes. We also found that the majority of corneal tissue loss occurs at the anterior stromal bed mainly in the first postoperative week and is followed by a regeneration of tissue. A thin central flap was noted, and it is not clear whether this was created intraoperatively or resulted from the presence of CTK, requiring further study.

  14. Nanotechnology in corneal neovascularization therapy--a review.

    Science.gov (United States)

    Gonzalez, Lilian; Loza, Raymond J; Han, Kyu-Yeon; Sunoqrot, Suhair; Cunningham, Christy; Purta, Patryk; Drake, James; Jain, Sandeep; Hong, Seungpyo; Chang, Jin-Hong

    2013-03-01

    Nanotechnology is an up-and-coming branch of science that studies and designs materials with at least one dimension sized from 1-100 nm. These nanomaterials have unique functions at the cellular, atomic, and molecular levels. The term "nanotechnology" was first coined in 1974. Since then, it has evolved dramatically and now consists of distinct and independent scientific fields. Nanotechnology is a highly studied topic of interest, as nanoparticles can be applied to various fields ranging from medicine and pharmacology, to chemistry and agriculture, to environmental science and consumer goods. The rapidly evolving field of nanomedicine incorporates nanotechnology with medical applications, seeking to give rise to new diagnostic means, treatments, and tools. Over the past two decades, numerous studies that underscore the successful fusion of nanotechnology with novel medical applications have emerged. This has given rise to promising new therapies for a variety of diseases, especially cancer. It is becoming abundantly clear that nanotechnology has found a place in the medical field by providing new and more efficient ways to deliver treatment. Ophthalmology can also stand to benefit significantly from the advances in nanotechnology research. As it relates to the eye, research in the nanomedicine field has been particularly focused on developing various treatments to prevent and/or reduce corneal neovascularization among other ophthalmologic disorders. This review article aims to provide an overview of corneal neovascularization, currently available treatments, and where nanotechnology comes into play.

  15. Use of the ophthalmic phacoemulsification instrument for tumors of the spinal cord: report of seven cases.

    Science.gov (United States)

    Sears, William R; Francis, Ian C

    2004-02-01

    In this retrospective cohort study, we examined the safety, efficacy, and benefits of utilizing the readily available ophthalmic phacoemulsification instrument for the surgery of seven intramedullary spinal cord tumors. Historically, the conventional neurosurgical ultrasonic aspirator was an adaptation of the original Cavitron Phaco-Emulsifier aspirator used in cataract surgery. The ophthalmic instrument has a 1.0-mm internal diameter operating tip. This is much smaller and provides improved visualization and surgical control when compared with the conventional neurosurgical instrument, which has a tip diameter of 3-4 mm. A satisfactory surgical and clinical outcome was achieved in all seven patients with safe and substantial subtotal excision of their tumors. We found the ophthalmic instrument provided excellent visualization and precision in operating on cases of intramedullary spinal cord tumor.

  16. Management of Residual Refractive Error after Cataract Phacoemulsification. Part 1. Keratorefractive Approaches

    Directory of Open Access Journals (Sweden)

    K. B. Pershin

    2017-01-01

    Full Text Available The review presents an analysis of the literature data on the methods of surgical correction of residual refractive error after cataract phacoemulsification. Keratorefractive and intraocular approaches are considered in details. A comparison of the efficacy and safety of different groups of methods on the example of comparative studies is given. Historically earlier keratorefractive methods (laser vision correction with LASIK and PRK techniques on intact eyes, LASIK after implantation of multifocal IOLs and arcuate keratotomy after phaco are indicated for the correction of astigmatic refractive error and a small spherical refractive error. Intraocular methods, including the replacement of the IOL and “piggyback” IOLs implantation are used to correct a large spherical refractive error. The introduction of new technology, the implantation of light-adjustable IOLs, will expand the existing evidence and provide greater predictability and efficiency of the method of correction of residual refractive error.

  17. Low temperature corneal laser welding investigated by atomic force microscopy

    Science.gov (United States)

    Matteini, Paolo; Sbrana, Francesca; Tiribilli, Bruno; Pini, Roberto

    2009-02-01

    The structural modifications in the stromal matrix induced by low-temperature corneal laser welding were investigated by atomic force microscopy (AFM). This procedure consists of staining the wound with Indocyanine Green (ICG), followed by irradiation with a near-infrared laser operated at low-power densities. This induces a local heating in the 55-65 °C range. In welded tissue, extracellular components undergo heat-induced structural modifications, resulting in a joining effect between the cut edges. However, the exact mechanism generating the welding, to date, is not completely understood. Full-thickness cuts, 3.5 mm in length, were made in fresh porcine cornea samples, and these were then subjected to laser welding operated at 16.7 W/cm2 power density. AFM imaging was performed on resin-embedded semi-thin slices once they had been cleared by chemical etching, in order to expose the stromal bulk of the tissue within the section. We then carried out a morphological analysis of characteristic fibrillar features in the laser-treated and control samples. AFM images of control stromal regions highlighted well-organized collagen fibrils (36.2 +/- 8.7 nm in size) running parallel to each other as in a typical lamellar domain. The fibrils exhibited a beaded pattern with a 22-39 nm axial periodicity. Laser-treated corneal regions were characterized by a significant disorganization of the intralamellar architecture. At the weld site, groups of interwoven fibrils joined the cut edges, showing structural properties that were fully comparable with those of control regions. This suggested that fibrillar collagen is not denatured by low-temperature laser welding, confirming previous transmission electron microscopy (TEM) observations, and thus it is probably not involved in the closure mechanism of corneal cuts. The loss of fibrillar organization may be related to some structural modifications in some interfibrillar substance as proteoglycans or collagen VI. Furthermore, AFM

  18. Changes on the corneal thickness and curvature after orthokeratology

    Science.gov (United States)

    Mitsui, Iwane; Yamada, Yoshiya

    2004-07-01

    To evaluate the corneal thickness and curvature changes after Orthokeratology contact lens wear, using the ORBSCAN II corneal topography system, corneal thickness and corneal curvature were measured on one hundred and twenty eyes of sixty patients before and after wearing the custom rigid gas permeable contact lenses for Orthokeratology. The contact lenses were specially designed for each eye. The subjects wore the orthokeratology lenses for approximately Four hours with their eyes closed. The corneal thickness of the subjects was increased on fifty-five eyes at not only the peripheral zone but also the center of the cornea. The average increase of central and peripheral corneal thickness was 18 micrometer and 22micrometer, respectively. The mean anterior curvature of corneal surface changed 1.25D. The mean posterior curvature of corneal endothelium side changed 0.75D.

  19. Evaluation of Macular Thickness by Optical Coherence Tomography After Phacoemulsification Surgery

    Directory of Open Access Journals (Sweden)

    Mehmet Tetikoğlu

    2014-03-01

    Full Text Available Objectives: To evaluate the incidence of cystoid macular edema (CME, its risk factors, and macular changes by optical coherence tomography (OCT after phacoemulsification. Materials and Methods: This study included 99 eyes of 65 patients who underwent phacoemulsification surgery in Okmeydanı Training and Research Hospital, Department of Ophthalmology. Foveal thickness, macular volume, and mean macular thickness were measured by OCT preoperatively and at 1st day, 1st week, 1st, and 3rd months postoperatively. Results: In this study, the incidence of postoperative CME was 3%. The mean central foveal thickness was preoperatively 250.4 (±18.5 μm, and postoperatively was 252.08 (±23.2 μm at 1st day, 261.4 (±27.8 μm at 1st week, 270.6 (±44.4 μm at 1st month, and 265.4 (±41.6 μm at 3rd month. The statistically significant increase in foveal thickness was defined between preoperative and 1st week, 1st month, 3rd month as well as between 1st week, 1st month, and 3rd month (p<0.01. Increase in macular thickness was demonstrated in 44 eyes (44.4% which was most frequently located in the parafoveal region. Intraoperative complications like iris trauma, posterior capsule tear, and vitreous loss were increased risk of CME (p=0.001. Conclusion: Subclinical macular thickness increment begins at 1st week and reaches maximum point at 1st month. Incidence of CME increased in patients who had a complicated cataract surgery, so they should be followed closely by OCT. (Turk J Ophthalmol 2014; 44: 88-91

  20. A novel method of combined phacoemulsification and vacuum trabeculoplasty ab interno

    Directory of Open Access Journals (Sweden)

    V. N. Trubilin

    2014-07-01

    Full Text Available Aim. To improve the efficacy of cataract and primary open-angle glaucoma (POAG surgery using a novel combined surgical technique.Materials and methods. 219 patients were included in the study. According to the design, all subjects weredivided into study group (n = 58 and two control groups (n = 78 and n = 83. Combined phaco and vacuum trabeculoplasty (VTP ab interno was performed in 58 study group patients. Pre-op and post-op, all patents had a complete eye examination including vision and hydrodynamics testing as well as anterior chamber depth (ACD and angle assessmentusing optical coherent tomography.Results. In study group, stable IOP decrease was observed for 2‑yrs follow-up. Phacoemulsification in cataract and POAG patients has an impact on anterior segment anatomy and topography owing to significant increase of ACD by 1.2 mm and anterior chamber angle by 3.3°. VTP ab interno provides additional ACD increase by 1.8 mm and anterior chamber angle by 15.9°. Complication rate was 8.5 % in study group (i.e., following combined phaco and VTP ab interno and 5.1 % and 8.4 % in control groups. Hospitalization days in all groups had no significant differences.Conclusion. A novel method of combined VTP ab interno and cataract phacoemulsification provides significant IOP decrease (by 74 % at 2‑yrs follow-up. Following VTP and phaco, fewer or even no hypotensive eye drops were required. This technique is less traumatic than traditional cataract and glaucoma surgery. Indication for combined VTP and phaco is (im mature cataract with medically (sub compensated POAG.

  1. Thermal characterization of phacoemulsification probes operated in axial and torsional modes.

    Science.gov (United States)

    Zacharias, Jaime

    2015-01-01

    To analyze temperature increases and identify potential sources of heat generated when sleeved and sleeveless phacoemulsification probes were operated in axial and torsional modes using the Infiniti Vision System with the Ozil torsional handpiece. Phacodynamics Laboratory, Pasteur Ophthalmic Clinic, Santiago, Chile. Experimental study. Two computer-controlled thermal transfer systems were developed to evaluate the contribution of internal metal stress and tip-to-sleeve friction on heat generation during phacoemulsification using axial and torsional ultrasound modalities. Both systems incorporated infrared thermal imaging and used a black-body film to accurately capture temperature measurements. Axial mode was consistently associated with greater temperature increases than torsional mode whether tips were operated with or without sleeves. In tests involving bare tips, axial mode and torsional mode peaked at 51.7°C and 34.2°C, respectively. In an example using sleeved tips in which a 30.0 g load was applied for 1 second, temperatures for axial mode reached 45°C and for torsional mode, 38°C. Friction between the sleeved probe and the incisional wall contributed more significantly to the temperature increase than internal metal stress regardless of the mode used. In all experiments, the temperature increase observed with axial mode was greater than that observed with torsional mode, even when conditions such as power or amplitude and flow rate were varied. Tip-to-sleeve friction was a more dominant source of phaco probe heating than internal metal stress. The temperature increase due to internal metal stress was greater with axial mode than with torsional mode. Dr. Zacharias received research funding from Alcon Laboratories, Inc., to conduct this study. He has no financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Acute Corneal Hydrops 3 Years after Intra-corneal Ring Segments and Corneal Collagen Cross-linking

    Science.gov (United States)

    Antonios, Rafic; Dirani, Ali; Fadlallah, Ali; Chelala, Elias; Hamadeh, Adib; Jarade, Elias

    2016-01-01

    This case report describes a 15-year-old male with allergic conjunctivitis and keratoconus, who underwent uneventful intra-corneal ring segment (ICRS) implantation and corneal collagen cross-linking (CXL) in the right eye. During the follow-up periods, the patient was noted to have several episodes of allergic conjunctivitis that were treated accordingly. At the 2 years postoperatively, he presented with another episode of allergic conjunctivitis and progression of keratoconus was suspected on topography. However, the patient was lost to follow-up, until he presented with acute hydrops at 3 years postoperatively. There are no reported cases of acute corneal hydrops in cross-linked corneas. We suspect the young age, allergic conjunctivitis and eye rubbing may be a risk factors associated with possible progression of keratoconus after CXL. Prolonged follow-up and aggressive control of the allergy might be necessary in similar cases. PMID:26957859

  3. [Representation and mathematical analysis of human corneal surface].

    Science.gov (United States)

    Tălu, Stefan; Tălu, Mihai; Giovanzana, Stefano

    2011-01-01

    In the description and analysis of human corneal surface are used various mathematical models based on parametric representations, used in biomechanical studies and 3D solid modeling of the cornea. Mathematical models are important into the biomechanics of the cornea to model the corneal behavior. Corneal biomechanics also has the potential to improve outcomes in refractive surgery. The objective of this paper is to present the most representative mathematical models currently used for modeling of human corneal in optics and biomechanics fields.

