scholarly journals Efficacy of Burst Mode Torsional Phacoemulsification in Age-Related Cataract

2020 ◽  
Vol 15 (1) ◽  
pp. 94-97
Author(s):  
Md Abdullah Al Masum ◽  
Md Kamrul Hasan Khan ◽  
Zulfikar Hasan ◽  
Natasha Kajmina
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Posterior Capsule ◽  
Burst Mode ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Corneal Wound ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
Best Corrected Visual Acuity

Introduction: Torsional ultrasound energy and burst mode interrupted energy delivery system are recent advancementsin the technique of phacoemulsification surgery. It has been reported that both these advancementshelpto reduce corneal wound burn and thermal induced endothelial cell loss and thereby helps to achieve excellent early postoperative visual outcome Objectives: To evaluate the efficacy of burst mode torsional phacoemulsification surgery in age-related cataract. Materials and Methods: Prospective observational study of 120 cases that underwent phacoemulsificationcataract surgery in which torsional energy was used in burst mode. Phacoemulsification was performed by “vertical –chop” technique. Intraoperatively corneal wound burn, Descemet’s membrane detachment, posterior capsule ruptureetc.were evaluated. Postoperatively corneal oedema, best corrected visual acuity, cystoid macular oedema were evaluated. Postoperatively eyes were examined at day 1, 1 week, 6 weeks and 3 months. Results: Mean age of the patients was 57.28± 8.20 years. Most of the patients 81(67.5%) had nuclear sclerosis grade-II cataract.Intraoperatively, moderate wound burn occurred in 02(1.6%) eyes, localized Descemet’s membrane detachmentin 03(2.5%) eyes and posterior capsule rupture occurred in 03(2.5%) cases. Postoperatively, moderate and severe corneal edema was found in 06(5.0%) and 04(3.3%) eyes respectively at day 1. At the end of 3 months follow-up, 114(95%) eyes maintained a best corrected visual acuity of ≥ 6/18, of which 109(90.8%) eyes achieved ≥ 6/9. Conclusion: Burst mode torsional phacoemulsfication is a very effective and advanced technique of cataract surgery. Intraoperative complications are very less and visual outcome is excellent. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 94-97

scholarly journals Clinical Study of Visual Outcome and Complications of Nd:YAG Laser Capsulotomy in Posterior Capsular Opacification Following Small Incision Cataract Surgery at a Tertiary Eye Care Centre in Rural Maharashtra - A Prospective Observational Study

2021 ◽  
Vol 8 (19) ◽  
pp. 1409-1413
Author(s):  
Varsha Ramesh Dhakne ◽  
Sourabh Hanumant Karad ◽  
Samartha Babasaheb Waghambare ◽  
Hanumant Tulshiram Karad ◽  
Uttam Haribhau Nisale ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Nd:Yag Laser ◽  
Visual Outcome ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Posterior Capsular Opacification ◽  
Corrected Visual Acuity ◽  
Nd:Yag Laser Capsulotomy ◽  
Best Corrected Visual Acuity

