CLINICAL CHARACTERISTICS AND RESULTS OF CATARACT SURGERY IN THE SMALL PUPIL EYE BY PHACOEMUSIFICATION

2018 ◽  
pp. 79-82
Author(s):  
Van Minh Pham ◽  
Van Nam Phan ◽  
Thi Thu Nguyen

Objectives: To investigate the clinical characteristics of cataract patients with small pupils and to evaluate the result of cataract surgery on the eye have small pupils by phacotechnique. Subjects and methods: Descriptive study, prospective, uncontrolled interventions. Sample selection. The sample size of 70 patients with 70 eyes of cataracts with small pupils was treated by phaco technique and intraocular lens implant within posterior chamber. Follow up to 3 months. Results: 70 eyes, the percentage of men and women was not different from 54.2% (38 male) compared to 45.8% (32 female). The mean age was 80 ± 8.74, from 58 to 99 years. The disease was mainly found in the age group over 70 years old with over 80% (51.5%). Visual acuity before surgery was very poor under 3m CF (count finger) for 68.6% (48/70). Visual acuity over 1/10 was only a small amount with 2.8% (2 eyes). Pseudoexfoliation was the most common reason complications of mydriasis with 32/70 eyes (45.7%) and 22/70 eyes (31.4%) for age. The preoperative pupilarysizewas mostly small with 63/70 eyes (90.0%), non-dilated pupils (7/70 eyes) (10.0%). Average pupil size was 3.34 mm (2 - 4mm). Iris condition: iris atrophy 20/10 eyes (28.6%), iris synechiae 11/10 (15.7%), irregular iris muscle with 51, 4% and good iris muscle accounted for 48.6%. Grade of cataract: Grade III: 31/70 eyes (44.3%), Grade IV: 32/70 eyes (45.7%), Grade II: 5/70 eyes (7.1%) and V:2/70 eyes (2.9%). Pupil expander technique: OVD injection with 42/70 eyes (60%), using iris hook with 23/70 eyes (32.9%). Pupillary size before and after intervention has changed from 3.7mm to 4.48mm. Conclusions: Iris expander techniques have been shown to have good dilated pupils: 60.0% OVD injection, iris hook was 32.9%, other methods 7.1% One-week visibility of good visual acuity was higher than that of postoperative one day (12.2%) and increased at 1 month and 3 months (20.0%). Very good visual acuity was not available and low vision group was 1.4% after 3 months. Key words: cataract surgery; phacoemusification, small pupil

2011 ◽  
Vol 21 (6) ◽  
pp. 748-753 ◽  
Author(s):  
Swati V. Zawar ◽  
Parikshit Gogate

Purpose. To assess safety and efficacy of temporal manual small incision cataract surgery (SICS) in context to visual outcome, astigmatism, and complications. Methods. This involved sclerocorneal tunnel, capsulotomy and hydrodissection. The incision was made with number 11 disposable surgical blade (costing Indian Rs. 2.50, $0.05). Nucleus extraction was done by phaco-sandwich method with the help of vectis and dialer. Posterior chamber intraocular lens implantation was done according to biometric findings. A record of intraoperative and postoperative complications was made. The final postoperative assessment of astigmatism was done with spectacle correction on the 45th day as per the refraction findings. Results. Two thousand eyes were operated by temporal, manual small incision sutureless technique. Uncorrected visual acuity was ≥6/18 in 1636 (81.7%) patients on the first postoperative day, in 1652 (82.6%) patients at 2 weeks, and in 1732 (88.6%) patients at 6 weeks. Best-corrected visual acuity (BCVA) ≥6/18 was achieved in 1868 (93.4%) patients at 6 weeks, with 46 (2.3%) having BCVA <6/60, 24 (1.2%) of whom had preexisting retinal pathology. At 6 weeks, 1876 (93.8%) eyes had with-the-rule and 134 (6.2%) against-the-rule astigmatism (mean 0.7±1.25 D). Iris prolapse was noted in 3 (0.15%), wound leak in 3 (0.15%), and transient corneal edema in 136 (6.8%) eyes. Average surgery time was 6 minutes. Conclusions. Temporal SICS with number 11 disposable surgical blade and nucleus delivery by phaco-sandwich method gave excellent outcome with minimal astigmatism and low complication rate at economic cost.