  4. The molecular genetics of the corneal dystrophies--current status.

    Science.gov (United States)

    Klintworth, Gordon K

    2003-05-01

    The pertinent literature on inherited corneal diseases is reviewed in terms of the chromosomal localization and identification of the responsible genes. Disorders affecting the cornea have been mapped to human chromosome 1 (central crystalline corneal dystrophy, familial subepithelial corneal amyloidosis, early onset Fuchs dystrophy, posterior polymorphous corneal dystrophy), chromosome 4 (Bietti marginal crystalline dystrophy), chromosome 5 (lattice dystrophy types 1 and IIIA, granular corneal dystrophy types 1, 2 and 3, Thiel-Behnke corneal dystrophy), chromosome 9 (lattice dystrophy type II), chromosome 10 (Thiel-Behnke corneal dystrophy), chromosome 12 (Meesmann dystrophy), chromosome 16 (macular corneal dystrophy, fish eye disease, LCAT disease, tyrosinemia type II), chromosome 17 (Meesmann dystrophy, Stocker-Holt dystrophy), chromosome 20 (congenital hereditary endothelial corneal dystrophy types I and II, posterior polymorphous corneal dystrophy), chromosome 21 (autosomal dominant keratoconus) and the X chromosome (cornea verticillata, cornea farinata, deep filiform corneal dystrophy, keratosis follicularis spinulosa decalvans, Lisch corneal dystrophy). Mutations in nine genes (ARSC1, CHST6, COL8A2, GLA, GSN, KRT3, KRT12, M1S1and TGFBI [BIGH3]) account for some of the corneal diseases and three of them are associated with amyloid deposition in the cornea (GSN, M1S1, TGFBI) including most of the lattice corneal dystrophies (LCDs) [LCD types I, IA, II, IIIA, IIIB, IV, V, VI and VII] recognized by their lattice pattern of linear opacities. Genetic studies on inherited diseases affecting the cornea have provided insight into some of these disorders at a basic molecular level and it has become recognized that distinct clinicopathologic phenotypes can result from specific mutations in a particular gene, as well as some different mutations in the same gene. A molecular genetic understanding of inherited corneal diseases is leading to a better appreciation of the

  5. Monitoring of cornea elastic properties changes during UV-A/riboflavin-induced corneal collagen cross-linking using supersonic shear wave imaging: a pilot study.

    Science.gov (United States)

    Nguyen, Thu-Mai; Aubry, Jean-François; Touboul, David; Fink, Mathias; Gennisson, Jean-Luc; Bercoff, Jeremy; Tanter, Mickael

    2012-08-31

    Keratoconus disease or post-LASIK corneal ectasia are increasingly treated using UV-A/riboflavin-induced corneal collagen cross-linking (CXL). However, this treatment suffers from a lack of techniques to provide an assessment in real-time of the CXL effects. Here, we investigated the potential interest of corneal elasticity as a biomarker of the efficacy of this treatment. For this purpose, supersonic shear wave imaging (SSI) was performed both ex vivo and in vivo on porcine eyes before and after CXL. Based on ultrasonic scanners providing ultrafast frame rates (~30 kHz), the SSI technique generates and tracks the propagation of shear waves in tissues. It provides two- and three-dimensional (2-D and 3-D) quantitative maps of the corneal elasticity. After CXL, quantitative maps of corneal stiffness clearly depicted the cross-linked area with a typical 200-μm lateral resolution. The CXL resulted in a 56% ± 15% increase of the shear wave speed for corneas treated in vivo (n = 4). The in vivo CXL experiments performed on pigs demonstrated that the quantitative estimation of local stiffness and the 2-D elastic maps of the corneal surface provide an efficient way to monitor the local efficacy of corneal cross-linking.

  6. Contact lens rehabilitation following repaired corneal perforations

    Directory of Open Access Journals (Sweden)

    Sreenivas V

    2006-03-01

    Full Text Available Abstract Background Visual outcome following repair of post-traumatic corneal perforation may not be optimal due to presence of irregular keratometric astigmatism. We performed a study to evaluate and compare rigid gas permeable contact lens and spectacles in visual rehabilitation following perforating corneal injuries. Method Eyes that had undergone repair for corneal perforating injuries with or without lens aspiration were fitted rigid gas permeable contact lenses. The fitting pattern and the improvement in visual acuity by contact lens over spectacle correction were noted. Results Forty eyes of 40 patients that had undergone surgical repair of posttraumatic corneal perforations were fitted rigid gas permeable contact lenses for visual rehabilitation. Twenty-four eyes (60% required aphakic contact lenses. The best corrected visual acuity (BCVA of ≥ 6/18 in the snellen's acuity chart was seen in 10 (25% eyes with spectacle correction and 37 (92.5% eyes with the use of contact lens (p Conclusion Rigid gas permeable contact lenses are better means of rehabilitation in eyes that have an irregular cornea due to scars caused by perforating corneal injuries.

  7. Corneal Phaeohyphomycosis Caused by Bipolaris hawaiiensis

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    Winai Chaidaroon

    2016-07-01

    Full Text Available Purpose: To report a rare case of keratitis infected by Bipolaris hawaiiensis. Methods: A patient who was diagnosed as fungal keratitis caused by B. hawaiiensis was retrospectively reviewed for history, clinical characteristics, risk factors, laboratory findings, treatments, and outcomes. Results: A 63-year-old man with a history of trauma and saw dust in the left eye presented with a corneal ulcer. Eye examination revealed whitish infiltration with a feathery edge and small brownish deposits in the anterior stroma of the left cornea. Numerous septate hyphal fragments were detected in a corneal specimen, and nucleotide sequence analysis identified B. hawaiiensis. Treatment was started with 5% natamycin eyedrops and oral itraconazole. Subsequently, a corneal plaque developed which did not respond to medication and debridement. The patient underwent therapeutic penetrating keratoplasty. Conclusions: B. hawaiiensis is a rare cause of corneal phaeohyphomycosis. A brownish pigmented infiltration is an important diagnostic clue, however microbiologic studies are required to obtain a definite diagnosis. Although antifungal medication and debridement are the mainstay of most corneal fungal infection, therapeutic penetrating keratoplasty can prevent morbidity related to this fungal infection.

  8. Corneal Phaeohyphomycosis Caused by Bipolaris hawaiiensis

    Science.gov (United States)

    Chaidaroon, Winai; Supalaset, Sumet; Tananuvat, Napaporn; Vanittanakom, Nongnuch

    2016-01-01

    Purpose To report a rare case of keratitis infected by Bipolaris hawaiiensis. Methods A patient who was diagnosed as fungal keratitis caused by B. hawaiiensis was retrospectively reviewed for history, clinical characteristics, risk factors, laboratory findings, treatments, and outcomes. Results A 63-year-old man with a history of trauma and saw dust in the left eye presented with a corneal ulcer. Eye examination revealed whitish infiltration with a feathery edge and small brownish deposits in the anterior stroma of the left cornea. Numerous septate hyphal fragments were detected in a corneal specimen, and nucleotide sequence analysis identified B. hawaiiensis. Treatment was started with 5% natamycin eyedrops and oral itraconazole. Subsequently, a corneal plaque developed which did not respond to medication and debridement. The patient underwent therapeutic penetrating keratoplasty. Conclusions B. hawaiiensis is a rare cause of corneal phaeohyphomycosis. A brownish pigmented infiltration is an important diagnostic clue, however microbiologic studies are required to obtain a definite diagnosis. Although antifungal medication and debridement are the mainstay of most corneal fungal infection, therapeutic penetrating keratoplasty can prevent morbidity related to this fungal infection. PMID:27721785

  9. Corneal trephination with the femtosecond laser.

    Science.gov (United States)

    Meltendorf, Christian; Schroeter, Jan; Bug, Reinhold; Kohnen, Thomas; Deller, Thomas

    2006-10-01

    To evaluate the feasibility and cut quality of corneal trephination in human donor corneal tissue with the femtosecond laser. Twelve human corneoscleral discs were inserted in an artificial anterior chamber. After corneal thickness measurement and tonometry, the cornea was mounted on a femtosecond laser (FEMTEC; 20/10 Perfect Vision, Heidelberg, Germany) through a contact lens (patient interface). Trephination was performed with diameters of 7.0, 7.5, 8.0, and 8.5 mm in 3 corneas each. The corneal button was removed from the corneoscleral disc in 2 of the 3 corneas in each case. The cut was not manipulated in the remaining corneas to enable histologic detection of possible tissue bridges. The cut edges were macroscopically and light-microscopically examined for quality. Corneal buttons and corneoscleral discs could be separated by blunt dissection in all cases. Tissue bridges were more common in thicker edematous corneas than in thinner ones. Both the macro- and microscopic examination disclosed smooth rectilinear cut margins with a perpendicular cut edge. This feasibility study shows that the femtosecond laser enables sufficient trephination of human donor corneas.

  10. Corneal reconstruction by stem cells and bioengineering

    Directory of Open Access Journals (Sweden)

    Arjamaa O

    2012-09-01

    Full Text Available Olli ArjamaaDepartment of Biology, University of Turku, Turku, FinlandAbstract: Almost 300 million people are visually impaired worldwide due to various eye diseases such as cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy, and corneal diseases. Notably, ten million people are blind because of severe ocular surface diseases and the majority of cases occur in developing countries. Blinding ocular surface diseases have, however, become treatable by grafting of surface layers, or by full-thickness transplantation of the cornea. As the demand for human corneal tissue for surface reconstruction and transplantation far exceeds the supply, methods are being developed to supplement tissue donation. Xenotransplantation of the cornea or cells from genetically modified pigs may become one of the solutions. Transplantation of limbal stem cells within tissue biopsies, to restore the transparency of the cornea is another remarkable method, which has shown its potential in several clinical studies. The combination of stem cell technology and engineering of biocompatible tissue equivalent, still at preclinical stage, has shown us how synthetic corneal tissue is able to guide cultured corneal stromal stem cells of human origin, to become native-like stroma, the most important layer of the cornea. These findings give hope for a large-quantity production of biomaterial for corneal reconstruction. As such, clinical ophthalmologists should become more familiar with the methods of laboratory science.Keywords: eye, grafting, keratoplasty, xenotransplantation, cell reservoir, biocompatible tissue equivalent

  11. Astigmatism treatment during phacoemulsification: a review of current surgical strategies and their rationale

    Directory of Open Access Journals (Sweden)

    Giuliano de Oliveira Freitas

    2013-12-01

    Full Text Available Preexisting corneal astigmatism, present at the time of cataract surgery, is reviewed in detail throughout this article on its most important aspects such as occurrence rates, clinical relevance and current treatment options. Special emphasis is given to the latter aspect. Each method's rationale, advantage and limitation ishigh lightened. Comparisons between treatment options, whenever possible, are also provided.

  12. Analysis of the horizontal corneal diameter, central corneal thickness, and axial length in premature infants

    Directory of Open Access Journals (Sweden)

    Ozdemir Ozdemir

    2014-08-01

    Full Text Available Purpose: To determine the horizontal corneal diameter, central corneal thickness, and axial length in premature infants. Methods: Infants with a birth weight of less than 2,500 g or with a gestation period of less than 36 weeks were included in the study. Infants with retinopathy of prematurity (ROP were allocated to Group 1 (n=138, while those without ROP were allocated to Group 2 (n=236. All infants underwent a complete ophthalmologic examination, including corneal diameter measurements, pachymetry, biometry, and fundoscopy. Between-group comparisons of horizontal corneal diameter, central corneal thickness, and axial lengths were performed. Independent sample t-tests were used for statistical analysis. Results: Data was obtained from 374 eyes of 187 infants (102 female, 85 male. The mean gestational age at birth was 30.7 ± 2.7 weeks (range 25-36 weeks, the mean birth weight was 1,514 ± 533.3 g (range 750-1,970 g, and the mean postmenstrual age at examination was 40.0 ± 4.8 weeks. The mean gestational age and the mean birth weight of Group 1 were statistically lower than Group 2 (p0.05. Conclusions: The presence of ROP in premature infants does not alter the horizontal corneal diameter, central corneal thickness, or axial length.

  13. Media Language, Clear or Obscure

    DEFF Research Database (Denmark)

    Jakobsen, Bjarne le Fevre; Ejstrup, Michael

    2015-01-01

    Abstract— Be clear, not obscure. One of the four maxims for optimal communication is that it is essential to develop proficiency in being concise and clear. The question is whether this is really a good idea in all contexts. There is some evidence to the contrary. Undoubtedly, we have many contex...... for the survival of free speech....... growth in diversity, means that media need to be very cognizant of the stringency with which they handle the advice to be linguistically clear and concise. The need to pay great attention to situational awareness is highly visible and intrusive. Attention to situational awareness seems to be crucial...

  14. 21 CFR 886.1450 - Corneal radius measuring device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Corneal radius measuring device. 886.1450 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1450 Corneal radius measuring device. (a) Identification. A corneal radius measuring device is an AC-powered device intended to...

