Visual assessment between phacoemulsification and small incision with 5.2mm non-foldable intraocular lens implant.

Objective: To compare visual assessment between phacoemulsification and small incision with 5.2mm non-foldable intraocular lens implant. Study Design: Experiential Study. Setting: Institute of Ophthalmology, Liaquat University Hospital Jamshoro, Period: September 2019 to August 2020. Material & Methods: We performed cataract surgeries using the non-foldable intraocular lens in 100 patients. Two techniques were performed, dividing patients equally into Phaco (Group-A) and SI (Group-B) cataract surgery. The outcomes of both were analyzed uncorrected visual acuity and complications. Results: Of the total 50 patients who underwent phacoemulsification, 55% were male and 45% females in Group-A while Group B (SI surgery) were 45% were male and 35% were female. The intra-operative success rate was 90% in Phaco group and 74% in SI group. In comparison, small Incision group had 10% of patients had difficulty in capsulorhexis, 8% in posterior capsular rupture, 6% in zonular dialysis, 2% iridodialysis, and 0% showing nucleus drip with all complications being higher than in Phaco Group except for nucleus drip (2% vs. 0%). Although, post-operatively, individually groups have similar complications with no notable difference seen, yet astigmatism was lesser in Group A than in Group B. Conclusion: Both techniques showed similar outcomes in the uncorrected visual acuity; however, astigmatism and complication rates were lesser in the phacoemulsification study group.

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Comparison of surgical and visual outcomes following capsulotomy using the envelope and continuous curvilinear capsulorhexis technique in manual small incision cataract surgery

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v12i1.14681 ◽

2016 ◽

Vol 12 (1) ◽

pp. 10-13

Author(s):

Sanjib Kr Chaudhary ◽

Shailesh Mani Pokhrel ◽

Manoj Sharma ◽

Badri Prasad Badhu ◽

Bhuwan Govinda Shrestha ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Posterior Capsular Opacification ◽

Surgical Time ◽

Small Incision Cataract Surgery ◽

Small Incision ◽

Uncorrected Visual Acuity ◽

Group A ◽

Group B

Background & Objectives: Capsulotomy is one of the important step in cataract surgery which can affect the surgical outcomes. The aim of the study was to compare the outcomes of envelope and continuous curvilinear capsulorhexis technique in manual small incision cataract surgery (MSICS). Materials & Methods: A total of 72 eyes of 72 patients undergoing MSICS were studied. The patients were equally divided into two groups i.e. 36 patients each in envelope capsulotomy (Group A) and continuous curvilinear capsulotomy (CCC) group (Group B).Results: Mean surgical time (±SD) in Group A was 355.83 sec ±37.79 sec and in Group B was 375 sec ±31.214 (p=0.02). Uncorrected visual acuity on postoperative day 1 was 6/9 or better in 50% (18) cases in Group A and in 36% (13) cases in Group B (p=0.28). Best corrected visual acuity (BCVA) on post-operative week 12 was 6/9 or better in 30.6% (n=11) cases in Group A and in 36% (n=13) cases in Group B (p=0.43). On 12th week postoperatively, Grade 2 posterior capsular opacification (PCO) was seen in 30.6 % (n=11) cases of Group A and in 16.6 % (n=6) cases of Group B (p=0.17). Conclusion: CCC technique can be considered superior to envelope technique for long term visual rehabilitation.JCMS Nepal. 2016;12(1):10-13.

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Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

Journal of Ophthalmology ◽

10.1155/2018/7342917 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Takayuki Baba ◽

Tomohiro Nizawa ◽

Toshiyuki Oshitari ◽

Shuichi Yamamoto

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Intraocular Lens ◽

Refractive Error ◽

Surgical Outcomes ◽

Case Series ◽

Cell Loss ◽

Significant Difference ◽

Group A ◽

Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

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Comparison of early visual quality in patients with moderate myopia using different optical zones in small incision lenticule extraction (SMILE)

BMC Ophthalmology ◽

10.1186/s12886-020-01798-y ◽

2021 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Yan Wu ◽

Zhenping Huang

Keyword(s):

