‘Comparison of Safety and Performance of Two Ophthalmic Viscosurgical Devices in Cataract Surgery’

Abstract Purpose: To compare the safety and performance of two ophthalmic viscosurgical devices (OVDs) Bio-Hyalur SV (Sodium Hyaluronate 3.0%) (Biotech Healthcare Group, Luzern, Switzerland) and Protectalon (sodium hyaluronate 2.0%) (VSY Biotechnology, Turkey) in cataract surgery. Methods: One hundred twenty eyes of one hundred twenty patients who underwent phacoemulsification surgery were included in the study. Postoperatively sixty eyes using Bio-Hyalur-SV were classified as Group 1, and sixty eyes using Protectalon as Group 2. Patients aged 45 and over, Grade I, II or III unilateral / double stained cataract, healthy eyes creating cataract inclueded in this study . Endothelial cell morphological parameters including endothelial cell density (ECD), cell number, cell area, coefficient of variation (CV) in cell size, cell hexagonality and central corneal thickness (CCT) were measured preoperatively and at postoperative first week, first and third month visits.Intraocular pressure (IOP) was measured with an applanation tonometer at every visit. Results: . There was a statistically significant decrease in the mean ECD all follow-up times when compared with the preoperative visit (p=0.000). In terms of mean ECD levels there was no significant difference between the two groups within three months postoperatively (p=0.616) In the first week after surgery, there was an significant increase in CCT in Group 1 and Group 2 respectively (p=0.000). The IOP was <23 mmHg in all of the patients on the first day after surgery. There was no significant difference in the incidence of IOP peaks between the two groups in every vizits. In both groups, a significant increase was observed in the mean IOP at first day, first week, and first month after surgery compared to preoperative values (p=0.000). But no significant difference in IOP increase in Group 1 (P=0.092), Group 2 (P=0.013) compared to preoperative values at third month postoperatively (p <0.001 significant with Bonferrotti correction). Conclusion: The two OVD’s used in this study during cataract surgery were safe and effective. Both OVD’s resulted in similar rates of transient IOP increases and corneal endothelial damage also provided good anterior chamber depth and were fairly easy to remove.

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Evaluation of Optical Low Coherence Reflectometry Parameters in Patients with Exfoliation Syndrome

Journal of Ophthalmology ◽

10.1155/2015/658091 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Emrullah Beyazyıldız ◽

Özlem Beyazyıldız ◽

Süleyman Günaydın ◽

Emrah Kan ◽

Mert Şimşek ◽

...

Keyword(s):

Healthy Subjects ◽

Corneal Thickness ◽

Anterior Chamber Depth ◽

Exfoliation Syndrome ◽

Low Coherence ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Optical Low Coherence Reflectometry ◽

Group 1

Purpose. To evaluate optical low coherence reflectometry (OLCR) parameters in patients with exfoliation syndrome (EXS) undergoing cataract surgery.Methods. Forty-seven eyes of 47 patients with EXS (Group 1), and 55 eyes of 55 healthy subjects (Group 2) were included in the study. Anterior chamber depth (ACD), lens thickness (LT), axial length (AL), central corneal thickness (CCT), horizontal corneal length (HCL), and pupil diameter (PD) parameters were measured by OLCR (Lenstar LS 900, Haag-Streit) and compared between groups. Shapiro-Wilk test and Mann WhitneyUtests were used for statistical analyses.Results. The mean ACD, HCL, and PD values were significantly lower in EXS group than in healthy subjects (P= 0.01,P= 0.04, andP<0.001, resp.). The mean LT was significantly higher in EXS group than in healthy subjects (P= 0.007). There was no significant difference between groups in means of AXL and CCT.Conclusions. According to OLCR measures, eyes with EXS have shallower ACD, smaller PD, thicker LT, shorter HCL, and no significantly different CCT levels.

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Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v16i3.458 ◽

2019 ◽

Vol 16 (3) ◽

pp. 168-178

Author(s):

Anu Malik ◽

Smruti Ranjan Dethi ◽

Yogesh Kumar Gupta ◽

Alka Gupta

Keyword(s):

Cataract Surgery ◽

Randomized Study ◽

Corrected Visual Acuity ◽

Age Related ◽

Significant Difference ◽

Induced Astigmatism ◽

The Mean ◽

Group 2 ◽

Surgically Induced ◽

Group 1

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.

