Surgical management challenges and clinical results of bimanual micro-incision phacoemulsification cataract surgery in children with congenital cataract

1970 ◽  
Vol 3 (1) ◽  
pp. 3-8
Author(s):  
M Amon
Keyword(s):  
Cataract Surgery ◽  
Surgical Management ◽  
Congenital Cataract ◽  
Clinical Results ◽  
Posterior Capsular Opacification ◽  
Surgical Removal ◽  
Promising Alternative ◽  
Age Related ◽  
Phacoemulsification Cataract Surgery

Introduction: Small incisions in cataract surgery have shown to reduce tissue damage, postoperative inflammation and pain. Objective: To describe in detail the surgical management challenges and clinical results of bimanual micro-incision phacoemulsification cataract surgery in children with congenital cataract. Materials and methods: In 22 eyes of 14 children aged from 11 months to 17 years with congenital cataract, micro-incision cataract surgery with lensectomy, bimanual aspiration or phacoemulsification and implantation of an intraocular lens (SN60WF, Alcon®) was performed under general anesthesia. The visual equivalent obtained with age-related methods, the slit-lamp examination, and refractive outcome were documented in the medical records and were analyzed retrospectively. The patients fulfilled at least 3 months of follow up. Results: In all operated eyes, micro-incision cataract surgery could be performed without serious intra-operative complications. Lensectomy was safely combined with a primary posterior capsulorhexis and anterior vitrectomy in 17 of 22 eyes. Corneal incision length ranged between 2.2 mm and 2.6 mm (mean: 2.3 ± 0.2 mm). No cases of postoperative hypotony and increased inflammation were observed. One eye required surgical removal of the after-cataract 7 months after surgery. Laser capsulotomy for posterior capsular opacification had to be performed in 2 (9 %) eyes. In all other eyes (19/22), visual axis remained clear during follow-up.Conclusion: Micro-incision cataract surgery is a promising alternative to conventional pediatric cataract surgery, since the technique showed to be comparably safe and effective. Longer follow-up examinations will now be performed.Key words: congenital cataract; bimanual micro-incision phacoemulsificationDOI: 10.3126/nepjoph.v3i1.4270Nepal J Ophthalmol 2011;3(5):3-8

Cataract

2012 ◽  
Author(s):  
Georgia Cleary ◽  
David Spalton
Keyword(s):  
Postoperative Complications ◽  
Cataract Surgery ◽  
Congenital Cataract ◽  
Intraoperative Complications ◽  
Intraocular Lenses ◽  
Posterior Capsular Opacification ◽  
Clinical Knowledge ◽  
Practical Skills ◽  
Age Related ◽  
Nd:Yag Laser Capsulotomy

The chapter begins by discussing lens anatomy and embryology, before covering the key areas of clinical knowledge, namely acquired cataract, clinical evaluation of acquired cataract, treatment for acquired cataract, intraoperative complications of cataract surgery, infectious postoperative complications of cataract surgery, non-infectious postoperative complications of cataract surgery, congenital cataract, management of congenital cataract, and lens dislocation. Practical skills are then covered, including biometry, local anaesthesia, operating microscope and phacodynamics, intraocular lenses, and Nd:YAG laser capsulotomy. The chapter concludes with three case-based discussions, on age-related cataract, postoperative endophthalmitis, and posterior capsular opacification.

scholarly journals Nanogel-Facilitated In-Situ Delivery of a Cataract Inhibitor

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1150
Author(s):  
Dixa Gautam ◽  
Michelle G. Pedler ◽  
Devatha P. Nair ◽  
Jonathan Mark Petrash
Keyword(s):  
Cataract Surgery ◽  
Vision Loss ◽  
Effective Means ◽  
Lens Capsule ◽  
Posterior Capsular Opacification ◽  
Surgical Removal ◽  
Visual Disability ◽  
Visual Axis ◽  
Number Of Patients ◽  
Subsequent Degradation

