Congenital and developmental cataract surgery with undercorrected Intraocular lens (IOL) power implantation targeting emmetropia at 8 years of age and post-operative refractive status

Background: In congenital and developmental cataract primary undercorrection of intraocular lens (IOL) power is a common practice. However, long-term refractive status of these children is largely unknown. Aims and Objective: To analyse refractive status after cataract surgery with undercorrected IOL power implantation in congenital and developmental cataract. Materials and Methods: This study was descriptive, retrospective conducted for three years from 1st January 2013 to 31st December 2015. The children (> 6 months to <=7 years of age) who underwent cataract surgery for congenital and developmental cataract with a primary IOL implantation and had reached the age of 8 years were studied. The data were collected in terms of demography, axial length, biometry, IOL implanted, hyperopic correction and postoperative refractive status at 8 years. Results: Total numbers of children operated were 181 with total eyes 288. Unilateral cases were 74 (40.88%) and bilateral 107 (59.12%). Male were 121 (66.85%) and female were 60 (33.15%) with male is to female ratio of 2:1. Right eye was involved in 152 (52.8%) and left eye 136 (47.2%). The mean axial length at the age of one year was 20.75 mm, and gradually increased as age increased which was 22.47 mm at 6 years. The mean biometry was 27.9 diopter (D) at the age of one year which gradually decreased as age increased. Of the total 288 congenital cataract operated, complete follow-up documents were available for 77 (26.74%) eyes up to 8 years which showed emmetropia achieved in 25.97%, myopia in 28.57% and hypermetropia in 45.45%. Conclusion: Primary IOL implantation with hyperopic correction is accepted practice in congenital and developmental cataract. Emmetropia can be achieved however some hyperopic or myopic refractive status at the age of 8 years is not a surprise. Myopic shift continues as the age increases. Parent awareness for early detection and surgery, optical correction and regular follow-up are essential for good outcome.

Download Full-text

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

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v13i2.44 ◽

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.

Download Full-text

Post Cataract Surgery Refractive Error in Myopic Patients Using SRK/T Versus Holladay 1 Formula for IOL Power Calculation

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v34i2.947 ◽

2019 ◽

Vol 34 (2) ◽

Author(s):

Sidra Anwar, Atif Mansoor Ahmad, Irum Abbas, Zyeima Arif

Keyword(s):

Intraocular Lens ◽

Refractive Error ◽

Axial Length ◽

Power Calculation ◽

Mean Error ◽

Iol Power Calculation ◽

Group A ◽

Iol Power ◽

The Mean ◽

Group B

Purpose: To compare post-operative mean refractive error with SandersRetzlaff-Kraff/theoretical (SRK-T) and Holladay 1 formulae for intraocular lens (IOL) power calculation in cataract patients with longer axial lengths. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Ophthalmology, Shaikh Zayed Hospital Lahore from 01 January 2017 01 January, 2018. Material and Methods: A total of 80 patients were selected from Ophthalmology Outdoor of Shaikh Zayed Hospital Lahore. The patients were randomly divided into two groups of 40 each by lottery method. IOL power calculation was done in group A using SRK-T formula and in group B using Holladay1 formula after keratomery and A-scan. All patients underwent phacoemulsification with foldable lens implantation. Post-operative refractive error was measured after one month and mean error was calculated and compared between the two groups. Results: Eighty cases were included in the study with a mean age of 55.8 ± 6.2 years. The mean axial length was 25.63 ± 0.78mm, and the mean keratometric power was 43.68 ± 1.1 D. The mean post-operative refractive error in group A (SRK/T) was +0.36D ± 0.33D and in group B (Holladay 1) it was +0.68 ± 0.43. The Mean Error in group A was +0.37D ± 0.31D as compared to +0.69D ± 0.44D in group B. Conclusion: SRK/T formula is superior to Holladay 1 formula for cases having longer axial lengths. Key words: Phacoemulsification, intraocular lens power, longer axial length, biometry.

