scholarly journals Nd:YAG capsulotomy incidence associated with five different single-piece monofocal intraocular lenses: a 3-year Spanish real-world evidence study of 8293 eyes

Eye ◽  
2021 ◽  
Author(s):  
José I. Belda ◽  
Javier Placeres Dabán ◽  
Juan Carlos Elvira ◽  
Derek O’Boyle ◽  
Xavier Puig ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Yttrium Aluminum Garnet ◽  
Study Data ◽  
The Other ◽  
Intraocular Lenses ◽  
Real World Evidence ◽  
Single Piece ◽  
Survival Plot ◽  
Regional Hospitals

Abstract Objectives To investigate the associations between different single-piece monofocal intraocular lenses (IOLs) and neodymium-doped yttrium aluminum garnet laser (Nd:YAG) capsulotomy incidence 3 years after cataract surgery in a Spanish cohort. Methods This is a longitudinal retrospective cohort study. Data were extracted from the electronic medical records of two large regional hospitals in Spain. Patients aged ≥65 years receiving cataract surgery with placement of five different IOLs and with ≥6 months of baseline data were included. We report the Nd:YAG capsulotomy incidence 3 years post cataract surgery, and the survival plot over the 3 years of follow-up time. The associated adjusted (age, gender, and diabetic retinopathy) multivariate analysis with odds ratios (ORs) and 95% CIs is also presented. Results The cohort (53% female, mean age 75 ± 5.9 years) included 14,519 eyes (Alcon AcrySof = 2968, AJL LLASY60 = 1776, Medicontur Bi-flex = 5176, Zeiss Asphina = 4478, and IOL Tech Stabibag = 121). Of these, 8293 were retained until 3-year follow-up. At 3 years after cataract surgery, the Nd:YAG capsulotomy incidence was 5% for Alcon AcrySof, while it ranged from 21.2% to 31.1% for the other IOLs (p < 0.0001 for each comparison). The odds for Nd:YAG capsulotomy were significantly higher (p < 0.0001) for other IOLs compared with those of Alcon AcrySof (ORs = 8.85, 5.86, 5.74, 5.21 for AJL LLASY60, Medicontur Bi-flex, IOL Tech Stabibag, and Zeiss Asphina, respectively). Conclusions The lower Nd:YAG capsulotomy rates for Alcon AcrySof IOLs compared to the other IOLs support the importance of lens choice in reducing patient burden and treatment costs.

scholarly journals 5 year incidence of YAG capsulotomy and PCO after cataract surgery with single-piece monofocal intraocular lenses: a real-world evidence study of 20,763 eyes

Eye ◽  
2019 ◽  
Vol 34 (5) ◽  
pp. 960-968 ◽  
Author(s):  
Paul G. Ursell ◽  
Mukesh Dhariwal ◽  
Derek O’Boyle ◽  
Javeed Khan ◽  
Alessandra Venerus
Keyword(s):  
Cataract Surgery ◽  
Incidence Rates ◽  
Intraocular Lenses ◽  
Yttrium Aluminium Garnet ◽  
Bonferroni Adjustment ◽  
Age Related ◽  
Real World Evidence ◽  
Single Piece ◽  
Adjusted Logistic Regression ◽  
Uk National Health Service

Abstract Objectives To evaluate the 3- and 5-year incidence of posterior capsule opacification (PCO) and neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy in patients following cataract surgery, comparing results for different single-piece acrylic hydrophilic and hydrophobic monofocal intraocular lens (IOL) models and other patient factors. Patients and methods Electronic medical record data collected from seven United Kingdom (UK) National Health Service (NHS) ophthalmology clinics for routine, age-related (≥65 years) cataract surgeries that implanted single-piece acrylic monofocal IOLs during 2010–2013 were used to calculate 3- and 5-year incidence of Nd:YAG and PCO. IOL models of Alcon Acrysof, AMO Tecnis, Bausch & Lomb (B & L) Akreos, LenStec Softec, and Rayner Flex were analyzed. Pairwise comparisons were conducted between AcrySof IOLs and other IOLs using Bonferroni adjustment for multiplicity. Multivariate analyses were conducted adjusting for known confounders. Results The incidence of Nd:YAG capsulotomy ranged between 2.4–12.6% at 3 years and 5.8–19.3% at 5 years post-cataract surgery. Similarly, the incidence of PCO ranged between 4.7–18.6% at 3 years and 7.1–22.6% at 5 years. When comparing all of the single-piece IOLs, AcrySof demonstrated the lowest incidence rates for both PCO and Nd:YAG (P < 0.001 for each comparison). From adjusted logistic regression analysis, AcrySof were associated with lower 3- and 5-year odds of Nd:YAG and PCO incidence. Conclusions Following cataract surgery with single-piece monofocal IOLs different incidence rates of PCO were observed with different IOLs. AcrySof IOLs were associated with significantly lower incidence of PCO requiring Nd:YAG treatment over periods of 3 and 5 years.