BACKGROUND Posterior capsule opacification (PCO) is the most common delayed complication of cataract surgery. Nd:YAG (Neodymium yttrium aluminium garnet) laser posterior capsulotomy presents the advantages of a non-invasive, effective, relatively safe technique to manage intact posterior capsule that opacifies postoperatively. With this background we want to study the visual outcome and complications following Nd-YAG laser posterior capsulotomy in posterior capsular opacification following small incision cataract surgery (SICS). METHODS The study includes 64 patients attending outpatient department of a tertiary eye care hospital at Latur from June 2018 to May 2019 who have undergone SICS with PMMA PC IOL (polymethyl methacrylate posterior chamber intraocular lens) implantation and clinically diagnosed with posterior capsular opacification. 64 eyes with PCO were subjected to Nd:YAG laser posterior capsulotomy after detailed slit lamp bio microscopic examination pre- and post-capsulotomy. Follow-up was done at 1 hour, 1 week, 2 weeks and 4 weeks and patients were examined for visual outcome and any complications at each visit. RESULTS There were 16 males (25 %) and 48 females (75 %) with a mean age of 65 years. Posterior capsule opacification occurs within 3 years accounting for 46.9 % of the cases. Elschnig pearls type of PCO was more common when compared to fibrous type of PCO. Best corrected visual acuity (BCVA) before Nd:YAG laser capsulotomy was less than 6 / 60 in 35 patients (54.7 %) and within 6 / 60 to 6 / 24 in 23 patients (35. 9 %) with 6 patients (9.4 %) accounting for visual acuity between 6 / 24 to 6 / 18. After Nd - YAG Laser Capsulotomy, 46.9 % gained best corrected visual acuity of 6 / 18 or better, 39.1 % cases improved 6 / 12 and better and BCVA of 6 / 9, 6 / 6 was observed in 11 cases and 1 case respectively. Only 12 out of 64 patients had complications. Raised intraocular pressure (IOP) was found in 4 patients. Intraocular lens (IOL) pitting was found in 8 patients. CONCLUSIONS Nd:YAG laser capsulotomy is a safe, effective and a non-invasive procedure which avoids all the complications of surgical capsulotomy in patients of posterior capsule opacification. KEYWORDS Posterior capsule opacification (PCO), Nd:Yag Laser Capsulotomy, Best Corrected Visual Acuity (BCVA), Central Subfield Macular Thickness (CSMT)

Intravitreal aflibercept efficacy in neovascular age-related macular degeneration with suboptimal response to anti-vascular endothelial growth factor-A therapy

2019 ◽  
Vol 30 (5) ◽  
pp. 1082-1090
Author(s):  
Jordi Monés ◽  
Marc Biarnés ◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Endothelial Growth Factor ◽  
Best Corrected Visual Acuity

Importance: To provide new insights into aflibercept effect in non-naive-treated patients with neovascular age-related macular degeneration. Purpose: To assess the efficacy of intravitreal aflibercept in patients with neovascular age-related macular degeneration without optimal response to previous anti-vascular endothelial growth factor A therapy. Design: Single-arm, multi-centre, prospective study. Participants: Patients ⩾50 years with active neovascular age-related macular degeneration, best-corrected visual acuity between 20/32 and 20/320 with suboptimal response to ranibizumab or bevacizumab. Methods: Aflibercept was administered monthly (3-first months), and bimonthly thereafter until month 8. Anatomical and functional outcomes were assessed. Main outcome measure: Percentage of eyes without intra or subretinal fluid on optical coherence tomography after 3-monthly loading doses of aflibercept. Results: A total of 46 patients were included. At week 12, 45.7% (95% confidence interval: 31.5%–60.1%) of eyes showed no fluid on optical coherence tomography. The mean (standard deviation) best-corrected visual acuity increased from 65.1 (8.3) to 69.6 (8.1) letters (+4.5 (5.8) p < 0.0001) and was stabilized at week 40 as compared to baseline. Mean central macular thickness decreased from 430 (119) µm to 323 (100) µm at week 12 (–107 (90) µm, p < 0.0001) and was reduced at week 40 (–46 (111) µm, p = 0.0056). At week 40, 21.7% (95% confidence interval: 9.8%–33.7%) had no fluid. There was a case of presumed noninfectious endophthalmitis that was successfully managed. Conclusion: Almost half of patients presented no fluid on optical coherence tomography at week 12, and there was a clinically significant improvement in best-corrected visual acuity. At week 40, one in five patients did not show intra or subretinal fluid, central macular thickness decreased and best-corrected visual acuity was stabilized compared to baseline.

scholarly journals Retro-pupillary iris fixated intraocular lens: A boon to aphakia

2021 ◽  
Vol 7 (2) ◽  
pp. 415-418
Author(s):  
Subramanya K Giliyar ◽  
Ravi Bypareddy ◽  
Kamakshi N Moger ◽  
Vinutha Moger ◽  
Deeksha Bekal
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Simple Procedure ◽  
Visual Outcome ◽  
Secondary Outcome ◽  
Corrected Visual Acuity ◽  
Corneal Decompensation ◽  
Best Corrected Visual Acuity ◽  
Capsular Support

