scholarly journals Visual Acuity Outcomes after Phacoemulsification in Eyes with Good Visual Acuity before Cataract Surgery

2021 ◽  
Author(s):  
Nikolaos Dervenis ◽  
Anna Praidou ◽  
Panagiotis Dervenis ◽  
Dimitrios Chiras ◽  
Brian Little
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Exclusion Criteria ◽  
Related Factors ◽  
Postoperative Visual Acuity ◽  
Good Visual Acuity ◽  
Snellen Visual Acuity ◽  
Vitreous Loss ◽  
Surgery Outcomes

Abstract Objective: To analyze cataract surgery outcomes and related factors in eyes presenting with good visual acuity. Subject and Methods: Retrospective longitudinal of patients undergoing phacoemulsification between the years 2014-2018 in Moorfields Eye Hospital and satellite units. Pre- and postoperative visual acuity (unaided, with glasses, with pinhole) were analyzed. Inclusion criteria were age≥40 years and pinhole visual acuity ≥6/9 preoperatively. Exclusion criteria were no postoperative visual acuity data. VA change variable was also defined according to postoperative visual acuity being above or below the Snellen 6/9 threshold. Results: 2720 eyes were included in the analysis. The unaided LogMAR visual acuity improved from 0.54 to 0.20 (p<0.001), the LogMAR visual acuity with glasses improved from 0.35 to 0.05(p<0.001) and the LogMAR pinhole visual acuity improved from 0.17 to 0.13(p<0.001). 8.1% of patients had Snellen visual acuity <6/9 postoperatively. Mean follow up period was 23,6±9.9 days. In multivariate logistic regression, factors associated with visual acuity <6/9 postoperatively were: age [OR=0.96, 95% CI (0.95, 0.98), p<0.001], vitreous loss [OR=0.21, 95% CI (0.08, 0.56), p=0.002] and iris trauma [OR=0.28, 95% CI (0.10, 0.82) p=0.02]. No significant adverse events occurred. Conclusions: Visual acuity improved significantly overall in this group of patients, although at least 8.1% of them did not reach their pinhole preoperative visual acuity. Worse visual acuity outcomes were associated with increasing age, vitreous loss and iris trauma. The 6/9 vision threshold may not be able to accurately differentiate those who may benefit from cataract surgery and those who may not.

CLINICAL CHARACTERISTICS AND RESULTS OF CATARACT SURGERY IN THE SMALL PUPIL EYE BY PHACOEMUSIFICATION

2018 ◽  
pp. 79-82
Author(s):  
Van Minh Pham ◽  
Van Nam Phan ◽  
Thi Thu Nguyen
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Clinical Characteristics ◽  
Low Vision ◽  
Sample Selection ◽  
Posterior Chamber ◽  
Good Visual Acuity ◽  
Before And After ◽  
Grade Ii ◽  
Small Pupil

Objectives: To investigate the clinical characteristics of cataract patients with small pupils and to evaluate the result of cataract surgery on the eye have small pupils by phacotechnique. Subjects and methods: Descriptive study, prospective, uncontrolled interventions. Sample selection. The sample size of 70 patients with 70 eyes of cataracts with small pupils was treated by phaco technique and intraocular lens implant within posterior chamber. Follow up to 3 months. Results: 70 eyes, the percentage of men and women was not different from 54.2% (38 male) compared to 45.8% (32 female). The mean age was 80 ± 8.74, from 58 to 99 years. The disease was mainly found in the age group over 70 years old with over 80% (51.5%). Visual acuity before surgery was very poor under 3m CF (count finger) for 68.6% (48/70). Visual acuity over 1/10 was only a small amount with 2.8% (2 eyes). Pseudoexfoliation was the most common reason complications of mydriasis with 32/70 eyes (45.7%) and 22/70 eyes (31.4%) for age. The preoperative pupilarysizewas mostly small with 63/70 eyes (90.0%), non-dilated pupils (7/70 eyes) (10.0%). Average pupil size was 3.34 mm (2 - 4mm). Iris condition: iris atrophy 20/10 eyes (28.6%), iris synechiae 11/10 (15.7%), irregular iris muscle with 51, 4% and good iris muscle accounted for 48.6%. Grade of cataract: Grade III: 31/70 eyes (44.3%), Grade IV: 32/70 eyes (45.7%), Grade II: 5/70 eyes (7.1%) and V:2/70 eyes (2.9%). Pupil expander technique: OVD injection with 42/70 eyes (60%), using iris hook with 23/70 eyes (32.9%). Pupillary size before and after intervention has changed from 3.7mm to 4.48mm. Conclusions: Iris expander techniques have been shown to have good dilated pupils: 60.0% OVD injection, iris hook was 32.9%, other methods 7.1% One-week visibility of good visual acuity was higher than that of postoperative one day (12.2%) and increased at 1 month and 3 months (20.0%). Very good visual acuity was not available and low vision group was 1.4% after 3 months. Key words: cataract surgery; phacoemusification, small pupil

