scholarly journals Incidence, management, and outcome of complex cataracts in a tertiary eye set up

2020 ◽  
Vol 5 (8) ◽  
pp. 207-215
Author(s):  
Dr. Ritu Verma ◽  
◽  
Dr. Meghna Shrishrimal ◽  
Dr. Shirali Gokharu ◽  
Dr. Dhaivat Shah ◽  
...  

Aim: To study the incidence, management, and outcome of complex cataract cases in a tertiary eyecare center. Material and methods: Retrospective observational study with analysis of recordsdone for patients who were operated on for complex cataract from December 2019 to February2020. Results: 300/10,000 patients had complex cataracts requiring additional surgical skills,advanced equipment, and better patient counseling. 5.3% (16/300) of patients needed intracameraladrenaline whereas 1.3% (4/300) needed Visco mydriasis. A capsular tension ring was implanted in4.3%(13/300) of patients. 4% (12/300) underwent sphincterotomies whereas 2% (6/300) had toundergo synechiolysis. Iris hooks were used in only 0.6% of patients (2/300). Posterior capsularrent was seen in 1.6%(5/300) which was managed by placing a Posterior chamber IOL in the sulcus.2.6% (8/300) had implantation of the iris-claw lens and 2.3% (7/300) were left aphakic forsecondary IOL to be implanted at a later date. The visual outcome was better than 6/18 in 76% ofpatients. 24% of patients had an improvement in their visual acuity by a line or 2 but was less than6/18 due to corneal degenerations, corneal scarring, Retinal pathologies, and colobomas.Conclusion: Although these cataracts demand more expertise on behalf of the surgeon, theoutcome can be very rewarding if done with proper planning. The knowledge of small incisioncataract surgery is highly valuable in such situations.

2020 ◽  
Vol 5 (8) ◽  
pp. 207-215
Author(s):  
Dr. Ritu Verma ◽  

Aim: To study the incidence, management, and outcome of complex cataract cases in a tertiary eyecare center. Material and methods: Retrospective observational study with analysis of recordsdone for patients who were operated on for complex cataract from December 2019 to February2020. Results: 300/10,000 patients had complex cataracts requiring additional surgical skills,advanced equipment, and better patient counseling. 5.3% (16/300) of patients needed intracameraladrenaline whereas 1.3% (4/300) needed Visco mydriasis. A capsular tension ring was implanted in4.3%(13/300) of patients. 4% (12/300) underwent sphincterotomies whereas 2% (6/300) had toundergo synechiolysis. Iris hooks were used in only 0.6% of patients (2/300). Posterior capsularrent was seen in 1.6%(5/300) which was managed by placing a Posterior chamber IOL in the sulcus.2.6% (8/300) had implantation of the iris-claw lens and 2.3% (7/300) were left aphakic forsecondary IOL to be implanted at a later date. The visual outcome was better than 6/18 in 76% ofpatients. 24% of patients had an improvement in their visual acuity by a line or 2 but was less than6/18 due to corneal degenerations, corneal scarring, Retinal pathologies, and colobomas.Conclusion: Although these cataracts demand more expertise on behalf of the surgeon, theoutcome can be very rewarding if done with proper planning. The knowledge of small incisioncataract surgery is highly valuable in such situations.


Author(s):  
Referano Agustiawan ◽  
Elvioza Elvioza ◽  
Soedarman Sjamsoe ◽  
Waldensius Girsang

Introduction: To report management and outcome of dropped nucleus in Jakarta Eye Center Methods: Retrospective review of the records of 19 consecutive patients who underwent pars plana vitrectomy for retain lens fragments at Jakarta Eye Center from January 2010 to September 2012.  Result: The mean age of the patient was 57 years (range 48-79). There were 10 males (53%) and 9 females (47%). 10 patients (53%) had vitrectomy within 1 day of phacoemulsification, 6(32%) within 1 week and 3(15%) after more than 1 week. Eight patients (42%) achieved a final visual acuity of 0.5 or better, only 3 patients (15%) had final visual acuity 1-meter finger counting or worse. 74% patient achieved final acuity better than pre-op (14 patients). Early vitrectomy group has 3 patients (30%) with complication, intermediate vitrectomy group has 33% complication and late vitrectomy has 33 % complication. Posterior chamber IOL were implanted in 12 patients (63%), 2 patients had scleral fixation IOL, anterior chamber IOL in 2 patients, and only 3 patients (16%) were left aphakic. Conclusion: Surgical management in cases of nucleus drop in JEC showed good result with very limited complications.  In most cases, vitrectomy was performed immediately after cataract surgery. Early vitrectomy has no significant differences in complications and visual outcome than 1 week vitrectomy and late vitrectomy after cataract surgery.  


