scholarly journals Capsular Blockage Syndrome: Clinical and Anterior Segment Optical Coherence Tomography (OCT) Characteristics

2021 ◽  
Author(s):  
Hsin-Yu Yang ◽  
Sui-Ching Kao ◽  
Chieh-Chih Tsai ◽  
Wei-Kuang Yu
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Low Dose ◽  
Anterior Segment ◽  
Topical Steroid ◽  
Anterior Segment Oct ◽  
Corrected Visual Acuity ◽  
Nd:Yag Laser Capsulotomy ◽  
Significant Difference

Abstract Background:CBS is a rare phenomenon which is found during and after cataract surgery. The mechanism, OCT presentation and clinical characteristics are not well studied. Methods:Document patients with CBS who underwent examination, including refraction, best-corrected visual acuity, slit lamp, anterior segment OCT, and onset after cataract surgery. All patients underwent Nd:YAG laser capsulotomy and were prescribed a low-dose topical steroid for seven days. Post-capsulotomy refraction and visual acuity were recorded.Results:This study included 18 eyes. Patients’ mean age was 80 (range, 54–92). The duration between cataract surgery and CBS diagnosis ranged 15–136 months. According to anterior segment OCT findings, we subcategorized the patients into four types: minimally opaque (n=4, 22%), uniformly turbid (n=7, 39%), focally condensed (n=5, 28%), and diffused sparkling (n=2, 11%). After laser capsulotomy, mean visual acuity improved 0.18 ± 0.09 on the LogMar. A significant difference in absolute refraction changes between the groups was noted— maximum in the focally condensed and minimum in the uniformly turbid types. No patient developed complications or needed further treatment for CBS during mean follow-up of 80 months.Conclusion:High-resolution anterior segment OCT is useful for analyzing pathological changes in the CBS. Our study implies that these four types of CBS presentation indicate various causes of late-CBS formation, as well as distinct clinical presentation and post–laser capsulotomy outcome. In addition, YAG laser capsulotomy is a safe late-CBS treatment modality.

Intracameral r-tPA for the management of severe fibrinous reactions in TASS after cataract surgery

2021 ◽  
pp. 112067212110020
Author(s):  
Perach Osaadon ◽  
Nadav Belfair ◽  
Itay Lavy ◽  
Eyal Walter ◽  
Jaime Levy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Anterior Segment ◽  
Case Series ◽  
Corneal Edema ◽  
Recombinant Tissue Plasminogen Activator ◽  
Maximal Effect ◽  
Corrected Visual Acuity ◽  
Tissue Plasminogen

Background: To describe the use of intracameral recombinant tissue plasminogen activator (r-tPA) in the treatment of severe fibrinous reactions in toxic anterior segment syndrome (TASS) after cataract surgery. Methods: A case series of 59 eyes of 59 patients with severe fibrinous anterior chamber reaction following cataract surgery who received intracameral r-tPA (25 µg/0.1 ml). The main outcome measures after intracameral r-tPA were the incidence of complete fibrinolysis, time of maximal effect, visual acuity, and complications. Results: Severe fibrinous reactions appeared 11.5 ± 5.3 days after cataract surgery. Fibrinolysis was observed 2.33 ± 2.70 days after rtPA use and 36 eyes (61%) exhibited resolution of the fibrin by the end of the first day following injection ( p < 0.001). Transient corneal edema observed at 1-day after injection was the only complication reported during the injection of r-tPA or at follow-up. Eight eyes (13.6%) required a second r-tPA injection. Best-corrected visual acuity improved from 0.88 ± 0.67 logMAR units before rtPA injection to 0.48 ± 0.49 logMAR units at 1-month ( p < 0.001). Conclusions: The application of r-tPA was a quick and efficacious therapeutic approach for the management of severe fibrinous reactions in TASS after cataract surgery. In a clinical setting, intracameral r-tPA may be useful when rapid visual recovery is needed.

scholarly journals Safety and Efficacy of 25G vitrectomy surgery for malignant glaucoma in pseudophakia