Visual Acuity ◽

Night Vision ◽

Small Incision Lenticule Extraction ◽

Small Incision ◽

Spatial Frequencies ◽

Significant Difference ◽

Group A ◽

Optical Zone ◽

Lenticule Extraction ◽

Group B

Abstract Background The early visual qualities of patients with moderate myopia were evaluated after small incision lenticule extraction (SMILE) using different optical zones. Methods In this retrospective case study, 27 cases (51 eyes) were selected, including 10 cases in Group A (19 eyes), 6.6–6.8 mm in the optical zone, 10 cases in Group B (19 eyes), 6.4–6.5 mm in the optical zone, and 7 cases in Group C (13 eyes),6.1–6.3 mm in the optical zone. The following items were examined preoperatively and 1 month postoperatively: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical, cylinder, central corneal thickness (CCT), corneal mean curvature (CMC), total ocular aberrations (TA), total low order aberrations (tLOAs), defocus, astigmatism and total high order aberrations (tHOAs), spherical, coma, trefoil, modulation transfer function (MTF), MTFcutoff, SR, objective scatter index (OSI), point scatter function at 50 and 10% (PSF50%, PSF10%), and contrast visual acuity of 100, 20, and 9% (VA100%, VA20%, and VA9%). We compared the three groups by Kruskal-Wallis test. Wilcoxon signed ranks test was used for each group before and 1 month after surgeries. P< 0.05 was considered statistically significant. Results There was no significant difference in UCVA, BCVA, CCT, cylinder, and CMC in three groups preoperatively and 1 month postoperatively (P> 0.05). Comparison of the aberrations of the three groups showed statistically significant difference only in TA, tLOA, defocus, astigmatism and SA preoperatively, and trefoil 1 month postoperatively(P< 0.05). The postoperative TA, tLOAs, defocus, astigmatism and trefoil of the three groups were lower than those before surgeries (P< 0.05). The postoperative tHOAs of Group B and C was lower than those before surgeries (P< 0.05). The MTF results showed that before surgeries, there were significant differences in three groups (P< 0.05) in spatial frequencies 5~15 cycles per degree (cpd), and no differences in 20~30 cpd(P> 0.05), while no difference were observed in all spatial frequencies postoperatively (P> 0.05). Comparing the preoperative and postoperative MTF values for each group, the results showed that there was a significant difference in Group C at 5~20 cpd after surgeries(P< 0.05). There was no significant difference in MTFcutoff, SR, OSI, PSF50%, PSF10%, VA100%, VA20%, and VA9% in the three groups preoperatively (P> 0.05). One month after surgeries, higher VA9% values were measured for Group C compared to Group A and B (P < 0.05). There was no significant difference in each group before and after surgeries (P> 0.05). Conclusion SMILE could improve the visual qualities of patients with moderate myopia. Reducing the surgical optical zone will only affect night vision slightly.

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Improving the Outcomes of Modified Manual Small Incision Cataract Surgery Using Clinical Audit

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i3.1234 ◽

2021 ◽

Vol 37 (3) ◽

Author(s):

Muhammad Ifraheem Khan ◽

Saba Ali Arif ◽

Muhammad Raja ◽

Sheikh Ijaz ◽

Muhammad Saeed Khan

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Clinical Audit ◽

Cataract Extraction ◽

University Hospital ◽

Small Incision Cataract Surgery ◽

Small Incision ◽

Corrected Visual Acuity ◽

Good Technique ◽

Capsular Rupture

Purpose: To use clinical audit in improving the outcomes of manual small incision cataract surgery technique Study Design: Clinical audit. Place and Duration: Layton Rehmatullah Benevolent Trust Eye hospital Karachi, from September 2019 to December 2019. Methods: Two hundred patients who had undergone Manual Small Incision Cataract surgery were selected. Cases with traumatic cataract, weak zonules, pseudoexfoliation, and more than 1 diopter difference in keratometric readings, corneal and retinal pathologies were excluded. Surgical complications and visual outcomes were recorded on the 7th postoperative day. Refractive data was recorded from subjective refraction. Data was analyzed by University Hospital Bristol formula. Standards were set using international literature. Deficiencies were noted and technique was modified to improve the outcome. The audit was repeated after 2 months to see whether modifications had improved the outcome. Results: In the first audit, posterior capsular rupture rate was 1%, corrected visual acuity of 6/12 or better was achieved in 85.36% and surgically induced cylinder of less than 2 DC was achieved in 75.60% of the patients. In the second audit all standards were achieved. Posterior capsular rupture did not occur. Corrected visual acuity of 6/12 or better was achieved in 90.50% and induced cylinder of less than 2 DC was achieved in 87.05% of the patients. Conclusion: Clinical audit of the surgical procedures is a good technique in improving the outcomes of manual small incision cataract surgery. Key Words: Cataract extraction, clinical audit, posterior capsular rupture, astigmatism, visual acuity.