Download Full-text

Cataract Surgery following Sequential Myopic and Hyperopic LASIK

Case Reports in Ophthalmology ◽

10.1159/000488849 ◽

2018 ◽

Vol 9 (2) ◽

pp. 264-268

Author(s):

Tao Ming Thomas Chia ◽

Hoon C. Jung

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Calculation Method ◽

Cataract Extraction ◽

Power Calculation ◽

Iol Implantation ◽

Patient Dissatisfaction ◽

Iol Power Calculation ◽

Iol Power

We report a case of patient dissatisfaction after sequential myopic and hyperopic LASIK in the same eye. We discuss the course of management for this patient involving eventual cataract extraction and intraocular lens (IOL) implantation with attention to the IOL power calculation method used.

Download Full-text

Predictive Refractive Error Post Congenital and Developmental Cataract Surgery

Berkala Kedokteran ◽

10.20527/jbk.v17i2.11702 ◽

2021 ◽

Vol 17 (2) ◽

pp. 179

Author(s):

Eva Imelda ◽

Feti Karfiati ◽

Maya Sari Wahyu ◽

Irawati Irfani ◽

Primawita Oktarima ◽

...

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Refractive Error ◽

Axial Length ◽

Prediction Error ◽

Visual Rehabilitation ◽

Predictive Error ◽

Age At Surgery ◽

Significant Difference ◽

Developmental Cataract

Abstract: Cataract is one of the leading treatable causes of visual impairment in children. Visual rehabilitation is crucial for the development of good visual function after cataract surgery in children. The research aimd to describe post-operative Predictive Refractive Error (PRE) in congenital and developmental cataracts in Cicendo National Eye Hospital from January 2017 to December 2018. This is a retrospective analytic observational study from medical records. We found 107 eyes of 62 children with congenital and developmental cataracts had had cataract surgery and primary implantation of Intraocular Lens (IOL) in Pediatric Ophthalmology and Strabismus Unit, Cicendo National Eye Hospital. The patients were divided into two groups, with axial length (AXL) of ≤ 24 mm and > 24 mm. The paired t-test was used to compare Predictive Error (PE) in SRK/T, SRK II, and Showa SRK formula. Mean age at surgery was 6.7 ± 4.0 years. Ninety-five eyes had AXL ≤ 24 mm, and 12 eyes had AXL > 24 mm. Prediction Error from patients with AXL ≤ 24 mm was 0.29 D, and from patients with AXL > 24 mm was 2.40 D in SRK/T formula (P < 0.05). There was no significant difference between PE and Absolute Predictive Error (APE) in SRK/T, SRK II, and Showa SRK in patients with AXL > 24 mm (P > 0.05). SRK/T is the most predictable formula in patients with AXL ≤ 24 mm. There is no significant difference in patients with AXL > 24 mm in all formulas. Keywords: congenital and developmental cataract, axial length, Prediction Error, intraocular lens

Download Full-text

A-scan biometry, phacoemulsification, and foldable intraocular lens implantation in a young orangutan (Pongo pygmaeus)

Open Veterinary Journal ◽

10.4314/ovj.v11i1.18 ◽

2021 ◽

Vol 11 (1) ◽

pp. 121-127

Author(s):

Natthanet Sritrakoon ◽

Winyu Karntip ◽

Sirirat Niyom ◽

Susadee Khemton ◽

Panuwat Pakpiboon ◽

...