scholarly journals Outcomes of Femtosecond Laser Assisted Cataract Surgery Performed by Resident and Attending Surgeons

2021 ◽  
Vol 13 (01) ◽  
pp. e26-e31
Author(s):  
Spencer C. Cleland ◽  
Daniel W. Knoch ◽  
Jennifer C. Larson
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Retrospective Chart Review ◽  
Dissipated Energy ◽  
Independent Practice ◽  
Postoperative Visual Acuity ◽  
Included Patient ◽  
Duration Of Surgery ◽  
The Difference

Abstract Objective The study aimed to evaluate the safety and efficacy of resident surgeons performing femtosecond laser assisted cataract surgery (FLACS). Methods A retrospective chart review was conducted at the University of Wisconsin-Madison from postgraduate year four residents performing FLACS between 2017 and 2019. Data were also collected from residents performing manual cataract surgery, and attending surgeons performing FLACS for comparison. Recorded data included patient demographics, pre- and postoperative visual acuity, pre- and postoperative spherical equivalent, nuclear sclerotic cataract grade, ocular and systemic comorbidities, intraocular lens, duration of surgery, cumulative dissipated energy (CDE), and intraoperative and postoperative complications. Results A total of 90 cases were reviewed with 30 resident manual cases, 30 resident FLACS cases, and 30 attending FLACS cases. Resident manual (25.5 ± 6.8 minutes) and resident FLACS (17.5 ± 7.1 minutes) cases took a significantly longer time to complete compared with attending FLACS cases (13.6 ± 4.4 minutes; p < 0.001). There was higher CDE in resident FLACS and resident manual cases compared with attending FLACS cases, but the difference was not statistically significant (p = 0.06). Postoperative visual acuity was not statistically different at 1-day and 1-month after surgery among the three groups. Resident FLACS complications, which included one case requiring an intraoperative suture to close the wound, two cases with intraoperative corneal abrasions, two cases with postoperative ocular hypertension, and one case with cystoid macular edema, were not significantly greater than attending FLACS complications (p = 0.30). Conclusion The FLACS performed by resident surgeons had comparable visual acuity outcomes to FLACS performed by attending surgeons, and to manual cataract surgery performed by resident surgeons. However, resident FLACS cases took significantly longer time to complete, and they were associated with a higher CDE and minor complication rate compared with attending FLACS cases. Introducing advanced technologies into surgical training curricula improves resident preparedness for independent practice, and this study suggests FLACS can be incorporated safely and effectively into resident education.

The patient-reported outcome of age-related cataract using Catquest-8SF questionnaire

2020 ◽  
Vol 1 (3) ◽  
pp. 145-153
Author(s):  
Sheng-Xia Wang ◽  
◽  
Yun-Hong Du ◽  
Wen-Jing Liu ◽  
Ping Liu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Patient Reported Outcome ◽  
Chinese Version ◽  
Surgery Group ◽  
Age Related ◽  
Patient Reported ◽  
Degree Of Satisfaction ◽  
Improvement Score

