scholarly journals Refractive Lens Exchange Combined with Primary Posterior Vitrectorhexis in Highly Myopic Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Tarek A. Mohamed ◽  
Wael Soliman ◽  
Dalia M. EL Sebaity ◽  
Ahmed M. Fathalla

Purpose. To evaluate efficacy and safety of primary vitrectorhexis for posterior capsulotomy in highly myopic patients undergoing refractive lens exchange. Methods. The study is a prospective nonrandomized interventional study. The study comprised 60 eyes of 60 myopic patients. All patients underwent refractive lens exchange (RLE) and foldable IOL implantation combined with primary posterior capsulotomy. We used a 23-gauge vitrectomy probe for the creation of the posterior capsule opening. We followed the patients for one year. Results. During surgery, the IOLs remained well centered in the capsular bag after creation of the capsulotomy. Postoperatively, we did not report any complications related to lens centration or changes in the posterior capsulotomy size. No eye required YAG laser posterior capsulotomy and no cases of retinal detachment (RD) occurred during the follow-up period. Conclusion. Primary posterior vitrectorhexis during RLE is an efficient method in preventing the occurrence of posterior capsular opacification (PCO) and the need for YAG laser posterior capsulotomy with its possible complications.

Vision ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 8
Author(s):  
Diego de Ortueta

Purpose: We evaluated the refractive visual outcomes and efficacy of Transepithelial Photorefractive Keratectomy (TransPRK) using Smart Pulse Technology with static and dynamic cyclotorsion and the AMARIS 1050 Hz RS laser platform from Schwind in the eyes after a refractive lens exchange. Setting/Venue: Aurelios Augenlaserzentrum, Recklinghausen. Methods: We retrospectively evaluated the data of 552 consecutive eyes treated with refractive lens exchange between 2016 and 2019. A total of 47 eyes (8.5%) required a touch up after the clear lens exchange. From 43 eyes of 43 patients, we obtained a minimum follow up of 3 months. In all cases, we performed a TransPRK with a minimum optical zone of 7.2 mm, centering the ablation on the vertex of the cornea. Results: The average age of the treated eyes was 57 years old, with a range between 48 and 68 years. The mean treated sphere was 0.42 diopters (D), with a range between −1.0 and +1.75 D. The mean astigmatism was 1.06 D. Postoperatively, after laser vision correction, we reduced the sphere to a mean of 0.11 D (range −0.5 to +0.75 D), and, postoperatively, the mean astigmatism was 0.25 D (range −0.75 to 0 D). The predictability for a spheric equivalent (SEQ) of 0.5 D was 91%, and for 1 D it was 100% of the cases. No eye lost more than one Snellen line. Conclusions: TransPRK with smart pulse was predictable for correcting ametropia after Clear Lens Surgery.


2020 ◽  
Vol 10 (6) ◽  
pp. 2190 ◽  
Author(s):  
Bojan Pajic ◽  
Pavel Zakharov ◽  
Brigitte Pajic-Eggspuehler ◽  
Zeljka Cvejic

A prospective feasibility study was conducted to determine whether a new wearable device, the Visual Behavior Monitor (VBM), was easy to use and did not present any difficulties with the daily activities of patients. Patients for cataract surgery and refractive lens exchange were randomly selected and screened for inclusion in the study. A total of 129 patients were included in the study as part of a multicenter study. All measurements were performed before surgery. Upon inclusion, patients were trained to wear the device, instructed to wear it for a minimum of 36 h, and were scheduled to return in one week. The VBM measures the distance at which patients’ visual activities are performed, the level of illumination, and head translational and rotational movements along the three axes. On the follow-up visit, patients completed a questionnaire about their experience in wearing the device. All patients underwent standard diagnostic testing, with their cataract grade determined by the Lens Opacities Classification System (LOCS) classification. Results indicate that 87% of patients felt comfortable using the wearable device while 8% of patients responded as not feeling comfortable (5% of patients did not respond to the question). In addition, 91% of patients found it easy to attach the wearable to the magnetic clip while 4% of patients did not find it easy, and 5% of patients did not respond. Overall, patients found the device easy to use, with most reporting that the device was not intrusive.