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A comparative study of sclero-corneal and clear corneal tunnel incision in manual small-incision cataract surgery

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v3i1.4273 ◽

1970 ◽

Vol 3 (1) ◽

pp. 19-22

Author(s):

S Archana ◽

AK Khurana ◽

U Chawla

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Posterior Chamber ◽

Small Incision Cataract Surgery ◽

Surgically Induced Astigmatism ◽

Small Incision ◽

Group A ◽

Induced Astigmatism ◽

Group B ◽

Surgically Induced

Background: Cataract surgery techniques have improved a lot over the years from couching to the latest micro-incision cataract surgery. Objectives: To compare the temporal sclero-corneal and clear corneal tunnel incisions in patients undergoing manual small-incision cataract surgery (SICS) with respect to the surgically-induced astigmatism. Materials and methods: The present study included 60 patients who underwent manual SICS with posterior chamber intraocular lens implantation. Group A comprised of 30 patients, selected randomly, who underwent sutureless manual SICS through 6 mm curvilinear clear corneal tunnel incision made temporally and Group B comprised of 30 patients, selected randomly, who underwent sutureless manual SICS through 6 mm straight sclero-corneal tunnel made temporally. The patients were assessed at 1 week, 2 weeks, 1 month and 2 months post-operatively and visual acuity and keratometry findings were recorded. The amount of surgically induced astigmatism was calculated using Holladay’s formula. Statistics: Numerical data were compared between the two groups using unpaired Student’s t-test. The p value of < 0.50 was considered significant. Results: The mean induced astigmatism in Group A was 2.69 ± 0.84 D at 1 week, 2.31 ± 0.77 D at 2 weeks; 2.03 ± 0.82 D at 4 weeks and 1.98 ± 0.54 D at 8 weeks post-operatively. In group B, it was 1.85 ± 0.62 D, 1.56 ± 0.54 D, 1.35 ± 0.49 D and 1.34 ±0.45 D at 1 week, 2 weeks, 4 weeks and 8 weeks postoperatively. Uncorrected visual acuity (UCVA) of 20/ 20 was seen in 20 % of patients in group A and in 40 % in group B at 8 weeks postoperatively. Conclusion: Surgically-induced astigmatism is significantly higher in clear corneal manual SICS than in sclero-corneal. Our study confirmed the safety and improvement in visual acuity after small-incision cataract surgery using sclero-corneal tunnel incision. Key words: astigmatism; sclero-corneal; clear corneal tunnel; extra-capsular cataract surgery; small incision cataract surgery DOI: 10.3126/nepjoph.v3i1.4273Nepal J Ophthalmol 2011;3(5):19-22

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Outcomes of out-of-hospital extracorporeal membrane oxygenation transfers: significance of initiation site and personnel

Perfusion ◽

10.1177/0267659119897784 ◽

2020 ◽

Vol 35 (7) ◽

pp. 633-640

Author(s):

Toru Mihama ◽

Spencer Liem ◽

Nicholas Cavarocchi ◽

Hitoshi Hirose

Keyword(s):

Survival Rate ◽

Extracorporeal Membrane Oxygenation ◽

Complication Rate ◽

Survival Rates ◽

University Hospital ◽

Complication Rates ◽

Membrane Oxygenation ◽

Group A ◽

Technical Complication ◽

Group B

Background: Extracorporeal membrane oxygenation is an accepted therapy option for refractory cardiac or respiratory failure. The outcomes of cases initiated at non–extracorporeal membrane oxygenation centers and subsequently transported for management to an extracorporeal membrane oxygenation center require further investigation. Methods: Retrospective institutional review board–approved database research and chart reviews were performed on referrals for extracorporeal membrane oxygenation initially admitted to an outside non–extracorporeal membrane oxygenation center hospital (OSH) then transferred to our extracorporeal membrane oxygenation center (Thomas Jefferson University Hospital (TJUH)). Unstable patients were placed on extracorporeal membrane oxygenation at OSH (Group A) before transport, while others were initiated at our certified extracorporeal membrane oxygenation center (Group B) upon arrival. Group A was further subdivided into patients cannulated by OSH personnel (Group AOSH) or TJUH transport team (Group ATJUH). Outcomes and complications were compared between the different initiation sites and personnel. Results: A total of 108 patients were transferred from August 2010 to June 2018. The technical complication rate for all Group A patients was 33/49 (67%), while that of Group B was 24/59 (41%); p = 0.006. Within Group A, Group AOSH had a greater technical complication rate with 29/33 (88%) than Group ATJUH with 4/16 (25%); p < 0.001. extracorporeal membrane oxygenation survival rate was 34/49 (69%) in Group A and 43/59 (73%) in Group B; p = 0.690. The extracorporeal membrane oxygenation survival rate for Group AOSH and Group ATJUH was 21/33 (64%) and 13/16 (81%), respectively; p = 0.210. Conclusion: Promising extracorporeal membrane oxygenation survival rates were observed in transferred patients. The complication rates related to cannulation technique were significantly higher when patients were initiated at non–extracorporeal membrane oxygenation centers, especially when placed by personnel from non–extracorporeal membrane oxygenation centers.

