Outcome of cataract surgery in eyes with uveitis

Purpose: To assess the outcome of cataract surgery in patients with uveitis without the use of prophylactic high dose (> 5-10 mg/day) systemic steroid. Method: A hospital based prospective study enrolling 64 eyes of 60 patients with uveitis and cataract from May 2013 to April 2014 having intraocular inflammation under control for at least 3 months preoperatively and underwent phacoemulsification with in bag placement of foldable acrylic intraocular lens (IOL). Results: Twenty six male and 34 female were included with mean age of 47.23 ± 16.85SD (16-85) years. In 43.75 % of eyes the uveitis was idiopathic followed by sarcoiduveitis (18.7%), Herpetic uveitis (15.6%), Tubercular uveitis (6.2%), VKH (4.6%), HLAB 27(4.6%), Behcet’s, endogenous endophthalmitis, Wegener’s granulomatosis and lepromatous uveitis (1.5% each). Anterior chamber cell count was grade 1+ in 33 eyes (51.56%) on 1st post-operative day and in 29 eyes (45.31%) on second follow up. Out of total 11 eyes (17.18%) that developed fibrin, 7 eyes were treated with subconjunctival injection of dexamethasone with half hourly topical steroid drops. Other 4 eyes that developed fibrin responded to half hourly topical steroid. Dose of oralprednisolone increased in 6 patients in early post operative duration. At the final follow up, 50 eyes (92.58% ) had improvement in best corrected visual acuity and cystoidmacular edema (CME) in 5% (n=3) eyes. Conclusion: Even without the use of preoperative high dose of oral steroid, inflammation was under control with significant improvement in visual acuity 3 months postoperatively.

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Capsular Blockage Syndrome: Clinical and Anterior Segment Optical Coherence Tomography (OCT) Characteristics

10.21203/rs.3.rs-557637/v1 ◽

2021 ◽

Author(s):

Hsin-Yu Yang ◽

Sui-Ching Kao ◽

Chieh-Chih Tsai ◽

Wei-Kuang Yu

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Low Dose ◽

Anterior Segment ◽

Topical Steroid ◽

Anterior Segment Oct ◽

Corrected Visual Acuity ◽

Nd:Yag Laser Capsulotomy ◽

Significant Difference

Abstract Background:CBS is a rare phenomenon which is found during and after cataract surgery. The mechanism, OCT presentation and clinical characteristics are not well studied. Methods:Document patients with CBS who underwent examination, including refraction, best-corrected visual acuity, slit lamp, anterior segment OCT, and onset after cataract surgery. All patients underwent Nd:YAG laser capsulotomy and were prescribed a low-dose topical steroid for seven days. Post-capsulotomy refraction and visual acuity were recorded.Results:This study included 18 eyes. Patients’ mean age was 80 (range, 54–92). The duration between cataract surgery and CBS diagnosis ranged 15–136 months. According to anterior segment OCT findings, we subcategorized the patients into four types: minimally opaque (n=4, 22%), uniformly turbid (n=7, 39%), focally condensed (n=5, 28%), and diffused sparkling (n=2, 11%). After laser capsulotomy, mean visual acuity improved 0.18 ± 0.09 on the LogMar. A significant difference in absolute refraction changes between the groups was noted— maximum in the focally condensed and minimum in the uniformly turbid types. No patient developed complications or needed further treatment for CBS during mean follow-up of 80 months.Conclusion:High-resolution anterior segment OCT is useful for analyzing pathological changes in the CBS. Our study implies that these four types of CBS presentation indicate various causes of late-CBS formation, as well as distinct clinical presentation and post–laser capsulotomy outcome. In addition, YAG laser capsulotomy is a safe late-CBS treatment modality.

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Treatment Strategies in Acute Post-operative Endophthalmitis after Cataract Surgery at a Tertiary Eye Hospital in Nepal: A 5-year Retrospective Review

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v13i1.31077 ◽

2021 ◽

Vol 13 (1) ◽

pp. 82-90

Author(s):

