scholarly journals Six steps for a successful phacoemulsification in hard cataracts

2021 ◽  
pp. 029-030
Author(s):  
Venkatesh S ◽  
Mavnika Mavnika ◽  
Hedge Shruti P
Keyword(s):  
Endothelial Cell ◽  
Short Communication ◽  
Cell Loss ◽  
Appropriate Technology ◽  
Endothelial Cell Loss ◽  
Significant Complication ◽  
Suburban Areas ◽  
Capsular Rupture

Phacoemulsification in rock-hard cataracts is always challenging for the phaco surgeon. Patient presenting with hard cataract is common in rural and suburban areas. In such situations phaco surgeons face higher incidence of significant complication like endothelial cell loss, posterior capsular rupture, zonular dialysis. By judicious use of the appropriate technology like perfect power modulations, enhanced fluidics, adequate OVDs usage better results can be achieved in these cases. In this short communication we have put together six salient steps that would help the surgeon in achieving successful phacoemulsification in hard cataracts.

scholarly journals Influence of rebubbling on anterior segment parameters and refractive outcomes in eyes with DMEK for Fuchs endothelial dystrophy

2021 ◽  
Author(s):  
Bishr Agha ◽  
Raimund Forster ◽  
Thomas Kohnen ◽  
Ingo Schmack
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Anterior Segment ◽  
Cell Loss ◽  
Endothelial Cell Loss ◽  
Refractive Outcome ◽  
Refractive Outcomes ◽  
Scheimpflug Imaging ◽  
Fuchs Endothelial Dystrophy ◽  
Anterior Segment Parameters

Abstract Purpose To evaluate the potential impact of rebubbling on the anterior segment parameters and refractive outcomes in patients with graft detachment following uneventful DMEK for Fuchs endothelial dystrophy (FED). Methods Retrospective institutional cohort study of comparing 34 eyes of 31 patients with rebubbling for graft detachment following Descemet membrane endothelial keratoplasty (DMEK) to 33 eyes of 28 patients with uneventful DMEK. Main outcome parameters were various corneal parameters obtained by Scheimpflug imaging, refractive outcome, corrected distance visual acuity (CDVA), and endothelial cell density (ECD). Results Anterior and posterior corneal astigmatism, corneal densitometry, central corneal thickness, and anterior chamber depth and volume showed no significant differences. Preoperative distribution of astigmatism axis orientations showed a high proportion of anterior corneal with-the-rule astigmatism (71%) in eyes requiring rebubbling. Mean postoperative cylinder in the rebubbling group (1.21 ± 0.85 D) was significantly higher compared to the controls (p = 0.04), while differences in spherical equivalent (SE) were insignificant (p = 0.24). Postoperative CDVA was 0.11 ± 0.11 in the control group compared to 0.21 ± 0.17 in the rebubbling group (p = 0.03). Eyes with subsequent rebubbling demonstrated a significantly higher endothelial cell loss (56% versus 37%) (p < 0.001). Conclusion Apart from higher cylinder values, refractive outcome and corneal parameters assessed by Scheimpflug imaging were comparable in eyes with rebubbling and controls. However, a reduced visual acuity and an increased endothelial cell loss should be taken into consideration prior to rebubbling especially in eyes with circumscribed graft detachment.

scholarly journals Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus

2021 ◽  
Vol 10 (11) ◽  
pp. 2421
Author(s):  
Dominika Janiszewska-Bil ◽  
Barbara Czarnota-Nowakowska ◽  
Katarzyna Krysik ◽  
Anita Lyssek-Boroń ◽  
Dariusz Dobrowolski ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Adverse Events ◽  
Penetrating Keratoplasty ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Cell Loss ◽  
Anterior Lamellar Keratoplasty ◽  
Significant Difference

We compared the visual and refractive outcomes, intraocular pressure (IOP), endothelial cell loss (ECL), and adverse events in keratoconus patients after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) with the best corrected visual acuity (BCVA) below 0.3 (logMAR 0.52). This is a prospective, comparative cohort study of 90 eyes (90 patients) with a clinical diagnosis of keratoconus. Patients underwent a complete eye examination before the surgical approach, 6 and 12 months postoperatively that consisted of BCVA, refractive astigmatism (AS), central corneal thickness (CCT), IOP, and ECL. Secondary outcomes were adverse events related to the surgical procedure. With lower ECL and less adverse events, DALK was revealed to be beneficial over PK with similar visual outcomes. Results: There was no significant difference between the BCVA in the DALK and PK groups (at 6 months: 0.49 ± 0.17 vs. 0.48 ± 0.17; p = 0.48; at 12 months: 0.54 ± 0.17 vs. 0.52 ± 0.14; p = 0.41). The mean value of AS was significantly lower after the PK procedure when compared to DALK, after both 6 and 12 months of follow up (p < 0.001). The CCT in the DALK group was significantly lower when compared to the PK group (at 6 months: 452.1 ± 89.1 µm vs. 528.9 ± 69.9 µm, p < 0.0001; at 12 months: 451.6 ± 83.5 µm vs. 525.5 ± 37.1 µm). The endothelial cell loss at 12 months after surgery was significantly lower after DALK when compared to PK (p < 0.0001). DALK transplantation should be considered as an alternative procedure in the surgical treatment of keratoconus.

