Comparison of postoperative best corrected visual acuity following topical versus peribulbar anaesthesia for phacoemulsification with foldable intraocular lens implantation

2019 ◽  
Vol 9 (2) ◽  
pp. 36-39
Author(s):  
M B Dongre ◽  
◽  
Divya Dhopey ◽  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Peribulbar Anaesthesia ◽  
Lens Implantation ◽  
Best Corrected Visual Acuity

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

scholarly journals Reimplantasi Lensa Setelah Komplikasi Operasi Katarak

2012 ◽  
Vol 6 (4) ◽  
pp. 168
Author(s):  
Gilbert W. S. Simanjuntak
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Open Space ◽  
Clinical Findings ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
Best Corrected Visual Acuity ◽  
Secondary Intraocular Lens Implantation

Ada keterbatasan laporan implementasi lensa intraokuler sekunder di Indonesia. Penelitian ini bertujuan untuk melaporkan hasil implementasi lensa intraokuler sekunder di Rumah Sakit Communion of Churches in Indonesia (CCI) Cikini, Fakultas Kedokteran Universitas Kristen IndonesiaJakarta. Penelitian dengan sumber data sekunder rekam medis pasien dengan bedah inclusi eventful dengan atau tanpa implementasi lensa dan setiap komplikasi post operasi, termasuk penurunan penglihatan dan inflamasi katarak. Segmen anterior dan posterior diperiksa secara menyeluruh dan dicatat. Sinechiolisis dilakukan 360o dan viskoelastik disuntikkan untuk membuka ruangan antara iris dan kapsul rensi remain. Remain vitreous di depan chamber dipotong dan diangkat. Intraocular lens (IOL) ditanam di sulkus. Hasilnya yaitu ada 8 pasien yang memenuhi kriteria inklusi yang kemudian dievaluasi (50% adalah pria), 6 pasien underwent extracapsular catarac extraction (ECCE), dan 2 pasien underwent phacoemulsification before. Semua pasien mempunyai kornea sentral yang jernih. Ada 5 pasien denganuveitis dan opasitas vitreous. Ada 1 pasien dengan (AC IOL), 2 pasien dengan (PCIOL) terdislokasi sebagian pada rongga vitreous dan sisanya aphakic. Semua prosedur bedah dikerjakan dengan anastesi lokal retrobulbar dan diimplementasi IOL pada sulkus tanpa fiksasi. Rata-rata umuradalah 56,3 + 18,5 tahun. Rata-rata best corrected visual acuity (BCVA) sebelum operasi 0,33 + 0,26 dan setelah operasi 0,89 + 0,16 (p = 0,000). Rata-rata intraocular pressure (IOP) adalah 20,25 + 8,2 dan 15,25 + 3,5 mmHg sebelum dan sesudah operasi secara berurutan (p = 0,140). Pemantauan dilakukan 1 - 60 bulan. Implementasi IOL sekunder dapatmemperbaiki penglihatan dan mengurangi subjektif dan temuan klinik setelah operasi katarak sebelumnya.Kata kunci: Intraokuler, implementasi, katarakAbstractThere are limited reports of secondary intraocular lens implantation in Indonesia. The purpose of study is to report the result of secondary intraocular lens implantation in Cikini Communion of Churches in Indonesia (CCI) Hospital/Faculty of Medicine University Universitas Kristen Indonesia Jakarta. Retrospective study of medical records of patients with inclusioneventful cataract surgery with or without lens implantation with any complications postoperatively, including reduced vision and inflammation. Anterior and posterior segment findings were examine thoroughly and recorded. Synechiolysis done 360 degree and viscoelastic injected to open space between iris and remain lens capsule. Remain vitreous in anterior chambercut and removed. Intraocular lens (IOL) implanted in the sulcus. There are 8 patients that fulfills inclusion criteria which then evaluated (50% are men), 6 patients underwent extracapsular catarac extraction (ECCE), and 2 patientsunderwent phacoemulsification before. All patient have clear central cornea. There are 5 patients with uveitis and vitreous opacity. There are 1 patients with (AC IOL), 2 patients with (PC IOL) dislocated some part to vitreous cavity and the rest aphakic. All surgical procedures were done under local retrobulbar anesthesia and IOL implanted in the sulcus withoutfixation. Mean age were 56,3 + 18,5 years. Mean best corrected visual acuity (BCVA) preoperatively 0,33 + 0,26 and postoperatively 0,89 + 0,16 (p = 0,000). Mean intraocular pressure (IOP) were 20,25 + 8,2 and 15,25 + 3,5 mmHg pre and post operative respectively (p = 0,140). Follow up was 1 - 60 months. Secondary IOL implantation can improve vision and reduce subjective and clinical findings after remarkable cataract surgery.Key words: Intraocular, implementation, cataract

scholarly journals Analysis of the surgical treatment of posterior lenticonus associated with congenital cataract