2018 ◽  
Vol 103 (7) ◽  
pp. 993-1000 ◽  
Author(s):  
Alexander C Day ◽  
Mukesh Dhariwal ◽  
Michael S Keith ◽  
Frank Ender ◽  
Caridad Perez Vives ◽  
...  

PurposeTo assess the prevalence and severity of preoperative and postoperative astigmatism in patients with cataract in the UK.SettingData from 8 UK National Health Service ophthalmology clinics using MediSoft electronic medical records (EMRs).DesignRetrospective cohort study.MethodsEyes from patients aged ≥65 years undergoing cataract surgery were analysed. For all eyes, preoperative (corneal) astigmatism was evaluated using the most recent keratometry measure within 2 years prior to surgery. For eyes receiving standard monofocal intraocular lens (IOLs), postoperative refractive astigmatism was evaluated using the most recent refraction measure within 2–12 months postsurgery. A power vector analysis compared changes in the astigmatic 2-dimensional vector (J0, J45) before and after surgery, for the subgroup of eyes with both preoperative and postoperative astigmatism measurements. Visual acuity was also assessed preoperatively and postoperatively.ResultsEligible eyes included in the analysis were 110 468. Of these, 78% (n=85 650) had preoperative (corneal) astigmatism ≥0.5 dioptres (D), 42% (n=46 003) ≥1.0 D, 21% (n=22 899) ≥1.5 D and 11% (n=11 651) ≥2.0 D. After surgery, the refraction cylinder was available for 39 744 (36%) eyes receiving standard monofocal IOLs, of which 90% (n=35 907) had postoperative astigmatism ≥0.5 D and 58% (n=22 886) ≥1.0 D. Visual acuity tended to worsen postoperatively with increased astigmatism (ρ=−0.44, P<0.01).ConclusionsThere is a significant burden of preoperative astigmatism in the UK cataract population. The available refraction data indicate that this burden is not reduced after surgery with implantation of standard monofocal IOLs. Measures should be taken to improve visual outcomes of patients with astigmatic cataract by simultaneously correcting astigmatism during cataract surgery.


1970 ◽  
Vol 1 (1) ◽  
pp. 13-19 ◽  
Author(s):  
A Gurung ◽  
DB Karki ◽  
S Shrestha ◽  
AP Rijal

Background: An effective method for cataract surgery should be identified to combat cataract blindness. Aim: To study the surgical outcome of conventional extracapsular cataract extraction versus manual small-incision cataract surgery. Materials and methods: A randomized clinical trial was carried out including one hundred eyes (88 patients) which were divided into two groups using systematic randomization: groups of conventional extracapsular cataract extraction with posterior chamber intraocular lens (ECCE with PCIOL) implantation and manual small-incision cataract surgery (MSICS). The postoperative parameters/variables studied were the unaided and best-corrected visual acuity and astigmatism. Statistics: Epi info 2000 version statistical software was used for data analysis and calculation of relative risk, 95% CI and p value. The p value of less than 0.05 was considered as significant. Results: In the immediate postoperative period, unaided visual acuity of =/> 6/18 was achieved in 24 subjects in MSICS group versus 7 in ECCE with PCIOL group (RR=2.05, 95% CI=1.44 - 2.94, p = 0.0002), whereas the same at 6 - 8 weeks postoperatively was found in 28 and 22 subjects in those groups respectively (RR=1.27, 95% CI=0.86-1.89, p=0.23). The astigmatism of =/> 2 at 6 - 8 weeks was found in 35 and 17 subjects from the conventional and MSICS groups respectively ( R=2.28, 95% CI = 1.39-3.73, p=0.0002). Conclusion: Both MSICS and conventional ECCE with PCIOL are safe and effective techniques for treatment of cataract patients. A more rapid recovery of good vision can be achieved with MSICS than with conventional ECCE with PCIOL in the immediate postoperative period. Key words: ECCE; MSICS; visual acuity; astigmatism DOI: 10.3126/nepjoph.v1i1.3668 Nep J Oph 2009;1(1):13-19