To evaluate post operative visual outcome and complications of retro-pupillary iris fixated Intracoular lens (IOL) in aphakia. This is a prospective interventional case study conducted at our tertiary eye care centre from March 2018 to February 2019 All monocular aphakias secondary to any cause with no capsular support, good iris diaphragm support and BCVA of better than 6/60 were included. Patients who required combined procedures like trabeculectomy and retinal procedure were excluded. Patients with poor endothelial count/ corneal decompensation, any posterior segment pathologies, pre existing glaucoma and any form of uveitis were also excluded from the study. Pre operative visual acuity, slit lamp examination and fundus examination were carried out. Anterior vitrectomy and retropupillary fixation of iris claw lens were done. The primary outcome was to assess the post operative visual acuity and secondary outcome was to analyse post operative complications at various intervals up to 6 months after surgery. Our study comprised of thirty eyes of 30 aphakic patients. RPIFIOL was inserted as primary intraocular lens in 18 patients (%) and secondary intraocular lens in 12 patients(%). Baseline best corrected visual acuity was 0.831±0.66 logMAR. Four patients had light perception at baseline. The mean best corrected visual acuity was 0.77±0.35 logMAR at month 1, 0.64±0.36logmAR at month 3 and 0.53±0.33logmAR at month 6 respectively. Mean intraocular pressure at baseline was 16mmHg. Mean intraocular pressure at month 1, 3 and 6 were 17mmHg, 16mmHg, and 16mmHg. Among the complications, twelve eyes (40%) had significant ovalisation of pupil at post operative month 1 which persisted at month 6, two eyes(6.66%) had transient ocular hypertension (OHT), and none of the eyes progressed to glaucoma. Choroidal detachment was noted in 2 eyes (6.66%), CME in 3 eyes (9.99%), 1 eye (3.33%) had retinal detachment and 2 eyes (6.66%) had one haptic disenclavation. Among the complications, ovalisation of pupil was the most common observed one. Retro-pupillary Iris fixated IOL is an effective, safe and simple procedure for management of aphakia in eyes with no posterior capsular support.

scholarly journals Three-Month Results of Brolucizumab Intravitreal Therapy in Patients with Wet Age-Related Macular Degeneration

2021 ◽  
Vol 18 (16) ◽  
pp. 8450
Author(s):  
Katarzyna Michalska-Małecka ◽  
Dorota Śpiewak ◽  
Dorota Luksa
Keyword(s):  
Visual Acuity ◽  
Retinal Thickness ◽  
Age Related Macular Degeneration ◽  
Central Retinal Thickness ◽  
Membrane Flow ◽  
Membrane Area ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
The Mean ◽  
Best Corrected Visual Acuity

The purpose of the study was to evaluate changes in best corrected visual acuity, central retinal thickness, area and flow in the neovascular membrane and to compare therapeutic outcomes from baseline in patients who received three doses of Beovu (brolucizumab) at three-month follow-up. Material and methods: A prospective observational study conducted at the Prof. K. Gibiński University Clinical Center of the Medical University of Silesia in Katowice. Eight patients with exudative form of age-related macular degeneration (AMD) were observed. Results: The mean best corrected visual acuity (BCVA) outcome increased with each subsequent visit. The mean central retinal thickness (CRT) result also improved (decreased) with each subsequent visit, except for the last measurement. A statistically significant change in neovascular membrane area was observed after the first injection. In further treatment, the membrane area underwent changes that were not statistically significant. A statistically significant change in neovascular membrane flow was demonstrated after the first and second injections. Discussion: Our study confirmed the efficacy of brolucizumab in the treatment of patients with exudative AMD in terms of improvements in best corrected visual acuity (BCVA), central retinal thickness (CRT), neovascular membrane area, and neovascular membrane flow area.