AIM: To assess the patient-reported outcome of phacoemulsification with posterior chamber single focus foldable intraocular lens (SIOL) using the Chinese version of Catquest-8SF questionnaire (Catquest-8SF-CN), evaluate the applicability of Catquest-8SF scale in northern Chinese and its sensitivity to cataract surgery. METHODS: Prospective clinical case follow-up study. The patients were recruited from the Central Hospital of Tai’an and completed the Catquest-8SF questionnaire by face-to-face interviews before and 3mo after surgery at the hospital. RESULTS: A total of 120 cataract patients with median age 67.6y and 52.5% female completed the Catquest-8SF. The Cronbach’s α coefficient of the total scale, daily-activity sub-table and comprehensive-evaluation sub-table were 0.861, 0.853 and 0.748 respectively. There was a high level of consistency between two investigators. The cumulative contribution rate was 66.64% by using the principal component analysis and the maximum variance orthogonal rotation method. The preoperative score of the Catquest-8SF-CN had a significant negative correlation with preoperative binocular mean weighted visual acuity and age (P<0.05), while a significant positive correlation with education level (F=6.094, P<0.001). The patients without systemic comorbidities got higher score than those who with (P<0.05). Three months after surgery, 102 (85%) patients came for follow-up and completed the questionnaire. Significant improvement of visual acuity was observed in both binocular and monocular surgery groups (t=10.404, P<0.001). There was higher improvement in binocular weighted visual acuity of binocular surgery group than in monocular surgery group (t=-20.77, P<0.001). The postoperative score was significantly higher in both groups than before (P<0.001). There was a significant improvement in the total score after cataract surgery. The 94 patients (92.2%) were very satisfied or satisfied with the operation; 92 patients (90.2%) thought the surgery achieved their expectations, and they all felt satisfactory. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery. CONCLUSION: The Chinese version of Catquest-8SF questionnaire is suitable for the age-related cataract population in northern China. It is highly responsive to cataract surgery and brief, so it may have the potential to become part of a routine clinical assessment for cataract surgery in China. The patient’s overall satisfaction is high, which illustrates that the medical service we provide matches the patient’s needs. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery.

Time to achieve best postoperative visual acuity following Boston keratoprosthesis surgery

2021 ◽  
pp. bjophthalmol-2020-317483
Author(s):  
Jonathan El-Khoury ◽  
Majd Mustafa ◽  
Roy Daoud ◽  
Mona Harissi-Dagher
Keyword(s):  
Visual Acuity ◽  
Contributing Factors ◽  
Time Duration ◽  
Patient Demographics ◽  
Snellen Visual Acuity ◽  
Boston Type 1 Keratoprosthesis ◽  
The Mean ◽  
Retroprosthetic Membrane

Background/aimsTo evaluate the time needed for patients with Boston type 1 keratoprosthesis (KPro) to reach their best-corrected visual acuity (BCVA) and all contributing factors.MethodsWe retrospectively reviewed 137 consecutive eyes from 118 patients, measured how long they needed to reach their BCVA and looked at factors that might affect this time duration including patient demographics, ocular comorbidities and postoperative complications.ResultsThe mean follow-up was 5.49 years. The median time to BCVA postoperatively was 6 months, with 47% of patients achieving their BCVA by 3 months. The mean best achieved logMAR visual acuity was 0.71, representing a gain of 6 lines on the Snellen visual acuity chart. Postoperative glaucoma, retroprosthetic membrane (RPM) and endophthalmitis prolonged this duration. We found no correlation between the following factors and time to BCVA: gender, age, indication for KPro surgery, primary versus secondary KPro, number of previous penetrating keratoplasties, previous retinal surgery, intraoperative anterior vitrectomy and preoperative glaucoma.ConclusionIn our retrospective cohort, the majority of subjects reached their BCVA between 3 and 6 months after KPro implantation. This duration was significantly prolonged by the development of postoperative glaucoma, RPM and endophthalmitis.

scholarly journals Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Cataract Surgery ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

scholarly journals Cataract Surgery and Uveitis

2016 ◽  
Vol 9 (3) ◽  
Author(s):  
Mumtaz Hussain ◽  
Muhammad Moin ◽  
Nazir Ahmad Aasi ◽  
Muhammad Waqas ◽  
Jawaid Mughal
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
General Hospital ◽  
Cataract Extraction ◽  
Extracapsular Cataract Extraction ◽  
Iol Implantation ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

The study of 30 patients was performed at Lahore General Hospital, and Institute Of Ophthalmology Mayo Hospital, Lahore from June 1989 to June 2003 for 14 years. Total number of eyes were 34 where 2 patients had both eyes. Age ranged from 12-65 years. Males were 11 and females were 19. all the patients had planned extracapsular cataract extraction with IOL implantation. Total follow up period ranged from 1-5 years and best corrected visual acuity in these patients after surgery was 6/12 to 6/6. Post operatively, eyes had vitreous membranes and glaucomatous reaction.