2021 ◽  
Author(s):  
Honglei Li ◽  
Huiran Bai ◽  
Dongle Liu ◽  
Yanfeng Han ◽  
Xiaoming Wu

Abstract Purpose Herein, we elucidated the effect of anterior capsule polishing (ACP) during cataract surgery on the rate of neodymium: YAG (Nd: YAG) laser capsulotomy in multifocal intraocular lens (MIOL). Methods We extracted the medical records of patients who underwent phacoemulsification with MIOL between May 2016 and April 2017 from the files of the patients, and the follow-ups of fewer than 3 years were excluded. The participants were divided into the ACP group and the non- ACP group based on whether the anterior capsule was polished. The primary outcome was whether to perform Nd: YAG capsulotomy during the follow-up. We analyzed the time from IOL implantation to Nd: YAG laser capsulotomy using the Kaplan-Meier survival curves. Results The ACP group comprised 70 eyes and non-ACP group, 60 eyes. One year postoperatively, 7.14% of the eyes in the ACP group and 8.33% in the non-ACP group required Nd: YAG laser capsulotomy (P > 0.99). After 2 years, it was 24.29% and 18.33%, respectively (P = 0.52). After 3 years, it was 30.0% and 28.33% respectively (P = 0.85). There was no distinct difference in the probability for Nd: YAG laser between the ACP group and the non-ACP group evaluated using Kaplan-Meier survival curves (P = 0.81). Patients with implantation of diffractive MIOL (AT LISA tri 839MP) had a high probability of requiring Nd: YAG laser capsulotomy. Conclusion Polishing the anterior capsule had no remarkable effect on reducing the rate of Nd: YAG laser capsulotomy after phacoemulsification in MIOL.


2020 ◽  
Vol Volume 16 ◽  
pp. 1125-1137
Author(s):  
Cristina Ariadna Nicula ◽  
Raluca Popescu ◽  
Anca Maria Rednik ◽  
Dorin Nicula ◽  
Adriana Elena Bulboaca ◽  
...  

2019 ◽  
Vol 30 (1) ◽  
pp. 224-228
Author(s):  
Wael Soliman ◽  
Tarek A Mohamed ◽  
Khaled Abdelazeem ◽  
Mohamed Sharaf

Aim: The aim of this study was to study the safety and efficacy of posterior capsulorhexis in vitrectomized eyes undergoing combined phacoemulsification or irrigation/aspiration and silicone oil removal. Methods: This prospective non-randomized interventional study involved 115 silicone-filled eyes of 115 previously vitrectomized patients. All patients underwent combined phacoemulsification or underwent irrigation/aspiration and silicone oil removal, followed by foldable intraocular lens implantation combined with primary posterior trans-scleral capsulorhexis. A 23-gauge trans-scleral vitrectomy probe was used to form the posterior capsulorhexis (vitrectorhexis). Patients were followed for 6 months. Results: Intraocular lenses maintained good centration in the capsular bag during and after trans-scleral posterior capsulorhexis. No complications were observed in the postoperative period regarding lens centration or size of the posterior capsulorhexis. No included eyes needed YAG laser posterior capsulotomy and no recurrent retinal detachment was reported during follow-up. Conclusion: Performing primary trans-scleral capsulorhexis in patients undergoing combined phacoemulsification, or irrigation/aspiration and silicone oil removal, enabled achievement of an early postoperative clear visual axis and prevented the onset of dense postoperative posterior capsular opacification in previously silicone-filled eyes. This technique is reproducible and may facilitate additional intra-operative procedures and uncomplicated postoperative follow-up of retinal detachment patients without requiring YAG laser capsulotomy.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
A. M. Sherif ◽  
M. A. Ammar ◽  
Y. S. Mostafa ◽  
S. A. Gamal Eldin ◽  
A. A. Osman

Purpose.To evaluate effectiveness of simultaneous topography-guided photorefractive keratectomy and corneal collagen cross-linking in mild and moderate keratoconus.Methods. Prospective nonrandomized interventional study including 20 eyes of 14 patients with grade 1-2 keratoconus that underwent topography-guided PRK using a Custom Ablation Transition Zone (CATz) profile with 0.02% MMC application immediately followed by standard 3 mw/cm2UVA collagen cross-linking. Maximum ablation depth did not exceed 58 μm. Follow-up period: 12 months.Results.Progressive statistically significant improvement of UCVA from0.83±0.37logMAR preoperative, reaching0.25±0.26logMAR at 12 months (P<0.001). Preoperative BCVA (0.27±0.31logMAR) showed a progressive improvement reaching0.08±0.12logMAR at 12 months (P=0.02). MeanKmax reduced from48.9±2.8to45.4±3.1 D at 12 months (P<0.001), meanKmin reduced from45.9±2.8 D to44.1±3.2 D at 12 months (P<0.003), mean keratometric asymmetry reduced from3.01±2.03 D to1.25±1.2 D at 12 months (P<0.001). The safety index was 1.39 at 12 months and efficacy index 0.97 at 12 months.Conclusion. Combined topography-guided PRK and corneal collagen cross-linking are a safe and effective option in the management of mild and moderate keratoconus.Precis. To our knowledge, this is the first published study on the use of the CATz ablation system on the Nidek Quest excimer laser platform combined with conventional cross-linking in the management of mild keratoconus.


