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 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 Penetrating eye injuries in pediatric population: An epidemiological study and visual outcome

2016 ◽  
Vol 7 (4) ◽  
pp. 84-87
Author(s):  
Kabindra Bajracharya ◽  
Salma KC Rai ◽  
Arjun Malla Bhari ◽  
Hari Bahadur Thapa ◽  
Anjita Hirachan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pediatric Population ◽  
Visual Outcome ◽  
Eye Injury ◽  
Pediatric Ophthalmology ◽  
Eye Injuries ◽  
Penetrating Eye Injury ◽  
Wooden Stick ◽  
One Year ◽  
Better Than

Introduction: Penetrating eye injury is an important cause of visual impairment in pediatric population.Aims and Objectives: To study the epidemiology and visual outcome of penetrating eye injuries in pediatric population presented to Lumbini Eye Institute, the tertiary eye hospital of western Nepal.Materials and Methods: This retrospective study was conducted at the Department of Pediatric Ophthalmology and Strabismus, Lumbini Eye Institute over a period of one year from June 2014 to May 2015. All patients of penetrating eye injuries up to the age of 15 years were included in the study. The demographics of the patient, cause and duration of injury were recorded. The presenting and final best corrected visual acuity, anterior and posterior segment findings were recorded in specially designed proforma.Results: A total number of 127 children (127 eyes) presented with penetrating eye injuries during a year. The incidence of penetrating eye injury in one year was 127 out of 12927 new patients. Minimum age was 11 months, while the maximum age was 15 years with mean of 7.29 years (SD= ±3.49). Male and female patients were 99 (78%) and 28 (22%) respectively. Involvement of right eye was seen in 69 cases (54.33%) and left eye 58 (45.67%). The most common cause of injury was wooden stick in 55 cases (43.31%) followed by iron wire 12 (9.45%) and the stone 11 (8.66%). Corneal laceration was found in 102 cases (80.31%), scleral laceration in 10 (7.87%) and corneo-scleral laceration in 15 (11.81%). Seventy three percent patients were blind at the time of presentation whereas at discharge 37.63% were blind and 11.43% of patients had visual acuity better than 6/18 at presentation whereas 35.48% had visual acuity better than 6/18 after treatment.Conclusion: Penetrating eye injury is one of the common causes attending Pediatric Ophthalmology Department. Penetrating eye injury is common in male and majority of trauma is caused by wooden stick. The awareness of ocular trauma and its consequences should be increased to reduce incidence of childhood blindness.Asian Journal of Medical Sciences Vol.7(4) 2016 84-87

scholarly journals Deep Anterior Lamellar Keratoplasty followed by Toric Lens Implantation for the Treatment of Concomitant Anterior Stromal Diseases and Cataract

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000008 ◽  
Author(s):  
Vincenzo Scorcia ◽  
Andrea Lucisano ◽  
Vincenzo Savoca Corona ◽  
Valentina De Luca ◽  
Adriano Carnevali ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cataract Surgery ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Toric Iol ◽  
Iol Implantation ◽  
Anterior Lamellar Keratoplasty ◽  
Topographic Astigmatism

Purpose To evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) followed by phacoemulsification and toric intraocular lens (IOL) implantation for the treatment of concomitant stromal disease and cataract. Methods In this retrospective non-comparative interventional case series, ten eyes affected by stromal disease and cataract underwent DALK followed by phacoemulsification with toric IOL implantation after a minimum period of 5 months from complete suture removal. In each case, topographic astigmatism, refraction, visual acuity, and endothelial cell density were recorded before DALK and 1, 6, and 12 months after cataract surgery. In addition, IOL rotation was evaluated using anterior segment optical coherence tomography. Results Big-bubble DALK was performed in all eyes but one that received manual dissection. Topographic astigmatism averaged 5.6 ± 2.2 diopters (D) after suture removal; refractive astigmatism decreased to 0.55 ± 0.61 D as early as one month after cataract surgery and did not change substantially throughout the follow-up period. In all patients, one month after phacoemulsification uncorrected and best spectacle-corrected visual acuity were, respectively, ≥20/40 and ≥20/25 with a residual spherical equivalent of 0.00 ± 0.84 D. At the latest follow-up visit, in all cases the IOL rotation was ≤5 degrees from the intended position and the endothelial cell loss within 8.5%. No complications were recorded. Conclusions DALK followed by phacoemulsification with toric IOL implantation optimizes visual and refractive outcomes in patients with concomitant stromal disease and cataract. In comparison with a combined procedure, the sequential approach offers better predictability of the postoperative refraction in the absence of an increased risk of complications.