Factors Influencing Visual Outcome after Penetrating Keratoplasty Combined with Intraocular Lens Implantation

2003 ◽  
Vol 13 (2) ◽  
pp. 134-138 ◽  
Author(s):  
J.B. Jonas ◽  
R.M. Rank ◽  
W.M. Budde ◽  
G. Sauder
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Penetrating Keratoplasty ◽  
Visual Outcome ◽  
Intraocular Lens Implantation ◽  
Postoperative Visual Acuity ◽  
Factors Influencing ◽  
Lens Implantation ◽  
Preoperative Visual Acuity

Purpose To establish which factors influence visual outcome after penetrating keratoplasty combined with intraocular lens implantation. Methods This retrospective noncomparative clinical interventional case series study included 135 consecutive patients (mean age 70.2 ± 13.6 years) who underwent central penetrating allogenic keratoplasty combined with intraocular lens (IOL) implantation, all operated by the same surgeon. There were 79 triple procedures, 33 keratoplasties combined with an exchange of IOL, and 23 penetrating keratoplasties combined with a secondary implantation of a posterior chamber lens. Mean follow-up was 28.3 ± 18.7 months (range 3.3–112 months). Reasons for keratoplasty were herpetic or traumatic corneal scars or defects (46), Fuchs corneal endothelial dystrophy (22), pseudophakic or aphakic bullous keratopathy (49), corneal endothelial decompensation due to other reasons (15), and keratoconus (3). Main outcome measures were postoperative visual acuity and gain in visual acuity. Results Mean postoperative visual acuity and mean gain in visual acuity were 0.33 ± 0.21 (median 0.30) and 0.25 ± 0.20 (median 0.20), respectively. Compared with the preoperative measurements, mean visual acuity increased in 129 patients (129/135, 95.6%). Factors influencing postoperative visual outcome and gain in visual acuity were preoperative visual acuity (p<0.005), reason for keratoplasty (p<0.005), and diameter of the graft (p = 0.046). Postoperative visual outcome was independent of age, sex, right or left eye, presence of diabetes mellitus, preoperative refractive error, length of follow-up, duration of surgery, and preoperative intraocular pressure. Conclusions The most important factors influencing visual outcome after central penetrating allogenic keratoplasty combined with IOL surgery are preoperative visual acuity, graft size, and reason for keratoplasty. Other factors such as age, sex, diabetes mellitus, and preoperative refractive error do not substantially influence postoperative visual outcome.

Dome-shaped macula: a potential protective factor for visual acuity after cataract surgery in patients with high myopia

2019 ◽  
Vol 103 (11) ◽  
pp. 1566-1570 ◽  
Author(s):  
Xiangjia Zhu ◽  
Wenwen He ◽  
Shaohua Zhang ◽  
Xianfang Rong ◽  
Qi Fan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Axial Length ◽  
High Myopia ◽  
Protective Factor ◽  
Choroidal Neovascularisation ◽  
Postoperative Visual Acuity ◽  
Younger Age ◽  
Male Sex ◽  
Central Fovea

PurposeTo evaluate whether the presence of dome-shaped macula (DSM) is a protective factor for visual acuity after cataract surgery in patients with high myopia.MethodsIncluded were 891 highly myopic cataract eyes (600 patients) that were examined by optical coherence tomography (OCT) through the central fovea and underwent cataract surgery in our hospital. DSM was defined as an inward bulge >50 µm in horizontal or vertical OCT sections. The incidences of various maculopathies were compared between eyes with and those without DSM. The influences of age, sex, eye laterality, axial length and DSM on postoperative visual acuity were evaluated by multivariate linear regression.ResultsOf the 891 eyes, 123 (13.8%) had DSM. There was a greater association of DSM with extrafoveal retinoschisis (RS) than with other vision-threatening complications such as foveal RS and choroidal neovascularisation. In addition to axial length and age, sex was associated with the presence of DSM (p=0.016). In bilateral high myopia, the incidence of DSM increased with the degree of anisometropia and was more common in the longer eye of patients with anisometropia. Younger age, male sex, shorter axial length and the presence of DSM were associated with better postoperative visual acuity in highly myopic cataract eyes (β=0.124, p=0.002; β=0.142, p<0.001; β=0.275, p<0.001 and β=−0.088, p=0.038, respectively).ConclusionAssociated with fewer visual threatening macular complications, presence of DSM may be a protective factor for visual function after cataract surgery in highly myopic eyes.

