scholarly journals Application of 14-MHz Ultrasonography with Tissue Harmonic Imaging to Determine Posterior Capsule Integrity in Traumatic Cataract

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Bin Wu ◽  
Qingyu Li ◽  
Yangchen Liu ◽  
Di Wu ◽  
Jianmin Gao ◽  
...  

Purpose. To report the application of 14-MHz ultrasonography with tissue harmonic imaging (14 MHz + THI) to determine the integrity of the posterior capsule (PC) in traumatic cataract (TC). Methods. Patients with TC who were scheduled to undergo cataract extraction and whose PC could not be observed by slit lamp examination were included in the study. The status of the PC was determined by 14 MHz + THI before cataract extraction and confirmed during surgery. The results regarding PC integrity obtained from 14 MHz + THI and intraoperative direct observation were compared. Result. The study enrolled 52 eyes of 52 patients (49 men and 3 women), with a mean age of 42.15 years ± 11.23 (SD). The nature of the trauma was blunt (3 eyes) or sharp (49 eyes). The 14 MHz + THI method showed 21 PCs to be intact and 31 to have ruptured before cataract surgery. During surgery, 23 PCs were observed to be intact, while 29 PCs were ruptured. 27 PCs were ruptured and 19 were intact, as determined by the two methods. The 14 MHz + THI observations were consistent with the intraoperative observations of the PC (kappa = 0.764), with no significant difference between the two methods (P=0.687). The sensitivity, specificity, and accuracy of 14 MHz + THI for observation of the PC were 93.10%, 82.60%, and 88.46%, respectively. Conclusion. The 14 MHz + THI method can accurately reveal the integrity of the PC in TC. It has important clinical value in the selection of cataract surgery methods and the prediction of complications during TC surgery.

2019 ◽  
Vol 43 (1) ◽  
pp. 50
Author(s):  
Aquirina Caesari Putri ◽  
Rozalina Loebis

Background: Pediatric cataracts are major causes of children’s blindness. Surgery has proven to be beneficial in terms of visual function prognosis. Contrast sensitivity evaluation after surgery is as important as visual acuity considering that natural world consists of various objects in low-to-medium contrasts. The purpose of this study is to analyze the difference of contrast sensitivity outcomes based on ages at surgery. Method: Retrospective data of children with pediatric developmental cataract from July 2013 to November 2015 were collected. All children who underwent cataract surgery at 60-months-old or less were randomized into two groups, ≤24 months and >24-to-60 months. Contrast sensitivity was then examined with preferential-looking method using Hiding Heidi low-contrast test face chart. The main outcome measures were contrast sensitivity of both groups. Age-at-evaluation, cataract onset, duration of follow-up, duration of deprivation and visual acuity were also noted. Result: Of 14 children (23 eyes), 11 eyes (47,8%) were in ≤24 months group, 12eyes (52,2%) were in >24-to-60 months group. All eyes underwent cataract extraction and similar type of intraocular lens implantation. Mean age-at-surgery was 28,2 months±16,8 (SD). Mean contrast sensitivity for each group was 47,50 %±42,29 and 18,33%±27,38, respectively, with p-value 0,031. Further analysis of Spearman’s correlation test demonstrated significant negative correlation (rs = -0,559; p = 0,006) between the two groups. Conclusion: There was statistically significant difference in contrast sensitivity between those who underwent surgery at ≤24 months and >24-to-60 months. Children who underwent surgery at older ages tend to have better contrast sensitivity afterwards.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Yawen Guo ◽  
Chengzhe Lu ◽  
Bin Wu ◽  
Jianmin Gao ◽  
Jun Li ◽  
...  

Purpose. To report the application of 25 MHz B-scan ultrasonography (MHzB) to determine the integrity of the posterior capsule (PC) in posterior polar cataract (PPC). Methods. Patients with whom PPC was clinically diagnosed using slit lamp microscopy who underwent 25 MHzB before phacoemulsification were retrospectively reviewed. The status of the PC was determined by 25 MHzB before phacoemulsification and confirmed during cataract surgery. Results. In total, 21 eyes in 14 clinically diagnosed PPC patients were enrolled in this study. Out of 25 MHzB images, 19 PCs were found to be intact, while 2 showed dehiscence before cataract surgery. During phacoemulsification, 17 PCs were observed to be intact, while 4 PCs showed posterior capsule rupture (PCR). These 4 PCR cases included the above 2 eyes, in which preexisting dehiscence was detected by 25 MHzB. The other 2 PCR cases showed high reflectivity between high echoes in posterior opacities and the PC, indicating synechia between the PPC and PC. Conclusion. This is the first report to show that 25 MHzB can be used to clearly visualize the status of the PC in PPC. These results, in turn, could be used to select the appropriate treatment and to thereby avoid further complications during PPC surgery.


2021 ◽  
pp. 112067212110483
Author(s):  
Romolo Appolloni ◽  
Pasquale Viggiano ◽  
Maria Luisa Carrella ◽  
Federica Evangelista ◽  
Alessandro Appolloni ◽  
...  