  15. An Ultra-thin Amniotic Membrane as Carrier in Corneal Epithelium Tissue-Engineering.

    Science.gov (United States)

    Zhang, Liying; Zou, Dulei; Li, Sanming; Wang, Junqi; Qu, Yangluowa; Ou, Shangkun; Jia, Changkai; Li, Juan; He, Hui; Liu, Tingting; Yang, Jie; Chen, Yongxiong; Liu, Zuguo; Li, Wei

    2016-02-15

    Amniotic membranes (AMs) are widely used as a corneal epithelial tissue carrier in reconstruction surgery. However, the engineered tissue transparency is low due to the translucent thick underlying AM stroma. To overcome this drawback, we developed an ultra-thin AM (UAM) by using collagenase IV to strip away from the epithelial denuded AM (DAM) some of the stroma. By thinning the stroma to about 30 μm, its moist and dry forms were rendered acellular, optically clear and its collagen framework became compacted and inerratic. Engineered rabbit corneal epithelial cell (RCEC) sheets generated through expansion of limbal epithelial cells on UAM were more transparent and thicker than those expanded on DAM. Moreover, ΔNp63 and ABCG2 gene expression was greater in tissue engineered cell sheets expanded on UAM than on DAM. Furthermore, 2 weeks after surgery, the cornea grafted with UAM based cell sheets showed higher transparency and more stratified epithelium than the cornea grafted with DAM based cell sheets. Taken together, tissue engineered corneal epithelium generated on UAM has a preferable outcome because the transplanted tissue is more transparent and better resembles the phenotype of the native tissue than that obtained by using DAM for this procedure. UAM preserves compact layer of the amniotic membrane and maybe an ideal substrate for corneal epithelial tissue engineering.

  16. Progression in keratoconus and the effect of corneal cross-linking on progression.

    Science.gov (United States)

    Brown, Sarah E; Simmasalam, Rubinee; Antonova, Nataliya; Gadaria, Neha; Asbell, Penny A

    2014-11-01

    Ultraviolet corneal collagen cross-linking (CXL) has been shown to possibly delay, halt, or even reverse disease progression in keratoconus. Understanding of keratoconic progression in untreated eyes, however, is still incomplete and is hampered by the varying definitions and metrics used to evaluate corneal changes. As a result, the CXL literature varies widely in criteria for progression and parameters for successful outcomes. To date, there have been few long-term, well-controlled clinical trials supporting the efficacy of CXL to prevent progression in keratoconus. Review of our data on keratoconus suggests the course of corneal change is difficult to predict and that many keratoconic eyes appear stable once the eyes begin to exhibit frank changes in corneal curvature typical of keratoconus. Better-defined metrics for progression in keratoconus are needed. Larger, long-term randomized clinical trials may more clearly establish the efficacy and safety of CXL in the management of keratoconus and determine which patients are the best candidates for this procedure.

  17. Forest clearing and regional landsliding

    Science.gov (United States)

    Montgomery, D.R.; Schmidt, K.M.; Greenberg, H.M.; Dietrich, W.E.

    2000-01-01

    The influence of forest clearing on landsliding is central to longstanding concern over the effects of timber harvesting on slope stability. Here we document a strong topographic control on shallow landsliding by combining unique ground-based landslide surveys in an intensively monitored study area with digital terrain modeling using high-resolution laser altimetry and a coarser resolution regional study of 3224 landslides. As predicted by our digital terrain-based model, landslides occur disproportionately in steep, convergent topography. In terrain predicted to be at low risk of slope failure, a random model performs equally well to our mechanism-based model. Our monitoring shows that storms with 24 hr rainfall recurrence intervals of less than 4 yr triggered landslides in the decade after forest clearing and that conventional monitoring programs can substantially underestimate the effects of forest clearing. Our regional analysis further substantiates that forest clearing dramatically accelerates shallow landsliding in steep terrain typical of the Pacific Northwest.

  18. Endothelial cell study in a case of Werner′s syndrome undergoing phacoemulsification and Yettrium-Aluminum-Garnet laser capsulotomy

    Directory of Open Access Journals (Sweden)

    Vasudha Kemmanu

    2012-01-01

    Full Text Available Werner′s syndrome (WS is a rare autosomal recessive disorder with multisystem manifestations of premature aging from the second decade of life. Cataract is one of the features of WS. Cataract surgery is complicated with postoperative wound dehiscence and bullous keratopathy when the surgery is done by intracapsular or conventional extracapsular method. We report the short-term result of phacoemulsification and Neodymimum Yettrium-Aluminum-Garnet laser (Nd YAG capsulotomy in a case of WS with bilateral cataracts. Postoperatively and post capsulotomy, there was no change in the endothelial cell morphology. There was an 8.6% decrease in endothelial cell count at the end of 15 months postoperatively and 11 months post YAG capsulotomy. This decrease is within the acceptable range of cell loss after phacoemulsification and YAG capsulotomy. To the best of our knowledge, this is the first reported case of YAG laser capsulotomy in WS.

  19. Corneal nerve microstructure in Parkinson's disease.

    Science.gov (United States)

    Misra, Stuti L; Kersten, Hannah M; Roxburgh, Richard H; Danesh-Meyer, Helen V; McGhee, Charles N J

    2017-03-03

    Ocular surface changes and blink abnormalities are well-established in Parkinson's disease. Blink rate may be influenced by corneal sub-basal nerve density, however, this relationship has not yet been investigated in Parkinson's disease. This case-control study examined the ocular surface in patients with moderately severe Parkinson's disease, including confocal microscopy of the cornea. Fifteen patients with moderately severe Parkinson's disease (modified Hoehn and Yahr grade 3 or 4) and fifteen control participants were recruited. Ophthalmic assessment included slit-lamp examination, blink rate assessment, central corneal aesthesiometry and in vivo corneal confocal microscopy. The effect of disease laterality was also investigated. Of the 15 patients with Parkinson's disease, ten were male and the mean age was 65.5±8.6years. The corneal sub-basal nerve plexus density was markedly reduced in patients with Parkinson's disease (7.56±2.4mm/mm(2)) compared with controls (15.91±2.6mm/mm(2)) (pParkinson's disease (0.79±1.2mBAR) and the control group (0.26±0.35mBAR), p=0.12. Sub-basal nerve density was not significantly different between the eye ipsilateral to the side of the body with most-severe motor symptoms, and the contralateral eye. There was a significant positive correlation between ACE-R scores and sub-basal corneal nerve density (R(2)=0.66, p=0.02). This is the first study to report a significant reduction in corneal sub-basal nerve density in Parkinson's disease and demonstrate an association with cognitive dysfunction. These results provide further evidence to support the involvement of the peripheral nervous system in Parkinson's disease, previously thought to be a central nervous system disorder.

  20. Normal corneal endothelial cell density in Nigerians

    Directory of Open Access Journals (Sweden)

    Ewete T

    2016-03-01

    Full Text Available Temitope Ewete,1 Efeoghene Uchenna Ani,2 Adegboyega Sunday Alabi1 1MeCure Eye Center, Lagos, 2Department of Ophthalmology, University of Port Harcourt, Port Harcourt, Nigeria Aim: The aim of the study was to describe the corneal endothelial cell density of adults at the MeCure Eye Center and to determine the relationship between age, sex, and corneal endothelial cell density. Methods: This study was a retrospective study looking at those records of individuals who had undergone specular microscopy or corneal endothelial cell count measurement at the MeCure Eye Center. Results: The endothelial cell characteristics of 359 healthy eyes of 201 volunteers were studied. The mean corneal endothelial cell density (MCD was 2,610.26±371.87 cells/mm2 (range, 1,484–3,571 cells/mm2. The MCD decreased from 2,860.70 cells/mm2 in the 20–30-year age group to 2,493.06 cells/mm2 in the >70-year age group, and there was a statistically significant relationship between age and MCD with a P-value of <0.001. There was no statistically significant correlation between sex and corneal endothelial cell density (P=0.45. Conclusion: This study shows that endothelial cell density in Nigerian eyes is less than that reported in the Japanese, American, and Chinese eyes, and is comparable to that seen in Indian and Malaysian eyes. Keywords: corneal, endothelial cell density, Nigerian

  1. Comparison of the Posterior Capsule Rupture Rates Associated with Conventional (Start to Finish) Versus Reverse Methods of Teaching Phacoemulsification.

    Science.gov (United States)

    Suryawanshi, Milind; Gogate, Parikshit; Kulkarni, Anil N; Biradar, Archana; Bhomaj, Pooja

    2016-01-01

    Comparison of the rates of posterior capsule rupture (PCR) associated with conventional versus a reverse method of teaching phacoemulsification. Trainees were taught conventional (start-to-finish) phacoemulsification beginning with an incision (tunnel construction) to capsulorhexis, sculpting, nucleus cracking, segment removal, cortex aspiration, intraocular lens implantation, and viscoelastic removal. In the reverse method, after incision and capsulorhexis, the trainees were progressively taught viscoelastic wash, cortex aspiration, segment removal, nucleus cracking, sculpting, and intraocular lens implantation. Trainees from a Tertiary Eye Care Centre were classified as beginners, for their first 30 cases and then trainees for their next 70 surgeries. Data were collected on posterior capsular rent and vitreous loss during each step of training. Thirty-two ophthalmic surgeons learning phacoemulsification surgery on 609 cataracts cases were supervised by 3 trainers. Fifteen beginners performed 287 surgeries using the conventional method, and 17 beginners performed 322 surgeries with the reverse method. The incidence of PCR was 18/287 (6.2%) with the conventional method and 15/322 (4.6%) with the reverse method (P = 0.38). PCR occurred during cortex aspiration (8/287, 2.8%) and segment removal (5/287, 1.7%) in the conventional method. PCR occurred during nucleus cracking, segment removal, and cortex aspiration (4/322 surgeries for each step, 1.2%). In the follow, 70 cases (trainees) there was no difference in PCR with either method (4.7% vs. 4.3%, P = 0.705). Conventional and reverse method for training phacoemulsification were both safe in a supervised setting.

  2. A Simple Way to Achieve the Routine Position for Phacoemulsification in a Patient with Marked Thoracic Kyphosis

    OpenAIRE

    Razeghinejad, Mohammad-Reza; Eghbal, Mohammad-Hossein

    2009-01-01

    Purpose To introduce a simple way for achieving the routine position for phacoemulsification in a patient with a marked thoracic kyphosis. Case Report A 74-year-old man with marked thoracic kyphosis and visually significant cataracts presented for surgery; he was unable to lie flat due to the severe deformity. The best possible surgical position was achieved by placing a chair with an adjustable top between a standard operating table and another small table. The wheels of the table and the ch...

  3. Combined 30-degree bevel up and down technique against 0-degree phaco tip for phacoemulsification surgery of hard cataracts.

    Science.gov (United States)

    Joshi, Rajesh Subhash; Muley, Sonal Jayant

    2017-01-01

    To evaluate the effective phaco time (EPT), cumulative dissipated energy (CDE) and nucleus emulsification time (NET) as phaco parameters with 0- and 30-degree phaco tip. This prospective, interventional and observational case series included 294 patients scheduled for cataract removal by phacoemulsification technique. Patients with nuclear cataracts of grade 4 and 5 nuclear opalescence of Lens Opacities Classification System III were included in the study. Patients were consecutively allocated to phaco chop technique with 0-degree (0-degree group, n=147) and combined bevel up and down position using 30-degree phaco tip (combined bevel up/down group, n=147). The 0-degree group had phacoemulsification with 0-degree phaco tip, while the 30-degree group had chopping of the nucleus with bevel down phaco tip and emulsification of nuclear fragments was accomplished with bevel up tip. EPT, CDE, NET and intraoperative complications were noted and compared between the groups using analysis of variance. Average EPT, CDE and NET were lower in the 30-degree group than in the 0-degree group. However, no statistically significant difference was found in EPT (P=0.0733), CDE (P=0.0663) and NET (P=0.0633) between the two groups. No serious intraoperative complications were noted. The anterior chamber was maintained throughout the procedure in both groups. No patients had wound burn and miosis during the procedure. None of the patients developed bullous keratopathy, uveitis and cystoid macular edema during the follow-up period. Combined bevel up and down 30-degree tip can yield effective hard nucleus phacoemulsification. Bevel down tip of 30-degree helps in effective chopping and bevel up tip assists in emulsification of the nuclear fragments. Although combined bevel up and down 30-degree tip can yield effective hard nucleus phacoemulsification, no statistically significant difference was found in EPT, CDE and NET between the two groups.

  4. Phacoemulsification in hard cataracts: the "chop, trip and free" technique Facoemulsificação em cataratas duras: "Faco rasteira"

    OpenAIRE

    José Marcos S. Gonçalves

    2004-01-01

    Very hard cataracts continue to be a challenge to phacoemulsification due to the difficulty in breaking the nucleus and also in separating the broken nucleus from the adjacent epinucleus. The present technique is the presentation of a surgical maneuver which uses the Nagahara chopper and the phaco tip to divide the nucleus (including the epinucleus) as a whole and then emulsify it using little time and not very much phaco power.Cataratas muito duras continuam sendo um desafio para a facoemuls...