scholarly journals Anterior Capsule Opening Contraction and Late Intraocular Lens Dislocation after Cataract Surgery in Patients with Weak or Partially Absent Zonular Support

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 35
Author(s):  
Juris Vanags ◽  
Renārs Erts ◽  
Guna Laganovska
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Yttrium Aluminum Garnet ◽  
Late Complications ◽  
High Rate ◽  
Anterior Capsule ◽  
Capsular Tension Ring ◽  
Hydrophobic Acrylic ◽  
Capsular Bag

Background and objectives: To evaluate anterior capsule opening (ACO) contraction and late intraocular lens (IOL) dislocation after cataract surgery in patients with weak or partially absent zonular support and assess methods of reducing these complications. Materials and methods: For this prospective study, we enlisted cataract surgery patients in our hospital with preoperative diagnoses of weak zonules. All patients received phacoemulsification surgery with implantation of a hydrophobic acrylic IOL and capsular tension ring (CTR). ACO reductions were measured for six months after enrolment. Data on late IOL dislocations were collected five years after enrolment of the last patient. Results: Fifty-three patients were enrolled from 2011 to 2015. Over the six-month active follow-up period, ACO area reduction was 23% in patients receiving CTRs of 11 mm diameter and 8% for patients with CTRs of 12 mm, with an overall mean of 15% reduction. Five years after the last patient was enrolled, seven patients (13%) had experienced late IOL-CTR-capsular bag dislocation. For these patients, the mean ACO reduction in the first six months of follow-up was 33%, including for those who had received neodymium-doped yttrium aluminum garnet (Nd: YAG) anterior capsulotomies. Conclusion: Use of hydrophobic acrylic lenses and CTR reduces ACO contraction, with rates comparable to those after cataract surgery without ocular comorbidity. Our patients experienced a relatively high rate of late IOL-CTR-capsular bag dislocation. However, dislocated complexes were easily repositioned and few patients required IOL exchange. Frequent visits are warranted to promptly detect late complications of cataract surgery in patients with weak zonular support.

scholarly journals The Effects of Different Shapes of Capsulorrhexis on Postoperative Refractive Outcomes and Effective Position of the Intraocular Lens in Cataract Surgery

2018 ◽  
Author(s):  
Shixu Li ◽  
Yiping Hu ◽  
Ran Guo ◽  
Yushuang Shao ◽  
Jiangyue Zhao ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
The Other ◽  
Intraocular Lenses ◽  
Vertical Diameter ◽  
Refractive Outcomes ◽  
Age Related ◽  
Horizontal Diameter ◽  
Different Shapes

Abstract Background：To evaluate the effects of anterior capsular opening size on deviation from predicted refraction and the effective position of intraocular lens (ELP) in cataract surgery. Methods：Eighty patients (80 eyes) with simple age-related cataracts were treated from May 2018 to September 2018 at the Fourth Affiliated Hospital of China Medical University. The patients were divided into 2 groups : 40 eyes were implanted with the C-loop haptic intraocular lens (AMO Tecnis ZCB00) while the other 40 eyes were implanted with the plate haptic intraocular lens (CT ASPHINA 509M). Follow-up visits were conducted postoperatively at 1 week, 1 month, and 3 months during which patients underwent refraction and data collection after pupil dilation that included anterior segment photography and Scheimpflug imaging by Pentacam. The area, horizontal and vertical diameter of the capsulorrhexis, circularity, decentration, and package were analysed using the image analysis software Image-Pro-Plus 6.0 that evaluated the relationship between the different shapes of capsulorrhexis with deviation from predicted refraction and ELP in cataract surgery. Results: Deviation from predicted refraction and all of the parameters of capsulorrhexis were not correlative in the 509M IOL group, however, in the Tecnis IOL group, while the deviation from predicted refraction and all of the capsulorrhexis parameters were not correlative at 1 week, the deviation from predicted refraction did correlate with capsulorrhexis area,horizontal diameter at 1 month (P=0.029, P=0.048), and the capsulorrhexis area ,vertical diameter at 3 months (P=0.03, P=0.017).The ELP correlated with package in both groups postoperatively (r>0, P<0.05), but there is no other capsulorrhexis parameters correlate with ELP in the 509M IOL group (all P>0.05). For the Tecnis IOL group, the ELP and capsulorrhexis area were correlated at 1 week and 1 month, while the ELP and horizontal diameter, the ELP and vertical diameter were correlated at 1 week , but did not correlate with the other capsulorrhexis parameters in the Tecnis IOL group (all P>0.05). Conclusions: The shape of the capsulorrhexis has an effect on postoperative refractive outcomes and the effective position of intraocular lens in cataract surgery, and plate haptic intraocular lenses have better refractive stability than C-loop haptic intraocular lenses.（ChiCTR-TRC-1800015638）