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Long-term Analysis of Surgically Induced Astigmatism after Combined Vitrectomy and Cataract Surgery versus Cataract Surgery Alone

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.8.1029 ◽

2021 ◽

Vol 62 (8) ◽

pp. 1029-1035

Author(s):

Zee Yoon Byun ◽

Jung Hyun Lee ◽

Sang-Mok Lee ◽

Daniel Duck-Jin Hwang

Keyword(s):

Cataract Surgery ◽

Significant Difference ◽

Induced Astigmatism ◽

The Mean ◽

Group 2 ◽

23 Gauge ◽

Surgically Induced ◽

Sutureless Vitrectomy ◽

Group 1

Purpose: To compare the long-term changes in surgically induced astigmatism (SIA) in patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together with patients who underwent cataract surgery only.Methods: We retrospectively reviewed SIA changes for 1 year after surgery in patients who received only cataract surgery using phacoemulsification (group 1) and patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together (group 2). Flat keratometry (K1), steep keratometry (K2), and astigmatism axis were measured with automatic keratometry before and after the surgery. Vector analysis was used to calculate SIA at 1, 3, 6, and 12 months postoperatively. We then examined whether the SIA values at each time point were different between the two groups.Results: A total of 86 eyes were included in this study (group 1, n = 45; group 2, n = 41). The mean SIA values calculated at 1, 3, 6, and 12 months after surgery in group 1 were 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, and 0.59 ± 0.33, respectively. In group 2, the values were 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, and 0.61 ± 0.30, respectively. Over time, SIA decreased in both groups (all p < 0.001). There was no significant difference in the mean SIA between the two groups at each follow-up time point after surgery (p = 0.296, p = 0.728, p = 0.361, and p = 0.356, respectively).Conclusions: When 23-gauge sutureless vitrectomy and cataract surgery were performed together, the astigmatism change caused by surgery did not show a significant difference compared with that of the group who received cataract surgery only. Thus, 23-gauge sutureless vitrectomy may not significantly affect corneal astigmatism.

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Comparison of perioperative parameters in one-handed rotational phacoemulsification versus conventional phacoemulsification and femtosecond laser-assisted cataract surgery

International Journal of Ophthalmology ◽

10.18240/ijo.2021.12.09 ◽

2021 ◽

Vol 14 (12) ◽

pp. 1868-1875

Author(s):

Samuele Gigliola ◽

◽

Alfredo Niro ◽

Carmela Palmisano ◽

Pasquale Puzo ◽

...

Keyword(s):

Endothelial Cell ◽

Femtosecond Laser ◽

Cataract Surgery ◽

The Other ◽

Dissipated Energy ◽

Surgical Time ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Group 1

AIM: To compare perioperative parameters of one-handed rotational phacoemulsification technique (one-handed phaco-roll) with each of other two techniques, “Divide et Conquer” and femtosecond laser-assisted cataract surgery (FLACS) METHODS: In this retrospective and comparative cohort study, eyes with uncomplicated cataract (nuclear density grade 2 to 3) treated routinely with one-handed phaco-roll (n=23; Group 1) or “Divide et Conquer” (n=23; Group 2) or FLACS (n=23; Group 3) were enrolled. Intraoperative parameters including effective phaco-time (EPt), ultrasound time (USt), aspiration time, surgical time, phacoemulsification (phaco)-power, balanced salt solution (BSS) use, cumulative dissipated energy (CDE) were recorded and compared. Clinical outcomes including best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), endothelial cell loss (ECL), central corneal thickness (CCT) and central macular thickness (CMT), were assessed and compared pre-operatively and at 1mo after surgery. RESULTS: Aspiration and surgical time, and BSS used were lower in Group 1 (P<0.01) than other groups. EPt, phaco-power and CDE were lower in Group 1 (P<0.05) than Group 2 but not significantly different from Group 3. In Group 1, USt was lower (P<0.05) than Group 2 but higher (P<0.05) than Group 3. BCVA improved in all groups without significant difference between Group 1 and the other ones. No significant differences regarding all post-operative morphologic outcomes (ECD, ECL, CCT, CMT) were reported. No clinical complications occurred. CONCLUSION: One-handed phaco-roll seems to be less time-consuming than “Divide et Conquer” and FLACS and less energy-consuming than “Divide et Conquer”. Furthermore, one-handed phaco-roll seems to have an equal safety profile compared to the other two techniques.