Cataracts are a leading cause of blindness worldwide. Surgical removal of cataracts is a safe and effective procedure to restore vision. However, a large number of patients later develop vision loss due to regrowth of lens cells and subsequent degradation of the visual axis leading to visual disability. This postsurgical complication, known as posterior capsular opacification (PCO), occurs in up to 30% of cataract patients and has no clinically proven pharmacological means of prevention. Despite the availability of many compounds capable of preventing early steps in PCO development, there is currently no effective means to deliver such therapies into the eye for a suitable duration. To model a solution to this unmet medical need, we fabricated acrylic substrates as intraocular lens (IOL) mimics scaled to place into the capsular bag of the mouse lens following a mock-cataract surgery. Substrates were coated with a hydrophilic crosslinked acrylate nanogel designed to elute Sorbinil, an aldose reductase inhibitor previously shown to suppress PCO. Insertion of the Sorbinil-eluting device into the lens capsule at the time of cataract surgery resulted in substantial prevention of cellular changes associated with PCO development. This model demonstrates that a cataract inhibitor can be delivered into the postsurgical lens capsule at therapeutic levels.

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

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.

scholarly journals Refractive outcome of cataract surgery in eyes filled with silicone oil

2019 ◽  
Author(s):  
Piotr Kanclerz ◽  
Christoph Leisser ◽  
Andrzej Grzybowski ◽  
Paweł Lipowski
Keyword(s):  
Cataract Surgery ◽  
Silicone Oil ◽  
Spherical Equivalent ◽  
Refractive Outcome ◽  
Spherical Equivalent Refraction ◽  
Cataract Development ◽  
Oil Injection ◽  
Phacoemulsification Cataract Surgery

Abstract Background Cataract development is common in phakic eyes filled with silicone oil (SO), necessitating subsequent cataract removal. This study evaluated the refractive outcome in eyes filled with SO undergoing phacoemulsification cataract surgery (PCS). Methods This retrospective study evaluated patients with SO tamponade who were scheduled for PCS. Results Subjects (n=26) were followed-up for 29.5 ± 13.9 months after cataract surgery. The median spherical equivalent refraction (SER) was +5.3 D (interquartile range [IQR] +2.9 to +6.7) before PCS, and +3.4 D (IQR +2.0 to +4.4) after PCS. Within the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes (57.7%). In 13 eyes assessment of refraction after SO-removal was possible, and showed a myopic shift of -4.6 D (IQR -2.9 to -7.3) in the SER. After SO removal, 5 of 13 eyes (38.5%) were within ±1.0 D of the target refraction, while 9 out of 13 eyes (69.2%) were within ±2.0 D. Conclusions The refractive outcome after PCS for eyes filled with SO is less predictable than that for normal eyes. Some of the eyes undergoing silicone oil injection may require long-term tamponade.

scholarly journals A COMPARISION OF POSTERIOR CAPSULAR OPACITY FORMATION UPTO 1 YEAR IN PATIENTS WITH SMALL INCISION CATARACT SURGERY WITH FOLDABLE INTRAOCULAR LENS AND PHACOEMULSIFICATION WITH THE SAME INTRAOCULAR LENS

2020 ◽  
pp. 173-176
Author(s):  
Kinjal Rathod ◽  
Kinjal Trivedi ◽  
Snehal Nayi ◽  
Somesh Aggarwal
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Nd:Yag Laser ◽  
Visual Outcome ◽  
Posterior Capsular Opacification ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Common Procedure ◽  
Age Related

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.

scholarly journals Management of Aphakia with Visual Axis Opacification after Congenital Cataract Surgery Based on UBM Image Features Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Wensi Chen ◽  
Shiping He ◽  
Daoman Xiang
Keyword(s):  
Cataract Surgery ◽  
Mixed Type ◽  
Congenital Cataract ◽  
Ultrasound Biomicroscopy ◽  
Image Features ◽  
Imaging Features ◽  
Visual Axis ◽  
Anterior Vitrectomy ◽  
Congenital Cataract Surgery