1969 ◽  
Vol 2 (1) ◽  
pp. 100-104
Author(s):  
Haroon Rashid ◽  
Faizur Rahman ◽  
Sayed Ashfaq Ali Shah ◽  
Muhammad Ali Jan

Objectives: To evaluate the management and visual outcome of cataract surgery in children. Study design: Descriptive. Material and Methods: This study included one hundred pediatric patients having cataracts over a periodof two year, from Is' January 2005 to 31 st December 2006, at the Department of Ophthalmology, SaiduTeaching Hospital, Saidu Sharif, Swat. Results: Age range was fourteen years and below. Sixty five (65%) patients were males and thirty five (35%) females. Sixty three (63%) patients had congenital or developmental cataracts and thirty seven (37%) had traumatic cataracts. Extracapsular cataract extraction (aspiration) was performed on 150 eyes. Postoperative visual acuity was recordable in 112 eyes. Acorrected visual acuity of 6/18 or better was obtained in50 (44.64%) eyes. Forty one (36.6%) eyes obtained visual acuity of 6/24 to 6/60, while in 21 (18.75%) eyesthe visual acuity remained below 6/60. The most common postoperative complication was development ofthick posterior capsule, which occurred in 51 (34%) eyes and vitreous loss in 10 (6.6%) eyes. Pupil blockglaucoma developed in 4 (2.66%) eyes. No case developed endophthalmitis. Posterior chamber IOL wasimplanted in 9 (6%) eyes. Conclusions: Management of cataracts in children is still a problem and delayed presentation leads to poorvisual outcome. The public should be educated to seek early treatment for childhood cataracts. Paramedicsand doctors should be made aware of the problem and its management. Management of unilateral cataractsis still a difficult problem. Therefore search should continue for better surgical approach and better methodsof correction of aphakia so as to achieve better visual outcome. Key words: Childhood Cataracts, Congenital Cataracts and Traumatic Cataracts.


2011 ◽  
Vol 18 (02) ◽  
pp. 295-299
Author(s):  
MUHAMMAD MUMTAZ CHAUDHRY ◽  
MUHAMMAD MUBASHAR JALIS ◽  
AFZAL KHAN NIAZI

Purpose of study: To find out the prevalence and visual outcome of acute endophthalmitis after cataract surgery. Study Design: Retrospective. Period: 1st January 2001 to 31st December 2009. Setting: Wah Medical College, P.O.F. Hospital Wah Cantt, Rawalpindi. Materials and methods: Fifty cases of acute endophthalmitis who had undergone treatment. Each case of acute endophthalmitis was evaluated in terms of presentation, detailed examination, treatment and outcome. Microbiological culture of the vitreous aspirates was also done to identify the causative organism. The analysis was also meant to identify the prognostic factors of visual outcome of these cases. Results: Fifty patients presented with acute endophthalmitis out of the fifteen thousand cataract surgeries performed during the 9 year period. The incidence of endophthalmitis was 0.33% (95 % CI). A vitreous biopsy with intravitreal injection of antibiotics was done in all the cases presenting with acute endophthalmitis. Decreased visual acuity (90%) and pain (75%) were the main presenting features in these cases.. There were 36 (72%) culture positive cases, with staphylococci (50%) being the most common organism found. Vitreous biopsy yielded positive results in 36 (72%) patients while negative results with no microbial growth was found in 14(28%) patients. There were 20 (40%) growths of coagulase negative staphylococci, 5 (10%) growths of streptococci, 8 (16%) growths of coagulase positive staphylococci, and 3 (6%) of gram negative organisms. The final visual outcome was recorded after one month. 8 (16%) patients achieved 6/12 or better, 26 (52%) patients achieved moderately good visual acuity 6/60 to 6/12, while 16 (32%) patients achieved poor visual acuity of less than 6/60. Of the latter group who had poor visual acuity, 2 (4%) patients had only perception of light while 1 (2%) patient had no perception of light and 1 (2%) patient had blind and painful eye who had to undergo evisceration. 6 (16%) patients achieved 6/12 or better visual acuity. Conclusions: The incidence of endophthalmitis is consistent with other studies. Laboratory diagnosis of the vitreous aspirates helps in the treatment. Achieving a good visual outcome is possible with treatment of the cases of acute endophthalmitis.