  5. Morphologic change and the clinical effects of phacoemulsification combined with goniosynechialysis in primary angle-closure glaucoma

    Directory of Open Access Journals (Sweden)

    Zhong Sun

    2015-11-01

    Full Text Available AIM: To study themorphological changes of anterior chamber angle in patients with primary angle-closure glaucoma(PACGand in whom the closed anterior chamber angle was ≥180°(determined by gonioscopy dynamiclybefore and after phacoemulsification combined with goniosynechialysis and to evaluate the clinical efficacy of this surgry.METHODS:A prospective case series study. Seventy-nine cases(79 eyeswith cataract were enrolled. They went to our hospital for phacoemulsification and were diagnosed as PACG, in whom the closed anterior chamber angle was ≥180°(determined by gonioscopy dynamicly. They were observed for the changes of anterior chamber angle, intraocular pressure(IOPand the best-corrected visual acuity(BCVApre- and post-operative from January to December in 2013.The angle opening distance 500(AOD500and trabecular-iris angle 500(TIA500before and after surgeries were analyzed using paired student t-test. The range of goniosynechia and BCVA before and after surgeries were analyzed using Kruskal-Wallis H test.RESULTS:The IOPs of 58 eyes were normal(≤21mmHgwithout any medications at 1mo after operation, and 56 eyes at 6mo after operation. The range of goniosynechia, AOD500, TIA500 and BCVA before operation had significant difference compared with those at 1 and 6mo after operation(PCONCLUSION:Phacoemulsification combined with goniosynechialysisis is an effective method for angle closure glaucoma simply caused by pupillary block, coexisted with cataract. The angle closure glaucoma without pupillary block which has long course and the location of peripheral iris is anterior and the closure glaucoma coexisted with cataract caused by several different mechanisms should be treated with medicine management after phacoemulsification combined with goniosynechialysisis.

  6. Phacoemulsification using iris-hooks for capsular support in high myopic patient with subluxated lens and secondary angle closure glaucoma

    Directory of Open Access Journals (Sweden)

    Morris Brid

    2006-01-01

    Full Text Available We report an unusual case of angle closure glaucoma in a 78-year-old highly myopic female patient. The patient did not show any preoperative signs of subluxation of lens. However, the capsular bag was noted to be unstable during surgery. The patient was managed with phacoemulsification of lens using a novel method of iris hooks for stabilization of capsular bag during surgery.

  7. Disappearance of anterior chamber with high intraocular pressure in phacoemulsification%超声乳化术中前房消失伴高眼压

    Institute of Scientific and Technical Information of China (English)

    傅波; 苗春旭; 冯万国; 宫冰冰; 肖梦媛

    2013-01-01

    incision in 43 cases.Iris atrophy and depigmentation observed at corresponding part.The pupil is no longer circular.For 3 eyes with minor rupture of posterior capsule,IOL was implanted in capsular bag as usual.For 2 cases which had apparent rupture of posterior capsule and vitreous prolapse,anterior vetrectomy performed,IOL was implanted through ciliary groove and suspended by suturing above.Detachement of Descemte' s membrane in 6 cases,repositioned by bubbles.Corneal edema to varied extent appeared in 58 cases but recovered within 3 ~ 5 days.Conclusion Anterior chamber disappearance with high intraocular pressure might happened in cataract phacoemulsification.It makes tools lose operating room,increases operation risk and complication accordingly.It' s partly related to anatomy factors,but some related to operation skills.Special attention and effective measures should be given to overcome the risks.

  8. Acute Corneal Hydrops in Children with Primary Infantile Glaucoma: A Report of 31 Cases over 23 Years at the LVPEI.

    Directory of Open Access Journals (Sweden)

    Anil K Mandal

    Full Text Available Relatively little data exist regarding the outcomes of children with primary infantile glaucoma presenting with acute corneal hydrops. The aim of our study was to determine the surgical outcome of children of infantile glaucoma who presented with acute corneal hydrops.In total, 38 eyes of 31 consecutive children of infantile glaucoma presented with acute corneal hydrops who underwent primary combined trabeculotomy-trabeculectomy (CTT by a single surgeon from January 1990 to December 2012 at the LV Prasad Eye Institute (LVPEI, a tertiary eye care centre in Southern India were enrolled in this retrospective study. Primary outcome measures were intraocular pressure (IOP control (IOP ≤ 16 mmHg under anaesthesia or IOP ≤ 21 mmHg without anaesthesia and clearance of corneal edema. Secondary outcome measures were visual acuity (VA, corneal diameter, bleb appearance, intraoperative and postoperative complications.Mean age at presentation was 6.4 months (range, 2-11 months and seven eyes (23% had bilateral affliction. At presentation, all eyes (100% had moderate to severe degree of corneal edema with a mean preoperative IOP of 25.6 ±5.1 mmHg. Postoperatively, the IOP reduced to 12.0 ± 3.8 mmHg (difference = -13.6, 95% CI = -15.7 to -11.5, t = -13.18, p<0.0001, and the percentage reduction in IOP was 53.05%. Preoperatively 83% of the eyes were on antiglaucoma medication, and postoperatively 2 eyes (5.3% required 1 antiglaucoma medication for control of IOP. Preoperatively, corneal edema was present in all eyes and postoperatively it cleared in all of them. Significant myopic astigmatism was present in 28 eyes (74%, the commonest being compound myopic astigmatism (75% followed by simple myopic astigmatism (21%. Normal VA (best-corrected VA; BCVA ≥ 20/60 was achieved in 44.4% of the eyes and 22.2% eyes had low vision (BCVA, <20/60 to 20/400. Complete success (IOP control and clearance of corneal oedema was obtained in 94.7% eyes. There were no

  9. 白内障超声乳化术后泪膜稳定性变化的临床研究%Study After Phacoemulsification Tear Film Stability Changes

    Institute of Scientific and Technical Information of China (English)

    崔雅玲; 刘志英

    2015-01-01

    Objective To investigate the tear film after phacoemulsification and ocular surface changes . Methods Randomly selected hospital phacoemulsification in patients with 1 6 2 cases(1 6 2 eyes) ,respectively ,in the preoperative and postoperative 1 d ,7 d ,1 mo ,3 mo row symptoms (DES ) , tear film break -up time (BU T ) ,basal tear secretion test (Sit ) ,corneal fluorescein staining score (CFS ) .Comparison of preoperative and postoperative differences before each period of the data .Results 1 d、7 d、1 mo postoperative discomfort in the patient complained of eye surgery compared with preoperative increased .compared with the preoperative sta-tistically significant ( P<0 .0 5 );Sit inside after 1 d、7 d increase ,compared with the preoperative statistically significant(P<0 .05 );1 d、7 d、1 mo within BUT shortened ,compared with the preoperative statistically sig-nificant( P<0 .0 5 );After surgery1 d、7 d CFS increased ,compared with the preoperative statistically significant ( P<0 .0 5 ) .Conclusion Postoperative period ,phacoemulsification affect tear film stability ,it should be noted before the tear film function tests and intraoperative and postoperative protection of the tear film .%目的:探讨白内障超声乳化手术后泪膜和眼表的变化。方法随机选择在我院行白内障超声乳化术患者162例(162眼),观察术前及术后第1 d、7 d、1 mo、3 mo自觉症状(DES)、泪膜破裂时间(BUT)、基础泪液分泌试验(Sit )、角膜荧光素染色评分(CFS )并进行统计学分析。结果术后1 d、7 d、1 mo患者自觉症状较术前增加,与术前相比差异有统计学意义( P<0.05);术后1 d、7 d内Sit增加,与术前相比差异有统计学意义(P<0.05);术后1 d、7 d、1 mo BUT缩短,与术前相比差异有统计学意义(P<0.05);术后1 d、7 d CFS增高;与术前相比差异有统计学意义( P<0.05)。结论白内障超声乳化术后1个月

  10. 基层医院开展超声乳化白内障吸除术临床体会%The clinical experience of carrying out phacoemulsification in hospitals

    Institute of Scientific and Technical Information of China (English)

    赵书辉; 丁颖; 杨凤霞

    2012-01-01

    目的 介绍基层医院开展超声乳化治疗白内障的临床经验、对并发症进行观察,分析其发生的原因及探讨防治原则.方法 对某院行超声乳化白内障吸除术治疗的患者200例(220只眼)的手术情况进行回顾性分析.结果 术后3个月矫正视力< 0.05者5只眼(2.3%),0.05 ~0.1者6只眼(2.7%),0.1~0.5者90只眼(40.9%),0.5~1.0者100只眼(45.5%),>1.0者19只眼(8.6%);术中并发症:切口灼伤1只眼(0.4%);虹膜损伤者16只眼(7.3%);晶状体后囊膜破裂者20只眼(9.1%);角膜后弹力层撕脱着1只眼(0.4%);晶状体核块坠入玻璃体腔者3只眼(1.4%).术后并发症:角膜水肿者10只眼(4.5%),未见其他严重并发症发生.结论 超声乳化白内障吸除术操作难度大,对术者技术要求高,强调在开展该手术时首先要熟悉机器的性能,其次要选择合适的病人,要求术者熟悉手术步骤并能处理相关并发症,这样就能逐渐达到熟练掌握该项手术的目的.%OBJECTIVE To introduce the clinical experience of carrying out phacoemulsification in the treatment of cataract in hospitals, to observe the complications, to analyze the reasons of occurrence and to discuss control principles. METHODS 200 patients (220 eyes) with phacoemulsification surgery in our hospital were analyzed. RESULTS 3 months after treatment, corrected vision 1.0 in 19 eyes (8.6%); Intraoperative complications: incision burns 1 eye, (0.4%); iris damage of the eye only 16, (7.3%); posterior capsular rupture 20 eyes (9.1%); tear of Descemet's membrane 1 eye, (0.4%); crystalline lens in vitreous cavity 3 eyes, (1.4%). The postoperative complications: the corneal edema 10 eyes, (4.5%), there were no serious complications. CONCLUSION Phacoemulsification is difficult. For operators, high technical requirements are needed and it emphasizes that be familiar with the performance of the machine before operation, then selecting the right patients , be

  11. Corneal collagen crosslinking for keratoconus. A review

    Directory of Open Access Journals (Sweden)

    M. M. Bikbov

    2014-10-01

    Full Text Available Photochemical crosslinking is widely applied in ophthalmology. Its biochemical effect is due to the release of singlet oxygen that promotes anaerobic photochemical reaction. Keratoconus is one of the most common corneal ectasia affecting 1 in 250 to 250 000 persons. Currently, the rate of iatrogenic ectasia following eximer laser refractive surgery increases due to biomechanical weakening of the cornea. Morphologically and biochemically, ectasia is characterized by corneal layers thinning, contact between the stroma and epithelium resulting from Bowman’s membrane rupture, chromatin fragmentation in keratocyte nuclei, phagocytosis, abnormal staining and arrangement of collagen fibers, enzyme system disorders, and keratocyte apoptosis. In corneal ectasia, altered enzymatic processes result in the synthesis of abnormal collagen. Collagen packing is determined by the activity of various extracellular matrix enzymes which bind amines and aldehydes of collagen fiber amino acids. In the late stage, morphological changes of Descemet’s membrane (i.e., rupture and detachment develop. Abnormal hexagonal-shaped keratocytes and their apoptosis are the signs of endothelial dystrophy. The lack of analogs in domestic ophthalmology encouraged the scientists of Ufa Eye Research Institute to develop a device for corneal collagen crosslinking. The parameters of ultraviolet (i.e., wavelength, exposure time, power to achieve the desired effect were identified. The specifics of some photosensitizers in the course of the procedure were studied. UFalink, a device for UV irradiation of cornea, and photosensitizer Dextralink were developed and adopted. Due to the high risk of endothelial damage, this treatment is contraindicated in severe keratoconus (CCT less than 400 microns. Major effects of corneal collagen crosslinking are the following: Young’s modulus (modulus of elasticity increase by 328.9 % (on average, temperature tolerance increase by 5

  12. Corneal collagen crosslinking for keratoconus. A review

    Directory of Open Access Journals (Sweden)

    M. M. Bikbov

    2014-01-01

    Full Text Available Photochemical crosslinking is widely applied in ophthalmology. Its biochemical effect is due to the release of singlet oxygen that promotes anaerobic photochemical reaction. Keratoconus is one of the most common corneal ectasia affecting 1 in 250 to 250 000 persons. Currently, the rate of iatrogenic ectasia following eximer laser refractive surgery increases due to biomechanical weakening of the cornea. Morphologically and biochemically, ectasia is characterized by corneal layers thinning, contact between the stroma and epithelium resulting from Bowman’s membrane rupture, chromatin fragmentation in keratocyte nuclei, phagocytosis, abnormal staining and arrangement of collagen fibers, enzyme system disorders, and keratocyte apoptosis. In corneal ectasia, altered enzymatic processes result in the synthesis of abnormal collagen. Collagen packing is determined by the activity of various extracellular matrix enzymes which bind amines and aldehydes of collagen fiber amino acids. In the late stage, morphological changes of Descemet’s membrane (i.e., rupture and detachment develop. Abnormal hexagonal-shaped keratocytes and their apoptosis are the signs of endothelial dystrophy. The lack of analogs in domestic ophthalmology encouraged the scientists of Ufa Eye Research Institute to develop a device for corneal collagen crosslinking. The parameters of ultraviolet (i.e., wavelength, exposure time, power to achieve the desired effect were identified. The specifics of some photosensitizers in the course of the procedure were studied. UFalink, a device for UV irradiation of cornea, and photosensitizer Dextralink were developed and adopted. Due to the high risk of endothelial damage, this treatment is contraindicated in severe keratoconus (CCT less than 400 microns. Major effects of corneal collagen crosslinking are the following: Young’s modulus (modulus of elasticity increase by 328.9 % (on average, temperature tolerance increase by 5

  13. Corneal Topographic Analysis in Patients with Cataract

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    We studied the corneal curvature of 161 eyes in 101 patients, aged from 50 to 80 years (mean: 63 years), with senile cataract using the Topographic Modeling System (IMS) preoperatively. The results revealed that mean surface asymmetry index (SAD was 0. 36 and mean surface regularity index (SRI) 0. 79. Simulated keratometry reading (Sim K) was 44. 46 D, and 43. 56 D. Minimun K reading was 42. 60 D. The same patterns of corneal topography in both eyes were 50% in 60 patients who had binocular examination....

