Postoperative corneal edema in modern cataract surgery

GlaucomaNews ◽  
2020 ◽  
pp. 51-52
Author(s):  
A.B. Movsisyan ◽  
◽  
E.A. Egorov ◽  
Keyword(s):  
Cataract Surgery ◽  
Corneal Edema

По данным ВОЗ, на сегодня катаракта является одной из основных причин нарушения зрения (33%) после аномалий рефракции [1]. В России на 10000 населения 1200 человек страдают данной патологией [2]. Единственным эффективным методом лечения катаракты является ее экстракция с имплантацией ИОЛ [5]. В настоящее время оперативное лечение катаракты – одно из наиболее распространенных хирургических вмешательств [3, 4]. Ежегодно в мире проводится более 10 млн операций по экстракции катаракты, в России – 542 000 операций [2]. При этом сохраняется тенденция к росту заболеваемости катарактой [1, 2, 6], а следовательно, и потребность к увеличению количества проводимых операций. Современное хирургическое лечение катаракты подразумевает разрушение и удаление хрусталика через малые самогерметизирующиеся разрезы. Самым безопасным и эффективным методом лечения катаракты во всем мире признана ультразвуковая экстракция катаракты с имплантацией интраокулярной линзы [7-10]. В России 3/4 катаракт удаляются данным методом [2]. Однако, несмотря на усовершенствование предоперационной подготовки пациентов, методики факоэмульсификации катаракты, анестезиологического пособия, профилактики бактериальных и воспалительных изменений глаза, а также развития кистозного макулярного отека, осложнения в послеоперационном периоде все же встречаются. Это приводит к увеличению срока реабилитации и может снизить в последующем клинико-функциональные результаты операции

Safety and Efficacy of Temporal Manual Small Incision Cataract Surgery in India

2011 ◽  
Vol 21 (6) ◽  
pp. 748-753 ◽  
Author(s):  
Swati V. Zawar ◽  
Parikshit Gogate
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Corneal Edema ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Safety And Efficacy ◽  
Excellent Outcome ◽  
Sutureless Technique ◽  
Small Incision ◽  
Sandwich Method

Purpose. To assess safety and efficacy of temporal manual small incision cataract surgery (SICS) in context to visual outcome, astigmatism, and complications. Methods. This involved sclerocorneal tunnel, capsulotomy and hydrodissection. The incision was made with number 11 disposable surgical blade (costing Indian Rs. 2.50, $0.05). Nucleus extraction was done by phaco-sandwich method with the help of vectis and dialer. Posterior chamber intraocular lens implantation was done according to biometric findings. A record of intraoperative and postoperative complications was made. The final postoperative assessment of astigmatism was done with spectacle correction on the 45th day as per the refraction findings. Results. Two thousand eyes were operated by temporal, manual small incision sutureless technique. Uncorrected visual acuity was ≥6/18 in 1636 (81.7%) patients on the first postoperative day, in 1652 (82.6%) patients at 2 weeks, and in 1732 (88.6%) patients at 6 weeks. Best-corrected visual acuity (BCVA) ≥6/18 was achieved in 1868 (93.4%) patients at 6 weeks, with 46 (2.3%) having BCVA <6/60, 24 (1.2%) of whom had preexisting retinal pathology. At 6 weeks, 1876 (93.8%) eyes had with-the-rule and 134 (6.2%) against-the-rule astigmatism (mean 0.7±1.25 D). Iris prolapse was noted in 3 (0.15%), wound leak in 3 (0.15%), and transient corneal edema in 136 (6.8%) eyes. Average surgery time was 6 minutes. Conclusions. Temporal SICS with number 11 disposable surgical blade and nucleus delivery by phaco-sandwich method gave excellent outcome with minimal astigmatism and low complication rate at economic cost.

scholarly journals The Anterior Chamber Injection of Moxifloxacin Injection to Prevent Endophthalmitis after Cataract Surgery: A Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Xiao-lei Wang ◽  
Xiao-yong Huang ◽  
Zhen Wang ◽  
Wei Sun
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Meta Analysis ◽  
Corneal Edema ◽  
Intraventricular Injection ◽  
Cochrane Library ◽  
Study Selection ◽  
Computer Based ◽  
The Difference ◽  
The Cochrane Library

Purpose. A meta-analysis was performed to compare the efficacy of an anterior chamber injection of moxifloxacin in the prevention of endophthalmitis after cataract surgery. Methods. A computer-based search of PubMed, Embase, the Cochrane Library, and the Clinical Trial database for articles related to anterior intraventricular injection of moxifloxacin for the prevention of endophthalmitis after cataract surgery was performed through April 2019. Study selection, data exclusion, and quality assessment were performed by two independent observers. Statistical analysis for the meta-analysis was performed by RevMan5.3 software. Results. Eight studies were included, with a total of 123,819 eyes. The meta-analysis showed that an anterior chamber injection of moxifloxacin can prevent the incidence of endophthalmitis after cataract surgery (OR = 0.29, 95% CI (0.15, 0.56), P=0.0002), and the difference was statistically significant. There were no significant differences between the moxifloxacin injection and nonmoxifloxacin injection groups in regard to UCVA (log MAR) (SMD = −0.13, 95% CI (−0.62, 0.35), P=0.60), BCVA (log MAR) (SMD = −0.27, 95% CI (−1.28, 0.74), P=0.60), IOP (SMD = −0.04, 95% CI (−0.02, 0.01), P=0.22), corneal edema (OR = 1.03, 95% CI (0.23, 4.69), P=0.97), CCT (SMD = −0.01, 95% CI (−0.07, 0.05), P=0.77), or ECD (SMD = 0.00, 95% CI (−0.06, 0.07), P=0.94). Conclusion. An anterior chamber injection of moxifloxacin can effectively prevent the incidence of endophthalmitis after cataract surgery, while the moxifloxacin injection and nonmoxifloxacin injection groups had similar results in regard to UCVA (log MAR), BCVA (log MAR), IOP, corneal edema, CCT, and ECD.