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Long-term silicone oil tamponade in eyes with complicated retinal detachment

European Journal of Ophthalmology ◽

10.1177/11206721211019551 ◽

2021 ◽

pp. 112067212110195

Author(s):

Orit Vidne-Hay ◽

Eva Platner ◽

Amir Alhalel ◽

Joseph Moisseiev

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Silicone Oil ◽

Final Visual Acuity ◽

Complication Rates ◽

Ocular Surgery ◽

Group A ◽

Silicone Oil Tamponade ◽

Group B

Purpose: To report the visual and anatomic outcomes of eyes with exceedingly long-term silicone oil tamponade. Methods: A retrospective chart review of 43 eyes of 41 patients with silicone oil tamponade for 5 years or more. Rates of retinal reattachment, visual acuity, and complications are presented. Further analysis was performed to identify if silicone oil complications are more common in eyes with lower vision. For this, cases were divided into group A-visual acuity of 20/400 or better and group B-visual acuity of less than 20/400. Results: Mean silicone oil duration was 12.6 ± 6.3 years. The etiology at presentation included: recurrent RRD (60.46%), RRD secondary to trauma (25.58%), and TRD (13.95%). Ninety-three percent of eyes underwent at least one ocular surgery before the vitrectomy with silicone oil tamponade. The retinal attachment rate was 55.8%. Mean visual acuity at presentation was 2.03 ± 0.6 logMAR, and at the final follow-up, 1.85 ± 0.78 logMAR ( p = 0.166). Emulsification developed in 33.3% of cases, glaucoma in 28.6%, band keratopathy in 21.4%, and corneal decompensation in 16.7%. In 26.2% of eyes, the final visual acuity was 20/400 or better (group A). In 73.8% of eyes, final visual acuity was worse than 20/400 (group B). The rates of silicone oil emulsification and glaucoma were not statistically significant between groups. Conclusions: Long-term silicone oil tamponade is a possible option in eyes with complicated retinal detachment following multiple intravitreal procedures, although the complication rates are relatively high. In 26.2% of eyes, visual acuity of 20/400 or better can be preserved for many years.

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Avoidance of hydrocele after non microsurgical varicocelectomy by pre-emptive eversion of tunica vaginalis in infertile men with varicocele

International Surgery Journal ◽

10.18203/2349-2902.isj20191867 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1462

Author(s):

Hosam Farouk Abdelhameed ◽

Mohammed Abu El‑Hamd ◽

Mena Zarif Helmy

Keyword(s):

Hospital Stay ◽

Sperm Count ◽

University Hospital ◽

Complication Rates ◽

Tunica Vaginalis ◽

Infertile Men ◽

Significant Difference ◽

Duration Of Surgery ◽

Group A ◽

Group B

Background: In infertile men with varicocele, controlled studies clearly indicate that varicocelectomy improves pregnancy rates. Non microsurgical varicocelectomy is associated with many complications; hydrocele is the most common one. Many techniques have been done to reduce the incidence of post-varicocelectomy hydrocele which is somewhat difficult to be done. This study aimed to evaluate the efficacy of pre-emptive eversion of tunica vaginalis in avoidance of post-operative hydrocele after non microsurgical varicocelectomy and its effect on fertility.Methods: A total number of 115 infertile men with varicocele underwent varicocelectomy during August 2015 to December 2016 in Sohag university hospital. Fifty five patients underwent bilateral microsurgical varicocelectomy (group A), were compared with 60 patients who underwent bilateral non microsurgical varicocelectomy with pre-emptive eversion of tunica vaginalis (group B) as regard, development of post-operative hydrocele, operative time, complication rates, hospital stay and effect on spontaneous pregnancy.Results: Group A has longer duration of surgery (26±11.7minutes versus 20±10.2minutes) while there was no significant difference in hospital stay (6±2.5 hours versus 6±1.5 hours) in both groups. No post-operative wound infection in both groups. There was one case (1.6%) develop scrotal haematoma in (group B) only. No post-operative recurrence in both groups. No post-operative hydrocele developed in both groups. Improvement in sperm count, motility and morphology occurred in both groups. No significant difference in percentage of paternity during 6-24 months.Conclusions: Pre-emptive eversion of tunica during non- microsurgical varicocelectomy might be offered as an adjunctive technique to avoid development of post-operative hydrocele that is easy, not time consuming and has comparable results of microsurgical varicocelectomy.