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Standard Technique ◽

Pongo Pygmaeus ◽

Power Calculation ◽

Iol Implantation ◽

Ocular Biometry ◽

Normal Behavior ◽

Almost All

Background: Cataracts are the major cause of visual impairment in animals which can be curable by surgical treatment. Phacoemulsification is the standard technique for cataract treatment that is applied to almost all species with a high success rate. Case Description: A 2-year-old intact female orangutan (Pongo pygmaeus) was presented for the study having bilateral opacity of the lenses, for 2 weeks. Ophthalmic examination revealed mature cataract OU. Ocular biometry measurements using A-scan ultrasonography for appropriate intraocular lens (IOL) refractive power calculation were carried out. Electroretinography was applied to ensure retinal function is intact. The orangutan underwent phacoemulsification OU and +24 diopter IOL implantation OS to restore vision. IOL implantation was not carried out OD because of a posterior capsular tear. Retinoscopy after 3 weeks postoperatively revealed +2.0 diopters OS. The outcome of the cataract surgery was successful during 3 years follow-up. The orangutan lived with other orangutans and was alert with normal behavior such as catching food, climbing trees, and swinging hand over hand from one branch to another. Conclusion: Cataract surgery with phacoemulsification OU and adjusted IOL implantation OD was successful with few complications in this orangutan. Vision was restored with normal behavior, even though an adjusted IOL was inserted in only one eye.

Download Full-text

Nucleus Drop or Intraocular Lens Drop Underwent Pars Plana Vitrectomy due to Complication of Cataract Surgery

International Journal of Retina ◽

10.35479/ijretina.2019.vol002.iss002.73 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Noviana Kurniasari Vivin ◽

Ari Djatikusumo ◽

Elvioza Elvioza ◽

Gitalisa Andayani ◽

Anggun Rama Yudantha ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Iol Implantation ◽

Secondary Iol Implantation ◽

Choice Of Procedure ◽

Department Of Ophthalmology ◽

Pars Plana

Abstract Background: The incidence of nucleus drop or intraocular lens (IOL) drop as the complication of phacoemulsification increases due to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary IOL implantation is the choice of procedure for management. This study aims to determine the frequency, outcomes, and complication of PPV in the case of nucleus drop or IOL drop in the Department of Ophthalmology, Fakultas Kedokteran Universitas Indonesia – Rumah Sakit Cipto Mangunkusumo (FKUI-RSCM) Methods: This study is a retrospective descriptive study conducted in the Vitreoretinal Division of the Department of Ophthalmology, FKUI - RSCM. Research data was taken from the medical records of all nucleus drop or IOL drop patients underwent PPV in January 2017-December 2017. Results: There were 19 cases studied. The incidence of nucleus drop occurred in phacoemulsification surgery techniques (94.7%) and ECCE techniques (5.3%). Vitrectomy surgery was performed ≤2 weeks in 31.6% and >2 weeks in 68.4% after the patient first arrived at the vitreoretinal clinic. Most pre-PPV visual acuity was 1/60-6/60 (47.1%). In the final follow-up, visual acuity improved from 6/45 to 6/6 occurred in 42.2% of cases. Complication after PPV and secondary IOL implantation include elevated IOP (10.5%), IOL decentration (5.3%), corneal decompensation (5.3%), macular edema (5.3%), and retinal detachment (5.3%). Conclusion: Nucleus drop or IOL drop generally occurs in phacoemulsification cataract surgery techniques. Improved visual acuity was achieved after PPV and secondary IOL implantation at the end of the follow-up period. Most common post-PPV complication is elevated IOP.

Download Full-text

Prognostic Factors for Low Visual Acuity after Cataract Surgery with Vitreous Loss

Journal of Ophthalmology ◽

10.1155/2021/6691904 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Michael Mimouni ◽

Michal Schaap-Fogler ◽

Philip Polkinghorne ◽

Gilad Rabina ◽

Rita Ehrlich

Keyword(s):