1993 ◽  
Vol 3 (1) ◽  
pp. 42-46 ◽  
Author(s):  
R. David ◽  
R. Yagev ◽  
M. Shneck ◽  
D. Briscoe ◽  
E. Gilad ◽  
...  

A total of 143 anterior chamber (AC) intra-ocular lenses (IOL) of various designs were implanted in a five-year period and followed for 18 to 76 months. The lenses were inserted as a secondary implant after extracapsular cataract extraction (ECCE) complicated by vitrectomy, or after primary intra-capsular extraction. The complications (corneal edema, uveitis/glaucoma, extrusion/imbedding, cystoid macular edema), the final visual acuity and the need for removal of the IOL were analyzed. Only small differences were found between the different lenses but some association was found between complicated surgery (ECCE + vitrectomy) and a higher rate of complication, poorer visual outcome and more frequent need for IOL removal. Cystoid macular edema was encountered only in cases with complicated ECCE. A high percentage of other ocular pathologies was found among the cases, possibly implying that diseased eyes are more prone to surgical complications. An alternative to the AC-IOL in cases with a ruptured posterior capsule is the suture-supported posterior chamber IOL, but the flexible-loop AC-IOL may not yet be obsolete.


2020 ◽  
Vol 7 (4) ◽  
pp. 110-117
Author(s):  
Dr. Priyanka S. Kanekar ◽  
Dr. Smita Patare ◽  
Dr. Roopa Naik

Background: The modern cataract surgery involves implantation of posterior chamber intraocular lens (PCIOL) when the posterior capsule is intact. However, in case of weak or no capsular support, PCIOL implantation is not possible. In such situations, implantation of secondary Iris claw lens (ICIOL) or Scleral fixated IOL(SFIOL) remains as treatment options. The aim of this study was to compare the efficacy of ICIOL and SFIOL in terms of visual outcomes and complications in aphakic patients. Methods: This prospective randomized study was done from January 2019 to December 2019. Forty aphakic patients fulfilling inclusion criteria, who attended the ophthalmology outpatient department of VVPF’s Medical college and hospital, Ahmednagar were included in this study. These patients were randomly divided into two groups such as Group 1 included 20 patients who underwent ICIOL implantation and Group 2 included 20 patients who underwent SFIOL implantation. The preoperative and postoperative evaluation was done with visual acuity, slit-lamp examination, IOP, fundus examination for the follow up period of 6 months. Results were analysed with Chi square test and t-test using SPSS software. Results: 85% ICIOL and 80% of SFIOL patients had final Best Corrected Visual Acuity (BCVA) of 6/18-6/6. Surgical time in ICIOL was significantly less than SFIOL group (p=0.00). Suture related complications were significantly more in SFIOL group. However, oval pupil and pigment dispersion were seen more in ICIOL group but were harmless. One patient in SFIOL group developed Cystoid Macular Edema (CME) which persisted till final follow up and 1 haptic of ICIOL was disenclavated which was re-enclavated. Conclusion: Comparable final visual outcome was found between ICIOL group and SFIOL group. However, Implantation of ICIOL required less surgical time with fewer complications and hence is a better alternative to SFIOL implantation in correction of aphakia.


1989 ◽  
Vol 54 (7) ◽  
pp. 1785-1794 ◽  
Author(s):  
Vlastimil Kubáň ◽  
Josef Komárek ◽  
Zbyněk Zdráhal

A FIA-FAAS apparatus containing a six-channel sorption equipment with five 3 x 26 mm microcolumns packed with Spheron Oxin 1 000, Ostsorb Oxin and Ostsorb DTTA was set up. Combined with sorption from 0.002M acetate buffer at pH 4.2 and desorption with 2M-HCl, copper can be determined at concentrations up to 100, 150 and 200 μg l-1, respectively. For sample and eluent flow rates of 5.0 and 4.0 ml min-1, respectively, and a sample injection time of 5 min, the limit of copper determination is LQ = 0.3 μg l-1, repeatability sr is better than 2% and recovery is R = 100 ± 2%. The enrichment factor is on the order of 102 and is a linear function of time (volume) of sample injection up to 5 min and of the sample injection flow rate up to 11 ml min-1 for Spheron Oxin 1 000 and Ostsorb DTTA. For times of sorption of 60 and 300 s, the sampling frequency is 70 and 35 samples/h, respectively. The parameters of the FIA-FAAS determination (acetylene-air flame) are comparable to or better than those achieved by ETA AAS. The method was applied to the determination of traces of copper in high-purity water.


