Cataract

2012 ◽  
Author(s):  
Georgia Cleary ◽  
David Spalton
Keyword(s):  
Postoperative Complications ◽  
Cataract Surgery ◽  
Congenital Cataract ◽  
Intraoperative Complications ◽  
Intraocular Lenses ◽  
Posterior Capsular Opacification ◽  
Clinical Knowledge ◽  
Practical Skills ◽  
Age Related ◽  
Nd:Yag Laser Capsulotomy

The chapter begins by discussing lens anatomy and embryology, before covering the key areas of clinical knowledge, namely acquired cataract, clinical evaluation of acquired cataract, treatment for acquired cataract, intraoperative complications of cataract surgery, infectious postoperative complications of cataract surgery, non-infectious postoperative complications of cataract surgery, congenital cataract, management of congenital cataract, and lens dislocation. Practical skills are then covered, including biometry, local anaesthesia, operating microscope and phacodynamics, intraocular lenses, and Nd:YAG laser capsulotomy. The chapter concludes with three case-based discussions, on age-related cataract, postoperative endophthalmitis, and posterior capsular opacification.

Cataract

2016 ◽  
Author(s):  
Georgia Cleary ◽  
Allon Barsam
Keyword(s):  
Cataract Surgery ◽  
Visual Impairment ◽  
Crystalline Lens ◽  
Developed Countries ◽  
Infectious Complications ◽  
Intraocular Lenses ◽  
Clinical Knowledge ◽  
Practical Skills ◽  
Nd:Yag Laser Capsulotomy ◽  
Elective Surgical Procedure

This chapter focuses on cataract, which is the pathological opacification of the crystalline lens. Cataract is an important cause of visual impairment and blindness worldwide, in both developed and developing countries. Fortunately, acquired cataract is a reversible cause of visual impairment and, in developed countries, cataract surgery is the most commonly performed elective surgical procedure. This chapter outlines lens anatomy and embryology, along with clinical knowledge areas that include acquired cataract (clinical evaluation and treatment), intraoperative and post-operative (infectious and non-infectious) complications of cataract surgery, and lens dislocation. Practical skills, including biometry, local anaesthesia, implantation of intraocular lenses, and Nd:YAG laser capsulotomy, are also discussed.

Surgical management challenges and clinical results of bimanual micro-incision phacoemulsification cataract surgery in children with congenital cataract

1970 ◽  
Vol 3 (1) ◽  
pp. 3-8
Author(s):  
M Amon
Keyword(s):  
Cataract Surgery ◽  
Surgical Management ◽  
Congenital Cataract ◽  
Clinical Results ◽  
Posterior Capsular Opacification ◽  
Surgical Removal ◽  
Promising Alternative ◽  
Age Related ◽  
Phacoemulsification Cataract Surgery

Introduction: Small incisions in cataract surgery have shown to reduce tissue damage, postoperative inflammation and pain. Objective: To describe in detail the surgical management challenges and clinical results of bimanual micro-incision phacoemulsification cataract surgery in children with congenital cataract. Materials and methods: In 22 eyes of 14 children aged from 11 months to 17 years with congenital cataract, micro-incision cataract surgery with lensectomy, bimanual aspiration or phacoemulsification and implantation of an intraocular lens (SN60WF, Alcon®) was performed under general anesthesia. The visual equivalent obtained with age-related methods, the slit-lamp examination, and refractive outcome were documented in the medical records and were analyzed retrospectively. The patients fulfilled at least 3 months of follow up. Results: In all operated eyes, micro-incision cataract surgery could be performed without serious intra-operative complications. Lensectomy was safely combined with a primary posterior capsulorhexis and anterior vitrectomy in 17 of 22 eyes. Corneal incision length ranged between 2.2 mm and 2.6 mm (mean: 2.3 ± 0.2 mm). No cases of postoperative hypotony and increased inflammation were observed. One eye required surgical removal of the after-cataract 7 months after surgery. Laser capsulotomy for posterior capsular opacification had to be performed in 2 (9 %) eyes. In all other eyes (19/22), visual axis remained clear during follow-up.Conclusion: Micro-incision cataract surgery is a promising alternative to conventional pediatric cataract surgery, since the technique showed to be comparably safe and effective. Longer follow-up examinations will now be performed.Key words: congenital cataract; bimanual micro-incision phacoemulsificationDOI: 10.3126/nepjoph.v3i1.4270Nepal J Ophthalmol 2011;3(5):3-8