2018 ◽  
Vol 16 (4) ◽  
pp. 109-112
Author(s):  
Muhammad Adnan Khan ◽  
Muhammad Tariq Khan ◽  
Ashfaq Ur Rehman ◽  
Mohammad Idris ◽  
Muhammad Ayub Khan

Background: Posterior capsular opacification (PCO) is the most frequent complication of cataract surgery. The objective of this study was to determine the frequency of acute rise of intraocular pressure (IOP) following Neodymium-Yttrium Aluminum Garnet (Nd:Yag) laser posterior capsulotomy. Materials & Methods: This cross-sectional study was conducted in the Department of Ophthalmology, HMC, Peshawar, Pakistan, from July-December 2016. Sample size was 325 selected by consecutive sampling technique. Inclusion criteria were all patients having significant PCO after uneventful cataract surgery with intra ocular lens implant. Demographic variables were sex, age groups and age in years. Research variable was presence of acute rise of IOP following Yag laser capsulotomy. Pre-laser assessment included slit lamp examination and recording of IOP with Goldmann applanation tonometer by a single ophthalmologist. IOP was measured 3 hours after Nd: Yag laser capsulotomy. Rise in IOP was labeled when IOP was ≥5 mmhg from baseline. Mean ±SD was used to express quantitative variables like age. Categorical variables were analyzed as frequency and percentage. Goodness-of-fit was applied to compare the frequency of acute rise in IOP between sample and population. SPSS-20 was used for data entry and its analysis. Results: Out of 325 patients, 170(52.3%) were men and 155(47.7%) were women. The mean age of the sample was 44.92 ±23.843 years. A total of 107(32.9%) patients were 20-39 years old whereas 218(67.1%) were 40-70 years. IOP was raised in 61 (18.8%) patients while in 264(81.2%) patients it was not raised. The frequency of acute rise in IOP after Yag laser capsulotomy was significantly different in sample compared to population. Conclusion: Men were more than women, especially of old age. The frequency of acute rise in IOP after Yag laser capsulotomy was significantly different in sample compared to population.


Author(s):  
Philipp B. Baenninger ◽  
Janosch Rinert ◽  
Lucas M. Bachmann ◽  
Katja C. Iselin ◽  
Frantisek Sanak ◽  
...  

Abstract Purpose To assess the preoperative objective angle alpha and angle kappa measurements of patients deciding to undergo multifocal refractive lens surgery based on a subjective positive multifocal contact lens test (MCLT). Methods Retrospective, consecutive case series. Alpha and kappa angles were measured using the iTrace aberrometer. All patients also performed a 1-week MCLT. Only patients with a positive MCLT underwent surgery. Visual outcome (UCVA) was obtained in the 1-year follow-up. We assessed the preoperative distribution of angle values within MCLT positive and negative patient groups. Results Two hundred seventeen eyes (111 patients) were included. Mean age was 56.4 years (SD 5.6) and 46.9% were female. In 71 eyes (38 patients), MCLT was positive. Of them, 12 eyes (17%) had an angle alpha and angle kappa ≥ 0.5mm. Of 146 eyes (73 patients) who refrained from surgery due to a negative MCLT, 71 eyes (48.6%) had both angles small (<0.5mm). In the 1-year follow-up, UCVA improved by 0.68 logMAR (SD 0.51; p<0.001) from baseline. Eyes with both small angle alpha and kappa sizes improved by 0.78 logMAR (SD 0.56), as did eyes with high (≥0.5mm) angle sizes (0.82 logMAR (SD 0.53). UCVA of eyes (n=24) with high alpha but low kappa sizes improved less (−0.31 logMAR (SD 0.13; p=0.019)). Conclusion Four out of five patients with a positive MCLT also had correspondingly small angle values. One-half of patients with low preoperative angle values refrained from surgery due to a negative MCLT result. One-year visual acuity improvement was substantial and independent from angle sizes.


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