  14. Bessel Function Model for Corneal Topography

    CERN Document Server

    Okrasiński, Wojciech

    2011-01-01

    In this paper we consider a new nonlinear mathematical model for corneal topography formulated as two-point boudary value problem. We derive it from first physical principles and provide some mathematical analysis. The existence and uniqeness theorems are proved as well as various estimates on exact solution. At the end we fit the simplified model based on Modified Bessel Function of the First Kind with the real corneal data consisting of matrix of 123x123 points and obtain an error of order of 1%.

  15. Colletotrichum graminicola: a new corneal pathogen.

    Science.gov (United States)

    Ritterband, D C; Shah, M; Seedor, J A

    1997-05-01

    We report the first case of an ocular infection with the fungus Colletotrichum graminicola causing keratitis in a 27-year-old man. Twenty-four months after a postoperative course complicated by recurrent fungal keratitis requiring two penetrating keratoplasties, two anterior chamber washouts, a conjunctival flap, and medical treatment with topical natamycin, intracameral amphotericin B, and oral fluconazole. The patient has shown no signs of fungal recurrence despite a failed corneal graft. C. graminicola is a new corneal pathogen and should be included in the differential diagnosis of mycotic keratitis.

  16. Research on inhibition of corneal neovascularization

    Directory of Open Access Journals (Sweden)

    Zhang-Hui Yang

    2015-12-01

    Full Text Available Corneal transparency is the basis of the normal physiological functions.However, corneal neovascularization(CNVmay occur in the infection, mechanical and chemical injury or under other pathological conditions,which make the cornea lose original transparency and severe visual impairment. In recent years, along with the development of immunology, molecular biology, biochemistry and other disciplines, there is more in-depth understanding on the CNV, and clinical treatment of CNV has made new breakthroughs. This article provides an overview of the inhibition of CNV.

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

    Science.gov (United States)

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

    2014-12-01

    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). In this prospective study, 68 eyes of 68 patients were divided into two groups: Group 1 (test) comprised 34 eyes with immature senile cataract with PEX and Group 2 (control) included 34 eyes with immature senile cataract without PEX and any coexisting ocular pathology. Phacoemulsification (modern cataract surgery) was performed on both groups through stop and chop technique and comparative analysis of the incidence of intraoperative and immediate postoperative complications was made. There was no significant difference in rates of intraoperative complications between PEX (2.9%) and Control (0%) group. The mean pupil diameter was significantly smaller in Group 1 (pcontrol group compared to the group with PEX (p=0.027). Phacoemulsification can be safely performed by experienced hands in cataractous eyes with PEX. The incidence of intraoperative and immediate post-operative complications in eyes with PEX was not significantly different compared to eyes without PEX in our study. Further studies among a larger population are required.

  18. Evaluation of bacterial contamination rate of the anterior chamber during phacoemulsification surgery using an automated microbial detection system

    Institute of Scientific and Technical Information of China (English)

    Ibrahim; Kocak; Funda; Kocak; Bahri; Teker; Ali; Aydin; Faruk; Kaya; Hakan; Baybora

    2014-01-01

    ·AIM: To assess the incidence of anterior chamber bacterial contamination during phacoemulsification surgery using an automated microbial detection system(BacT/Alert).·METHODS: Sixty-nine eyes of 60 patients who had uneventful phacoemulsification surgery, enrolled in this prospective study. No prophylactic topical or systemic antibiotics were used before surgery. After antisepsis with povidone-iodine, two intraoperative anterior chamber aqueous samples were obtained, the first whilst entering anterior chamber, and the second at the end of surgery. BacT/Alert culture system was used to detect bacterial contamination in the aqueous samples.·RESULTS: Neither aqueous samples obtained at the beginning nor conclusion of the surgery was positive for microorganisms on BacT/Alert culture system. The rate of bacterial contamination during surgery was 0%. None of the eyes developed acute-onset endophthalmitis after surgery.· CONCLUSION: In this study, no bacterial contamination of anterior chamber was observed during cataract surgery. This result shows that meticulous surgical preparation and technique can prevent anterior chamber contamination during phacoemulsification cataract surgery.

  19. Reversible corneal toxicity of retained intracameral Perfluoro-n-octane

    Directory of Open Access Journals (Sweden)

    Saad S Alharbi

    2016-01-01

    Full Text Available A 58-year-old female presented with intracameral retained perfluoro-n-octane (PFO following previous retinal reattachment surgery. After 4 years of follow-up without related sequelae, the patient complained of a gradual decrease in vision secondary to corneal edema with whitish corneal precipitate inferiorly corresponding to the area of retained PFO. Three weeks after anterior chamber washout, corneal edema resolved and the patient obtained 20/40 visual acuity. Even though PFO considered to have a relatively good safety profile, early anterior chamber washout may prevent corneal toxicity and avoid later persistent corneal decompensation.

  20. Current status of accelerated corneal cross-linking

    Directory of Open Access Journals (Sweden)

    Michael Mrochen

    2013-01-01

    Full Text Available Corneal cross-linking with riboflavin is a technique to stabilize or reduce corneal ectasia, in diseases such as keratoconus and post-laser-assisted in situ keratomileusis (LASIK ectasia. There is an interest by patient as well as clinicians to reduce the overall treatment time. Especially, the introduction of corneal cross-linking in combination with corneal laser surgery demands a shorter treatment time to assure a sufficient patient flow. The principles and techniques of accelerated corneal cross-linking is discussed.

  1. Optical clearing at cellular level

    Science.gov (United States)

    Kinnunen, Matti; Bykov, Alexander V.; Tuorila, Juho; Haapalainen, Tomi; Karmenyan, Artashes V.; Tuchin, Valery V.

    2014-07-01

    Strong light scattering in tissues and blood reduces the usability of many optical techniques. By reducing scattering, optical clearing enables deeper light penetration and improves resolution in several optical imaging applications. We demonstrate the usage of optical tweezers and elastic light scattering to study optical clearing [one of the major mechanisms-matching of refractive indices (RIs)] at the single particle and cell level. We used polystyrene spheres and human red blood cells (RBCs) as samples and glycerol or glucose water solutions as clearing agents. Optical tweezers kept single microspheres and RBCs in place during the measurement of light scattering patterns. The results show that optical clearing reduces the scattering cross section and increases g. Glucose also decreased light scattering from a RBC. Optical clearing affected the anisotropy factor g of 23.25-μm polystyrene spheres, increasing it by 0.5% for an RI change of 2.2% (20% glycerol) and 0.3% for an RI change of 1.1% (13% glucose).

  2. Corneal heat scar caused by photodynamic therapy performed through an implanted corneal inlay.

    Science.gov (United States)

    Mita, Mariko; Kanamori, Tomomi; Tomita, Minoru

    2013-11-01

    A 60-year-old man had a combination of laser in situ keratomileusis and Kamra corneal inlay implantation to correct presbyopia. Although the outcome was favorable postoperatively, central serous chorioretinopathy was observed in the left eye along with a decrease in the uncorrected (UDVA) and corrected (CDVA) distance visual acuities and the corrected near visual acuity (CNVA). Photodynamic therapy (PDT) was later performed in a university hospital. After PDT, the patient experienced a decline in the visual acuity and came to our clinic a month after the PDT. Degeneration and a scar were observed at the location of the inlay due to the heat and burning. Flattening of the corneal topography was also observed where the corneal scar was located, along with a significant decrease in CDVA in the left eye. Prior to any surgery in which the corneal inlay is an impediment, surgeons should take advantage of the reversibility of the Kamra inlay by explanting the inlay.

  3. The Effect of Corneal Epithelium on Corneal Curvature in Patients with Keratoconus.

    Science.gov (United States)

    Akcay, Emine Kalkan; Uysal, Betul Seher; Sarac, Ozge; Ugurlu, Nagehan; Yulek, Fatma; Cagil, Nurullah; Aslan, Nabi

    2015-01-01

    To investigate the effects of corneal epithelium on corneal curvature in patients with keratoconus. This is a prospective, nonrandomized study. Fifty-nine eyes of 47 patients diagnosed as keratoconus and for whom corneal collagen crosslinking (CXL) was recruited in this study. This study is a single-center clinical trial. Pregnancy, lactation, connective tissue disease, corneal thickness below 350 μm, severe dry eyes, or scar of corneal surgery were exclusion criteria. Before and during CXL procedure after removing the corneal epithelium, maximum values of corneal apical curvature, simulated keratometry 1 (Sim-K1), simulated keratometry 2 (Sim-K2), temporal and inferior curvature values, all of which are 1.5 mm from the corneal center, were calculated. These values before and after removal of epithelium were compared statistically. Mean age of patients was 23.30 ± 5.5 (12-38) years. Twenty-eight (59%) were male while 19 (41%) were female. Mean values measured before and after removing the corneal epithelium were: apical curvature; 59.19 ± 7.2 (47.06-82.40) diopter (D) and 61.70 ± 8.8 (49.19-92.66) D (p = 0.001), SimK1; 47.57 ± 4.3 (39.14-64.57) D and 48.23 ± 4.3 (41.89-66.70) D (p = 0.001), SimK2; 52.04 ± 5.3 (43.56-69.34) D and 53.34 ± 5.6 (43.73-70.89) D (p = 0.001), inferior curvature; 53,85 ± 5.2 (43.47-76.56) D and 55.05 ± 5.8 (44.56-81.93) D (p = 0.002), temporal curvature 49.49 ± 5.1 (41.50-71.03) D and 51.53 ± 5.4 (41.58-73.34) D (p = 0.001), respectively. In keratoconus patients during CXL treatment, after removing the corneal epithelium, more steepness is detected in the curvature of the steeper area of the cornea. When evaluating patients with keratoconus, the masking effect of corneal epithelium on values of curvature should be taken into consideration.

  4. 超声乳化白内障手术对角膜知觉的影响%The effect of phacoemulsification on corneal sensation

    Institute of Scientific and Technical Information of China (English)

    郑丹莹; 龙艳; 郭未艾; 杨晖; 张振平

    2004-01-01

    目的观察颞侧透明角膜切口的超声乳化白内障手术对角膜知觉的影响.方法随机抽取行颞侧透明角膜切口超声乳化白内障吸出术的老年性白内障患者30例(30只眼),分别于术前、术后1天、术后1、3、6月、术后1年行角膜知觉检查,用Cohet-Bonnet角膜知觉计分别测量角膜中央、上方、下方、鼻侧、颞侧的角膜知觉阈值(以测定器的尼龙丝长度表示).结果术后1天全部病人角膜知觉显著减退,中央减少40.4%、颞侧减少39.9%,上方、下方和鼻侧分别减少33%、28.5%、28.7%.上方、下方、鼻侧角膜知觉术后6个月恢复,中央及颞侧角膜切口知觉术后1年恢复.结论小切口超声乳化白内障手术可影响角膜知觉,但术后角膜知觉恢复较快.

  5. Congenital Unilateral Corneal Anaesthesia with Microphthalmos: A Case Report

    Directory of Open Access Journals (Sweden)

    George Voyatzis

    2012-01-01

    Full Text Available Congenital corneal anaesthesia (CCA is an uncommon condition difficult to diagnose. We report the case of a 20-month-old boy who presented with unilateral congenital corneal anaesthesia. The child was referred with a persistent corneal epithelial defect, unresponsive to symptomatic local treatment for over 10 months. Intensive topical treatment and strict corneal protection led to quick corneal healing. Congenital corneal anaesthesia occurs either alone or in association with neurological diseases or systemic congenital abnormalities. It is important to search for corneal anaesthesia in children with chronic ulcerations of the cornea and self-inflicted injuries. Early diagnosis and treatment are important due to the risk of poor visual prognosis. Management of CCA should aim for the prevention of epithelial defects and is a life-long process.