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Intraocular Pressure Changes during Femtosecond Laser-Assisted Cataract Surgery: A Comparison between Two Different Patient Interfaces

Journal of Ophthalmology ◽

10.1155/2019/5986895 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Chiara De Giacinto ◽

Rossella D’Aloisio ◽

Alessandro Bova ◽

Tommaso Candian ◽

Alberto Armando Perrotta ◽

...

Keyword(s):

Intraocular Pressure ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Soft Contact ◽

Soft Contact Lens ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Pressure Changes ◽

Group 1

Purpose. The aim of this retrospective cohort study was to evaluate intraocular pressure (IOP) changes during femtosecond laser-assisted cataract surgery (FLACS) using two different patient interface systems. Methods. 116 eyes of 116 patients scheduled for cataract surgery were divided into 2 groups: group 1 (61 eyes) and group 2 (55 eyes) underwent FLACS using Catalys Laser with fluid interface (liquid optics interface, LOI) and LenSx Laser with curved interface and soft contact lens (SoftFit), respectively. IOP was assessed using a portable rebound tonometer (Icare®) preoperatively, after docking, immediately after surgery, at one and seven days postoperatively. Results. In group 1, the mean IOP (±SD) was 14.1 ± 0.4 mmHg before surgery, 33.2 ± 1.1 mmHg after docking, and 21.4 ± 0.9 mmHg immediately after surgery. In group 2, the mean IOP was 13.8 ± 0.4 mmHg before surgery, 24.2 ± 1.4 mmHg after docking, and 20.2 ± 1.2 mmHg immediately after surgery. After the docking procedure, a statistically significant increase in IOP from the baseline was found in both groups (p<0.001). Moreover, no statistically significant difference in IOP measured at 1 and 7 days postoperatively was observed compared with the preoperative values (p>0.05) using both laser platforms. No intraoperative and postoperative complications were observed. Conclusions. FLACS suction phase resulted in a transient increase of IOP in both groups, especially with the LOI system, and it is probably related to the greater pressure of a suction ring and suction generated through the vacuum, independently from the effect of femtosecond laser itself.

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The Effects of Ramadan Fasting on Anterior Segment Parameters, Visual Acuity and Intraocular Pressures of the Eye

The Open Ophthalmology Journal ◽

10.2174/1874364101711010152 ◽

2017 ◽

Vol 11 (1) ◽

pp. 152-155 ◽

Cited By ~ 2

Author(s):

Ozlem Barut Selver ◽

Melis Palamar ◽

Kevser Gerceker ◽

Sait Egrilmez ◽

Ayse Yagci

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Corneal Thickness ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Ophthalmological Examination ◽

Significant Difference ◽

Before And After ◽

Group 2 ◽

Group 1

Objective: It is aimed to determine whether fasting during Ramadan has any significant effect on anterior chamber parameters, visual acuity and intraocular pressures. Methods: 31 fasting (Group 1) and 30 non-fasting healthy volunteers (Group 2) were enrolled. All cases underwent an ophthalmological examination and anterior segment parameter evaluation (central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), pupil size) with Pentacam before and after the breaking of the Ramadan fast in Group 1, before and after dinner in Group 2. Results: The mean age was 43.35 ± 13.20 in Group 1, 43.17 ± 12.90 in Group 2 (p= 0.955). No significant difference was detected in any of the parameters in both groups. Conclusion: There is a need for more detailed and associated studies to understand better about the influence of Ramadan fast on various ocular parameters.

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Effect of Uncomplicated Cataract Surgery on Central Macular Thickness in Diabetic and Non-diabetic Subjects

Journal of Ophthalmic and Vision Research ◽

10.18502/jovr.v14i4.5447 ◽

2019 ◽

Author(s):

Brahm Prakash Guliani ◽

Isha Agarwal ◽

Mayuresh P. Naik

Keyword(s):

Diabetic Retinopathy ◽

Cataract Surgery ◽

Normal Subjects ◽

Early Postoperative Period ◽

Macular Thickness ◽

Central Macular Thickness ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Group 1