2016 ◽  
Vol 50 (3) ◽  
pp. 91-95
Author(s):  
Filip Radotic ◽  
Nela Djonovic ◽  
Tatjana Sarenac-Vulovic ◽  
Suncica Sreckovic ◽  
Mirjana Petrovic-Janicijevic ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Gen Miura ◽  
Takayuki Baba ◽  
Tomoaki Tatsumi ◽  
Hirotaka Yokouchi ◽  
Shuichi Yamamoto

Purpose. To determine the effects of cataract surgery on contrast visual acuity and retinal sensitivity in patients with retinitis pigmentosa. Methods. Retinal sensitivity and contrast visual acuity were determined by microperimetry (MAIA) and contrast sensitivity acuity tester (CAT-CP), respectively, before and after cataract surgery. The significance of the correlations between visual acuity, retinal sensitivity, contrast visual acuity, improvements after surgery, and macular structure before and after cataract surgery was determined. Results. Retinal sensitivity and contrast visual acuity were significantly improved after cataract surgery. The correlations among postoperative visual acuity, postoperative retinal sensitivities, and preoperative ellipsoid zone length were significant. The postoperative retinal sensitivity of the central 10° and the ellipsoid zone length was particularly significantly correlated. Preoperative contrast visual acuity and the amount of improvement and preoperative retinal sensitivity and the amount of improvement were significantly negatively correlated. The contrast visual acuity under both the 100% and 10% photopic and mesopic conditions improved significantly after cataract surgery. Conclusions. Cataract surgery in retinitis pigmentosa patients with preserved ellipsoid zones significantly improved retinal sensitivity and contrast visual acuity. Cataract surgery can be expected to improve retinal sensitivity and contrast visual acuity under various conditions, even if preoperative visual parameters are low, as long as the ellipsoid zone is preserved.


2021 ◽  
Vol 33 (2) ◽  
pp. 98-101
Author(s):  
Md Abdul Matin ◽  
Mahbubur Rahman Shahin ◽  
Zakia Farhana ◽  
Sajed Abdul Khaleque

Introduction: Posterior capsular opacification is caused by migration and proliferation of cuboidal epithelium from remnant of anterior capsule and equatorial part of the lens capsule. Posterior capsular opacification also called after cataract is a nagging post surgical complication following phacoemulsification or non phaco cataract surgery (small incision cataract surgery or conventional cataract surgery) ECCE with posterior chamber intraocular lens implantation. Posterior capsular opacification is actually misnomer. Though there are many factors suggested to reduced posterior capsular opacification. The incidence of PCO still exists considerably. Aims and Objective are to find out the visual improvement after Nd yag laser posterior capsulotomy. Materials and Methods: The prospective study was conducted in the department of ophthalmology of Ad-din Women Medical College Hospital, Dhaka, Bangladesh from June 2014 to June 2018. 175 patients of 189 eyes with significant PCO. Before laser capsulotomy all patients were assess by routine slit lamp examination, IOP measurement and posterior segment examination done for every patient for exclusion of Gross posterior segment pathology. Results: The study had female preponderance (58.86%). Most of the patients 165 were 40 to 80 years old (87.31%). The patients had pre laser visual acuity 6/9 to 6/18 (31.75%) 6/24 to <6/60 (68.25%). After laser capsulotomy functional visual acuity upto 6/8 were 169 (89.42%) and 6/24 to <6/60 were 20 (10.58%). The mean pre and post laser capsulotomy visual functional score were 54.45±36.44 and 94.16±50.36 respectively. Conclusion: Nd YAG laser capsulotomy is safe, non-invasive and effective procedure. Medicine Today 2021 Vol.33(2): 98-101