scholarly journals Comparison of postoperative results after implantation of hydrophilic acrylic or hydrophobic acrylic intraocular lens: Data of one-year prospective clinical study

Medicina ◽  
2008 ◽  
Vol 44 (12) ◽  
pp. 936 ◽  
Author(s):  
Reda Žemaitienė ◽  
Martynas Špečkauskas ◽  
Brigita Glebauskienė ◽  
Vytautas Jašinskas
Keyword(s):  
Visual Acuity ◽  
Clinical Study ◽  
Posterior Capsule Opacification ◽  
Intraocular Lenses ◽  
Posterior Capsule ◽  
Prospective Clinical Study ◽  
Single Piece ◽  
One Year ◽  
Hydrophobic Acrylic

Objective. To evaluate and compare the impact of two sharp-edge optic foldable intraocular lenses (IOLs) of similar design made from different material (hydrophilic acrylic or hydrophobic acrylic) on visual function, anterior and posterior capsule opacification at one-year follow-up after cataract phacoemulsification. Material and methods. Seventy-two eyes of 72 patients scheduled for cataract surgery were included in a prospective clinical study. Two foldable sharp-edge optic posterior chamber acrylic IOLs of similar design were used. Thirty-nine eyes of 39 patients received a single-piece hydrophilic acrylic (PC 511, Ophtec) IOL and 33 eyes of 33 patients – single-piece hydrophobic acrylic (AcrySof, SA60AT, Alcon) IOL. Visual acuity, anterior capsule opacification (ACO), capsulorrhexis/optic overlapping, and posterior capsule opacification (PCO) were evaluated. The intensity of ACO was assessed subjectively. PCO values in the entire IOL optic area and in the central 3-mm optic zone were assessed using a photographic image analysis system (EPCO 2000). The patients were examined at one year postoperatively. Results. There were no significant differences in best-corrected visual acuity and capsulorrhexis/optic overlapping between IOL types at 1-year follow-up after surgery. In the single-piece hydrophilic acrylic IOL group, the grade of ACO density was significantly higher in capsulorrhexis rim area (1.56±0.71 and 1.00±0.75) and in the capsule/optic area (1.62±0.67 and 1.00±0.75) (P<0.05). PCO values of the entire IOL optic area (0.12±0.13 and 0.024±0.02) as well as in the central 3-mm optic zone (0.06±0.11 and 0.001±0.003) was significantly higher in the single-piece hydrophilic acrylic IOL group one year postoperatively (P<0.05). In 33.3% of cases of the single-piece hydrophilic acrylic IOL group, contraction of haptics to IOL optics was present one year postoperatively, which was not present in any case of the single-piece hydrophobic acrylic IOL group. Conclusions. One-year follow-up after cataract surgery has shown a significant difference in ACO and PCO development comparing single-piece hydrophilic acrylic and single-piece hydrophobic acrylic intraocular lenses. The effect of hydrophobic acrylic foldable lenses on preventing anterior and posterior capsule opacification is mainly a result of the acrylic hydrophobic biomaterial.

Comparison of Sulcus Implantation of Single-Piece Hydrophilic Foldable Acrylic and Polymethylmethacrylate Intraocular Lenses in Eyes with Posterior Capsule Tear during Phacoemulsification Surgery

2007 ◽  
Vol 17 (4) ◽  
pp. 595-600 ◽  
Author(s):  
M. Taskapili ◽  
G. Gulkilik ◽  
M.S. Kocabora ◽  
M. Ozsutcu ◽  
C. Yilmazli ◽  
...  
Keyword(s):  
Corneal Edema ◽  
Intraocular Lenses ◽  
Posterior Capsule ◽  
Single Piece ◽  
Posterior Capsule Tear ◽  
Group A ◽  
Induced Astigmatism ◽  
The Mean ◽  
Acrylic Group