scholarly journals Deep Anterior Lamellar Keratoplasty followed by Toric Lens Implantation for the Treatment of Concomitant Anterior Stromal Diseases and Cataract

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000008 ◽  
Author(s):  
Vincenzo Scorcia ◽  
Andrea Lucisano ◽  
Vincenzo Savoca Corona ◽  
Valentina De Luca ◽  
Adriano Carnevali ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cataract Surgery ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Toric Iol ◽  
Iol Implantation ◽  
Anterior Lamellar Keratoplasty ◽  
Topographic Astigmatism

Purpose To evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) followed by phacoemulsification and toric intraocular lens (IOL) implantation for the treatment of concomitant stromal disease and cataract. Methods In this retrospective non-comparative interventional case series, ten eyes affected by stromal disease and cataract underwent DALK followed by phacoemulsification with toric IOL implantation after a minimum period of 5 months from complete suture removal. In each case, topographic astigmatism, refraction, visual acuity, and endothelial cell density were recorded before DALK and 1, 6, and 12 months after cataract surgery. In addition, IOL rotation was evaluated using anterior segment optical coherence tomography. Results Big-bubble DALK was performed in all eyes but one that received manual dissection. Topographic astigmatism averaged 5.6 ± 2.2 diopters (D) after suture removal; refractive astigmatism decreased to 0.55 ± 0.61 D as early as one month after cataract surgery and did not change substantially throughout the follow-up period. In all patients, one month after phacoemulsification uncorrected and best spectacle-corrected visual acuity were, respectively, ≥20/40 and ≥20/25 with a residual spherical equivalent of 0.00 ± 0.84 D. At the latest follow-up visit, in all cases the IOL rotation was ≤5 degrees from the intended position and the endothelial cell loss within 8.5%. No complications were recorded. Conclusions DALK followed by phacoemulsification with toric IOL implantation optimizes visual and refractive outcomes in patients with concomitant stromal disease and cataract. In comparison with a combined procedure, the sequential approach offers better predictability of the postoperative refraction in the absence of an increased risk of complications.

Ocular Abnormalities in Chronic Schizophrenia: Clinical Implications

1997 ◽  
Vol 31 (2) ◽  
pp. 252-256 ◽  
Author(s):  
Deidre Smith ◽  
Christos Pantelis ◽  
John McGrath ◽  
Christine Tangas ◽  
David Copolov
Keyword(s):  
Visual Acuity ◽  
Chronic Schizophrenia ◽  
Clinical Implications ◽  
Double Blind Study ◽  
Related Factors ◽  
Double Blind ◽  
Ocular Abnormalities ◽  
Poor General Health ◽  
High Prevalence

Objective: As part of a randomised double-blind study of a new atypical antipsychotic we sought to determine both the levels of visual acuity and the occurrence of toxic side-effects in a group of patients treated for many years on a variety of antipsychotics. Method: Twenty-three inpatients with a DSM-III-R diagnosis of chronic schizophrenia from two separate hospital locations who met the criteria for the double-blind trial were examined for ocular abnormalities at both baseline and at trial completion. Results: At baseline a high prevalence of abnormalities was identified: 19 patients (82.6%) were found to have one or more ocular abnormalities, including lens opacities/cataracts and corneal pigmentation; three patients, with delusions related to the sun, were noted to have solar burns; a high proportion (almost 70%) of patients had untreated visual acuity problems. No further changes were observed at the follow-up examinations. Conclusions: The possible causes of ocular disturbance in schizophrenia and the reasons for the relatively high ocular morbidity in this group are thought to result from both illness-related factors and the effects of antipsychotic medication. Causality is confounded by a number of issues such as the high prevalence of smoking, poor general health and the variety of antipsychotic medications used in the treatment of psychosis as well as substance abuse. The clinical implications are considered in this paper in relation to the move towards community-based psychiatric services.

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