  6. Corneal Higher Order Aberrations in Granular, Lattice and Macular Corneal Dystrophies

    Science.gov (United States)

    Yagi-Yaguchi, Yukari; Yamaguchi, Takefumi; Okuyama, Yumi; Satake, Yoshiyuki; Tsubota, Kazuo; Shimazaki, Jun

    2016-01-01

    Purpose To evaluate the corneal higher-order aberrations (HOAs) in granular, lattice and macular corneal dystrophies. Methods This retrospective study includes consecutive patients who were diagnosed as granular corneal dystrophy type2 (GCD2; 121 eyes), lattice corneal dystrophies type 1, type 3A (LCDI; 20 eyes, LCDIIIA; 32 eyes) and macular corneal dystrophies (MCD; 13 eyes), and 18 healthy control eyes. Corneal HOAs were calculated using anterior segment optical coherence tomography, and the correlations between HOAs and visual acuity were analyzed. Results HOAs of the total cornea within 4 mm diameter were significantly larger in GCD2 (0.17 ± 0.35 μm), in LCDI (0.33 ± 0.27), LCDIIIA (0.61 ± 1.56) and in MCD (0.23 ± 0.18), compared with healthy controls (0.09 ± 0.02μm, all P GCD2 (0.32 ± 0.48), in LCDI (0.60 ± 0.46), LCDIIIA (0.83 ± 2.29) and in MCD (0.44 ± 0.24), compared with healthy controls (0.19 ± 0.06, all P GCD2, there was no significant correlation between logMAR and HOAs (r = 0.113, P = 0.227). In MCD, LCDI and LCDIIIA, logMAR was positively significantly correlated with HOAs (r = 0.620 and P = 0.028, r = 0.587 and P = 0.007, r = 0.614 and P < 0.001, respectively). Conclusions Increased HOAs occur in eyes with corneal dystrophies, especially in eye with LCD and MCD. Larger amount corneal HOAs are associated with poorer visual acuity in patients with LCD and MCD. PMID:27536778

  7. The receptor for advanced glycation end products RAGE is involved in corneal healing.

    Science.gov (United States)

    Nass, Norbert; Trau, Stefanie; Paulsen, Friedrich; Kaiser, Delia; Kalinski, Thomas; Sel, Saadettin

    2017-05-01

    Impaired corneal healing is still a major cause of blindness. As RAGE (receptor for advanced glycation endproducts) is involved in inflammation and wound healing in other tissues, we here investigated its relevance for corneal wound healing. Corneal re-epithelialization after alkaline injury was analysed in an ex-vivo approach with cultured, enucleated eyes from mice either of the C57Bl/6 NChR genotype (RAGE+/+) and mice of the same strain lacking the RAGE gene (RAGE-/-). The wound area was determined time dependently by fluorescence imaging using fluorescein staining. The eyes of RAGE-/- mice showed a significantly slower re-epithelialization than eyes of the RAGE+/- and the RAGE+/+ genotype. In immunohistochemistry, RAGE expression was increased in wounded corneas whereas the abundance of the RAGE ligand HMGB1 was unaffected, but an increase in S100b-like proteins was revealed upon injury. However, neither the addition of the RAGE agonist HMGB1 or an HMGB1 antagonising antibody nor bovine S100b protein to the culture medium of the wounded eyes had an effect on corneal wound closure in ex-vivo. Further gene expression analysis by RT-PCR demonstrated an increase in RAGE expression on the mRNA level, no significant regulation of HMGB1 and a differential regulation of the S100 gene family after alkaline burn of the cornea. In conclusion, RAGE is clearly involved in corneal re-epithelialization most probably mediated by signalling via S100 proteins. Copyright © 2017 Elsevier GmbH. All rights reserved.

  8. Combined 30-degree bevel up and down technique against 0-degree phaco tip for phacoemulsification surgery of hard cataracts

    Directory of Open Access Journals (Sweden)

    Joshi RS

    2017-06-01

    Full Text Available Rajesh Subhash Joshi, Sonal Jayant Muley Department of Ophthalmology, Vasantrao Naik Government Medical College, Yavatmal, Maharashtra, India Purpose: To evaluate the effective phaco time (EPT, cumulative dissipated energy (CDE and nucleus emulsification time (NET as phaco parameters with 0- and 30-degree phaco tip. Patients and methods: This prospective, interventional and observational case series included 294 patients scheduled for cataract removal by phacoemulsification technique. Patients with nuclear cataracts of grade 4 and 5 nuclear opalescence of Lens Opacities Classification System III were included in the study. Patients were consecutively allocated to phaco chop technique with 0-degree (0-degree group, n=147 and combined bevel up and down position using 30-degree phaco tip (combined bevel up/down group, n=147. The 0-degree group had phacoemulsification with 0-degree phaco tip, while the 30-degree group had chopping of the nucleus with bevel down phaco tip and emulsification of nuclear fragments was accomplished with bevel up tip. EPT, CDE, NET and intraoperative complications were noted and compared between the groups using analysis of variance. Results: Average EPT, CDE and NET were lower in the 30-degree group than in the 0-degree group. However, no statistically significant difference was found in EPT (P=0.0733, CDE (P=0.0663 and NET (P=0.0633 between the two groups. No serious intraoperative complications were noted. The anterior chamber was maintained throughout the procedure in both groups. No patients had wound burn and miosis during the procedure. None of the patients developed bullous keratopathy, uveitis and cystoid macular edema during the follow-up period. Conclusion: Combined bevel up and down 30-degree tip can yield effective hard nucleus phacoemulsification. Bevel down tip of 30-degree helps in effective chopping and bevel up tip assists in emulsification of the nuclear fragments. Although combined bevel up and down 30

  9. The relationship between central corneal thickness and corneal curvature in adult Nigerians

    Directory of Open Access Journals (Sweden)

    E. Iyamu

    2011-12-01

    Full Text Available Purpose: The aim of this study was to provide average values for central corneal thickness (CCT and corneal curvature (CC and also to determine a regression model for the relationship between CCT and CC in adult Nigerians without glaucoma.Methods: A total of 95 subjects consisting of 56 males and 39 females aged between 20 and 69 years with mean age of 47.1 ± 14.1 years were recruited for the study. Central corneal thickness was measured by ultrasound pachymetry (SW-1000P ultrasound pachymeter, Tianjin Suowei Electronic Technology, China and corneal curvature was measured by keratometry (Bausch & Lomb keratometer H-135A, USA.Results: The average values of 550.1 ± 33.1µm and 43.0 ± 1.1 D were obtained for CCT and CC respectively. CCT significantly correlated with age (p=0.01, and the regression model predicts a decrease of 6.0 µm in CCT per decade. No significant association was found between CC and age (p=0.56. Also, no significant association was found between CCT and CC (p=0.07. Female subjects had significantly steeper corneas than their male counterparts.Conclusion: Central corneal thickness decreases with increasing age. Neither CCT nor age appear to be significantly correlated with corneal curvature. (S Afr Optom 2011 70(1 44-50

  10. CORNEAL STROMAL THINNING: A RARE CORNEAL COMPLICATION AFTER BARE SCL ERA PTERYG I UM EXCISION TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Sulaiman Abdul

    2015-06-01

    Full Text Available INTRODUCTION : Bare sclera technique without using any anti - mitotic drugs are commonly employed in rural population. Corneal dellen formation and recurrence of pterygium are more common in these cases. But the corneal complication like stromal thinning, necrosis of corne a and sclera are not common. The corneal epithelium is a highly differentiated cell type that is self - renewing. Also corneal epithelium is important for the stromal replacement in the situations like chemical, thermal burns, ocular surgery like pterygium s urgery. Interference with status of stem cell replacement and as a consequent to it, stromal thinning is occurring in the pterygium surgery. P atient 1: A 68 yr s. old male patient underwent pterygium surgery ( B aresclera excision technique. After 30 days he developed corneal thinning with the punched out partial stromal loss without perforation or descmetocele or scleral thinning. Patient 2: A 60yr s. old male patient underwent pterygium surgery 2months back, he developed same type of corneal thinning. Both P atients were treated with tear drops and improved. CONCLUSION : The stromal thinning in these two cases is may be due to chemical factors like collagenase which might have been released from the traumatised conjunctival epithelial cells causing thinning wit hout replacement of stroma by limbal stem cells.

  11. Quantitative proteomic analysis of mice corneal tissues reveals angiogenesis-related proteins involved in corneal neovascularization.

    Science.gov (United States)

    Shen, Minqian; Tao, Yimin; Feng, Yifan; Liu, Xing; Yuan, Fei; Zhou, Hu

    2016-07-01

    Corneal neovascularization (CNV) was induced in Balb/c mice by alkali burns in the central area of the cornea with a diameter of 2.5mm. After fourteen days, the cornea from one eye was collected for histological staining for CNV examination, while the cornea from the other eye of the same mouse was harvested for proteomic analysis. The label-free quantitative proteomic approach was applied to analyze five normal corneal tissues (normal group mice n=5) and five corresponding neovascularized corneal tissues (model group mice n=5). A total of 2124 proteins were identified, and 1682 proteins were quantified from these corneal tissues. Among these quantified proteins, 290 proteins were significantly changed between normal and alkali burned corneal tissues. Of these significantly changed proteins, 35 were reported or predicted as angiogenesis-related proteins. Then, these 35 proteins were analyzed using Ingenuity Pathway Analysis Software, resulting in 26 proteins enriched and connected to each other in the protein-protein interaction network, such as Lcn-2, αB-crystallin and Serpinf1 (PEDF). These three significantly changed proteins were selected for further Western blotting validation. Consistent with the quantitative proteomic results, Western blotting showed that Lcn-2 and αB-crystallin were significantly up-regulated in CNV model, while PEDF was down-regulated. This study provided increased understanding of angiogenesis-related proteins involved in corneal vascular development, which will be useful in the ophthalmic clinic of specifically target angiogenesis.

  12. A brief history of corneal transplantation: From ancient to modern

    Directory of Open Access Journals (Sweden)

    Alexandra X Crawford

    2013-01-01

    Full Text Available This review highlights many of the fundamental concepts and events in the development of corneal transplantation - from ancient times to modern. Tales of eye, limb, and even heart transplantation appear in ancient and medieval texts; however, in the scientific sense, the original concepts of corneal surgery date back to the Greek physician Galen (130-200 AD. Although proposals to provide improved corneal clarity by surgical interventions, including keratoprostheses, were better developed by the 17 th and 18 th centuries, true scientific and surgical experimentation in this field did not begin until the 19 th century. Indeed, the success of contemporary corneal transplantation is largely the result of a culmination of pivotal ideas, experimentation, and perseverance by inspired individuals over the last 200 years. Franz Reisinger initiated experimental animal corneal transplantation in 1818, coining the term "keratoplasty". Subsequently, Wilhelmus Thorne created the term corneal transplant and 3 years later Samuel Bigger, 1837, reported successful corneal transplantation in a gazelle. The first recorded therapeutic corneal xenograft on a human was reported shortly thereafter in 1838-unsurprisingly this was unsuccessful. Further progress in corneal transplantation was significantly hindered by limited understanding of antiseptic principles, anesthesiology, surgical technique, and immunology. There ensued an extremely prolonged period of debate and experimentation upon the utility of animal compared to human tissue, and lamellar versus penetrating keratoplasty. Indeed, the first successful human corneal transplant was not performed by Eduard Zirm until 1905. Since that first successful corneal transplant, innumerable ophthalmologists have contributed to the development and refinement of corneal transplantation aided by the development of surgical microscopes, refined suture materials, the development of eye banks, and the introduction of

  13. A brief history of corneal transplantation: From ancient to modern.

    Science.gov (United States)

    Crawford, Alexandra Z; Patel, Dipika V; McGhee, Charles Nj

    2013-09-01

    This review highlights many of the fundamental concepts and events in the development of corneal transplantation - from ancient times to modern. Tales of eye, limb, and even heart transplantation appear in ancient and medieval texts; however, in the scientific sense, the original concepts of corneal surgery date back to the Greek physician Galen (130-200 AD). Although proposals to provide improved corneal clarity by surgical interventions, including keratoprostheses, were better developed by the 17(th) and 18(th) centuries, true scientific and surgical experimentation in this field did not begin until the 19(th) century. Indeed, the success of contemporary corneal transplantation is largely the result of a culmination of pivotal ideas, experimentation, and perseverance by inspired individuals over the last 200 years. Franz Reisinger initiated experimental animal corneal transplantation in 1818, coining the term "keratoplasty". Subsequently, Wilhelmus Thorne created the term corneal transplant and 3 years later Samuel Bigger, 1837, reported successful corneal transplantation in a gazelle. The first recorded therapeutic corneal xenograft on a human was reported shortly thereafter in 1838-unsurprisingly this was unsuccessful. Further progress in corneal transplantation was significantly hindered by limited understanding of antiseptic principles, anesthesiology, surgical technique, and immunology. There ensued an extremely prolonged period of debate and experimentation upon the utility of animal compared to human tissue, and lamellar versus penetrating keratoplasty. Indeed, the first successful human corneal transplant was not performed by Eduard Zirm until 1905. Since that first successful corneal transplant, innumerable ophthalmologists have contributed to the development and refinement of corneal transplantation aided by the development of surgical microscopes, refined suture materials, the development of eye banks, and the introduction of corticosteroids. Recent

  14. Corneal injuries from liquid detergent pods.

    Science.gov (United States)

    Gray, Michael E; West, Constance E

    2014-10-01

    Laundry and dishwasher detergent "pods" were introduced to the United States market in 2010 and are sold by several manufacturers. They represent a high percentage of household cleaning product exposure in the United Kingdom. We present a consecutive case series of 10 children seen in a 9-month period with corneal injuries from exposure to liquid detergent pods.