2019 ◽  
Author(s):  
fei you
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Safety And Efficacy ◽  
Corrected Visual Acuity ◽  
Malignant Glaucoma ◽  
Intraocular Hemorrhage ◽  
Significant Difference ◽  
Best Corrected Visual Acuity

Abstract Background: malignant glaucoma after cataract surgery is still one of the serious complications, if not handled properly，it may lead to serious consequences. It is notoriously difficult to treat. 25G vitrectomy was performed to evaluate the safety and efficacy for the treatment of malignant glaucoma in pseudophakia. Methods: This is a retrospective, comparative case series study. A total of 20 eyes of 20 patients with malignant glaucoma after phacoemulsification were analyzed retrospectively in The First Affiliated Hospital Of Anhui Medical University from May 2015 to January 2018. All Medical Data including the best corrected visual acuity (BCVA), Change of intraocular pressure (IOP), the length of eye axis, and the depth of anterior chamber were recorded. SPSS 17.0 statistical software was used for analysis .Before surgery, the best corrected visual acuity (BCVA) was 1.8±0.6. The intraocular pressure was between 18-57mmHg, with an average of 35.2±10.4mmHg.The depth of anterior chamber was between 0.9-1.9mm, with an average of 1.3±0.2mm.The length of eye axis was 19.7-22.5mm,with an average of 20.6±0.5mm.All the patients were accomplished with 25G vitrectomy. Besides, anterior chamber inflammatory reaction and other complications were also observed postoperation. Results: The patients were followed up for 6-12 months with an average of 9 months. BCVA at the last follow up improved to 0.8±0.1, and there was significant difference compared to that before operation (P<0.01).IOP was from 12-19mmHg, an average of 16.1±2.5mmHg, there was significant difference compared to that before operation (t=7.6, p<0.01).Only one patient occurred low IOP (6mmHg) after surgery, IOP returned to normal level (14mmHg) after conservative treatment. No serious complications including corneal endothelium decompensation, intraocular lens (IOL) capture, intraocular hemorrhage, endophthalmitis and uncontrolled IOP were observed. Conclusions: 25G minimally invasive vitrectomy can treat malignant glaucoma after cataract surgery safely and effectively

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.

scholarly journals Clinical Application of Foldable Capsular Vitreous Bodies in the Treatment of Severe Ocular Trauma and Silicone Oil Dependent Eyes

2021 ◽  
Author(s):  
Hao Jiang ◽  
Chao Xue ◽  
Yanlin Gao ◽  
Ying Chen ◽  
Yan Wang
Keyword(s):  
Visual Acuity ◽  
Clinical Application ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Anterior Segment ◽  
Vitreous Body ◽  
Corneal Opacity ◽  
Ultrasound Biomicroscopy ◽  
Significant Difference

Abstract Background: Recently, a new type of foldable capsular vitreous body (FCVB) has been developed for clinical application to fill the vitreous cavity with vitreous substitutes. It may be an ideal substitute for the vitreous body in eyes with severe retinal detachment. The aim of this study was to assess the application of a foldable capsular vitreous body (FCVB) in the treatment of severe ocular trauma and silicone oil (SO) dependent eyes.Methods: A retrospective analysis was performed on the clinical application of FCVB in the treatment of severe ocular trauma and SO dependent eyes. The results of best-corrected visual acuity and intraocular pressure (IOP) evaluation, B-scan ultrasonography or color Doppler ultrasonography, ultrasound biomicroscopy, and anterior segment photography were recorded during follow-up. A paired t-test was used to compare the difference in IOP before and after FCVB implantation. Results: Seven eyes of seven patients were included in the 6 months follow-up. In all cases, B-scan ultrasonography and ultrasound biomicroscopy showed that FCVB adapted closely to the globe wall and ciliary body, thus supporting the retina. Visual acuity did not improve, except in one case from LP to HM. The mean±SD IOP was 9.29±1.60mmHg prior to FCVB implantation and 10.43±0.98mmHg after implantation, with no significant difference between these measurements (P=0.066). Five of the seven patients developed differing degrees of corneal opacity and keratopathy. Conclusions: FCVB implantation may be a safe and effective method for the treatment of severe ocular trauma and SO dependent eyes. However, corneal opacity and keratopathy are potential serious complications after surgery. Appropriate case selection and proper surgical time require further investigation.