Purpose: To report potential choroidal changes in eyes undergoing femtosecond laser cataract surgery (FLACS) and phacoemulsification surgery (PCS) by OCT. Methods: The patients were images by means Spectral Domain OCT imaging with EDI technology which may obtain OCT image. We exported a single EDI-OCT scan passing through the fovea and then it was imported into ImageJ program to perform a quantitative analysis. Main outcome measures: The main outcome measures were: (i) sub foveal choroidal thickness (SFCT); (ii) the choroidal vascularity index (CVI); and (iii) central retinal thickness (CRT). Results: At postoperative 1 week, FLACS group showed an increased CRT (241.2 ± 31.6–245.5 ± 36.4 µm; p = 0.016). Likewise, CVI and SFCT exhibited a slight increase but no statistically differences were highlighted ( p > 0.05). At the follow-up visit of 1 month, all OCT parameters did not display any significant difference ( p > 0.05). At post-operative 1 week, the PCS group displayed a significant increase in CRT, SFCT, and CVI. On the contrary, at the follow-up visit of 1-month, all choroidal parameters were characterized by a no statistically significant reduction ( p > 0.05). Conclusions: Our study exhibited a significant increase in CT and CVI in eyes that underwent conventional cataract surgery. Femtosecond laser-assisted cataract extraction did not result in macular change due to less postoperative inflammation.


1998 ◽  
Vol 8 (1) ◽  
pp. 12-15 ◽  
Author(s):  
B.M. Hosal ◽  
O. Tekeli ◽  
E. Gürsel

Purpose. To estimate the incidence and the factors that may play a role in the etiology of eyelid malpositions after cataract extraction. Methods. We followed up 124 patients for six months after cataract extraction. Palpebral aperture, levator function, height of the upper lid crease, lower eyelid laxity and position of the punctums were recorded preoperatively and postoperatively. Post-cataract ptosis was defined as a 2 mm or greater drop in the lid margin after correcting for any change in the fellow eye. Results. None of the patients developed ectropion or entropion, but five (4%) developed punctal ectropion after surgery. The incidence of post-cataract ptosis was 7.3% at six months. Age, sex, preoperative measurements of levator function, lid crease and dermatochalasis were not predictive for the development of ptosis at six months. However, there was a significant difference in the preoperative palpebral fissure width between the patients with ptosis and those without (p<0.05). There was a positive correlation between the mean volume of local anesthetic and the degree of ptosis on the first postoperative day (p<0.05, r: 0.1873). The presence and amount of ptosis on the first postoperative day was the best predictor of post-cataract ptosis at six months (p<0.001). Conclusions. Several factors are involved in the development of post-cataract ptosis. Temporary ptosis may be related to the myotoxicity of the local anesthetic. The presence of ptosis on the first postoperative day is the best predictor for the development of ptosis at six months.


2018 ◽  
Vol 28 (6) ◽  
pp. 639-644 ◽  
Author(s):  
John Koshy ◽  
Nino Hirnschall ◽  
Ashok Kumar V Vyas ◽  
R Narendran ◽  
Alja Crnej ◽  
...  

Purpose: To evaluate the capsular bag performance and posterior capsule opacification development of two intraocular lenses differing in material and design. Methods: This study included patients who were scheduled for cataract surgery and compared a hydrophilic intraocular lens (Super flex® intraocular lens; Rayner Surgical, Worthing, UK) with a hydrophobic intraocular lens (AcrySof® SA60AT; Alcon, Fort Worth, TX, USA). Follow-ups were performed 1 month and 2 years after cataract surgery, including a slit lamp examination and retroillumination images. Results: In total, 80 eyes of 80 patients were recruited. At the 1-month follow-up, 6 of 39 cases had a gap between the posterior lens capsule and intraocular lens (1 case in the hydrophilic intraocular lens group and 5 cases in the hydrophobic intraocular lens group; p = 0.348). Objective and subjective posterior capsule opacification scoring showed no statistically significant difference between both groups (p = 0.123). Conclusion: Both intraocular lens showed a good capsular bag performance and a relatively low posterior capsule opacification development within the first 2 years after surgery.


Author(s):  
Argyrios Tzamalis ◽  
Myron Kynigopoulos ◽  
Grigoris Pallas ◽  
Ioannis Tsinopoulos ◽  
Nikolaos Ziakas