Neovaskulinės amžinės geltonosios dėmės degeneracijos gydymo ranibizumabu 24 mėnesių morfologiniai ir funkciniai pokyčiai

2015 ◽  
Vol 21 (3.2) ◽  
pp. 413-416
Author(s):  
Vilma Jūratė Balčiūnienė ◽  
Rosita Lažaunykaitė
Keyword(s):  
Visual Acuity ◽  
Macular Thickness ◽  
Age Related Macular Degeneration ◽  
Central Macular Thickness ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Before And After ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Key words: ranibizumab, age-related macular degeneration, central macular thickness. Research objective. To evaluate influence of treatment with vascular endothelial growth factor inhibitor, ranibizumab, for best corrected visual acuity and central macular thickness in patients with neovascular age-related macular degeneration. Materials and methods. In this retrospective study were included treatment – naive patients. Intravitreal injections were performed at Lithuanian University of Health Sciences Kaunas Clinics Eye clinic. In this study were analysed the 24-month morphological and functional outcomes of intravitreal ranibizumab injections. Best corrected visual acuity was meassured using the Snellen chart (Landolt’s rings C optotypes). Optical coherence tomography images were obtained using the spectral – domain OCT (NIDEK RS – 3000 Advance (NIDEK CO LTD, Japan). The central thickness measurements were obtained from macular thickness maps using the digital caliper tool. Results. In this study were included 88 patients. Best corrected visual acuity before treatment was 0.36 ± 0.22. The difference between visual acuity before and after first injection was 0.04 ± 0.22 (p = 0.03). Before fifth injection visual acuity was 0.41 ± 0.21, after – 0.46 ± 0.22 (p = 0.05). Central macular thickness before treatment was 297.81 ± 106.04 μm. The difference between central macular thickness before and after first injection was 85.21 ± 113.37 μm (p &lt; 0.001). Before second injection central macular thickness was 273.57 ± 87.49 μm, after – 234.51 ± 58.96 μm (p = 0.002). Before fourth injection central macular thickness was 237.20 ± 40.87 μm, after – 219.10 ± 42.26 μm (p = 0.04). The mean central macular thickness significantly decreased from 298.15 ± 104.78 to 229.08 ± 56.57 (p &lt; 0.001). In 24 month of treatment the average number of ranibizumab injections was 3.61 ± 1.55. Conclusions. Our study’s results showed that over 24 month best corrected visual acuity improvement was statistically significant after first and fifth injection. Baseline compared with last injection, there was not statistically significant difference. Central macular thickness improvement statistically significant was after first, second and fourth injection. There was statistically significant decreased baseline compared with the last injection. The mean number of ranibizumab injections was 3.61 ± 1.55 in 24 month.

Femto Circular Keratotomy to Halt the Progression of Keratoconus I and II

2016 ◽  
Vol 5 (3) ◽  
pp. 109-113
Author(s):  
Jörg H Krumeich ◽  
Nino Hirnschall ◽  
Detlev Breyer ◽  
Florian Laufer
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Statistical Evaluation ◽  
Optical Axis ◽  
Stage I ◽  
Time Points ◽  
Corrected Visual Acuity ◽  
Deep Incision ◽  
Descemet’S Membrane ◽  
Best Corrected Visual Acuity

ABSTRACT Aim To simplify and enhance safety in the generation of a stabilizing intracorneal scar by circular keratotomy (CKT). A femtosecond laser was used to perform individually sized intraparenchymal cuts. Materials and methods As equipped, the Ziemer Z6 femto-second laser cuts a 400-µm-deep incision with a diameter of 7.0 mm around the optical axis. The epithelium, Bowmann's membrane, the internal borders of Descemet's membrane, and the endothelium are not affected. The 3-, 6-, and 12-month postoperative values were compared with the 1-month postoperative keratometric readings and astigmatism. The preoperative best corrected visual acuity (BCVA) with glasses was compared with the values found at the same time points as noted above. Results Statistical evaluation indicated that keratometry within ±1.5D remained in 96.6, 93.1, and 96.6% of cases at the 3-, 6-, and 12-month time points respectively. Astigmatism was stable at the same time points in 100, 95.8, and 92.3%. The BCVA improved in 12 cases throughout the first post-operative year (48%, n = 25); however, 11 cases did not change (44%) and 2 cases lost at least one line (8.0%). Conclusion Femto CKT halts the progression of keratoconus for at least 1 year in 96.6% of cases. This treatment provides keratometric and refractive stability for over 1 year. This result, in conjunction with the significant improvement in BCVA, demonstrates the potential of this method for patients with stage I and II keratoconus. How to cite this article Krumeich JH, Hirnschall N, Breyer D, Laufer F. Femto Circular Keratotomy to Halt the Progression of Keratoconus I and II. Int J Kerat Ect Cor Dis 2016;5(3):109-113.