scholarly journals Pre-Descemetic Placement of Intracorneal Ring Segments for Keratoconus after Mechanical Implantation

2021 ◽  
pp. 940-943
Author(s):  
Faady Yahya ◽  
Christian F. Prünte ◽  
Hendrik P.N. Scholl ◽  
Zisis Gatzioufas
Keyword(s):  
Visual Acuity ◽  
High Resolution ◽  
Femtosecond Laser ◽  
Anterior Segment ◽  
Slit Lamp ◽  
Anterior Segment Oct ◽  
Ring Segment ◽  
Intracorneal Ring Segment

We report the case of a 23-year-old male who was referred to our clinic for a routine follow-up examination. The patient was treated for keratoconus 3 years ago in Colombia, where intracorneal ring segments were implanted mechanically in both eyes to improve his visual acuity. Surprisingly, we discovered a pre-descemetic placement of intracorneal ring segments, which could lead to potential complications, under circumstances. We illustrate this impressive finding with slit-lamp photography and high-resolution anterior segment OCT and advocate for the use of femtosecond laser as the method of choice for intracorneal ring segment insertion in order to provide maximal precision and safety.

scholarly journals Visual outcome of cataract surgery with IOL implantation in traumatic cataract among 189 children: The Lahan experience

2017 ◽  
Vol 5 (3) ◽  
pp. 1-10
Author(s):  
L R Puri ◽  
G S Shrestha
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Anterior Segment ◽  
Visual Outcome ◽  
Traumatic Cataract ◽  
Eye Injuries ◽  
Iol Implantation ◽  
Wooden Stick ◽  
Time Of Presentation

Trauma is an important cause of monocular blindness in the developing world. This study aims to determine the demo­graphic profile and visual outcome of cataract surgery among the children with traumatic cataract. It was a prospective and longitudinal study of 189 consecutive children below 16 years who underwent cataract surgery with intra ocular lens (IOL) implantation for traumatic cataract at Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from October 2012 to March 2014. Assessment included visual acuity measurement in the Snellen’s chart or the Cardiff card, anterior segment examina­tion with slit lamp, dilated fundus examination with the help of +20D lens in indirect ophthalmoscope, B-scan ultrasonogra­phy of posterior segment and objective and subjective refraction. Follow up was scheduled at first post-operative day, at dis­charge, one month and three months. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded. Among 189, majority of them were males (73%) and the average age was 8.8±3.6 years. The time of presentation ranged from 3 days to 8 years (median age two months). Wooden stick was the most common cause of injury (34.4%). The average preoperative visual acuity in logMAR scale was 1.6. The average postoperative visual acuity in logMAR scale was 0.8. Eye injuries with traumatic cataract are associated with significant visual impairment. Cataract surgery with intraocular lens implantation restores vision significantly.

scholarly journals Visual Acuity, Retinal Sensitivity, and Macular Thickness Changes in Diabetic Patients without Diabetic Retinopathy after Cataract Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Spela Stunf Pukl ◽  
Nataša Vidović Valentinčič ◽  
Mojca Urbančič ◽  
Irena Irman Grčar ◽  
Rok Grčar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Cataract Surgery ◽  
Diabetic Patients ◽  
Retinal Sensitivity ◽  
Diabetic Retina ◽  
Corrected Visual Acuity ◽  
Prospective Comparative Study

Aim. Functional and morphological macular study after cataract surgery in a group of diabetics without diabetic retinopathy compared to nondiabetics to evaluate the effect of surgical oxidative stress on diabetic retina.Methods. Prospective, comparative study. Preoperative eye exam, best corrected visual acuity (BCVA) measured by ETDRS letters, and optical coherence tomography (OCT) were followed by standard cataract surgery. The follow-up visits at 1, 3, and 6 months postoperatively included BCVA, OCT, and microperimetry, to analyze changes within and between the groups.Results. The BCVA improved significantly in diabetics and controls: 64.2 to 81.0 and 61.9 to 82.1 ETDRS at 6 months, respectively. The central macula at OCT significantly thickened in both groups, while the central 5 fields, corresponding to the microperimetry area, subclinically thickened from 284.20 to 291.18 μm at 6 months only in diabetics (p=0.026). A matching slight decrease in the microperimetry sensitivity from 1 to 6 months was found also only in diabetics, with mean average difference −0.75 dB (p=0.04).Conclusion. Underlying diabetes does not influence the surgical outcome in diabetics without diabetic retinopathy. However, slight thickening of wider macula and corresponding decrease in retinal sensitivity observed in diabetics 6 months postoperatively might influence visual function on long term.

