Posterior Capsular Opacification and Glistenings in Hydrophobic and Hydrophilic Intraocular Lenses

2019 ◽  
Author(s):  
Keyword(s):  
Intraocular Lenses ◽  
Posterior Capsular Opacification

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 Comparative Efficacy Between Trifocal and Bifocal Intraocular Lens Among Patients Undergoing Cataract Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ziran Zhang ◽  
Haiyang Jiang ◽  
Hongwei Zhou ◽  
Fang Zhou
Keyword(s):  
Systematic Review ◽  
Cataract Surgery ◽  
Meta Analysis ◽  
Intraocular Lenses ◽  
Cochrane Library ◽  
Posterior Capsular Opacification ◽  
Comparative Efficacy ◽  
Patient’S Satisfaction ◽  
Randomized Controlled ◽  
Secondary Outcomes

The comparative efficacy of trifocal and bifocal intraocular lenses (IOLs) remained uncertain among patients undergoing cataract surgery. A systematic review and meta-analysis was performed to answer this question. PubMed, Cochrane Library and Embase were searched to capture relevant randomized controlled trials (RCTs). Visual acuity (VA) and patient's satisfaction were regarded as primary outcomes. Secondary outcomes included residual sphere, spherical equivalence, residual cylinder, posterior capsular opacification (PCO), spectacle independence, and other complications. Statistical analysis was done using RevMan 5.2.0. A total of 9 studies (11 RCTs) with 297 participants (558 eyes) were included. Meta-analysis showed significant differences between trifocal and bifocal IOLs in the uncorrected near VA (mean difference [MD], −0.008; 95% confidence interval [Cl], −0.015 to −0.001; P = 0.028) and uncorrected intermediate VA (MD, −0.06; 95% CI, −0.10 to −0.02; P < 0.01). Trifocal IOLs were associated with decreased PCO incidence when compared to bifocal IOLs (relative risk [RR], 0.54; 95% CI, 0.31 to 0.95; P = 0.03). Trifocal IOLs may be superior to bifocal IOLs because of its improved intermediate VA and reduced incidence of PCO.

Trans-scleral posterior capsulorhexis in combined lens extraction and silicone oil removal

2019 ◽  
Vol 30 (1) ◽  
pp. 224-228
Author(s):  
Wael Soliman ◽  
Tarek A Mohamed ◽  
Khaled Abdelazeem ◽  
Mohamed Sharaf
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Intraocular Lenses ◽  
Posterior Capsular Opacification ◽  
Oil Removal ◽  
Visual Axis ◽  
Yag Laser ◽  
Lens Extraction ◽  
Silicone Oil Removal

Aim: The aim of this study was to study the safety and efficacy of posterior capsulorhexis in vitrectomized eyes undergoing combined phacoemulsification or irrigation/aspiration and silicone oil removal. Methods: This prospective non-randomized interventional study involved 115 silicone-filled eyes of 115 previously vitrectomized patients. All patients underwent combined phacoemulsification or underwent irrigation/aspiration and silicone oil removal, followed by foldable intraocular lens implantation combined with primary posterior trans-scleral capsulorhexis. A 23-gauge trans-scleral vitrectomy probe was used to form the posterior capsulorhexis (vitrectorhexis). Patients were followed for 6 months. Results: Intraocular lenses maintained good centration in the capsular bag during and after trans-scleral posterior capsulorhexis. No complications were observed in the postoperative period regarding lens centration or size of the posterior capsulorhexis. No included eyes needed YAG laser posterior capsulotomy and no recurrent retinal detachment was reported during follow-up. Conclusion: Performing primary trans-scleral capsulorhexis in patients undergoing combined phacoemulsification, or irrigation/aspiration and silicone oil removal, enabled achievement of an early postoperative clear visual axis and prevented the onset of dense postoperative posterior capsular opacification in previously silicone-filled eyes. This technique is reproducible and may facilitate additional intra-operative procedures and uncomplicated postoperative follow-up of retinal detachment patients without requiring YAG laser capsulotomy.

scholarly journals Comparison of Postoperative Visual Performance Between Bifocal and Trifocal Intraocular Lens Based on Randomized Controlled Trails: A Meta-Analysis

2018 ◽  
Author(s):  
Shanshan Jin ◽  
David S. Friedman ◽  
MM Kai Cao ◽  
MA Mayinuer Yusufu ◽  
MM Jingshang Zhang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Performance ◽  
Meta Analysis ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Posterior Capsular Opacification ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
The Difference