2020 ◽  
pp. 112067212091906
Author(s):  
David Vladimir Diamint ◽  
Juan Martin Giambruni

Objective To present the surgical outcome of posterior chamber intraocular lens scleral fixation using a 27-gauge trocar-assisted transconjunctival sutureless technique in aphakic patients due to cataract surgery complications with inadequate capsular support. Methods Six consecutive patients with aphakia due to cataract surgery complications with inadequate capsular bag support were operated by two surgeons. Intraocular lens scleral fixation was performed with a 27-gauge trocar-assisted transconjunctival sutureless technique. Patients were followed-up for 12 months. Preoperative and postoperative best-corrected visual acuities were assessed with Early Treatment Diabetic Retinopathy Study charts and expressed in decimals. Results All patients showed statistically significant best-corrected visual acuity improvement and excellent anatomic results. Mean preoperative best-corrected visual acuity was 0.17 (range of 0.1–0.2). Mean postoperative best-corrected visual acuity was 0.84 (range of 0.63–1.00). Mean initial spherical equivalent refractive error was +11.85 (range of +9.00 to +15.00). Mean final spherical equivalent refractive error was –0.25 (range of –1.25 to +2.25). There were no postoperative complications during the whole follow-up. Conclusion Fixation of a posterior chamber intraocular lens using a 27-gauge trocar-assisted transconjunctival sutureless intrascleral technique is an excellent option for aphakic patients secondary to cataract surgery complications with inadequate capsular support.


2007 ◽  
Vol 60 (11-12) ◽  
pp. 653-656 ◽  
Author(s):  
Slobodanka Latinovic ◽  
Vladimir Canadanovic ◽  
Nikola Babic ◽  
Ljiljana Ljesevic ◽  
Desanka Grkovic ◽  
...  

Introduction. Since 1996, advanced methods and new instruments for the assessment of vision quality of life (VisQoL) index (37 and 15) have been developed and applied at the University Eye Clinic in Novi Sad. Many researches assume that postoperative results should not be evaluated only by postoperative visual acuity, but also by subjective perception of visual function and the patients ability to perform everyday activities, i.e. by quality of life. Therefore, our clinical results were based on both parameters of visual function, as the most objective attributes for assessing outcomes of certain types of cataract surgery. Material and Methods. Based on the results of the Cataract Study in Vojvodina in 2004, 5.7% of patients waiting for cataract surgery were already blind, 16.5% had low vision with cataract on both eyes, and 57% of patients had monocular blindness. Results and Discussion. With improvement of visual acuity to 0.5 or higher, after cataract surgery in 96.5% of patients, the cumulative VisQoL 15-index changed from 59.3 to 95.5. Intraocular lens implantation contributed most to the significant improvement in the vision related quality of life. Our study showed that pseudophakic patients had better quality of life than aphakic patients, who had the same visual acuity and refractive correction. Difficulties in performing everyday activities, such as shopping, using the telephone and reading, were found in 12.7% of aphakic, but only in 3% of pseudophakic patients. Conclusion. Advanced phacoemulsification techniques enable operated cataract patients immediate vision recovery, better quality of life, and personal satisfaction with visual function in everyday activities.


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