Phacoemulsification in Eyes with Neovascular AMD Treated with Anti-VEGF Injections

2011 ◽  
Vol 21 (6) ◽  
pp. 766-770 ◽  
Author(s):  
Maria Muzyka-Woźniak
Keyword(s):  
Visual Acuity ◽  
Median Time ◽  
Time Interval ◽  
Neovascular Amd ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Case Series Study ◽  
Significant Difference ◽  
Best Corrected Visual Acuity

Purpose. To evaluate visual results of phacoemulsification in eyes with neovascular age-related macular degeneration (AMD) treated with anti–vascular endothelial growth factor (VEGF) intravitreal injections. Methods. This retrospective noncomparative interventional case-series study assessed best-corrected visual acuity (BCVA) at 4 timepoints: 1) baseline, immediately before first anti-VEGF injection; 2) preoperative, immediately before phacoemulsification; 3) postoperative, 1 month after phacoemulsification; 4) endpoint, at the last visit. Anti-VEGF retreatment regimen was based only on optical coherence tomography. The median time between anti-VEGF injections was evaluated for the time period before and after phacoemulsification. Results. Sixteen eyes of 16 patients were included. The median (range) baseline, preoperative, post-operative, and endpoint BCVA was 0.7 (0.3–1.3), 0.72 (0.4–1.3), 0.5 (0.05–1.0), and 0.36 (0.0–1.0) logMAR, respectively. Best-corrected visual acuity significantly improved after phacoemulsification (mean 3 logMAR lines) and remained stable during follow-up (median 14 months, range 7–28). There was no statistically significant difference in the median time interval between injections before phacoemulsification and after phacoemulsification. Conclusions. Phacoemulsification significantly improved BCVA in patients with choroidal neovascular AMD. This effect persisted during follow-up with no increased need for anti-VEGF injections to keep macula dry.

scholarly journals Clinical Study of Visual Outcome and Complications of Nd:YAG Laser Capsulotomy in Posterior Capsular Opacification Following Small Incision Cataract Surgery at a Tertiary Eye Care Centre in Rural Maharashtra - A Prospective Observational Study

2021 ◽  
Vol 8 (19) ◽  
pp. 1409-1413
Author(s):  
Varsha Ramesh Dhakne ◽  
Sourabh Hanumant Karad ◽  
Samartha Babasaheb Waghambare ◽  
Hanumant Tulshiram Karad ◽  
Uttam Haribhau Nisale ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Nd:Yag Laser ◽  
Visual Outcome ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Posterior Capsular Opacification ◽  
Corrected Visual Acuity ◽  
Nd:Yag Laser Capsulotomy ◽  
Best Corrected Visual Acuity