  15. Evaluation and Treatment of Perioperative Corneal Abrasions

    Directory of Open Access Journals (Sweden)

    Kira L. Segal

    2014-01-01

    Full Text Available Purpose. To evaluate perioperative risk factors for corneal abrasion (CA and to determine current care for perioperative CA in a tertiary care setting. Methods. Hospital-based, cross-sectional study. In Operating Room and Post-Anesthesia Care Units patients, a comparison of cases and controls was evaluated to elucidate risk factors, time to treatment, and most common treatments prescribed for corneal abrasions. Results. 86 cases of corneal abrasion and 89 controls were identified from the 78,542 surgical procedures performed over 2 years. Statistically significant risk factors were age (P=0.0037, general anesthesia (P<0.001, greater average estimated blood loss (P<0.001, eyes taped during surgery (P<0.001, prone position (P<0.001, trendelenburg position (P<0.001, and supplemental oxygen en route to and in the Post-Anesthesia Care Units (P<0.001. Average time to complaint was 129 minutes. 94% of cases had an inpatient ophthalmology consult, with an average time to consult of 164 minutes. The most common treatment was artificial tears alone (40%, followed by combination treatment of antibiotic ointment and artificial tears (35.3%. Conclusions. Trendelenburg positioning is a novel risk factor for CA. Diagnosis and treatment of perioperative corneal abrasions by an ophthalmologist typically require three hours in the tertiary care setting.

  16. Serological profile of candidates for corneal donation

    Directory of Open Access Journals (Sweden)

    Adroaldo Lunardelli

    2014-10-01

    Full Text Available Objetive: The purpose of this study is to map the serological profile of candidates to corneal donation at Irmandade Santa Casa de Misericórdia de Porto Alegre, identifying the percentage of disposal by serology and the marker involved. Methods: There have been analised – retrospectively – the results of serology of all corneal donors, made between the period of 1st january 2006 and 31st december 2012. Data analised were related to age, gender and the results of serology pertinent to viral markers (HBsAg, anti-HBc, anti-HCV and anti-HIV, these, determined by immunosorbent tests (ELISA. Results: In the period of the study, there were 2476 corneal donors at the institution, with a major incidence on the male gender, on an average of 58.7 years old. 23% of retention because of serological unfitness was also identified, that is, 570 samples were non-negative to any of the used tests. The marker anti- HBc was the most prevalent on the studied population, followed by the Hepatitis C virus (HCV and by the Human Immunodeficiency Virus (HIV. Conclusion: From the data found through this study, it is essential to have the participation of an efficient service on the serological evaluation of the candidates to corneal donation, once the security of the receptor must be taken into consideration in a population of donors with 23% of unfitness prevalence, in which the most prevalent marker is the one of Hepatits B.

  17. Peptide Amphiphiles in Corneal Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Martina Miotto

    2015-08-01

    Full Text Available The increasing interest in effort towards creating alternative therapies have led to exciting breakthroughs in the attempt to bio-fabricate and engineer live tissues. This has been particularly evident in the development of new approaches applied to reconstruct corneal tissue. The need for tissue-engineered corneas is largely a response to the shortage of donor tissue and the lack of suitable alternative biological scaffolds preventing the treatment of millions of blind people worldwide. This review is focused on recent developments in corneal tissue engineering, specifically on the use of self-assembling peptide amphiphiles for this purpose. Recently, peptide amphiphiles have generated great interest as therapeutic molecules, both in vitro and in vivo. Here we introduce this rapidly developing field, and examine innovative applications of peptide amphiphiles to create natural bio-prosthetic corneal tissue in vitro. The advantages of peptide amphiphiles over other biomaterials, namely their wide range of functions and applications, versatility, and transferability are also discussed to better understand how these fascinating molecules can help solve current challenges in corneal regeneration.

  18. Corneal topography measurements for biometric applications

    Science.gov (United States)

    Lewis, Nathan D.

    The term biometrics is used to describe the process of analyzing biological and behavioral traits that are unique to an individual in order to confirm or determine his or her identity. Many biometric modalities are currently being researched and implemented including, fingerprints, hand and facial geometry, iris recognition, vein structure recognition, gait, voice recognition, etc... This project explores the possibility of using corneal topography measurements as a trait for biometric identification. Two new corneal topographers were developed for this study. The first was designed to function as an operator-free device that will allow a user to approach the device and have his or her corneal topography measured. Human subject topography data were collected with this device and compared to measurements made with the commercially available Keratron Piccolo topographer (Optikon, Rome, Italy). A third topographer that departs from the standard Placido disk technology allows for arbitrary pattern illumination through the use of LCD monitors. This topographer was built and tested to be used in future research studies. Topography data was collected from 59 subjects and modeled using Zernike polynomials, which provide for a simple method of compressing topography data and comparing one topographical measurement with a database for biometric identification. The data were analyzed to determine the biometric error rates associated with corneal topography measurements. Reasonably accurate results, between three to eight percent simultaneous false match and false non-match rates, were achieved.

  19. Aspergillus terreus recovered from a corneal scraping.

    Science.gov (United States)

    Campbell, Suzanne

    2014-01-01

    A 52 year old, healthy male presented to his optometrist complaining of redness and irritation in the right eye. A foreign body was removed from the eye. The patient was started on ophthalmic solutions of vigamox and systane. At 48 hours, the patient reported increased redness, limited vision, and yellow discharge from the eye. The patient was referred to an ophthalmologist for further evaluation. Physical assessment revealed a superlative central infiltrate (extreme, centrally located injury that had permeated the cornea), diffuse corneal haze, and edema with a 3- to 4+ conjunctival injection and a 1 millimeter hypopyon (an effusion of pus into the anterior chamber of the eye). Corneal scrapings were collected for aerobic and anaerobic bacterial and fungal cultures. The patient was then prescribed. vancomycin, tobramycin, and natamycin ophthalmic eyedrops. On day three, fungal culture results indicated possible fungal forms seen. On day 12, results from the fungal culture of the corneal scraping revealed the causative agent to be Aspergillus terreus. Voriconazole eyedrops were added to the treatment regimen and continued for 10 weeks. The physician order for a fungal culture as well as laboratory data providing the final identification of Aspergillus terreus and laboratory comments indicating an elevated minimum inhibitory concentration (MIC) (> 2 microg/mL) to amphotericin B is associated with treatment failure positively impacted the patient outcome. After completion of the treatment regimen, a photo-therapeutic keratectomy (PTK) was performed in an attempt to remove the dense corneal scarring caused by the fungal infection.

  20. [Purulent corneal ulcers: etiology, pathogenesis, classification].

    Science.gov (United States)

    Kasparova, Evg A

    2015-01-01

    Advanced purulent corneal ulcer, as well as abscess, is a serious vision-threatening condition notable for its fulminant course and possible loss of the eye due to endophthalmitis. Its leading causes, pathogenesis, and classifications are described and analyzed in this paper.

  1. Change in corneal curvature induced by surgery

    NARCIS (Netherlands)

    G. van Rij (Gabriel)

    1987-01-01

    textabstractThe first section deals with the mechanisms by which sutures, incisions and intracorneal contact lenses produce a change in corneal curvature. To clarify the mechanisms by which incisions and sutures produce astigmatism, we made incisions and placed sutures in the corneoscleral limbus of

  2. Autophagy in granular corneal dystrophy type 2.

    Science.gov (United States)

    Choi, Seung-Il; Kim, Eung Kweon

    2016-03-01

    Autophagy is a lysosomal degradative process that is essential for cellular homeostasis and metabolic stress adaptation. Defective autophagy is involved in the pathogenesis of many diseases including granular corneal dystrophy type 2 (GCD2). GCD2 is an autosomal dominant disorder caused by substitution of histidine for arginine at codon 124 (R124H) in the transforming growth factor β-induced gene (TGFBI) on chromosome 5q31. Transforming growth factor β-induced protein (TGFBIp) is degraded by autophagy, but mutant-TGFBIp accumulates in autophagosomes and/or lysosomes, despite significant activation of basal autophagy, in GCD2 corneal fibroblasts. Furthermore, inhibition of autophagy induces cell death of GCD2 corneal fibroblasts through active caspase-3. As there is currently no pharmacological treatment for GCD2, development of novel therapies is required. A potential strategy for preventing cytoplasmic accumulation of mutant-TGFBIp in GCD2 corneal fibroblasts is to enhance mutant-TGFBIp degradation. This could be achieved by activation of the autophagic pathway. Here, we will consider the role and the potential therapeutic benefits of autophagy in GCD2, with focus on TGFBIp degradation, in light of the recently established role of autophagy in protein degradation.

  3. Polysaccharide coating of human corneal endothelium

    DEFF Research Database (Denmark)

    Schroder, H D; Sperling, S

    1977-01-01

    Electron microscopy revealed the presence of a 600-1500 A thick layer of polysaccharide on the surface of human corneal endothelial cells. The surface layer was visualized by combined fixation and staining in a mixture of ruthenium red and osmium tetroxide. The coating material was stable...

  4. Traumatic wound dehiscence after corneal keratoplasty

    Directory of Open Access Journals (Sweden)

    Patrick Frensel Tzelikis

    2015-10-01

    Full Text Available ABSTRACTPurpose:To assess patient characteristics, risk factors, outcomes, and the treatment of wound dehiscence (WD in patients after corneal keratoplasty.Methods:Retrospective chart review of 11 eyes of 11 patients with corneal grafts who underwent repair of WD from January 1, 2004 to December 31, 2012 at Hospital Oftalmologico de Brasilia.Results:Eight (72.7% patients were men and three were women. Six (54.5% patients had deep anterior lamellar keratoplasty (DALK and 5 had penetrating keratoplasty. The mean age at trauma was 31.1 years. The mean time from corneal keratoplasty to WD was 12.82 months (range, 3-33 months. The mean best-corrected visual acuity of patients before trauma was 20/60 (0.48 logMAR and after final treatment was 20/160 (0.90 logMAR (P=0.15. In one case, visual acuity decreased to no light perception because of retinal detachment and phthisis bulbi. Accidental blunt trauma and fall were the most common causes of WD.Conclusion:Patients who undergo corneal keratoplasty have a life-long risk of WD. The full-thickness rupture at the graft-host junction in our study suggests that the junction remains vulnerable, even following DALK, and can rupture with trauma. In our series, depending upon the severity of the trauma, postkeratoplastic WD can be associated with a good visual prognosis.

  5. Past and present of corneal refractive surgery

    DEFF Research Database (Denmark)

    Vestergaard, Anders Højslet

    Surgical correction of refractive errors is becoming increasingly popular. In the 1990s, the excimer laser revolutionized the field of corneal refractive surgery with PRK and LASIK, and lately refractive lenticule extraction (ReLEx) of intracorneal tissue, using only a femtosecond laser, has become...

  6. 白内障超声乳化人工晶体植入术屈光误差分析%Refractive error analysis of phacoemulsification and intraocular lens implantation

    Institute of Scientific and Technical Information of China (English)

    鲁诚; 魏承丽; 魏盟

    2014-01-01

    目的:分析白内障超声乳化术后屈光误差形成原因,探讨控制误差的有效方法。方法:选择白内障超声乳化人工晶体植入手术,术前预测屈光度与术后屈光度存在0.50 D屈光误差78例,对其进行统计分析,分析屈光误差形成原因。结果:78例(78只眼)屈光误差,其中A超电脑自动测量取值31例,高度近视并发白内障22例,外伤性白内障13例,角膜疾患12例。结论:0.50~2.00 D误差所占比率大,如掌握好角膜屈率,眼轴长度测量技术采用正确的测定方法,此类误差可以避免。A超电脑自动测量取值存在不足之处,应采用自动测量与手工测量相结合取最佳波形,波峰值采样取值,高度近视并发白内障、外伤性白内障采用A、B型超声联合对眼轴长度测定,反复测量,必要时双眼参照取值。角膜疾患也是致屈光误差的原因。%Objective:To analyze the cause of formation of refractive error after cataract phacoemulsification,to explore the effective methods to control the error.Methods:We selected the phacoemulsification and intraocular lens implantation operation to treat the patients.78 cases had refractive error with 0.50 between preoperative evaluation diopter and postoperative refractive diopter.We analyzed the clinical data and the cause of formation of refractive error.Results:78 cases(78 eyes) had refractive error, including the A super computer automatic measurement values of 31 cases,22 cases of high myopia combined with cataract, traumatic cataract in 13 cases,12 cases of corneal disease.Conclusion:The 0.50~2.00 D error ratio is high.If we can grasp the corneal curvature,the correct method of determination of the axial length measurement technology,this kind of error can be avoided.A super computer automatic measurement values exist deficiencies.We should take the best waveform using automatic measurement combined with manual measurement.The wave peak

  7. Clear Thinking about Alternative Therapies

    Science.gov (United States)

    ... for a multilevel marketing organization (known as “pyramid marketing”) 15 | Clear Thinking about Alternative Therapies Look before you leap n Don’t make your decision in a vacuum. Contact a variety of sources to get reliable, objective information about any alternative therapy you are considering. ...