2016 ◽  
Vol 11 (3) ◽  
pp. 138-143
Author(s):  
K. B Pershin ◽  
N. F Pashinova ◽  
Alina Vasil’evna Cherkashina ◽  
A. Yu Tsygankov
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Intraocular Lens ◽  
Congenital Cataract ◽  
Intraocular Lenses ◽  
Entire Group ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
Best Corrected Visual Acuity

Aim. The objective of the present study was to analyze the results of the surgical treatment of the children presenting with posterior lenticonus associated with congenital cataract. Materials and methods. The total of 8 children (8 eyes) with posterior lenticonus enrolled in this study accounted for 6.5% of all cases of congenital cataract treated at the “Excimer” Eye Center during the period from 2003 to 2015. The age of the patients varied from 0.2 to 15 (mean 8.1±3.8) years. Preoperatively, the uncorrected visual acuity was estimated to be 0.11±0.1 (0.01 - 0.3), with the best corrected visual acuity being 0.15±0.13 (range: 0.01 - 0.4). Lensectomy was performed under general anesthesia by means of the incision technology (1.8 and 2.2 mm) with the use of the Millenium, Stellaris microsurgical system (Bausch and Lomb, USA) and the Infinity system (Alcon, USA). In all the cases, different IOL models (Alcon, USA) were implanted; in four cases, the toric intraocular lenses were used. Results. In all the patients with posterior lenticonus and congenital cataract, the “dry” aspiration of the lens was performed. The distinctive features of posterior capsulorhexis included the use of two viscoelastic materials, viz. heavy Healon GV applied over the intraocular lens and ProVisc applied under the intraocular lens in the form of a “layer cake”. Thereafter, posterior capsulorhexis and vitrectomy were done. The lens was implanted into the capsular bag (n = 6) and into the ciliary sulcus (n = 2) with the anterior and posterior “optic capture”; the edges of the optical hole were placed behind the capsulorhexis hole. In the cases of the initial posterior capsular defect (n = 3), we performed vitreorhexis and vitrectomy followed by intraocular lens implantation. The best corrected visual acuity increased from 0.15 before the operation to 0.72 after surgery, with astigmatism being reduced from 2.3±0.9 to 1.6±065 diopters (overall astigmatism for the entire group) and from 1.81±0.46 to 0.56±0.56 diopters for the subgroup treated by means of toric IOL implantation. The patients remained under the observation during the follow-up period of more than 36 months. Conclusion. Lensectomy followed by intraocular lens implantation used for the treatment of the children presenting with posterior lenticonus and congenital cataract is the efficient method for the management of this combined pathology. Such features of the surgical technique as “dry” aspiration of the lens mass, posterior capsulorhexis, anterior vitrectomy, and optical capture taken together make it possible to achieve the favourable and stable functional outcome of the treatment.

Factors influencing myopic shift in children after intraocular lens implantation

2019 ◽  
Vol 30 (5) ◽  
pp. 933-940 ◽  
Author(s):  
Sandra Valeina ◽  
Santa Heede ◽  
Renars Erts ◽  
Svetlana Sepetiene ◽  
Elina Skaistkalne ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Intraocular Lenses ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Intraocular Lens Power ◽  
Lens Implantation ◽  
Myopic Shift ◽  
Lens Power ◽  
Best Corrected Visual Acuity

Introduction: Intraocular lenses have always been a controversial topic in pediatric cataract surgery. In the early 1990s in the post-Soviet states of Eastern Europe, intraocular lenses promised an easier full-time correction and amblyopia treatment. Since 1991, ophthalmologists in Latvia have been implanting intraocular lenses in infants. Amount of the postoperative myopic shift and its influencing factors, analyzed in this article, are important indicators of congenital cataract treatment. Materials and methods: A retrospective chart review off 85 children (137 eyes) who underwent foldable posterior chamber intraocular lens implantation at the Clinical University Hospital in Riga, Latvia, from 1 January 2006 until 31 December 2016, was performed. Depending on the age at surgery, patients were divided into six groups: 1–6, 7–12, 13–24, 25–48, 49–84, and 85–216 months. Results: The largest and more variable myopic shift was found in a group of diffuse/total and nuclear cataract with surgery before the age of 6 months. There was a statistically significant correlation between the acquired best-corrected visual acuity and the amount of myopic shift (rs = 0.33; p < 0.001). Comparing the amount of myopic shift in two groups of different intraocular lens implantation target refraction tactics, we did not find statistically significant differences. Comparing the amount of myopic shift and implanted intraocular lens power, a negative, statistically significant correlation was found. Conclusion: The earlier the cataract extraction surgery and intraocular lens implantation is performed, the larger the myopic shift. The morphological type of cataract, best-corrected visual acuity, secondary glaucoma, and intraocular lens power influence the amount of myopic shift.