BACKGROUND Posterior capsule opacification (PCO) is the most common delayed complication of cataract surgery. Nd:YAG (Neodymium yttrium aluminium garnet) laser posterior capsulotomy presents the advantages of a non-invasive, effective, relatively safe technique to manage intact posterior capsule that opacifies postoperatively. With this background we want to study the visual outcome and complications following Nd-YAG laser posterior capsulotomy in posterior capsular opacification following small incision cataract surgery (SICS). METHODS The study includes 64 patients attending outpatient department of a tertiary eye care hospital at Latur from June 2018 to May 2019 who have undergone SICS with PMMA PC IOL (polymethyl methacrylate posterior chamber intraocular lens) implantation and clinically diagnosed with posterior capsular opacification. 64 eyes with PCO were subjected to Nd:YAG laser posterior capsulotomy after detailed slit lamp bio microscopic examination pre- and post-capsulotomy. Follow-up was done at 1 hour, 1 week, 2 weeks and 4 weeks and patients were examined for visual outcome and any complications at each visit. RESULTS There were 16 males (25 %) and 48 females (75 %) with a mean age of 65 years. Posterior capsule opacification occurs within 3 years accounting for 46.9 % of the cases. Elschnig pearls type of PCO was more common when compared to fibrous type of PCO. Best corrected visual acuity (BCVA) before Nd:YAG laser capsulotomy was less than 6 / 60 in 35 patients (54.7 %) and within 6 / 60 to 6 / 24 in 23 patients (35. 9 %) with 6 patients (9.4 %) accounting for visual acuity between 6 / 24 to 6 / 18. After Nd - YAG Laser Capsulotomy, 46.9 % gained best corrected visual acuity of 6 / 18 or better, 39.1 % cases improved 6 / 12 and better and BCVA of 6 / 9, 6 / 6 was observed in 11 cases and 1 case respectively. Only 12 out of 64 patients had complications. Raised intraocular pressure (IOP) was found in 4 patients. Intraocular lens (IOL) pitting was found in 8 patients. CONCLUSIONS Nd:YAG laser capsulotomy is a safe, effective and a non-invasive procedure which avoids all the complications of surgical capsulotomy in patients of posterior capsule opacification. KEYWORDS Posterior capsule opacification (PCO), Nd:Yag Laser Capsulotomy, Best Corrected Visual Acuity (BCVA), Central Subfield Macular Thickness (CSMT)

Immediate Sequential Bilateral Cataract Surgery in Covid-19 Pandemic - A Prospective Study in a Tertiary Eye Care Centre of Eastern India

2021 ◽  
Vol 8 (30) ◽  
pp. 2691-2696
Author(s):  
Aanchal Priya ◽  
Sunil Kumar ◽  
Seema Singh
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Hospital Visit ◽  
Bilateral Cataract ◽  
Corrected Visual Acuity ◽  
Operative Complications ◽  
The Mean ◽  
Hospital Visits ◽  
Best Corrected Visual Acuity

BACKGROUND Immediate sequential bilateral cataract surgery (ISBCS) is the procedure in which both eyes are simultaneously operated in a single hospital visit. The onset of corona virus disease-19 (COVID-19) pandemic has raised the interest among ophthalmic surgeon in considering immediate sequential bilateral cataract surgery to reduce hospital visit of patients. This study was done to assess the intraoperative and post-operative complications and average number of hospital visits required after performing immediate sequential bilateral cataract surgery in COVID-19 pandemic. Also, the post-operative visual outcomes were evaluated. METHODS Patients with visually significant bilateral cataract with best corrected visual acuity ≤ 6/18 in better eye, axial length within range of 21 - 25 mm and age >18 years with no ocular and systemic co-morbidity were included in the study. All patients underwent immediate sequential bilateral cataract surgery from July 2020 to September 2020. Strict intraoperative protocols were followed in all cases. Intracameral injection of 0.1 ml moxifloxacin 0.5 % (vigamox / Novartis health care Pvt Ltd. Texas, USA) was given at the end of surgery in all cases. Intraoperative and post-operative complications, visual and refractive outcomes were analysed. RESULTS Sixty-four eyes of 32 patients with mean age 55 ± 2.82 years (range: 48 - 71 years) were included in the study. The mean pre-operative best corrected visual acuity was 0.64 ± 0.08 logarithm of minimum angle of resolution which improved significantly to 0.03 ± 0.03 at the end of second follow up on day 14 (P < 0.0001). The mean post-operative spherical equivalent was -0.22 ± 0.48 D. The target refraction within ± 0.50 D was achieved in 56 eyes (87.50 %) and within ± 1.0 D in all eyes. No vision threatening complications such as endophthalmitis, cystoid macular oedema, retinal detachment or corneal decompensation occurred in any of eyes. Total hospital visits were reduced to four per patients for both eye surgeries. CONCLUSIONS Immediate sequential bilateral cataract surgery may be considered as preferred practice in selected cases to reduce the risk of cross infection of COVID-19 by short hospitalization and less follow up visits. KEYWORDS Bilateral Cataract Surgery, COVID-19, Endophthalmitis

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