Visual Acuity ◽

Prognostic Factors ◽

Cataract Surgery ◽

Intraocular Lens ◽

Axial Length ◽

Visual Outcome ◽

Multivariable Logistic Regression Analysis ◽

Iol Implantation ◽

Secondary Iol Implantation ◽

Vitreous Loss

Purpose. The purpose of this study is to find prognostic factors associated with low visual acuity in patients experiencing vitreous loss during cataract surgery. Methods. A retrospective, noncomparative, interventional, case study of patients experiencing vitreous loss during cataract surgery. Data collected included demographics, best corrected visual acuity (BCVA), axial length (AL), presence of ocular comorbidity affecting central vision, timing of intraocular lens (IOL) implantation, position of the implanted lens, and the presence of corneal sutures. Low visual outcome was defined as BCVA < 20/40. Results. Overall, 179 patients (60.3% males) with a mean age of 73 ± 12 years and axial length of 23.5 ± 1.3 mm with a mean follow-up of 12 ± 13 months were included. In multivariable logistic regression analysis, low visual outcome was independently associated with persisting postoperative complications (OR 6.25, 95% CI 1.378–30.9), preexisting ocular comorbidities (OR 4.45, 95% CI 1.1–18.00), and secondary intraocular lens (IOL) implant (OR 10.36, 95% CI 1.8–60.00). Conversely, pars plana vitrectomy (PPV) for dislocated fragments of lens material, age > 70 years, gender, axial length, degree of surgeon, corneal suturing, and anterior chamber lens implantation were not found to have significant associations with low visual outcomes ( P > 0.05 ). Conclusions. Low visual outcome after vitreous loss during cataract surgery was associated with ocular comorbidities, secondary IOL implantation, development of cystoid macular edema, and additional surgical complications.

Download Full-text

A comparison of axial length measurement by using applanation A- Scan and IOL master for accuracy of predicting postoperative refraction

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.095 ◽

2021 ◽

Vol 7 (3) ◽

pp. 477-481

Author(s):

Harish R Trivedi ◽

Bhavik C Zala ◽

Nitesh S Pancholi

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Axial Length ◽

Length Measurement ◽

Power Calculation ◽

Spherical Equivalent ◽

Significant Difference ◽

Group A ◽

Iol Power ◽

Group B

The higher cost of IOL master is an issue in developing countries and hence it cannot be widely used for calculation of IOL power in such countries. Thus, the aim of the current study is to evaluate a cheaper alternative for the calculation of IOL power by comparing the axial length measurement obtained using applanation A-scan with that of IOL Master for accuracy of predicting postoperative refraction.A prospective, randomized, comparative study was done with 100 patients who were posted for cataract surgery. The patients were randomly divided into two groups of 50 patients each using computerized random number method. In Group A (n=50) axial length was measured with applanation A-scan and in Group B (n=50) axial length was measured with IOL Master. Before cataract surgery keratometry reading was taken with auto keratometer and intraocular lens (IOL) power calculation was done using SRK 2 formula in all patients. All patients were operated for cataract surgery by phacoemulsification and foldable intraocular lens were implanted in the bag. Postoperatively, best accepted refraction at 8th week was taken and mean spherical equivalent was calculated. 100 patients of cataract were subjected for cataract surgery by phacoemulsification.Corrected spherical equivalent on 8th postoperative week showed: 88% patients in Group A and 96% patients of Group B were within ± 1.00 D.56% patients of Group A and 76% patients of Group B were within ± 0.50 D.There was no statistically significant difference (p > 0.05) in axial length and corrected spherical equivalent between the two groups. There is no extra advantage of IOL Master over applanation A-scan for measuring Axial Length between 21 and 24.50 and predicting post-operative refractive outcome.