Factors Influencing Visual Outcome after Penetrating Keratoplasty Combined with Intraocular Lens Implantation

2003 ◽  
Vol 13 (2) ◽  
pp. 134-138 ◽  
Author(s):  
J.B. Jonas ◽  
R.M. Rank ◽  
W.M. Budde ◽  
G. Sauder
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Penetrating Keratoplasty ◽  
Visual Outcome ◽  
Intraocular Lens Implantation ◽  
Postoperative Visual Acuity ◽  
Factors Influencing ◽  
Lens Implantation ◽  
Preoperative Visual Acuity

Purpose To establish which factors influence visual outcome after penetrating keratoplasty combined with intraocular lens implantation. Methods This retrospective noncomparative clinical interventional case series study included 135 consecutive patients (mean age 70.2 ± 13.6 years) who underwent central penetrating allogenic keratoplasty combined with intraocular lens (IOL) implantation, all operated by the same surgeon. There were 79 triple procedures, 33 keratoplasties combined with an exchange of IOL, and 23 penetrating keratoplasties combined with a secondary implantation of a posterior chamber lens. Mean follow-up was 28.3 ± 18.7 months (range 3.3–112 months). Reasons for keratoplasty were herpetic or traumatic corneal scars or defects (46), Fuchs corneal endothelial dystrophy (22), pseudophakic or aphakic bullous keratopathy (49), corneal endothelial decompensation due to other reasons (15), and keratoconus (3). Main outcome measures were postoperative visual acuity and gain in visual acuity. Results Mean postoperative visual acuity and mean gain in visual acuity were 0.33 ± 0.21 (median 0.30) and 0.25 ± 0.20 (median 0.20), respectively. Compared with the preoperative measurements, mean visual acuity increased in 129 patients (129/135, 95.6%). Factors influencing postoperative visual outcome and gain in visual acuity were preoperative visual acuity (p<0.005), reason for keratoplasty (p<0.005), and diameter of the graft (p = 0.046). Postoperative visual outcome was independent of age, sex, right or left eye, presence of diabetes mellitus, preoperative refractive error, length of follow-up, duration of surgery, and preoperative intraocular pressure. Conclusions The most important factors influencing visual outcome after central penetrating allogenic keratoplasty combined with IOL surgery are preoperative visual acuity, graft size, and reason for keratoplasty. Other factors such as age, sex, diabetes mellitus, and preoperative refractive error do not substantially influence postoperative visual outcome.

Bioptics for high hyperopia with combined multifocal intraocular lens implantation and excimer ablation in young patients

2018 ◽  
Vol 29 (4) ◽  
pp. 426-430 ◽  
Author(s):  
Omer Trivizki ◽  
David Smadja ◽  
Michael Mimouni ◽  
Samuel Levinger ◽  
Eliya Levinger
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Laser In Situ Keratomileusis ◽  
Intraocular Lens Implantation ◽  
Multifocal Intraocular Lens ◽  
Distance Visual Acuity ◽  
Lens Implantation ◽  
Near Visual Acuity ◽  
High Hyperopia

Purpose:To analyze the visual and refractive outcome of the bioptics procedure combining multifocal intraocular lens implantation and excimer laser surgery in young patients with high hyperopic eyes not suitable for a single surgical procedure.Methods:This retrospective case series included 10 eyes of five patients (age range 18–30 years) with high hyperopia (spherical equivalent +8.51 ± 0.85 diopters (D)). They had been treated with serial multifocal intraocular lens implantation followed 6 weeks later by laser in situ keratomileusis for residual hyperopia. Uncorrected distance visual acuity, uncorrected near visual acuity, corrected distance visual acuity, corrected near visual acuity, and manifest refraction were evaluated before surgeries, after multifocal intraocular lens implantation, and 3 months post laser in situ keratomileusis.Results:No patients were lost to follow-up (6 months). The mean spherical equivalent decreased to +2.05 ± 1.33 D after multifocal intraocular lens implantation and to −0.10 ± 0.58 D after the laser in situ keratomileusis procedure. Success of the procedures was determined by uncorrected visual acuity. LogMAR uncorrected distance visual acuity improved by a total of more than six lines from 1.05 ± 0.18 LogMAR to 0.46 ± 0.12 LogMAR post multifocal intraocular lens implantation and to 0.15 ± 0.06 LogMAR after both surgeries. The LogMAR uncorrected near visual acuity increased by 0.81 ± 0.82 LogMAR after lens implantation due to loss of accommodation, and all eyes reached a LogMAR of 0 at 1 month postoperatively following laser in situ keratomileusis.Conclusions:A bioptics approach involving multifocal intraocular lens followed 6 weeks later by a laser in situ keratomileusis procedure for the correction of very high hyperopia enabled the resolution of the residual refractive error in young very high hyperopic patients.

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