scholarly journals Evolution of cataract surgery: Smaller incision - less complications

2012 ◽  
Vol 69 (5) ◽  
pp. 385-388 ◽  
Author(s):  
Vladimir Draganic ◽  
Miroslav Vukosavljevic ◽  
Milorad Milivojevic ◽  
Mirko Resan ◽  
Nenad Petrovic
Keyword(s):  
Cataract Surgery ◽  
Surgical Techniques ◽  
Visual Outcome ◽  
Cataract Extraction ◽  
Extracapsular Cataract Extraction ◽  
Corneal Incision ◽  
Visual Rehabilitation ◽  
Operative Trauma ◽  
Iol Implantation

Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/ forceps IOL implantation, phacoemulsification/ injector IOL implantation, microincision cataract surgery (MICS). Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Results. Uncorrected visual aquity 30 days postoperatively was ? 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS) there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Conclusion. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

Efficacy of surgical treatment of traumatic cataract with simultaneous intraocular lens implantation in children

2013 ◽  
Vol 4 (1) ◽  
pp. 37-40
Author(s):  
Diloram Asrarovna Zakirkhodzhayeva
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Early Postoperative Period ◽  
Eye Injury ◽  
Traumatic Cataract ◽  
Iol Implantation ◽  
Intraocular Injection ◽  
Lens Implantation ◽  
One Year

Background: eye injury is often accompanied by lens damage. Aim: To evaluate the efficacy of surgical treatment of traumatic cataract with simultaneous IOL implantation in children. Material and methods: The results of surgical treatment of traumatic cataract with simultaneous IOL implantation in 62 children were analyzed: in 48 boys (77.4%) and 14 girls (22.6%) with a mean age 8.1 years. Results: visual acuity after surgery gradually increased from 0.09 to 0.22 by the end of the first month, 0.43 in 6 months and 0.47 in one year of follow-up. In 85.5% of the operated children visual acuity in the late post-op period was accounted 0.3–1.0, and in 82.2% of cases binocular vision was recovered. In the early postoperative period following complications were observed: exudative iridocyclitis — 16.1%; deposits of fibrin in the pupil — 8%; pigment deposits on surface of the IOL — 19%; secondary cataract — 12%; IOL or its haptics dislocation — 3% cases. Conclusions: Early IOL implantation during traumatic cataract surgery in children is suitable. Use of viscoelastics allows minimizing the severity of postoperative inflammation and reducing a risk of complications. Intraocular injection of Gemasa during surgery is effective to resolve hyphema, intraocular hemorrhages and fibrinoid exudate.

scholarly journals Visual Outcome of Unilateral Paediatric Traumatic Cataract at R. M. Kedia Eye Hospital, Birganj, Nepal

2016 ◽  
Vol 12 (2) ◽  
pp. 40-43
Author(s):  
Sanjay Singh ◽  
Harikant Sah ◽  
Amar Keyal
Keyword(s):  
Causative Agent ◽  
Visual Outcome ◽  
Posterior Capsular Opacification ◽  
Traumatic Cataract ◽  
Protective Measures ◽  
Female Ratio ◽  
Visual Outcomes ◽  
Wooden Stick ◽  
Male To Female