Purpose: To assess the quantitative changes of macula in diabetic and non-diabetic eyes after uncomplicated cataract surgery. Methods: In this prospective interventional study being performed in a tertiary healthcare hospital, a total of 660 eyes were divided into two groups. Group 1 included 330 eyes from healthy subjects and group 2 included 330 eyes from well-controlled diabetic subjects with no diabetic retinopathy planned for phacoemulsification with foldable IOL implantation by the same surgeon under similar settings. Optical Coherence Tomography (Heidelberg Spectralis SD-OCT) was used to assess preoperative and postoperative central macular thickness (CMT) at weeks 1 and 6. Results: The mean CMT in group 1 preoperatively, at postoperative week 1, and at post-operative week 6 was 257.03 ± 20.904, 262.82 ± 17.010, and 265.15 ± 20.078 μm, respectively. The corresponding values in group 2 were 255.36 ± 17.852, 259.15 ± 16.644, and 266.09 ± 18.844 μm, respectively. There was no significant difference in the mean CMT values between the two groups on any of the three occasions when the CMT was measured (P = 0.374 and P = 0.313 at weeks 1 and 6, respectively). Conclusion: There was no statistically significant difference in CMT between normal subjects and diabetic subjects without diabetic retinopathy preoperatively and in early postoperative period after uncomplicated phacoemulsification surgery.

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Effect of capsular tension ring on refractive results in cases with pseudoexfoliation syndrome

European Journal of Ophthalmology ◽

10.1177/1120672120965469 ◽

2020 ◽

pp. 112067212096546

Author(s):

Nilay Kandemir Besek ◽

Gulsah Gumus ◽

Gamze Ozturk Karabulut ◽

Senay Asik Nacaroglu ◽

Ahmet Kirgiz ◽

...

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Refractive Error ◽

Capsular Tension Ring ◽

Significant Difference ◽

Hyperopic Shift ◽

The Mean ◽

Group 2 ◽

Lens Power ◽

Group 1

Purpose: To investigate the effect of capsular tension rings (CTRs) on postoperative refractive results in patients with pseudoexfoliation (PSX) syndrome. Materials and Methods: Sixty-nine patients with PSX syndrome who had uncomplicated cataract surgery between March 2016 and February 2019 were reviewed retrospectively. The patients were divided into two groups. The 35 patients in Group 1 received CTRs prior to intraocular lens implantation during cataract surgery, and the 34 patients in Group 2 had cataract surgery without CTRs. Significant zonular weakness, uncontrolled glaucoma, and ocular pathologies causing low visual acuity were excluded. The preoperative and postoperative keratometry and autorefraction measurements, preoperative expected refractive values, and absolute refractive error were recorded. Results: The mean ages of patients were 73.54 ± 9.78 years in Group 1 and 72.23 ± 6.72 years in Group 2 ( p = 0.521). There was no statistically significant difference between Group 1 and Group 2 in terms of expected preoperative refraction values (–0.52 ± 0.12,–0.56 ± 0.08, respectively, p = 0.118). There was a statistically significant difference in postoperative spherical equivalent values between Group 1 and Group 2 (–0.05 ± 0.97 and −0.92 ± 0.57, respectively, p < 0.01). A statistically significant difference was found between the two groups in terms of absolute refractive error (0.46 ± 0.74 in Group 1 and −0.34 ± 0.59 in Group 2 p < 0.01). Conclusion: CTR implantation causes hyperopic shift, which should be taken into consideration when calculating the lens power of intraocular lens in patients with PSX syndrome.

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Repair Integrity and Functional Outcomes Between Knot-Tying and Knotless Suture-Bridge Arthroscopic Rotator Cuff Repair: A Prospective Randomized Clinical Trial

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211002482 ◽

2021 ◽

Vol 9 (4) ◽

pp. 232596712110024

Author(s):

Koray Şahin ◽

Fatih Şentürk ◽

Mehmet Ersin ◽

Ufuk Arzu ◽

Mechmet Chodza ◽

...

Keyword(s):