Endothelial cell density change in fully dislocated XEN Gel IMPLANT after trabeculectomy: A case report

2021 ◽  
pp. 112067212198963
Author(s):  
Martina Menchini ◽  
Francesco Sartini ◽  
Filippo Tatti ◽  
Enrico Peiretti ◽  
Michele Figus
Keyword(s):  
Endothelial Cell ◽  
Anterior Chamber ◽  
Cell Density ◽  
Cell Loss ◽  
Endothelial Cell Density ◽  
Endothelial Cell Loss ◽  
Density Reduction ◽  
History Of ◽  
Cell Loss Rate

Purpose: To report a case of fully dislocated XEN Gel Implant device into the anterior chamber, 18 months after its implantation and its impact on endothelial cell density. Result: A 75-year-old man with a history of multiple glaucoma surgeries during the last three years presented with an entirely dislocated XEN Gel implant into the anterior chamber. An endothelial cell density reduction was observed over 18 months. Thus, the implant was removed. In the short-term after surgery, the endothelial cell loss rate reduced. Conclusion: XEN Gel Implant can dislocate into the anterior chamber, increasing endothelial cell loss in an eye already underwent multiple surgical procedures with subsequent adverse events. Therefore, if the implant seems displaced, the endothelial cell density should be monitored, and the length of the free-tube segment within the anterior chamber should be measured, during the patient’s follow-up.

Long-term endothelial cell loss and breakdown of the blood-aqueous barrier in cataract surgery

1991 ◽  
Vol 17 (5) ◽  
pp. 622-627 ◽  
Author(s):  
V. M.G. Ambrose ◽  
R. F. Walters ◽  
M. Batterbury ◽  
D. J. Spalton ◽  
J. I. McGill
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Endothelial Cell Loss ◽  
Blood Aqueous Barrier

ASSOCIATION BETWEEN ANTERIOR CHAMBER DEPTH AND ENDOTHELIAL CELL LOSS AFTER PHACOEMULSIFICATION

2021 ◽  
pp. 30-31
Author(s):  
Gargi Verma ◽  
Kishor Kumar
Keyword(s):  
Endothelial Cell ◽  
Anterior Chamber ◽  
Cell Damage ◽  
Anterior Chamber Depth ◽  
Cell Loss ◽  
Endothelial Cell Loss ◽  
Endothelial Cell Damage ◽  
Percentage Decrease ◽  
Central Cornea ◽  
Shallow Anterior Chamber

Purpose: To assess the association between anterior chamber depth and endothelial cell loss after phacoemulsication Material and Methods: Ninety patients were recruited for this comparative type of observational study who were further divided into 3 groups according to anterior chamber depth (ACD). All patients underwent phacoemulsication procedure and intraocular implantation. Postoperatively endothelial cell loss (ECL) was calculated by measuring percentage decrease in endothelial cell density of central cornea and regression coefcient between ACD and ECLwas assessed in each group. Results: Endothelial cell loss was signicantly higher in shallow anterior chambers to other groups and the association between ACD and ECLwas signicant only in shallow anterior chamber depth group. Conclusion: Eyes with shallow anterior chamber depth are at higher risk for endothelial cell damage and shows an association between ACD and ECLwhen compared to deep anterior chamber depth.

scholarly journals Donor, Recipient, and Operative Factors Associated With Increased Endothelial Cell Loss in the Cornea Preservation Time Study

2019 ◽  
Vol 137 (2) ◽  
pp. 185 ◽  
Author(s):  
Jonathan H. Lass ◽  
Beth Ann Benetz ◽  
Sanjay V. Patel ◽  
Loretta B. Szczotka-Flynn ◽  
Robert O’Brien ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Loss ◽  
Time Study ◽  
Endothelial Cell Loss ◽  
Factors Associated
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