Background & Objectives: To evaluate the visual outcomes of children presenting with unilateral traumatic cataract.Materials & Methods: We conducted a retrospective study of 111 children (70 males and 41 females) below 16 years of age who were diagnosed with unilateral traumatic cataract between June 2013 and May 2015 and who underwent surgical intervention and completed at least six months follow up at Paediatrics department (supported by ORBIS International), R. M. Kedia eye hospital, Birganj, Nepal. Data regarding demographic profile, causative agent, clinical course and visual outcomes were recorded.Results: There was a male predilection with a male to female ratio of 1.70:1. The age group more frequently affected was five to nine years (58.5%). Commonest causative agent was trauma with wooden stick in 20 eyes (18%) followed by firecrackers in 15 eyes (14%) and pen in 11 eyes (10%). Pre-existing posterior capsular defects were observed intraoperatively in six eyes. Anterior uveitis was evident in 21 cases and Posterior capsular opacification in 10 eyes. Best corrected visual acuity of 6/6-6/60 at six months was achieved in 91 cases (81%). Duration between injury and cataract surgery did not affect the final visual outcome of traumatic cataract patients.Conclusion: The best possible visual outcome of traumatic cataract depends on its management and its complication. Ocular trauma and traumatic cataract formation can be avoided by taking protective measures in sports, work and patient education.JCMS Nepal. 2016;12(2):40-3

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

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.  

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

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.

Visual Prognosis of Intraocular Lens Implantation in Cases of Traumatic Cataract in a Tertiary Care Hospital, Ganjam

2021 ◽  
Vol 8 (25) ◽  
pp. 2210-2215
Author(s):  
Sachala Bhoi ◽  
Pallavi Ray ◽  
Sanjukta Mahapatro ◽  
Kasturi Mohapatra ◽  
Chinmaya Mahapatra
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Ocular Trauma ◽  
Visual Outcome ◽  
Traumatic Cataract ◽  
Small Incision Cataract Surgery ◽  
Operative Complication ◽  
Small Incision ◽  
Good Visual Outcome ◽  
Lens Implantation

BACKGROUND Traumatic cataract is one of the common sequelae following ocular injury. It is one of the leading causes of preventable blindness. Ocular trauma leading to traumatic cataract, if managed early gives good visual outcome. Associated ocular structure involvement has much bearing on the management and prognosis of traumatic cataract. We wanted to study the visual outcome of cataract surgery in traumatic cataract. METHODS All patients included in this prospective study were subjected complete ocular examination, intra ocular lens (IOL) power calculation and small incision cataract surgery (SICS) with IOL implantation. Visual outcome was assessed after 1st week, 2 nd week, 6th week and 6 months. Postoperative visual outcome and post-operative complications were assessed. RESULTS Out of 50 cases studied, 56 % of cases were in the age group of less than 20 years. Male: Female ratio was 2.57 : 1. Traumatic cataract was higher in patients of rural background as compared to urban background (64 % vs 32 %). In 58 % of cases, penetrating injury was the type of trauma. 60 % of patients had visual acuity of less than 3/60 at presentation. Corneal injuries (34 %), scleral tear in (22 %) and iris related problems (18 %) were the most common associated findings. All the patients were treated with SICS with IOL implantation. Most common intra-operative complication was posterior capsule rupture seen in 14 % of cases, 34 % of patients had anterior uveitis as early post-operative complication and 24 % of patients developed PCO as late post-operative complication; 68 % of the patients achieved visual acuity of above 6/18. CONCLUSIONS Timely management and involvement of other structures in traumatic cataract determines the visual prognosis of cataract surgery in traumatic cataract. Thus, our study showed that traumatic cataract can be successfully managed surgically with intraocular lens implantation with good visual outcome, unless there is associated corneal opacity or posterior segment involvement. More emphasis should be laid on the preventive measures like mass health education and awareness about risk of ocular trauma, and need to adopt safety measures should be focused, especially during playground, and at workplace. KEYWORDS Traumatic Cataract, Small Incision Cataract Surgery, IOL, Visual Acuity

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.

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