Barsha Suwal ◽

Deepak Khadka ◽

Arjun Shrestha ◽

Rajan Shrestha

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intravitreal Injection ◽

Hand Movement ◽

Treatment Strategies ◽

Visual Outcome ◽

Oral Steroid ◽

Oral Antibiotic ◽

Pars Plana

Introduction: Despite best possible preventive measures, acute postoperative endophthalmitis (POE) is still the most devastating, sight-threatening complication after intraocular surgery and the most feared complication by treating surgeons. Materials and methods: It is a retrospective study of 22 eyes diagnosed as acute POE following cataract surgery in the last 5 years (2015-2019), aimed to evaluate the treatment strategies used in its management. Main outcome measures evaluated were rates of repeat intravitreal injection, adjunctive therapeutic regimens, pars plana vitrectomy (PPV) and visual outcome. Results: Twenty one eyes (95.45%) received repeated intravitreal injection. Adjuvant intravitreal steroid was used in 12 eyes (54.54%), oral steroid in 16 eyes (72.72%) and oral antibiotic in 8 eyes (36.36%). PPV was done in 8 eyes (34.78%) and all 8 eyes that underwent PPV had a vision of Hand Movement (HM) close to face. 7 eyes (87.5%) had early PPV within 1 week of diagnosis. The median best corrected visual acuity (BCVA) improved from 1.00 logMar to 0.8 logMar following treatment at 3 months follow up (p= 0.117). Conclusion: Repeat intravitreal injections were commonly employed. Early PPV was performed more commonly regardless of the visual acuity at the time of diagnosis of acute POE.

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The patient-reported outcome of age-related cataract using Catquest-8SF questionnaire

International Eye Research ◽

10.18240/ier.2020.03.03 ◽

2020 ◽

Vol 1 (3) ◽

pp. 145-153

Author(s):

Sheng-Xia Wang ◽

◽

Yun-Hong Du ◽

Wen-Jing Liu ◽

Ping Liu ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Patient Reported Outcome ◽

Chinese Version ◽

Surgery Group ◽

Age Related ◽

Patient Reported ◽

Degree Of Satisfaction ◽

Improvement Score

AIM: To assess the patient-reported outcome of phacoemulsification with posterior chamber single focus foldable intraocular lens (SIOL) using the Chinese version of Catquest-8SF questionnaire (Catquest-8SF-CN), evaluate the applicability of Catquest-8SF scale in northern Chinese and its sensitivity to cataract surgery. METHODS: Prospective clinical case follow-up study. The patients were recruited from the Central Hospital of Tai’an and completed the Catquest-8SF questionnaire by face-to-face interviews before and 3mo after surgery at the hospital. RESULTS: A total of 120 cataract patients with median age 67.6y and 52.5% female completed the Catquest-8SF. The Cronbach’s α coefficient of the total scale, daily-activity sub-table and comprehensive-evaluation sub-table were 0.861, 0.853 and 0.748 respectively. There was a high level of consistency between two investigators. The cumulative contribution rate was 66.64% by using the principal component analysis and the maximum variance orthogonal rotation method. The preoperative score of the Catquest-8SF-CN had a significant negative correlation with preoperative binocular mean weighted visual acuity and age (P<0.05), while a significant positive correlation with education level (F=6.094, P<0.001). The patients without systemic comorbidities got higher score than those who with (P<0.05). Three months after surgery, 102 (85%) patients came for follow-up and completed the questionnaire. Significant improvement of visual acuity was observed in both binocular and monocular surgery groups (t=10.404, P<0.001). There was higher improvement in binocular weighted visual acuity of binocular surgery group than in monocular surgery group (t=-20.77, P<0.001). The postoperative score was significantly higher in both groups than before (P<0.001). There was a significant improvement in the total score after cataract surgery. The 94 patients (92.2%) were very satisfied or satisfied with the operation; 92 patients (90.2%) thought the surgery achieved their expectations, and they all felt satisfactory. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery. CONCLUSION: The Chinese version of Catquest-8SF questionnaire is suitable for the age-related cataract population in northern China. It is highly responsive to cataract surgery and brief, so it may have the potential to become part of a routine clinical assessment for cataract surgery in China. The patient’s overall satisfaction is high, which illustrates that the medical service we provide matches the patient’s needs. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery.

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Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

Annals of African Surgery ◽

10.4314/aas.v18i3.4 ◽

2021 ◽

Vol 18 (3) ◽

pp. 143-149

Author(s):

Samuel Kyei ◽

Ebenezer Zaabaar ◽

Frank Assiamah ◽

Michael Agyemang Kwarteng ◽

Kofi Asiedu

Keyword(s):

Visual Acuity ◽

Postoperative Complications ◽

Cataract Surgery ◽

Medical Records ◽

Cross Sectional Study ◽

Small Incision Cataract Surgery ◽

Cross Sectional ◽

Small Incision ◽

Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

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Cataract Surgery and Uveitis

Annals of King Edward Medical University ◽

10.21649/akemu.v9i3.1332 ◽

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.