Comparative analysis of visual outcomes of multifocal and monofocal intraocular lenses in congenital cataract surgery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Luca Buzzonetti ◽  
Sergio Petroni ◽  
Carlo Maria De Sanctis ◽  
Paola Valente ◽  
Matteo Federici ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Cataract Surgery ◽  
Congenital Cataract ◽  
Intraocular Lenses ◽  
Visual Outcomes ◽  
Congenital Cataract Surgery

Postoperative Complications after Phacoemulsification and Implantation of Foldable Acrylic Intraocular Lenses in Dogs

2021 ◽  
Author(s):  
Babita Das ◽  
Apra Shahi ◽  
Vishnu Pratap Chandrapuria ◽  
Shobha Jawre ◽  
Madhu Swamy ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Cataract Surgery ◽  
Postoperative Complication ◽  
Corneal Opacity ◽  
Intraocular Lenses ◽  
Major Postoperative Complication ◽  
Ophthalmic Pathology ◽  
Cataractous Lens ◽  
Operative Complications ◽  
Post Operative Complications

Background: Despite significant advances in canine cataract surgery over the years, many post-operative complications persist and reduces the success rate of phacoemulsification procedure. The aim of current study was to evaluate post-operative complications encountered till 90 days after bimanual phacoemulsification with implantation of different acrylic Intraocular Lenses.Methods: The study was conducted on 24 canine eyes. All the clinical cases were subjected to detailed ocular, ultrasonography and neuro-ophthalmic tests for ascertaining cataract and associated neuro-ophthalmic pathology. Dogs were divided in four groups with 6 eyes in each group and subjected to phacoemulsification procedure for removal of cataractous lens and implanted with square edge or round edge hydrophilic or hydrophobicintra ocular lenses.Result: Statistically non-significant (p£0.05) variations were found for all the post- operative complications among the groups. Within the groups initially higher values were recorded and on subsequent days a declining trend of varying degrees were observed. The corneal opacity was a major postoperative complication leading to failure to achieve vision with other coinciding neuro-ophthalmic conditions.

scholarly journals A COMPARISION OF POSTERIOR CAPSULAR OPACITY FORMATION UPTO 1 YEAR IN PATIENTS WITH SMALL INCISION CATARACT SURGERY WITH FOLDABLE INTRAOCULAR LENS AND PHACOEMULSIFICATION WITH THE SAME INTRAOCULAR LENS

2020 ◽  
pp. 173-176
Author(s):  
Kinjal Rathod ◽  
Kinjal Trivedi ◽  
Snehal Nayi ◽  
Somesh Aggarwal
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Nd:Yag Laser ◽  
Visual Outcome ◽  
Posterior Capsular Opacification ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Common Procedure ◽  
Age Related

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.

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 Primary scleral-fixated posterior chamber intraocular lenses in patients with congenital lens subluxation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anjian Wang ◽  
Qi Fan ◽  
Yongxiang Jiang ◽  
Yi Lu
Keyword(s):  
Postoperative Complications ◽  
Cox Regression ◽  
Intraoperative Complications ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Cox Regression Analysis ◽  
Lens Subluxation ◽  
Visual Outcomes ◽  
Eye Trauma

Abstract Objective We investigated the long-term visual outcomes and ocular complications of primary scleral-fixated posterior chamber intraocular lenses (SF-PC-IOLs) in patients with congenital lens subluxation. Methods We enrolled 53 patients (77 eyes) with congenital lens subluxation caused by ectopia lentis, Marfan syndrome, and Weill–Marchesani syndrome who underwent primary implantation of a SF-PC-IOL. All patients underwent a complete ophthalmic examination include visual acuity (VA), intraocular pressure (IOP), intraocular lenses (IOL) position, intraoperative complications and postoperative complications. Cox regression analysis and survival analysis were used to evaluate the risk factors for postoperative complications. Results Seventy seven eyes from 53 patients were included. Mean age at surgery was 23 ± 20 years (5 to 67 years), with a mean follow-up of 39 ± 27 months (12 to 130 months). The best-corrected VA improved from 0.84 ± 0.55 to 0.26 ± 0.43 logarithms of the minimum angle of resolution (p < 0.001). Best-corrected VA improved postoperatively in 73 eyes (94%). The main causes of reduced vision after surgery were retinal pathologies and amblyopia. Complications included transient intraocular haemorrhage (2 eyes, 2.6%), early vitreous incarceration (2 eyes, 2.6%), retinal detachment (6 eyes, 7.8%) and IOL dislocation (3 eyes, 3.9%). Cox regression showed that postoperative eye trauma was a risk factor for long-term postoperative complications. Conclusion SF-PC-IOLs provide good visual outcomes in patients with congenital lens subluxation. The SF-PC-IOLs showed good stability, except in patients suffering from postsurgical eye trauma.