Objective. The purpose of this study was to study the imaging features of ultrasound biomicroscopy (UBM) in the aphakia with visual axis opacification (VAO) after congenital cataract surgery. Methods. From May 2015 to May 2018, aphakia patients with VAO who underwent congenital cataract surgery were examined by high-resolution bag/balloon UBM technique, and the results of UBM imaging were analyzed. According to UBM imaging features, different types of VAO were classified. Results. A total of 38 children (55 eyes) with VAO were included. 17 patients were bilateral, and 21 patients were unilateral. Patients with VAO were classified into 3 groups according to the UBM imaging features: membranous fibrosis VOA (17 cases, 28 eyes), cortical regeneration VOA (15 cases, 20 eyes), and mixed VOA (6 cases, 7 eyes). The patients in the membranous fibrosis group underwent Nd:YAG laser posterior capsulotomy, those in the cortical regeneration group underwent anterior vitrectomy, and those in the mixed type group underwent anterior vitrectomy with RF capsulotomy tip. After surgery, VAO were removed in all patients. During the follow-up period, in the membranous fibrotic VAO group, iris adhesion and pupillary occlusion were found in 2 eyes, and anterior vitrectomy combined with separation of iris adhesion was performed. In cortical regenerative and mixed type VAO groups, anterior vitrectomy was performed without opacity in the axial region. The total recurrence rate of VAO was 3.46%. Conclusion. After congenital cataract surgery, the UBM imaging features of aphakia with VAO are helpful to evaluate the condition of VAO before reoperation so as to choose the optimal surgical method to achieve better therapeutic effect.

Use of Cataract Surgery in Urban Beijing: a Post Screening Follow-up of the Elderly with Visual Impairment due to Age-related Cataract

2015 ◽  
Vol 30 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Xue-tao Ren ◽  
Torkel Snellingen ◽  
Hong Gu ◽  
Sawitri Assanangkornchai ◽  
Yan-hong Zou ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Visual Impairment ◽  
The Elderly ◽  
Age Related

scholarly journals Clinical outcomes and complications between FLACS and conventional phacoemulsification cataract surgery: a PRISMA-compliant Meta-analysis of 25 randomized controlled trials

2021 ◽  
Vol 14 (7) ◽  
pp. 1081-1091
Author(s):  
Li Chen ◽  
◽  
Xiao Lin ◽  
Hao-Yu Li ◽  
Yi Du ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Distant Visual Acuity ◽  
Phacoemulsification Cataract Surgery

AIM: To update and investigate the clinical outcomes and complications between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS). METHODS: A Meta-analysis was performed using databases, including Pubmed, Embase, and the Cochrane library. At least one of the clinical outcomes and/or complications data in each included randomized controlled trials (RCT) was reported. The quality of the RCT was assessed with the Cochrane risk assessments tool. RESULTS: Overall, 25 RCTs including 3781 eyes were included. No statistically significant difference detected between FLACS and CPCS in terms of corrected distant visual acuity (CDVA), uncorrected distant visual acuity (UDVA), and central corneal thickness (CCT) at the long-term follow up, although FLACS showed better CDVA at 1wk postoperatively, and less increase in CCT at 1d and 1wk. FLACS had better postoperative endothelial cell count (ECC) at 1 and 4-6wk, while there was no significantly difference between FLACS and CPCS at 1d, 3 and 6mo [weighted mean difference (WMD): 51.54, 95% confidence interval (CI): -5.46 to 108.54, P=0.08; WMD: 48.52, 95%CI: -17.54 to 114.58, P=0.15; WMD: 12.17, 95%CI: -48.61 to 72.94, P=0.69, respectively]. Postoperative endothelial cell loss (ECL) of the FLACS was significantly lower than that of the CPCS at 1, 4-6wk, and 3mo (P=0.02, 0.008, 0.03, respectively). However, there was no significant difference between two groups at 6mo (WMD: -30.36, 95%CI: -78.84 to 18.12, P=0.22). No significant difference was discovered with respect to the macular edema [odds ratio (OR): 0.93, 95%CI: 0.42 to 2.05, P=0.85], capsular complication excluding posterior capsular tears (OR: 0.79, 95%CI: 0.42 to 1.50, P=0.47) and intraocular pressure change (OR: 0.82, 95%CI: 0.39 to 1.72, P=0.60). However, posterior capsular tears were more common in CPCS group (OR: 0.12, 95%CI: 0.01 to 0.98, P=0.05). The effective phacoemulsification times were significantly lower in the FLACS group compared to the CPCS group (WMD: -0.78, 95%CI: -1.23 to -0.34, P=0.0006). CONCLUSION: No statistically significant difference is discovered between FLACS and CPCS in clinical outcomes at the long-term follow up. However, higher rate of posterior capsular tears is detected in patients receiving CPCS.

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

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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