Purpose: To evaluate the effect of asphericity and blue light filter (BLF) of three different intraocular lenses (IOLs) on the visual performance, second- and third-order aberrations (defocus, coma, trefoil), and contrast sensitivity after uneventful cataract surgery. Methods: One hundred and twenty eyes of 60 patients with clinically significant cataract were randomly assigned to receive one of the three IOL types: Bioline Yellow Accurate (aspheric, with BLF, i-medical, Germany), BioAcryl 60125 (spherical, without BLF, Biotech, France), and H65C/N (aspheric, without BLF, PhysIOL, Belgium). Each IOL was implanted in 40 eyes. Complete ophthalmologic examination, functional acuity contrast testing and wavefront analysis were performed 60 days postoperatively. Results: The mean postoperative best-corrected visual acuity (BCVA) was 0.95 ± 0.08, not differing statistically among the IOL groups (P = 0.83). Mean defocus and coma values did not yield any statistically significant difference through the IOL groups varying from –0.784 to –0.614 μm and 0.129 to 0.198 μm (P = 0.79 and 0.34, respectively). Bioline Yellow Accurate IOL presented less trefoil aberrations, 0.108 ± 0.05 μm, compared to the other two IOL types (BioAcryl [0.206 ± 0.19 μm] and Physiol [0.193 ± 0.17 μm], P < 0.05). Contrast sensitivity values did not differ among the groups under all lighting conditions. Bioline Yellow IOL showed a statistically higher loss of contrast sensitivity (between mesopic and mesopic with glare conditions) compared to the BioAcryl and PhysIOL in 12 and 3 cpd spatial frequencies, respectively (P < 0.05). Conclusion: Bioline Yellow IOL indicated lower contrast sensitivity under mesopic conditions when glare was applied but resulted in less trefoil aberrations after uneventful cataract surgery. No further differences were noted in postoperative visual performance among three IOL groups.


2019 ◽  
Vol 26 (08) ◽  
pp. 1365-1369 ◽  
Author(s):  
Khawaja Abdul Hamid ◽  
Shaista Habibullah

Cataract extraction is one of the commonest surgical procedures in Ophthalmology globally. Extracapsular cataract extraction ECCE), through a small incision (SICS), with insertion of an intraocular lens has been the most widely used method from 1990s until recently. Technological advances have led to the increasing use of phacoemulsification (PE) to emulsify and remove the lens. The technique requires a smaller incision, but requires substantial capital investment in theatre equipment. In this we compared the visual outcomes of patients undergoing both surgical techniques at a public sector hospital in Mirpur. Study Design: Single-center retrospective cohort study. Setting: Department of Ophthalmology, Divisional Headquarters Hospital, New Mirpur, AJK. Period: Cataract surgery cases from January 2018 to February 2019. Materials and Methods: 196 patients with age related cataract were included in the SICS group and 115 in the phacoemulsification group. The main comparative outcome was uncorrected visual acuity 4 weeks after surgery. Results: In this study, it was found that the primary post-operative visual outcome for small incision cataract surgery and phacoemulsification was comparable in terms of uncorrected visual acuity. No statistically significant difference was found in the proportions of SICS and phacoemulsification groups when compared for UCVA of 6/9 or better, 6/60 or better and 6/60 and worse.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bin Wu ◽  
Xiaoyong Yuan ◽  
Song Chen

Abstract Background To compare the accuracy of low-frequency ultrasound biomicroscopy (LFUBM) and 14-MHz ultrasonography with tissue harmonic imaging (14-MHz + THI) in the assessment of posterior capsule (PC) integrity in patients with traumatic cataracts (TCs). Methods From January 2019 to October 2020, 51 patients (51 eyes) with TCs who were scheduled for cataract extraction and for whom the PC of the lens could not be observed by the slit lamp visited Tianjin Eye Hospital, including 47 patients (47 eyes) with a penetrating injury of the eyeball and 4 patients (4 eyes) with a blunt injury of the eyeball. All eyes underwent LFUBM and 14-MHz + THI examinations before cataract extraction to determine the integrity of the PC. The integrity of the PC observed in surgery was the actual findings, and the consistency between the 2 methods was assessed in terms of the preoperative examination and intraoperative findings. Fisher’s exact test was used for consistency analysis, and P < 0.05 was considered statistically significant. Results Thirty-two eyes with ruptured PCs and 19 eyes with intact PCs were actual findings in surgery. Thirty eyes with ruptured PCs and 21 eyes with intact PCs were examined by LFUBM. Thirty-two eyes with ruptured PCs and 19 eyes with intact PCs were examined by 14-MHz + THI. There were no significant differences between the 2 methods and the intraoperative findings (P = 0.293 LFUBM, P = 0.623 14-MHz + THI). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LFUBM and 14-MHz + THI were 91 and 94%, 95 and 89%, 97 and 94%, 86 and 89% and 92 and 92%, respectively. Conclusions Both LFUBM and 14-MHz + THI were proved to have high levels sensitivity and specificity in diagnosing the status of the PC in TC and they can be used as accurate diagnostic tool in these cases.


Author(s):  
Olivia Esteban ◽  
Javier Mateo ◽  
Paula Casas ◽  
Javier Lara ◽  
Javier Ascaso

Because of the application of vitreoretinal surgical techniques to a broader range of posterior segment diseases and because cataract develops frequently in postvitrectomy eyes, cataract surgeons should be familiar with the challenges of cataract extraction in vitrectomized eyes. Cataract surgery after pars plana vitrectomy significantly improves visual acuity in 85% of cases, limited by retinal comorbidity and surgical complications. However, despite recent advances, this surgery remains a special challenge. The cataract surgeon can prepare for these challenges with awareness of such potential factors as an excessively mobile posterior capsule, silicon oil removal and special considerations concerning intraocular lens selection and power calculation. And consider the postoperative complications as posterior capsule opacification or refractive errors.


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