Rotator Cuff ◽

Constant Score ◽

Knot Tying ◽

Suture Bridge ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Cuff Repair ◽

Group 1

Background: Knot-tying suture-bridge (SB) rotator cuff repair may compromise the vascularity of the repaired tendon, causing tendon strangulation and medial repair failure. The knotless SB repair technique has been proposed to overcome this possibility and decrease retear rates. Purpose: To compare clinical and structural outcomes and retear patterns between the knot-tying and knotless SB techniques. We hypothesized that the knotless technique would result in lower retear rates owing to the preservation of intratendinous vascularity. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 104 patients with full-thickness rotator cuff tears were randomly and prospectively allocated to undergo knot-tying (group 1) or knotless (group 2) SB repair. Clinical outcome measures included range of motion, the visual analog scale (VAS) for pain, and the Constant score for function. Repair integrity was evaluated on magnetic resonance imaging scans using the Sugaya classification. Retears were also classified according to their pattern as type 1 (lateral) or type 2 (medial). Results: Overall, 88 patients (group 1: n = 42 [mean ± SD age, 54.3 ± 9.8 years]; group 2: n = 46 [mean ± SD age, 55.8 ± 8.2 years]) were included in the final analysis. The mean ± SD follow-up period was 25.4 ± 8.3 and 23.3 ± 7.2 months for groups 1 and 2, respectively. From preoperatively to postoperatively, the mean VAS pain score improved significantly in both groups (group 1: from 7.4 ± 1.7 to 1.0 ± 1.7; group 2: from 7.1 ± 1.9 to 1.3 ± 2.0; P < .0001 for both), as did the mean ± SD Constant score (group 1: from 51.7 ± 13.4 to 86.0 ± 11.5; group 2: from 49.4 ± 18.4 to 87.2 ± 14.8; P < .0001 for both). There was no significant difference between the groups for the postoperative VAS or Constant score. The retear rate was not significantly different between the groups (19.0% [8/42] in group 1 and 28.3% [13/46] in group 2; P > .05). There was a significant difference in the type 2 failure rate (75.0% [6/8] in group 1 and 23.1% [3/13] in group 2; P = .03). Conclusion: Both techniques showed excellent improvement and comparable clinical outcomes, and there was no significant difference in retear rates. Consistent with previously published data, the type 2 failure rate was significantly higher with the knot-tying technique. Registration: NCT03982108 ( ClinicalTrials.gov identifier).

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A Comparative Study Between Preoperative Subconjunctival Bevacizumab Injection And Postoperative Topical Application In Prevention Of Recurrence After Excision Of Primary Pterygium In Egyptian Patients

QJM ◽

10.1093/qjmed/hcab109.004 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Basma Helal Mohamed ◽

Othman Ali Othman Ziko ◽

Hisham M Khairy Abd El Dayem ◽

Nancy Ezzelregal Khamis Ahmed

Keyword(s):

Corneal Thickness ◽

Anterior Segment ◽

P Value ◽

Eye Drops ◽

Subconjunctival Injection ◽

Fibrovascular Tissue ◽

Significant Difference ◽

Group 2 ◽

Group 1 ◽

Primary Pterygium

Abstract Purpose to compare between recurrence incidence after primary pterygium excision when using preoperative subconjunctival injection of Bevacizumab (Avastin) and using it as a postoperative eye drops. Methods thirty two eyes of thirty patients (two patients had bilateral pterygium) with primary pterygia were clinically examined, classified into 3 groups and operated by simple excision with bare sclera technique. Group 1 included 10 patients received Bevacizumab (Avastin) in the form of eye drops (10 mg/ml) 3 times daily for 6 days postoperative. Group 2 included 10 patients received preoperative Bevacizumab in the form of subconjunctival injection (1.25 mg/0.05ml) single dose 1 week preoperative. Group 3 included 10 patients (12 eyes) 2 patients with bilateral Pterygium didn’t receive any form of Bevacizumab. Postoperative follow up was done clinically and by serial photography at 1 week, 1 month, 3 months and 6 months searching for signs of recurrence and/or complications. Results The results showed different grades of recurrence in 18 eyes of 32.True recurrence was seen in 7 patients of 18 (1 patient in group 1, 2 in group 2 and 4 in group3).Recurrence grades in group 1and 2 who used the Bevacizumab (20%grade II, 50% grade III, and 30% grade IV). Recurrence could be predicted by 100% depending on fibrovascular tissue appearing in the surgical bed at 3 months postoperative (P value 0.038).Preoperative fleshy pterygium has high statistical significance in realation to recurrence(P value = 0.006).Patient’s sex, residence and occupation had no statistically significant value in the process of recurrence (P value > 0.05). Patients with recurrent Pterygia (in group 1&2) had statistically significant changes in the corneal K- readings at 3 months and 6 months.No significant difference in the limbal or central corneal thickness in the operated eye and the other eye (Pvalue > 0.05). Conclusion Bevacizumab (Avastin) is a well tolerated drug with multiple drug delivery methods.The eye drops give better results than the subconjunctival injection.Appearance of fibrovascular tissue in the surgical bed at 3 months predict the recurrence by 100%. Preoperative fleshy pterygia will mostly recur again whatever Bevacizumab form was used .The corneal thickness by anterior segment OCT has no role in prediction or detection of early pterygium recurrence.

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