2021 ◽  
pp. 112067212199295
Author(s):  
Gurkan Erdogan ◽  
Nilay Kandemir Besek ◽  
Betul Onal Gunay ◽  
Alper Agca

Objective: To investigate the clinical outcomes of three surgical approaches for ectopia lentis in Marfan syndrome (MS) patients who had undergone crystalline lens removal with posterior chamber intraocular lens (IOL) implantation techniques comprising the intrascleral fixation of IOL, sutured scleral fixation of IOL, and IOL implantation with the use of a Cionni capsular tension ring (CTR). Methods: This is a retrospective comparative study, including 35 eyes of 21 patients who underwent the intrascleral fixation of IOL (group 1), scleral IOL fixation with the Z-suture (group 2), and IOL implantation with the use of a Cionni CTR (group 3) following crystalline lens removal. The surgical indications were as follows: no improvement in visual function after eyeglasses or contact lens application due to excessive irregular astigmatism and advanced crystalline lens decentration in which the edge of the crystalline lens came up to the optical axis, or dislocation of the crystalline lens resulting in aphakia and secondary glaucoma due to lens dislocation. The surgical outcomes and complications due to surgery were compared between the groups. Results: The mean age of the patients in the study was 12.3 ± 8.7 years (5–32 years). There were 10 eyes in group 1, 13 eyes in group 2, and 12 eyes in group 3. Visual acuity improved significantly in each group after surgery. Ocular residual astigmatism did not differ significantly between the groups ( p = 0.51). Conclusion: There were no significant differences between the three surgical approaches in the current study in terms of the postoperative results and complications.


2018 ◽  
Vol 11 (1) ◽  
pp. bcr-2018-225806 ◽  
Author(s):  
Archita Singh ◽  
Noopur Gupta ◽  
Vinod Kumar ◽  
Radhika Tandon

Implantable collamer lenses (ICL) have gained popularity for correction of myopia where kerato-refractive procedures are not indicated as in cases of high myopic refractive errors. Toxic anterior segment syndrome (TASS) is a very uncommonly reported postoperative complication following ICL implantation. A young patient developed severe corneal oedema and anterior segment inflammation on the first day after ICL implantation. Analysing retrospectively, possible idiosyncratic response to intracameral pilocarpine was considered as a cause for TASS. Prompt and intensive therapy with oral and topical potent steroids was visually rewarding. TASS, though a sterile inflammation can have catastrophic sequelae such as corneal decompensation and secondary glaucoma. Hence, timely identification and management is important.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Paolo Mora ◽  
Giacomo Calzetti ◽  
Stefania Favilla ◽  
Matteo Forlini ◽  
Salvatore Tedesco ◽  
...  

Purpose. To compare the functional and clinical outcomes of the iris-claw intraocular lens (IOL) placed on the anterior versus posterior surface of the iris. Patients and Methods. A multicenter, retrospective study. Data on eyes that underwent anterior or retropupillary iris-claw IOL implantation because of inadequate capsular support secondary to complicated cataract surgery, trauma, and dislocated/opacified IOLs since January 2015 were analyzed. For study inclusion, evaluation results had to be available in the medical records both preoperatively and at 1 and 12 months after implantation. The following parameters were compared between the groups: best-corrected distance visual acuity (BCDVA), spherical and cylindrical refractive error, endothelial cell density (ECD), central macular thickness (CMT), and percentage and type of postoperative complications. Results. In total, 60 eyes of 60 patients aged 73 ± 13 years were included: 28 eyes (47%) involved anterior, and 32 eyes (53%) retropupillary, iris-claw IOL fixations. Preoperatively, the groups were similar in all parameters except for a significantly higher proportion of retropupillary fixations in patients who had previously experienced a closed-globe trauma (p=0.03). The groups showed comparable improvements in BCDVA after surgery (final BCDVA: 0.34 ± 0.45 vs. 0.37 ± 0.50 logMAR in the anterior and retropupillary placement groups, respectively). During follow-up, no group difference was observed in refractive error or CMT. Both groups experienced similarly marked ECD loss and showed similar incidence of postoperative complications, with cystoid macular edema being the most common complication. Multivariable linear regression showed that BCDVA at 1 month was the best predictor of the final BCDVA. Conclusions. Anterior chamber and posterior chamber iris-claw IOL fixations proved equally effective and safe for aphakic correction in eyes with inadequate capsular support.


1988 ◽  
Vol 10 (1) ◽  
pp. 37-42 ◽  
Author(s):  
M. J. Wheeler ◽  
Linzi Waiters

The Kemtek 1000 Sample Processor has been evaluated for precision, accuracy, speed and reliability. Precision was better than 1.0% at all volumes tested and accuracy within ±5%. A l00-tube assay could be set up within 15 min when patient specimens plus two reagents were sampled using a two probe system. Carry-over could be reduced to <0.01% by using a sufficient number of wash steps, the latter being related to the assay requirements. Evidence was found for adsorption of protein to the probe tubing but inaccuracies due to this could be reduced by introducing wash steps between samples. Problems over 12 months have been minor and quickly resolved. The authors were pleased with the way the processor performed and their staffhave confidence in leaving it to set up their assays.


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