scholarly journals Comparative Efficacy Between Trifocal and Bifocal Intraocular Lens Among Patients Undergoing Cataract Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ziran Zhang ◽  
Haiyang Jiang ◽  
Hongwei Zhou ◽  
Fang Zhou
Keyword(s):  
Systematic Review ◽  
Cataract Surgery ◽  
Meta Analysis ◽  
Intraocular Lenses ◽  
Cochrane Library ◽  
Posterior Capsular Opacification ◽  
Comparative Efficacy ◽  
Patient’S Satisfaction ◽  
Randomized Controlled ◽  
Secondary Outcomes

The comparative efficacy of trifocal and bifocal intraocular lenses (IOLs) remained uncertain among patients undergoing cataract surgery. A systematic review and meta-analysis was performed to answer this question. PubMed, Cochrane Library and Embase were searched to capture relevant randomized controlled trials (RCTs). Visual acuity (VA) and patient's satisfaction were regarded as primary outcomes. Secondary outcomes included residual sphere, spherical equivalence, residual cylinder, posterior capsular opacification (PCO), spectacle independence, and other complications. Statistical analysis was done using RevMan 5.2.0. A total of 9 studies (11 RCTs) with 297 participants (558 eyes) were included. Meta-analysis showed significant differences between trifocal and bifocal IOLs in the uncorrected near VA (mean difference [MD], −0.008; 95% confidence interval [Cl], −0.015 to −0.001; P = 0.028) and uncorrected intermediate VA (MD, −0.06; 95% CI, −0.10 to −0.02; P &lt; 0.01). Trifocal IOLs were associated with decreased PCO incidence when compared to bifocal IOLs (relative risk [RR], 0.54; 95% CI, 0.31 to 0.95; P = 0.03). Trifocal IOLs may be superior to bifocal IOLs because of its improved intermediate VA and reduced incidence of PCO.

Comparison of polymethylmethacrylate versus hydrophobic acrylic lenses for primary intraocular lens implantation in pediatric cataract surgery

2020 ◽  
Vol 1 (3) ◽  
pp. 160-165
Author(s):  
Gamze Uçan Gündüz ◽  
◽  
Berna Akova Budak ◽  
Keyword(s):  
Postoperative Complications ◽  
Cataract Surgery ◽  
Intraocular Lenses ◽  
Safe Procedure ◽  
Pediatric Cataract ◽  
Iol Implantation ◽  
Group I ◽  
Pediatric Cataract Surgery ◽  
Group Ii ◽  
Hydrophobic Acrylic

AIM: To compare the visual results and postoperative complications of polymethylmethacrylate (PMMA) and hydrophobic acrylic intraocular lenses (IOLs) in children who underwent cataract extraction with primary IOL implantation. METHODS: This retrospective study included 117 eyes of 63 children with bilateral pediatric cataract undergoing cataract surgery and primary IOL implantation. The patients were divided into two groups, Group I included 58 eyes of 30 patients with PMMA IOLs; Group II included 59 eyes of 33 patients with hydrophobic acrylic IOLs. The clinical features, refraction errors, best corrected visual acuity (BCVA) and surgical complications were compared between two groups. RESULTS: The mean age at the time of surgery was 5.8 (2-12)y and mean follow up period was 40.5 (6-196)mo. Postoperatively, BCVA was ≥0.5 in 80 eyes (68.4%) and this was comparable in two groups. Visual axis opacification was seen in 28 eyes (48.3%) in Group I and 16 eyes (27.1%) in Group II and this difference was statistically significant (P=0.018). Postoperative IOL dislocation and posterior synechia formation were also noted. When all postoperative complications were considered, there were significantly less complications in the acrylic IOL group than PMMA IOL group (P=0.020). CONCLUSION: Pediatric cataract surgery with primary IOL implantation is a safe procedure. Hydrophobic acrylic IOLs may lead to less postoperative complications compared to PMMA IOLs.

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