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Sulcus Fixation of Foldable Intraocular Lenses Guided by Ultrasound Biomicroscopy

Journal of Ophthalmology ◽

10.1155/2015/520418 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Shasha Gao ◽

Tingyu Qin ◽

Shengnan Wang ◽

Yong Lu

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Ultrasound Biomicroscopy ◽

Intraocular Lenses ◽

Suture Fixation ◽

Corrected Visual Acuity ◽

Sulcus Fixation ◽

Uncorrected Visual Acuity ◽

Group A ◽

Group B

Background. To evaluate the clinical efficacy of suture fixation of foldable intraocular lens (IOL) in ciliary sulcus guided by ultrasound biomicroscopy (UBM).Methods. Thirty-five eyes of 32 cases needing suture fixation of foldable IOL in ciliary sulcus in our hospital were collected and divided into two groups: group A and group B. In group A, UBM was performed on 19 eyes of 17 cases before surgery to locate the projection position of ciliary sulcus in iris surface. In group B, the traditional sulcus fixation of IOL was performed on 16 eyes of 15 cases. The inserting position of needles, the haptics position of IOL and the IOL tilt, and decentration were observed by UBM examination 3 months after the surgery. Meanwhile, the vision and contrast sensitivity were analysed.Results. The differences in inserting position of the needle, the IOL tilt and decentration, the ratio of IOL haptics in sulcus, and uncorrected visual acuity were statistically significant (P<0.05). The differences in best corrected visual acuity (BCVA) and contrast sensitivity were not statistically significant (P>0.05).Conclusions.Sulcus fixation of foldable IOL aided by UBM can increase the accuracy of IOL haptics implanted into ciliary sulcus and reduce the IOL tilt and decentration.

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Reconstructive Approaches in Surgical Management of Congenital Pseudarthrosis of the Tibia

Journal of Clinical Medicine ◽

10.3390/jcm9124132 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4132

Author(s):

Andrea Laufer ◽

Adrien Frommer ◽

Georg Gosheger ◽

Robert Roedl ◽

Frank Schiedel ◽

...

Keyword(s):

External Fixation ◽

Bone Transport ◽

Bone Union ◽

Complication Rates ◽

Union Rate ◽

Bone Fusion ◽

Group A ◽

Primary Bone ◽

Group B

Treatment of congenital pseudarthrosis of the tibia remains a major challenge in pediatric orthopedics. Ideal timing and preference of surgical procedures are discussed controversially. A variety of reconstructive treatment strategies have been described in literature, but so far none has proven its superiority. The aim of treatment is to obtain long-term bone union, to prevent refracture, and to correct angular deformities and leg length discrepancies. This study retrospectively evaluates the outcome of different reconstructive strategies. Sixty-nine patients were identified who presented to our outpatient department between 1997 and 2019. Twenty-six of these patients underwent reconstructive surgical treatment and were included in this study. The study cohort was divided into three groups. Excision of the pseudarthrosis was performed in all patients in Group A and B, and in two patients of Group C. Group A (six/26 patients) received subsequent bone transport through external fixation maintaining original length. In Group B (15/26 patients), patients underwent either previous, simultaneous, or subsequent extrafocal lengthening through external fixation to reconstitute length. In Group C (five/26 patients), internal fixation with intramedullary nails was applied. Radiological and clinical evaluation was performed to assess bone union and complication rates. Results varied considerably between the study groups. Overall, the primary bone fusion rate was 69.2%. There were four refractures, all occurring in Group B. The long-term bone union rate without refracture was 53.8%. The overall complication rate was 53.8% and 23.1% showed persistent pseudarthrosis. Two secondary amputations were performed due to failed bone fusion. In conclusion, excision of the pseudarthrosis and extrafocal lengthening achieves a satisfying bone union rate and limb reconstruction, while bone transport does not offer significant advantages but shows higher complication rates. Intramedullary stabilization should be applied to maintain bone union, but shows lower bone union rates when used as a stand-alone treatment regimen. Regardless of the primary bone fusion rates, the probability of long-term bone union remains unpredictable.

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