Effect of 2-year nutritional supplementation on progression of age-related macular degeneration

2019 ◽  
Vol 30 (2) ◽  
pp. 376-381
Author(s):  
Alberto Piatti ◽  
Antonella Croce ◽  
Danilo Mazzacane ◽  
Giovanni Traina ◽  
Lina Ambrosino ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Exact Test ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Best Corrected Visual Acuity

Purpose: To examine the effect of a long-term nutritional supplementation on age-related macular degeneration progression. Methods: In this prospective, double-blind, placebo-controlled study, 80 patients with intermediate age-related macular degeneration were randomized (2:1) to receive 1 tablet/day of a nutritional supplement containing a mixture of carotenoids, vitamins and omega-3 fatty acids or placebo. Age-related macular degeneration progression assessed by digital fundus photography (primary outcome) and best-corrected visual acuity were evaluated. Differences between arms were tested using chi-square test or Fisher’s exact test. Results: Seventy-four patients completed the follow-up at 24 months (48 in the treated arm and 26 in the placebo arm). An age-related macular degeneration progression was observed in the 2.1% of patients of the treated arm and in the 15.4% of patients in the placebo arm (p = 0.05, Fisher’s exact test). Best-corrected visual acuity data alone were not statistically significant among groups. Conclusion: A clinically meaningful stabilization of intermediate age-related macular degeneration over a period of 2 years may be obtained by treating patients with a mixture of carotenoids, vitamins and omega-3 fatty acids.

scholarly journals Visual outcome following scleral fixated intraocular lens implantation

2017 ◽  
Vol 16 (2) ◽  
pp. 63-68
Author(s):  
Chunu Shrestha ◽  
Sabina Shrestha ◽  
Aparajita Manoranjan
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Visual Rehabilitation ◽  
Post Surgery ◽  
Corrected Visual Acuity ◽  
The Common ◽  
Best Corrected Visual Acuity ◽  
Scleral Fixated Intraocular Lens

Introduction: Scleral fixated intraocular lens(SFIOL) implantation to correct aphakia offers superior visual rehabilitation in comparison to aphakic spectacles or contact lens. This study was done to evaluate a simplified technique of scleral fixation of posterior chamber intra-ocular lens (IOL) in terms of visual outcome and complications.Methods: This was a prospective study enrolling 23 eyes of 23 patients who underwent anterior vitrectomy followed by ab-externo sclera fixation of posterior chamber IOL using 10.0 polypropylene sutures from January 2016 to February 2017 in Nepal Eye Hospital.Scleral flap was made at 3 and 9'o clock meridian to cover the knots which prevent erosion of the knots through conjunctiva.  Main outcome measures were post-operative best corrected visual acuity and post-operative complications.Result: Best corrected visual acuity were 6/6 - 6/18 in 86.9% (n=20), 6/24 - 6/60 in 8.7% (n=2) and worse than 6/60 in 4.3% (n=1)at six months followup. The mean spherical equivalent before surgery was +10.60 diopter and -1.14 diopter post-surgery. The common indicationsfor scleral fixated intraocular lens weretrauma in 60.86% (n=14), surgical aphakia in21.73% (n=5), spontaneous posterior dislocation of lens in 13.0% (n=3) and subluxated intraocular lens in 4.34% (n=1). The common complications were astigmatism in 91.30% (n=21), decentered IOL in 4.34% (n=1) and uveitis in 4.35% (n=1).Conclusion: Ab-externosclerated fixated intraocular lens is a safe and effective method for visual rehabilitation with low post-operative risk.

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