scholarly journals Xtra focus pinhole IOL (Morchers GMBH) a novel approach to tackle irregular astigmatism and large pupillary defects with a single step surgery

2019 ◽  
Vol 12 (4) ◽  
pp. e228902 ◽  
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Single Step ◽  
Novel Approach ◽  
Uncorrected Distance Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Corneal Scar ◽  
History Of

A 69-year-old patient presented to us with traumatic mydriasis with irregular pupil measuring 7 mm, with superior loss of iris tissue and large inferior peripheral iridotomy and pseudophakia. The patient had history of blunt trauma 3 years ago in a fire cracker injury. He was operated elsewhere primarily after the trauma for cataract surgery with intraocular lens implantation and had suboptimal visual outcome with glare and photophobia. He presented to us with irregular pupil and inferior iridectomy with pseudophakia. The uncorrected visual acuity was 20/150 improving to 20/50 with glasses. He had a history of cataract surgery with intraocular lens (IOL) implantation done elsewhere several years back. The patient was not a diabetic or hypertensive. There was a para central corneal scar causing irregular corneal astigmatism. Extra focus pinhole IOL was implanted in sulcus having a pinhole aperture 1.36 mm. Preoperative total corneal higher-order aberrations were 3.3 µ and total corneal coma was 0.97 µ. Postoperatively uncorrected distance visual acuity improved to 20/40 intermediate uncorrected visual acuity improved to 20/30 and uncorrected near visual acuity was J3.

Management of cataract in a case of retinitis pigmentosa with bilateral pseudoexfoliation syndrome

2021 ◽  
Vol 14 (2) ◽  
pp. e238936
Author(s):  
Sucheta Parija ◽  
Koyel Chakraborty
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Pseudoexfoliation Syndrome ◽  
Corrected Distance Visual Acuity ◽  
History Of ◽  
Hypertensive Woman ◽  
The Right

Retinitis pigmentosa (RP) patients are at higher risk for macular oedema, anterior capsular phimosis and spontaneous dislocation of the implanted lens after cataract surgery. A 70-year-old hypertensive woman presented with diminution of vision in her left eye since 2 years. She had history of cataract surgery in the right eye 1 year ago. Her visual acuity was 20/200 in right eye and hand movements in left eye. Slit-lamp examination showed anterior capsular phimosis with intraocular lens in the right eye and pseudoexfoliation in both the eyes. Fundus examination revealed features of RP in both the eyes. Optical coherence tomography showed bilateral foveal atrophy. The patient underwent phacoemulsification cataract surgery with intraocular lens implantation in left eye and Nd:YAG laser capsulotomy in right eye. Postoperative best corrected distance visual acuity was 20/125 in right eye and 20/80 in left eye. This case highlights a rare coincidence of pseudoexfoliation syndrome in a patient with RP and the precautions undertaken during cataract surgery for an optimal visual outcome.

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 Prognostic Factors for Low Visual Acuity after Cataract Surgery with Vitreous Loss

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Michael Mimouni ◽  
Michal Schaap-Fogler ◽  
Philip Polkinghorne ◽  
Gilad Rabina ◽  
Rita Ehrlich
Keyword(s):  
Visual Acuity ◽  
Prognostic Factors ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Visual Outcome ◽  
Multivariable Logistic Regression Analysis ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Vitreous Loss

Purpose. The purpose of this study is to find prognostic factors associated with low visual acuity in patients experiencing vitreous loss during cataract surgery. Methods. A retrospective, noncomparative, interventional, case study of patients experiencing vitreous loss during cataract surgery. Data collected included demographics, best corrected visual acuity (BCVA), axial length (AL), presence of ocular comorbidity affecting central vision, timing of intraocular lens (IOL) implantation, position of the implanted lens, and the presence of corneal sutures. Low visual outcome was defined as BCVA < 20/40. Results. Overall, 179 patients (60.3% males) with a mean age of 73 ± 12 years and axial length of 23.5 ± 1.3 mm with a mean follow-up of 12 ± 13 months were included. In multivariable logistic regression analysis, low visual outcome was independently associated with persisting postoperative complications (OR 6.25, 95% CI 1.378–30.9), preexisting ocular comorbidities (OR 4.45, 95% CI 1.1–18.00), and secondary intraocular lens (IOL) implant (OR 10.36, 95% CI 1.8–60.00). Conversely, pars plana vitrectomy (PPV) for dislocated fragments of lens material, age > 70 years, gender, axial length, degree of surgeon, corneal suturing, and anterior chamber lens implantation were not found to have significant associations with low visual outcomes ( P > 0.05 ). Conclusions. Low visual outcome after vitreous loss during cataract surgery was associated with ocular comorbidities, secondary IOL implantation, development of cystoid macular edema, and additional surgical complications.