Purpose To compare the results of sulcus implantation of acrylic and poly(methylmethacrylate) (PMMA) intraocular lens (IOL) in eyes with posterior capsule tear during phacoemulsification surgery. Methods In all eyes a posterior capsule tear developed during phacoemulsification surgery and an IOL to the ciliary sulcus was implanted primarily. A total of 89 eyes of 88 patients received hydrophilic foldable acrylic IOL (acrylic group). A total of 72 eyes of 72 patients received PMMA IOL (PMMA group). The mean age was 67.1 years and 68.1 years and postoperative follow-up period was 19.2 months and 17.9 months in acrylic and PMMA groups, respectively. Results Temporary corneal edema appeared in 33 eyes and 26 eyes, elevation of intraocular pressure in 17 eyes and 12 eyes, anterior chamber inflammatory reaction in 5 eyes and 5 eyes, clinical cystoid macular edema in 7 eyes and 12 eyes, and decentered IOL in 4 eyes and 3 eyes in acrylic and PMMA groups, respectively. Late postoperative endophthalmitis developed in two eyes of the PMMA group. Rhegmatogenous retinal detachment developed in one eye in each group. Final best-corrected visual acuities were 5/10 and above in 73 eyes (82.02%) in the acrylic group and 5/10 and above in 42 eyes (58.33%) in the PMMA group. Postoperative final induced astigmatism was 0.5±0.5 D (SD) in the acrylic group and 1.11±0.65 D (SD) in the PMMA group (p=0.0001) (independent samples t-test). Conclusions Increased astigmatism is more frequently seen in the PMMA group. The implantation of foldable acrylic IOL in the sulcus after posterior capsule tear maintains the advantages of small incision surgery.

scholarly journals Management of Dislocated Intraocular Lenses with Iris Suture

2016 ◽  
Vol 27 (1) ◽  
pp. 45-48 ◽  
Author(s):  
Mun Y. Faria ◽  
Nuno P. Ferreira ◽  
Mario Canastro
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Signs ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Pigment Dispersion ◽  
Corneal Incision ◽  
The Mean

Purpose Subluxated or malpositioned intraocular lenses (IOLs) and inadequate capsular support is a challenge for every ophthalmic surgeon. Iris suture of an IOL seems to be an easy technique for the management of dislocated 3-piece IOL, allowing the IOL to be placed behind the iris, far from the trabecular meshwork and corneal endothelium. The purpose of this study is to assess the results of pars plana vitrectomy (PPV) and iris suture of dislocated 3-piece acrylic IOLs. Methods In this retrospective, nonrandomized, interventional case consecutive study, of a total of 103 dislocated IOLs, 36 eyes were considered for analysis. All 36 eyes had subluxated or totally luxated 3-piece IOL and underwent iris suture at the Ophthalmology Department of Santa Maria Hospital-North Lisbon Hospital Center, Portugal, from January 2011 until November 2015. All patients underwent 3-port 23-G PPV. The optic zone of the dislocated IOL was placed anterior to the iris with the haptics behind, in the posterior chamber. Haptics were sutured to iris followed by placement of the optics behind iris plane. Postoperative measures included best-corrected visual acuity (BCVA), IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and development of macular edema. Results A total of 36 eyes of 36 patients were included. All underwent successful iris fixation of dislocated 3-piece IOL. Mean overall follow-up was 15.9 months (range 3-58 months). At presentation, 16 eyes (44.4%) had a luxated IOL and 20 eyes (55.6%) a subluxated IOL. As underlying cause, 17 eyes (47.2%) had a history of complicated cataract surgery, 5 eyes (13.9%) had a traumatic dislocation of the IOL, and 6 eyes (16.7%) had a previous vitreoretinal surgery. A total of 8 eyes (22.2%) had late spontaneous IOL dislocation after uneventful cataract surgery. The mean preoperative BCVA was 1.09 ± 0.70 logarithm of the minimal angle of resolution (logMAR) units and mean postoperative BCVA was 0.48 ± 0.58 of logMAR units. The mean visual acuity improvement was 4.08 ± 5.33 lines on the logMAR scale. In this study, every IOL was stable at the last follow-up. As late complications, macular edema occurred in 1 patient and retinal detachment occurred in 2 patients. There were no cases of endophthalmitis. Conclusions Iris suture fixation of subluxated IOL is a good treatment option for eyes with dislocated IOLs, leading to long-term stability of the IOL. The advantage of this procedure is using the same IOL in a closed eye surgery. No astigmatic difference is expected as no large corneal incision is needed.