  8. Endoscopy-guided vitreoretinal surgery following penetrating corneal injury: a case report

    Directory of Open Access Journals (Sweden)

    Motoko Kawashima

    2010-08-01

    keratoplasty, the graft remained clear and visual acuity was 20/40.Conclusion: Primary endoscopic surgery for vitreoretinal complications in eyes with perforating injury performed prior to penetrating keratoplasty appears to be advantageous in terms of avoiding damage to the corneal endothelium.Keywords: vitreoretinal surgery, emergency, foreign body

  9. CHARACTERISTICS OF MACULAR REGION AND VISUAL ACUITY IN GLAUCOMA PATIENTS AFTER PHACOEMULSIFICATION CATARACT SURGERY

    Directory of Open Access Journals (Sweden)

    E. N. Mityaeva

    2015-01-01

    Full Text Available Background: To improve safety of phacoemulsification cataract surgery, innovative technologies have been developed. Assessment of macular region status after the use of routine and innovative phaco technologies is of great interest. Aim: To compare effects of different phaco technologies on macular retina, visual acuity and intraocular pressure in patients with compensated glaucoma after uncomplicated phaco with intraocular lens implantation. Materials and methods: Phacoemulsification of immature cataract was performed in 52  patients (52 eyes using Oertli machine and uniform method. Patients were divided into 3 groups. Group 1 included 20  patients (20  eyes with simple (primary openangle glaucoma (POAG after phaco using easyPhaco technology. Group 2 included 20  POAG patients (20  eyes after phaco using routine technology. Group  3 included 12  patients without glaucoma after routine phaco. EasyPhaco technology involves using of the new Oertli machine parameters, phaco tip with new geometry, flow rate/vacuum setting of 1:10. Preoperatively, in all 40 patients with glaucoma, normal values of intraocular pressure were achieved using antiglaucomatous therapies. Visual acuity, intraocular pressure and macular thickness by optical coherent tomography were measured before the surgery, in 1 and 6 weeks after the procedure. Results: Increase of macular thickness (by 12–30  mcm compared to baseline was observed postoperatively in patients with and without glaucoma. After 1 week, mean macular thickness was significantly less in the easyPhaco group compared to routine phaco groups with and without glaucoma (221.5±15.4;238.3 ± 11.5 and 229.3 ± 16.9 mcm,respectively, p < 0.05. In the groups 1 and 3, macular thickness returned to preoperative values after 6 weeks (group 1: 210.5 ± 13.8 and 209.7 ± 16.3 mcm; group  3: 211.1 ± 14.4 and 211.1 ± 15.8  mcm,respectively. By contrast, after routine phaco technology in POAG

  10. Oxygen-deficient metabolism and corneal edema.

    Science.gov (United States)

    Leung, B K; Bonanno, J A; Radke, C J

    2011-11-01

    Wear of low-oxygen-transmissible soft contact lenses swells the cornea significantly, even during open eye. Although oxygen-deficient corneal edema is well-documented, a self-consistent quantitative prediction based on the underlying metabolic reactions is not available. We present a biochemical description of the human cornea that quantifies hypoxic swelling through the coupled transport of water, salt, and respiratory metabolites. Aerobic and anaerobic consumption of glucose, as well as acidosis and pH buffering, are incorporated in a seven-layer corneal model (anterior chamber, endothelium, stroma, epithelium, postlens tear film, contact lens, and prelens tear film). Corneal swelling is predicted from coupled transport of water, dissolved salts, and especially metabolites, along with membrane-transport resistances at the endothelium and epithelium. At the endothelium, the Na+/K+ - ATPase electrogenic channel actively transports bicarbonate ion from the stroma into the anterior chamber. As captured by the Kedem-Katchalsky membrane-transport formalism, the active bicarbonate-ion flux provides the driving force for corneal fluid pump-out needed to match the leak-in tendency of the stroma. Increased lactate-ion production during hypoxia osmotically lowers the pump-out rate requiring the stroma to swell to higher water content. Concentration profiles are predicted for glucose, water, oxygen, carbon dioxide, and hydronium, lactate, bicarbonate, sodium, and chloride ions, along with electrostatic potential and pressure profiles. Although the active bicarbonate-ion pump at the endothelium drives bicarbonate into the aqueous humor, we find a net flux of bicarbonate ion into the cornea that safeguards against acidosis. For the first time, we predict corneal swelling upon soft-contact-lens wear from fundamental biophysico-chemical principles. We also successfully predict that hypertonic tear alleviates contact-lens-induced edema.

  11. Patch graft for corneal perforation following trivial trauma in bilateral terrien′s marginal degeneration

    Directory of Open Access Journals (Sweden)

    Merle Fernandes

    2015-01-01

    Full Text Available A young female presented with blurred vision in the left eye after she rubbed her eye. On examination of both eyes, she had 360° thinning adjacent to the limbus, lipid deposition and superficial vascularization with a perforation in the left eye. The patient was diagnosed with bilateral Terrien′s marginal degeneration (TMD with perforation. Corneal topography of the right eye revealed high oblique astigmatism confirming the diagnosis. A peripheral patch graft was performed for the left eye. At 18 months postoperatively, the best-corrected visual acuity was 20/20 in both eyes. The graft was clear. Topography of right eye was stable, and the left eye had oblique astigmatism. Bilateral advanced TMD in a young patient presenting with corneal perforation following trivial trauma is extremely uncommon. Patch graft may be an option for restoring the globe integrity in such cases. Regular follow-up is necessary as the condition progresses slowly.

  12. The art of thinking clearly

    CERN Document Server

    Dobelli, Rolf

    2013-01-01

    The Art of Thinking Clearly by world-class thinker and entrepreneur Rolf Dobelli is an eye-opening look at human psychology and reasoning — essential reading for anyone who wants to avoid “cognitive errors” and make better choices in all aspects of their lives. Have you ever: Invested time in something that, with hindsight, just wasn’t worth it? Or continued doing something you knew was bad for you? These are examples of cognitive biases, simple errors we all make in our day-to-day thinking. But by knowing what they are and how to spot them, we can avoid them and make better decisions. Simple, clear, and always surprising, this indispensable book will change the way you think and transform your decision-making—work, at home, every day. It reveals, in 99 short chapters, the most common errors of judgment, and how to avoid them.

  13. Emodin ameliorates lipopolysaccharides-induced corneal inflammation in rats

    Institute of Scientific and Technical Information of China (English)

    Guo-Ling; Chen; Jing-Jing; Zhang; Xin; Kao; Lu-Wan; Wei; Zhi-Yu; Liu

    2015-01-01

    · AIM: To investigate the effect of emodin on pseudomonas aeruginosa lipopolysaccharides(LPS)-induced corneal inflammation in rats.· METHODS: Corneal infection was induced by pseudomonas aeruginosa LPS in Wistar rats. The inflammation induced by LPS were examined by slit lamp microscope and cytological checkup of aqueous humor.Corneal tissue structure was observed by hematoxylin and eosin(HE) staining. The activation of nuclear factor kappa B(NF-κB) was determined by Western blot.Messenger ribonucleic acid(m RNA) of tumor necrosis factor-α(TNF-α) and intercellular adhesion molecule-1(ICAM-1) in LPS-challenged rat corneas were measured with reverse transcription-polymerase chain reaction(RT-PCR).· RESULTS: Typical manifestations of acute corneal inflammation were observed in LPS-induce rat model,and the corneal inflammatory response and structure were improved in rats pretreated with emodin. Treatment with emodin could improve corneal structure, reduce corneal injure by reducing corneal inflammatory response. Emodin could inhibit the decreasing lever of inhibitor of kappa B alpha(IкBα) express, and the m RNA expression of TNF-α and ICAM-1 in corneal tissues was also inhibited by emodin. The differences were statistically significant between groups treated with emodin and those without treatment(P <0.01).·CONCLUSION: Emodin could ameliorate LPS-induced corneal inflammation, which might via inhibiting the activation of NF-κB.

  14. Ocular histopathological changes after eyeball enucleation induced by corneal trauma

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To observe the ocular histopathological changes aftereyeball enucleation induced by corneal trauma.Methods: Light microscopic examination was done on 117 eyeball specimens enucleated after corneal trauma (18 with corneal fissure and 99 with corneal perforating trauma).Results: Acute, subacute or chronic inflammatory changes, and fibrous membrane formation were observed in well-closed corneal wounds, whereas inflammation, atrophy and scar were observed in the focal tissues. But at the late period, secondary glaucoma, retinal detachment, endophthalmitis and eyeball atrophy resulted in blindness. Corneal fistula was observed in those with inadequate cure of wounds caused by ingrowth of corneal epithelium, embedment of iris and vitreous body, and large area of centrally located tissue deficiency of the corneal. A high incidence of endophthalmitis was noted due to the presence of corneal fistula. Severe inflammation was observed in the anterior segmental tissues with fibrous infiltration in the anterior chamber, which might result in rapid destruction of the eyeballs.Conclusions: Ocular pathology varies with the difference of the position, form, size and closing conditions of the corneal laceration after trauma.

  15. Writing clear animal activity proposals.

    Science.gov (United States)

    Pinson, David M

    2011-06-01

    Although IACUC-related topics are frequently discussed in the literature, there is little published information about how to write animal activity proposals. In this article, the author discusses key considerations in the writing and review of animal activity proposals. The author then describes a framework for developing and writing clear animal activity proposals that highlight animal welfare concerns. Though these recommendations are aimed at individuals writing and reviewing research proposals, the framework can be modified for other types of animal activity proposals.

  16. Anatomical characterization of central, apical and minimal corneal thickness

    Institute of Scientific and Technical Information of China (English)

    Federico; Saenz-Frances; Martha; Cecilia; Bermúdez-Vallecilla; Lara; Borrego-Sanz; Luis; Jaez; J; osé; Marìa; Martinez-de-la-Casa; Laura; Morales-Fernandez; Enrique; Santos-Bueso; Julián; Garcia-Sanchez; Julián; Garcia-Feijoo

    2014-01-01

    ·AIM: To anatomically locate the points of minimum corneal thickness and central corneal thickness(pupil center) in relation to the corneal apex.·METHODS: Observational, cross-sectional study, 299 healthy volunteers. Thickness at the corneal apex(AT),minimum corneal thickness(MT) and corneal thickness at the pupil center(PT) were determined using the pentacam. Distances from the corneal apex to MT(MD)and PT(PD) were calculated and their quadrant position(taking the corneal apex as the reference) determined:point of minimum thickness(MC) and point of central thickness(PC) depending on the quadrant position. Two multivariate linear regression models were constructed to examine the influence of age, gender, power of the flattest and steepest corneal axes, position of the flattest axis, corneal volume(determined using the Pentacam)and PT on MD and PD. The effects of these variables on MC and PC were also determined in two multinomial regression models.·RESULTS: MT was located at a mean distance of 0.909 mm from the apex(79.4% in the inferior-temporal quadrant). PT was located at a mean distance of 0.156 mm from the apex. The linear regression model for MD indicated it was significantly influenced by corneal volume(B =-0.024; 95% CI:-0.043 to-0.004). No significant relations were identified in the linear regression model for PD or the multinomial logisticregressions for MC and PC.·CONCLUSION: MT was typically located at the inferiortemporal quadrant of the cornea and its distance to the corneal apex tended to decrease with the increment of corneal volume.

  17. Anatomical characterization of central, apical and minimal corneal thickness

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    Federico Saenz-Frances

    2014-08-01

    Full Text Available AIM: To anatomically locate the points of minimum corneal thickness and central corneal thickness (pupil center in relation to the corneal apex.METHODS: Observational, cross-sectional study, 299 healthy volunteers. Thickness at the corneal apex (AT, minimum corneal thickness (MT and corneal thickness at the pupil center (PT were determined using the pentacam. Distances from the corneal apex to MT (MD and PT (PD were calculated and their quadrant position (taking the corneal apex as the reference determined:point of minimum thickness (MC and point of central thickness (PC depending on the quadrant position. Two multivariate linear regression models were constructed to examine the influence of age, gender, power of the flattest and steepest corneal axes, position of the flattest axis, corneal volume (determined using the Pentacam and PT on MD and PD. The effects of these variables on MC and PC were also determined in two multinomial regression models.RESULTS: MT was located at a mean distance of 0.909 mm from the apex (79.4% in the inferior-temporal quadrant. PT was located at a mean distance of 0.156 mm from the apex. The linear regression model for MD indicated it was significantly influenced by corneal volume (B=-0.024; 95%CI:-0.043 to -0.004. No significant relations were identified in the linear regression model for PD or the multinomial logistic regressions for MC and PC.CONCLUSION: MT was typically located at the inferior-temporal quadrant of the cornea and its distance to the corneal apex tended to decrease with the increment of