scholarly journals Persistent troublesome floaters necessitating the explantation of XtraFocus Pinhole IOL (Morcher)

2019 ◽  
Vol 12 (4) ◽  
pp. e229057 ◽  
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Cataract Extraction ◽  
Blurred Vision ◽  
Uncorrected Visual Acuity ◽  
History Of ◽  
Irregular Astigmatism

A 41-year-old patient presented with blurred vision and photophobia in the left eye with an uncorrected visual acuity of 20/150, improving to 20/30 with pinhole and diagnostic rigid gas permeable lens trial. He had a history of trauma with subsequent cataract extraction with residual irregular astigmatism and traumatic mydriasis. XtraFocus Pinhole intraocular lens (Morcher) was implanted in the left eye and the vision improved to 20/40. Postoperatively, the patient experienced significant floaters which persisted to the extent of necessitating explantation of implant.

scholarly journals Visual outcome and early complications of sutureless and glueless scleral fixated intraocular lens

2016 ◽  
Vol 8 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Lalit Agarwal ◽  
Nisha Agarwal ◽  
Rajya Laxmi Gurung ◽  
Rahul Chaubey ◽  
Bhaskar Kumar Jha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Case Series ◽  
Corneal Edema ◽  
Visual Outcome ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Study Results ◽  
Capsular Support ◽  
Scleral Fixated Intraocular Lens

Introduction: In the absence of capsular support, anterior chamber intraocular lens (IOL), iris fixated IOL and sutured scleral fixated intraocular lens (SFIOL) implantation have been performed for many years. Recently sutureless glued SFIOL have been used as a primary or secondary procedure to correct aphakia. In this study we have used sutureless and glueless technique of SFIOL implantation. Methodology: An interventional case series was conducted. Aphakic patients without capsular support, sub-luxated lens (>180°), dislocated lens and dislocated IOL were the inclusion criteria. The patients with hazy cornea, non-dilating pupil, macular scar and glaucoma were not enrolled in the study. Results: Of 62 eyes who completed 1 month follow- up, 48 were men and 14 women. There was a significant improvement in uncorrected distance visual acuity after surgery (p<0.001). One month postoperative best corrected distance visual acuity was 6/18 or better in 45 eyes (72.6%). The common early postoperative complications were hypotony, corneal edema. No serious complications such as endophthalmitis and retinal detachment were seen. Conclusion: Our technique of sutureless and glueless SFIOL implantation showed good visual outcome in the absence of serious complications. SFIOL will be the only choice in eyes that have anatomic contraindications like non constricting pupil, large sectoral iridectomy and peripheral anterior synechia in which other types of lens are not suitable.Nepal J Ophthalmol 2016; 8(15): 41-46 

scholarly journals Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation

2012 ◽  
Vol 1 (2) ◽  
pp. 128-130
Author(s):  
Tova Lifshitz ◽  
Jaime Levy ◽  
Anry Pitchkhadze
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Cylinder Power ◽  
Best Corrected Visual Acuity

ABSTRACT We present the case of a 73-year-old patient who underwent successful phacoemulsification and toric intraocular lens (IOL) implantation to correct high stable astigmatism due to keratoconus and cataract. Preoperative refraction was −3.25 −4.0 × 98°. A toric IOL (Acrysof SN60T6) with a spherical power of 16.5 D and a cylinder power of 3.75 D at the IOL plane and 2.57 D at the corneal plane was implanted and aligned at an axis of 0°. Uncorrected visual acuity improved from 6/60 to 6/10. Postoperative best corrected visual acuity was 6/6, 6 months after the operation. In conclusion, phacoemulsification with toric IOL implantation can be performed in eyes with keratoconus and cataract. How to cite this article Levy J, Pitchkhadze A, Lifshitz T. Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation. Int J Kerat Ect Cor Dis 2012;1(2):128-130.