scholarly journals Accelerated corneal endothelial cell loss in two patients with granulomatosis with polyangiitis following phacoemulsification

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fang-Chi Hsiao ◽  
Hung-Ta Chen ◽  
Kuan-Jen Chen ◽  
Yi-Jen Hsueh ◽  
Yaa-Jyuhn James Meir ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Cataract Surgery ◽  
Granulomatosis With Polyangiitis ◽  
Corneal Edema ◽  
Cell Loss ◽  
Multiple Organs ◽  
First Case ◽  
Before And After ◽  
The Right

Abstract Background Generally, the loss rate of human endothelial cells (HCEC) in routine cataract surgery is 8.5%. When the corneal endothelial cells density (ECD) drops, the HCEC may decompensate to keep cornea dehydration which leads to corneal edema. Granulomatosis with polyangiitis (GPA) is an uncommon autoimmune disease involving multiple organs including eyes such as conjunctivitis, scleritis, uveitis, and corneal ulcer. In this study, we report two cases of GPA whose corneal ECD decreased significantly after phacoemulsification cataract surgery. Case presentation In the first case of 69-year-old male with GPA, the ECD dropped 39.6% (OD) four months after phacoemulsification and 38.1% (OS) six months postoperatively respectively. At the final follow-up, the residual ECD was only 55% in the right eye in the 49th month, and 56% remained in the left eye in the 39th month. In the second case of 54-year old female, left ECD dropped 63.9% at the 4th month after surgery and 69.6% ECD remained at the 15th month postoperatively while similar ECD of right eye before and after left eye surgery. Conclusion Extensive preoperative ophthalmic evaluation and meticulous postoperative inflammation control should be applied to prevent severe loss of HCEC in GPA patients.

Oxygen therapy for corneal edema after cataract surgery

2015 ◽  
Vol 41 (7) ◽  
pp. 1370-1375 ◽  
Author(s):  
Farideh Sharifipour ◽  
Mahmoodreza Panahi-Bazaz ◽  
Esmaeil Idani ◽  
Maryam Hajizadeh ◽  
Azadeh Saki
Keyword(s):  
Cataract Surgery ◽  
Oxygen Therapy ◽  
Corneal Edema

scholarly journals Improving Intraocular Lens Calculation in Fuchs Endothelial Dystrophy According To Preoperative Degree of Corneal Edema

2021 ◽  
Author(s):  
Beatriz Gargallo-Martinez ◽  
Amanda Ortiz-Gomariz ◽  
Ana Maria Gomez-Ramirez ◽  
Angel Ramon Gutiérrez-Ortega ◽  
Jose Javier Garcia-Medina
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Target Selection ◽  
Corneal Transplantation ◽  
Corneal Edema ◽  
Power Calculation ◽  
Iol Power Calculation ◽  
Iol Power ◽  
Fuchs Endothelial Dystrophy

Abstract Fuchs endothelial dystrophy (FED) is a bilateral, asymmetric, progressive corneal endothelium disorder that causes corneal edema. Resolution of corneal edema is only possible by corneal transplantation. Cataract surgery is a common surgery that replaces the natural lens of the eye by an artificial intraocular lens (IOL). The IOL-power calculation depends mainly on the anterior corneal keratometry and the axial length. In patients with FED, anterior keratometry may be affected by corneal edema and calculations may be less accurate. Therefore, the aim of this study is to establish the theorical postoperative refractive error due to corneal edema resolution after Descemet stripping endothelial keratoplasty combined with cataract surgery and IOL implantation. For this, anterior keratometry was measure preoperatively with edematous cornea and postoperatively after corneal edema resolution. Both keratometries were compared and used to calculate the respective theorical IOL-powers. The difference between target IOLs was used to establish the theorical refractive error due to corneal edema resolution. The results showed that corneal edema resolution induces a change in anterior keratometry, which affects IOL-power calculations and causes a hyperopic shift. The patients with moderate-to-severe preoperative corneal edema had higher theorical refractive error so their target selection should be adjusted for additional − 0.50D.

scholarly journals Persistent Corneal Decompensation due to Anterior Dislocation of Soemmering Ring Cataract

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Travis Peck ◽  
Shruti Aggarwal ◽  
Sandra Johnson
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Corneal Edema ◽  
Anterior Dislocation ◽  
Surgical Removal ◽  
History Of ◽  
Corneal Decompensation ◽  
Early Surgical Intervention ◽  
Soemmering Ring ◽  
Ring Dislocation

Purpose. We present a case of a patient with Soemmering ring after cataract surgery and a potential complication that can arise as a result of its presence. Observations. A patient with history of ruptured globe status after repair and lensectomy, complicated by aphakic secondary open angle glaucoma, was referred for management of second injury to the same eye. This injury resulted in Soemmering ring dislocation into the anterior chamber. The cortical material caused a significant increase in intraocular pressure and corneal decompensation. Surgical removal of the Soemmering ring and Ahmed glaucoma tube implant was performed with control of intraocular pressures; however corneal edema could not be reversed. Conclusions and Importance. This case report illustrates the serious consequences that can be caused by Soemmering rings without early surgical intervention. Care must be taken to completely remove cortical material during cataract surgery to prevent their formation.

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