Abstract Background：To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed and Science Direct was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no clinical significance [MD=-0.01, 95%CI: (-0.02,0.00), p=0.97]. There was no difference for the distant-corrected near VA (DCNVA) with MD of 0.01[95%CI (-0.02, 0.05), p=0.86]. Compared with trifocal group, bifocal group showed a significantly worse uncorrected intermediate visual acuity (UIVA) [MD=0.09,95%CI:(0.01,0.17), p＜0.01]. No difference was found in distance-corrected intermediate VA(DCIVA) [MD= 0.09, 95%CI: (-0.04, 0.23) , p＜0.01] between two groups. For the AT LISA group, the subgroup analysis also indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839M) [MD= 0.18, 95%CI: (0.12, 0.24), p=0.35 for UIVA and MD= 0.19, 95%CI: (0.13, 0.25), p=0.21 for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA(UDVA) and corrected distance visual acuity (CDVA) [MD=0.01, 95%CI: (-0.01,0.04), p=0.51 for UDVA; MD=0.00, 95%CI: (-0.01,0.01), p=0.94 for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD=-0.08, 95% CI: (-0.19, 0.03), p=0.51 for spherical equivalent; MD=-0.09, 95%CI: (-0.21, 0.03), p=0.78 for cylinder; MD=-0.09, 95% CI: (-0.27, 0.08), p=0.28 for sphere]. No difference was found for spectacle independence, Posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR=0.92, 95% CI: (0.74, 1.15), p=0.93 for spectacle independence; RR=0.81, 95% CI: (0.74, 1.15), p=0.65 for PCO; RR=0.98, 5% CI: (0.86, 1.12), p=0.97 for satisfaction]. Conclusion: Patients receiving trifocal IOLs have a better intermediate VA than bifocal IOLs, especially for the AT LISA subgroup. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.

scholarly journals Comparison of Postoperative Visual Performance Between Bifocal and Trifocal Intraocular Lens Based on Randomized Controlled Trails: A Meta-Analysis

2019 ◽  
Author(s):  
Shanshan Jin ◽  
David S. Friedman ◽  
Kai Cao ◽  
Mayinuer Yusufu ◽  
Jingshang Zhang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Cataract Surgery ◽  
Clinical Performance ◽  
Meta Analysis ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Posterior Capsular Opacification ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background：To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no clinical significance [MD=-0.01, 95%CI: (-0.02,0.00)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (-0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD=0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA(DCIVA) [MD= 0.09, 95%CI: (-0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839M) [MD= 0.18, 95%CI: (0.12, 0.24) for UIVA and MD= 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA(UDVA) and corrected distance visual acuity (CDVA) [MD=0.01, 95%CI: (-0.01,0.04) for UDVA; MD=0.00, 95%CI: (-0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD=-0.08, 95% CI: (-0.19, 0.03) for spherical equivalent; MD=-0.09, 95%CI: (-0.21, 0.03) for cylinder; MD=-0.09, 95% CI: (-0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR=0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR=1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR=0.98, 5% CI: (0.86, 1.12) for patient satisfaction]. Conclusion: Patients receiving trifocal IOLs, especially AT LISA tri 839M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs. Keywords: bifocal; trifocal; intraocular lenses; cataract surgery; randomized; IOLs; meta-analysis.

scholarly journals Incidence of primary peripheral posterior capsular opacification after cataract surgery and posterior capsular opacification in the patients implanted with foldable intraocular lenses

2018 ◽  
Vol 9 (2) ◽  
pp. 149-155
Author(s):  
Rajesh Subhash Joshi
Keyword(s):  
Cataract Surgery ◽  
Care Center ◽  
Central India ◽  
Visual Outcome ◽  
Late Presentation ◽  
Intraocular Lenses ◽  
Posterior Capsular Opacification ◽  
Posterior Capsular Opacity ◽  
Neodymium Yag Laser

Introduction: Preexisting posterior capsular opacification is commonly seen in the developing world due to late presentation of patients for cataract surgery. Patients are implanted with either hydrophilic or hydrophobic IOL. Effect of these IOLs on pre-existing posterior capsular opacification has not yet been reported.Aim: To determine the incidence of peripheral preexisting posterior capsular opacity (PPPCO) in patients undergoing cataract surgery and the rate of posterior capsular opacification (PCO) following implantation of hydrophilic and hydrophobic intraocular lens (IOLs).Study design: Prospective, observational case study Setting: Tertiary eye care center in central India. Methodology: 1400 consecutive patients undergoing phacoemulsification of senile cataract between July 2009 and June 2010 discovered to have PPPCO were included in the analysis. Patients were either implanted with hydrophilic (n= 40) or hydrophobic IOL (n=40). Images of the posterior capsule immediately and 3-years postoperatively were compared. Patients were followed up for development of PCO, visual outcome at 3 years and neodymium: YAG laser posterior capsulotomy (NYLPC) rate.Results: Eighty patients were found to have PPPCO (incidence of 5.7%). 47.5% of PPPCOs were from mature senile cataracts (n = 38), 36.2% were from posterior subcapsular cataracts (n = 29) and 16.2% were from posterior polar cataracts (n = 13). NYLPC was performed in 9 patients receiving hydrophilic (22.5%) and 3 patients receiving hydrophobic IOLs (7.5%; p = 0.12). Average time to NYLPC was 18 months in the hydrophilic and 30 months in the hydrophobic group (p = 0.002). Visual outcome was satisfactory at 3-years of follow-up.Conclusion: PPPCO is a frequent occurrence in mature cataract and there is a higher incidence of PCO in PPPCO patients implanted with hydrophilic IOL than with hydrophobic IOL. Therefore, hydrophobic IOL should be considered for patients discovered to have PPPCO during cataract removal.

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