Download Full-text

Biometric parameters and intra ocular lens power used for cataract eyes in Karnali, Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v6i2.11690 ◽

2014 ◽

Vol 6 (2) ◽

pp. 192-196

Author(s):

Pawan Baral ◽

Nabin Baral ◽

Indra Man Maharjan ◽

Bhoj Raj Gautam ◽

Madhavendra Bhandari

Keyword(s):

Cataract Surgery ◽

Axial Length ◽

Total Sample ◽

Ocular Lens ◽

Biometric Parameters ◽

Number Of Patients ◽

Case Files ◽

Iol Power ◽

The Mean ◽

Lens Power

Introduction: The biometric parameters of the eye are measured for the calculation of the intra ocular lens power to be used in cataract surgery. Objective: To report the keratometry reading, axial length and intra ocular lens power used for eyes operated for cataract in Karnali Zone, Nepal, and to compare these findings with those reported in other similar studies. Subjects and methods: The data for the study were retrospectively collected from the case files of patients who had undergone cataract surgery between January 2011 and July 2012 in Karnali Zone, Nepal. These surgeries were performed in an outreach surgical camp organized by the Himalaya Eye Hospital, Nepal, as a part of its annual program. The SPSS 16.0 and Microsoft Excel 2007 software were used for the data analysis.Results: The total number of patients taken for the study was 1055 and the total number of eyes was 1055. There were 530 (50.23%) males and 525 (49.77%) females, with the mean age of 64.34±11.25, ranging from 8 to 98 years.The mean keratometry reading for the total sample was 44.11±1.6 (range, 34.00D to 49.00D). The mean axial length for the total sample was 22.68±0.88 (range, 17.75 to 26.17). The mean IOL power for the total sample was 21.60±1.74 (range, +15.00 to +30.00).Conclusion: The biometric eye parameters of keratometry, axial length and IOL power of this study required for cataract surgery in a Karnali population are similar to those presented in other similar studies from Nepal and abroad.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11690Nepal J Ophthalmol 2014; 6(12): 192-196

Download Full-text

Outcomes and Complications of Sutured Scleral-Fixated Foldable Intraocular Lens Implantation: A Retrospective Study of 5-Year Follow-Up

Journal of Ophthalmology ◽

10.1155/2021/5525064 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Ting Yu ◽

Mengting Yu ◽

Wenjie Wu ◽

Xinna Wu ◽

Suzhen Xiao ◽

...

Keyword(s):

Retrospective Study ◽

Intraocular Lens ◽

Tertiary Hospital ◽

Long Term Outcomes ◽

Iol Implantation ◽

Minimum Angle ◽

The Mean ◽

Iol Dislocation

Purpose. To evaluate long-term outcomes and complications of sutured scleral-fixated foldable intraocular lens (IOL) implantation. Design. Retrospective study. Methods. Patients who underwent sutured scleral-fixated foldable IOL implantation using 10-0 polypropylene suture were followed up for at least 5 years at one Chinese tertiary hospital and two primary hospitals. Results. 52 eyes among 48 patients (35 male and 13 female) were evaluated. The mean age (years) was 50.27 ± 20.08 (range: 6 to 81). The mean postoperative follow-up time (months) was 79.70 ± 18.84 (range: 60 to 121). The mean best-corrected visual acuity (BCVA) improved from 0.83 ± 0.69 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.50 ± 0.45 logMAR at the last follow-up visit. There was improved or unchanged BCVA in 44 eyes (84.62%) and reduced BCVA in 8 eyes (15.38%). Mild intraoperative intravitreal hemorrhage was observed in 3 eyes (5.77%). Early postoperative complications included transient elevated intraocular pressure (IOP) in 5 eyes (9.62%) and hypotony in 1 eye (1.92%). Secondary epimacular membrane occurred in 5 eyes (9.62%) and retinal detachment (RD; 3 years postsurgery), subconjunctival suture knot exposure (5 years postsurgery), and persistent elevated IOP (in a GRAVES patient) occurred in 1 eye (1.92%) each. No suture erosion or breakage nor IOL dislocation was observed. No visually threatening IOL tilt or decentration was reported in any patient. Conclusion. Sutured scleral-fixated foldable IOL implantation demonstrated satisfactory long-term outcomes and rare suture-related complications. This technology was safe and did not require complicated equipment and is of considerable interest in the setting of aphakia without adequate capsule support.

Download Full-text