scholarly journals Study of patients with Pseudoexfoliation syndrome undergoing cataract surgery

2021 ◽  
Vol 7 (2) ◽  
pp. 184-189
Author(s):  
G Srinivasan ◽  
Deepa R
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Pseudoexfoliation Syndrome ◽  
Posterior Capsular Opacification ◽  
Pupillary Dilatation ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

To analyze the visual outcome in patients with pseudoexfoliation and to know the surgical parameters to cogitate in patients with pseudoexfoliation syndrome. An Observational study which was conducted in the Ophthalmology department in a tertiary care hospital in a rural area from June 2019 to December 2019. A total of 52 eyes of 52 patients aged 40 years and above, of either sex, clinically diagnosed with senile cataract and associated with pseudoexfoliation were enrolled in the study. After assessing best corrected visual acuity (BCVA), a detailed anterior and posterior segment examination was performed along with lacrimal sac syringing, manual keratometry, contact A-scan biometry and intraocular lens (IOL) power was calculated. All patients underwent manual small incision cataract surgery under peribulbar anaesthesia and intraocular lens was implanted. Intraoperative complications were noted during the surgery and was reported .Best corrected visual acuity was recorded on day 1, at 1week and at 1 month of follow up. Out of 52eyes of 52 patients, 29 were females (55.76%) and 38 eyes (73.07%) exhibited bilateral involvement. Distribution of the PXF material in various ocular structures was observed and majority of them (36.53%) had PXF material equally in iris, pupillary margin and lens. Based on the morphology of cataract associated with psudoexfoliation, nuclear cataract was the most commonly observed in 16 eyes (30.76%) and 42 eyes (80.76%) had moderate pupillary dilatation. The intraoperative difficulties observed during cataract surgery was poor pupillary dilatation which was managed by controlled sphincterotomy during the surgery in 3 eyes (5.76%), Iridiodialysis, rhexis extension, zonular dialysis each in 1 eye and posterior capsular rent in 2 eyes. Around 92.30% of the total study population achieved post-operative BCVA of 6/12 or better at 1month of follow up. Decreased visual acuity was noted in 2 (3.84%) eyes due to persistent corneal edema, one eye (1.92%) had posterior capsular opacification and one eye (1.92%) had cystoid macular edema. This study concludes that with careful preoperative assessment and necessary intraoperative precautions, good visual outcome can be achieved in patients with cataract with pseudoexfoliation.

First Postoperative Day Visual Outcome Following 6 mm Manual Small Incision Cataract Surgery Using Intratunnel Phacofracture Technique

2014 ◽  
Vol 07 (01) ◽  
pp. 26 ◽  
Author(s):  
Sudhir Singh ◽  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Low Cost ◽  
Visual Outcome ◽  
Cataract Extraction ◽  
Research Centre ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Uncorrected Visual Acuity ◽  
Cataract Patients

Object:To study first postoperative day visual outcome following 6 mm manual small incision cataract surgery (MSICS) using intratunnel phacofracture technique.Design:Retrospective design.Setting:Tertiary eye care centre.Participants:A total of 216 patients who underwent MSICS performed by a single surgeon at the JW Global Hospital & Research Centre, Mount Abu, India from April 2012 to March 2013. Cataract patients with any other ocular comorbidity were not included. One hundred and thirty-six cataract patients (72 male/64 female) with a mean age of 59.75 years (range 40–80 years) were included in the study. All surgeries were performed by a single surgeon using the 6 mm MSICS intratunnel phacofracture technique.Outcome measures:The first postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and rates and types of complications were recorded.Results:A total of 136 surgeries were performed using the 6 mm MSICS intratunnel phacofracture technique. All the surgeries were performed by a single experienced surgeon. The mean UCVA and mean BCVA at first postoperative day were 0.367 (Snellen equivalent 20/46) and 0.226 (Snellen equivalent 20/33) log MAR units, respectively. No serious peri- and postoperative complications were encountered.Conclusions:The 6 mm MSICS is a safe, fast, and low-cost cataract extraction technique. It is an effective alternate to costly phacoemulsification.