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Long-Term Efficacy of Dexamethasone Intravitreal Implant in the Treatment of Vogt-Koyanagi-Harada (VKH) Disease Relapsing Posterior Uveitis

10.21203/rs.3.rs-393685/v1 ◽

2021 ◽

Author(s):

Tarek Roshdy Elhamaky

Keyword(s):

Visual Acuity ◽

Posterior Uveitis ◽

Systemic Steroid ◽

Foveal Thickness ◽

Dexamethasone Intravitreal Implant ◽

Central Foveal Thickness ◽

Intravitreal Implant ◽

The Mean ◽

Vkh Disease

Abstract Purpose: To investigate the efficacy and safety of dexamethasone intravitreal implant in the treatment of relapsing posterior uveitis in patients with chronic recurrent VKH disease.Methods: This is a prospective study of 29 eyes of 16 patients with posterior uveitis in chronic recurrent VKH disease. All patients received previous systemic steroid and immunosuppressive regimens. All patients underwent a comprehensive ophthalmic examination, including BCVA (log MAR), IOP, FFA, and SD-OCT. All patients underwent intravitreal injection with sustained-release dexamethasone 0.7 mg implant (Ozurdex®). Primary outcome measures included mean change in best corrected visual acuity (BCVA) and central foveal thickness (CFT) at 24 months follow-up compared to baseline. Results: At 24 months follow-up, the mean BCVA improved from 0.82 ± 0.13 to 0.38 ± 0.06logMAR (P <0.0001). The mean CFT reduced from 505 ± 29 to 244 ± 23 um (P <0.0001). The mean IOP changed from 15.1±2.2 to16.9±3.1 mmHg with no significant value. Twenty-one eyes (72.4%) received one injection, while eight eyes (27.6%) required two injections. The mean number of injections was 1.2± 0.60. The mean follow-up time was 24.75± 0.9months. No serious ocular or systemic adverse events were noted during the follow-up period. Ocular hypertension was recorded in there (10.3%) eyes and controlled by IOP lowering medications. Cataract progression occurred in 11 (37.9%) eyes.Conclusions: Our cohort highlights the beneficial effects of the Dexamethasone implant 0.7 mg in the treatment of VKH disease relapsing posterior uveitis improving visual acuity, reducing macular edema, and minimizing the burden of systemic steroid in this sample study.

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

Ophthalmology Point of Care ◽

10.5301/oapoc.0000008 ◽

2017 ◽

Vol 1 (1) ◽

pp. oapoc.0000008 ◽

Cited By ~ 1

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.

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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.

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Correlation between visual acuity at discharge and on final follow-up in patients undergoing manual small incision cataract surgery

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_986_20 ◽

2021 ◽

Vol 69 (3) ◽

pp. 586

Author(s):

Anika Amritanand ◽

DeepthiE Kurian ◽

Monseena Mathew ◽

Mable Keziah ◽

Grace Rebekah

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Small Incision Cataract Surgery ◽

Small Incision

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Changes in Retinal Vasculature and Thickness After Femtosecond Laser-assisted Cataract Surgery and Conventional Cataract Surgery Using Optical Coherence Tomography Angiography

10.21203/rs.3.rs-1212191/v1 ◽

2022 ◽

Author(s):

Hong Zhang ◽

Liangzhang Tan ◽

Fang Tian ◽

Xue Gong ◽

Lu Chen ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Optical Coherence Tomography Angiography ◽

Macular Thickness ◽

Retinal Vasculature ◽

Optical Coherence ◽

Age Related

Abstract Purpose To assess the changes in retinal vasculature and thickness after femtosecond laser-assisted cataract surgery (FLACS) using optical coherence tomography angiography (OCTA).Methods Fifty-six eyes of 56 patients with age-related cataract were enrolled in this study. Patients were divided into FLACS or conventional phacoemulsification surgery (CPS) due to the choice of operation. Vessel density (VD) and thickness at the macular area and optic nerve head (ONH) were checked by OCTA at baseline and at 1 day, 1 month and 3 months after cataract surgery.Results In the FLACS group: The radial peripapillary capillary (RPC) density displayed a significant reduction during the follow-up (P < 0.05), even when the retinal nerve fiber layer (RNFL) thickness was not significantly changed. There was a significant negative correlation between the changes in RPC density and femtosecond laser-assisted pre-treatment time (FLAPT) at 1 day and 1 month after cataract surgery respectively (both P < 0.05). At 3 months postoperatively, the macular thickness had a significant increase in all regions (all P < 0.05). In the CPS group, the retinal VD and thickness did not show statistically significant changes in all regions during the follow-up (all P > 0.05). However, the best corrected visual acuity (BCVA) was significantly improved in both groups postoperatively (both P < 0.001).Conclusions OCTA provided a promising analysis of retinal vascular alterations, demonstrating the reduction of RPC density and the increase of macular thickness after FLACS. However, these changes had no effect on the improvement of visual acuity after cataract surgery.

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