scholarly journals Combined Femtosecond Laser-Assisted Cataract Surgery and 27-Gauge Transconjunctival Sutureless Vitrectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sami Yılmaz ◽  
Remzi Avcı ◽  
Ayşegül Mavi Yıldız
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Refractive Error ◽  
Vitreoretinal Surgery ◽  
Future Trend ◽  
Intraocular Lenses ◽  
Combined Surgery ◽  
Retrospective Clinical Study ◽  
The Mean

Purpose. To report the outcomes of combined surgery using femtosecond laser-assisted cataract surgery (FLACS) and sutureless 27-gauge pars plana vitrectomy with intravitreal tamponade. Methods. This retrospective clinical study involved 23 eyes of 23 patients on whom combined vitreoretinal surgery was performed. Patients were initially given the femtosecond laser treatment that was performed after selection of capsulotomy and lens fragmentation patterns. The capsulotomy diameter was chosen as 4.9 mm in all patients. After the femtosecond laser, the sutureless phacovitrectomy procedure was performed. At the end of surgery, perfluoropropane or sterile air tamponade was applied. Results. The mean age of patients was 66.43 ± 7.61 (range, 54–83) years. Fifteen patients were females (65.2%). The mean follow-up was 16.09 ± 4.71 (range, 9–25) months. The most common surgical indication was epiretinal membrane (65.3%). The mean preoperative best-corrected visual acuity (BCVA) was 0.71 ± 0.44 (range, 1.7–0.3) logMAR, and the mean postoperative BCVA at 6 months was 0.16 ± 0.14 (range, 0.4–0) logMAR p<0.001. The mean target sphere refractive error was −0.24 ± 0.16 (range, −0.50–0.11) D, and the mean postoperative spherical equivalent refractive error was −0.14 ± 0.39 (range, −1.00–0.50) D at 6 months p=0.196. All intraocular lenses (IOLs) remained well centered in the capsular bag during surgery and follow-up. There was no iris capture, posterior synechiae, capsular opacification, or pseudophakic cystoid macular edema. The only complication related to femtosecond laser was two cases of subconjunctival haemorrhage related with suction. Conclusions. FLACS is a safe and effective technique providing the advantage of repeatable, precise capsulorhexis shape and size to achieve a well-centered and stable IOL postoperatively. These advantages can certainly improve the results of vitrectomy, especially in gas-filled eyes. FLACS and 27-gauge sutureless combined surgery may be a future trend in appropriate cases.

Biocompatibility of hydrophilic acrylic, hydrophobic acrylic, and silicone intraocular lenses in eyes with uveitis having cataract surgery: Long-term follow-up

2011 ◽  
Vol 37 (1) ◽  
pp. 104-112 ◽  
Author(s):  
Claudette Abela-Formanek ◽  
Michael Amon ◽  
Guenal Kahraman ◽  
Joerg Schauersberger ◽  
Roman Dunavoelgyi
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lenses ◽  
Long Term Follow Up ◽  
Hydrophobic Acrylic

scholarly journals The Effectiveness of Time Perspective Therapy on Maternal Dark Tetrad Personality and Separation Anxiety Symptoms of Preschool Children

2021 ◽  
Author(s):  
Parisa Ghasemi Zadeh ◽  
◽  
Leila Shameli ◽  
Habib Hadian Fard ◽  
◽  
...  
Keyword(s):  
Preschool Children ◽  
Repeated Measures ◽  
Time Perspective ◽  
Separation Anxiety ◽  
Study Data ◽  
Anxiety Symptoms ◽  
The Other ◽  
Control Group ◽  
Post Test

Objectives: This study aimed to investigate the effectiveness of time perspective therapy (TPT) on maternal dark tetrad personality and separation anxiety symptoms in preschool children. Methods: This quasi-experimental study was carried out using pre-test and post-test design with a control group and a one-step follow-up. Out of all preschool children with Separation Anxiety symptoms of Kazerun, in winter of 2019, 32 individuals were selected via convenience sampling method and randomly assigned to experimental (16 persons) and control groups (16 persons). Mothers of Children in the experimental group participated in six 90-minute sessions once per week of TPT. The study data were obtained by using dirty dozen scales, short sadistic impulse scale and children symptom inventory-4. The achieved data were analyzed by analysis of variance with repeated-measures in SPSS-22. Results: Findings indicated that maternal TPT leads to significant decrease in Separation Anxiety symptoms and narcissism (p≤0.05) in the post-test and follow up. But it doesnchr('39')t have any significant decrease in the other sub scales of dark tetrad personality (P≥0.05). Conclusion: Maternal Time Perspective therapy decreases Separation Anxiety symptoms in preschool children and narcissism of mothers but it doesnchr('39')t have any result in the other sub scales of dark tetrad personality of mothers.

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