Outcomes of refractive error correction in pseudophakic patients using a sulcus piggyback intraocular lens

2020 ◽  
pp. 112067212090356
Author(s):  
Eliya Levinger ◽  
Michael Mimouni ◽  
Yaron Finkelman ◽  
Yossi Yatziv ◽  
Jonathan Shahar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity

Purpose: The purpose of this study was to assess the results of a sulcus intraocular lens (Sulcoflex) for pseudophakic refractive errors following phacoemulsification cataract surgery. Methods: This retrospective clinical observational cohort study included consecutive eyes in which a Sulcoflex was implanted. Uncorrected distance visual acuity and corrected distance visual acuity as well as refractive outcomes were assessed. The minimum follow-up time required for inclusion was 3 months. Results: In total, 15 eyes ( n = 15) were evaluated. The mean follow-up was 14 months (range: 3–18 months). The Sulcoflex aspheric (653L) was implanted in 13 eyes and the Sulcoflex toric (653T) in two eyes. The preoperative mean logMAR (Snellen) uncorrected distance visual acuity and corrected distance visual acuity were 0.88 (20/150) and 0.27 (20/40), respectively. The postoperative mean logMAR (Snellen) corrected distance visual acuity was 0.15 (20/30). The preoperative mean spherical equivalent was −0.22 ± 5.95 D and the postoperative mean spherical equivalent was −1.59 ± 1.45 D. There was a significant and strong correlation ( r = 0.64, p < 0.001) between the attempted and the achieved spherical equivalent. Conclusion: The Sulcoflex is a safe and viable option for patients with residual refractive error following cataract surgery.

scholarly journals Demographic pattern, clinical profile and visual outcome of patients with optic neuritis in a tertiary level eye care center of eastern Nepal

2014 ◽  
Vol 11 (3) ◽  
pp. 250-253
Author(s):  
BG Shrestha ◽  
M Sharma ◽  
P Lavaju ◽  
SM Pokharel ◽  
N Agrawal ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Care Center ◽  
Visual Outcome ◽  
Clinical Profile ◽  
Response To Treatment ◽  
Female Ratio ◽  
History Of ◽  
Intravenous Steroids ◽  
Time Of Presentation

Introduction: Optic neuritis is one of the common causes of sudden visual impairment. Early diagnosis and treatment with intravenous steroids can hasten visual recovery. Objective: To analyze the demographic pattern, clinical profile, and response to treatment with pulse methylprednisolone in patients presenting with optic neuritis. Methods: A hospital based retrospective analysis of records of patients with optic neuritis presenting at BPKIHS between April 2010 to February 2012 was carried out. Demographic pattern, clinical profile and visual outcome at the time of presentation and discharge were recorded. Results: Thirty-five patients (44 eyes) presented with optic neuritis. A total of 33 eyes (75%) had papillitis and 11 eyes (25%) had retrobulbar optic neuritis. Male to female ratio was 2.18:1. The mean age at presentation was 31.20 ± 17.07 years. Diminution of vision was the commonest mode of presentation. Bilateral involvement was seen in 9 patients (25.71%). The 38 eyes (86.36%) had abnormal pupillary reaction. Eight patients (22.85%) had preceeding history of trauma, 1 (2.85%) had ethmoidal sinusitis and 1 (2.85%) otitis media. At the time of discharge 32 eyes (72.7%) showed recovery in visual acuity after pulse I.V. methylprednisolone therapy. Duration at presentation, visual acuity at presentation and diagnosis did not affect the final visual outcome (p=0.486, p=0.162 and p=0.122 respectively). Conclusion: Majority of patients presented with papillitis of idiopathic origin. Most of the cases were unilateral. Most patients with visual acuity of at least perception of light or better at the time of presentation improved after pulse I.V. methylprednisolone therapy. DOI: http://dx.doi.org/10.3126/hren.v11i3.9641 Health Renaissance 2013;11(3):250-253

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