scholarly journals Comparasion of efficacy and safety of Difluprednate 0.05% and Nepafenac 0.1% in reducing macular thickness and volume after cataract surgery

2017 ◽  
Vol 15 (4) ◽  
Author(s):  
Vishal Katiyar ◽  
Ankur Yadav ◽  
Sanjiv Gupta ◽  
Poonam Kishore ◽  
Prateep Phadikar
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Macular Thickness ◽  
Efficacy And Safety ◽  
Thickness Change ◽  
Corrected Visual Acuity ◽  
Group D ◽  
Best Corrected Visual Acuity ◽  
Ophthalmic Suspension

Objective- To evaluate and compare efficacy and safety of topical Difluprednate ophthalmic emulsion 0.05% with Nepafenac ophthalmic suspension 0.1% in patients of uneventful cataract surgery with respect to postoperative macular thickness and volume. Design- A prospective, single centric, tertiary care centre based, comparative, interventional study from August 2013 to July 2014 Subjects- Total 206 ( Group N=106, Group D=100) patients were followed up who completed their 12 weeks follow up Methodology- Surgery was performed by phacoemulsification technique by clear corneal incision with foldable PCIOL implantation by a single surgeon having 10 years of surgical experience. Post operative patients were divided into 2 groups. Group N were given topical treatment with Nepafenac ophthalmic suspension  0.1% TID starting 24 hours before surgery  and continued post-op 4 weeks. Group D were given Difluprednate ophthalmic emulsion 0.05% QID post surgery for 2 weeks followed by BID for 2 weeks.  Main outcome measures: Postoperative assessment of patients were done on 1st day and on 1st, 8th and12th  weeks  after the surgery for best corrected visual acuity (BCVA) by logMAR, intraocular pressure by Applanation tonometry and macular thickness and volume by SD-OCT. Statistical test used was sample Unpaired and paired ‘t’ test  and statistical analysis was done with SPSS 20.0 ( IBM, USA). Results- There was increase in the measured mean central subfield thickness( CST) at 8 and 12 weeks as compared to 1 week , in both the study groups (P<0.05). On comparing the volume (in mm3) and average thickness (in µm) at 1 week, it was observed that thickness of group N (266.82±25.06 µm) was statistically higher than that of group D (253.14±22.21µm) (P= 0.03). The comparison of best corrected visual acuity (LogMAR) and the intraocular pressure recordings showed no difference between the patients of two studied groups recorded at 1 week and 8 weeks and 12weeks. Conclusion- Both Nepafenac ophthalmic suspension 0.1% and Difluprednate ophthalmic emulsion 0.05% are equally effective in controlling macular thickness change after uneventful cataract surgery.

scholarly journals Safety and Efficacy of 25G vitrectomy surgery for malignant glaucoma in pseudophakia

2019 ◽  
Author(s):  
fei you
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Safety And Efficacy ◽  
Corrected Visual Acuity ◽  
Malignant Glaucoma ◽  
Intraocular Hemorrhage ◽  
Significant Difference ◽  
Best Corrected Visual Acuity

Abstract Background: malignant glaucoma after cataract surgery is still one of the serious complications, if not handled properly，it may lead to serious consequences. It is notoriously difficult to treat. 25G vitrectomy was performed to evaluate the safety and efficacy for the treatment of malignant glaucoma in pseudophakia. Methods: This is a retrospective, comparative case series study. A total of 20 eyes of 20 patients with malignant glaucoma after phacoemulsification were analyzed retrospectively in The First Affiliated Hospital Of Anhui Medical University from May 2015 to January 2018. All Medical Data including the best corrected visual acuity (BCVA), Change of intraocular pressure (IOP), the length of eye axis, and the depth of anterior chamber were recorded. SPSS 17.0 statistical software was used for analysis .Before surgery, the best corrected visual acuity (BCVA) was 1.8±0.6. The intraocular pressure was between 18-57mmHg, with an average of 35.2±10.4mmHg.The depth of anterior chamber was between 0.9-1.9mm, with an average of 1.3±0.2mm.The length of eye axis was 19.7-22.5mm,with an average of 20.6±0.5mm.All the patients were accomplished with 25G vitrectomy. Besides, anterior chamber inflammatory reaction and other complications were also observed postoperation. Results: The patients were followed up for 6-12 months with an average of 9 months. BCVA at the last follow up improved to 0.8±0.1, and there was significant difference compared to that before operation (P<0.01).IOP was from 12-19mmHg, an average of 16.1±2.5mmHg, there was significant difference compared to that before operation (t=7.6, p<0.01).Only one patient occurred low IOP (6mmHg) after surgery, IOP returned to normal level (14mmHg) after conservative treatment. No serious complications including corneal endothelium decompensation, intraocular lens (IOL) capture, intraocular hemorrhage, endophthalmitis and uncontrolled IOP were observed. Conclusions: 25G minimally invasive vitrectomy can treat malignant glaucoma after cataract surgery safely and effectively

scholarly journals Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent

2021 ◽  
Vol 10 (10) ◽  
pp. 2129
Author(s):  
Yuji Takayanagi ◽  
Sho Ichioka ◽  
Akiko Ishida ◽  
Aika Tsutsui ◽  
Masaki Tanito
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Corneal Endothelial Cell ◽  
Efficacy And Safety ◽  
Fellow Eye ◽  
Corrected Visual Acuity ◽  
Corneal Endothelial Cell Density ◽  
Anterior Chamber Flare ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

The aim of this study is to compare the surgical efficacy and safety between microhook ab-interno trabeculotomy (µLOT) and iStent trabecular micro-bypass stent implantation when both were combined with cataract surgery in both eyes of patients. Sixty-four glaucomatous eyes (32 participants; mean age, 75.9 ± 7.6 years; 15 men, 17 women) were included retrospectively. Intraocular pressure (IOP), number of antiglaucoma medications, best-corrected visual acuity (BCVA), anterior chamber flare (ACF) and corneal endothelial cell density (CECD) were evaluated preoperatively, as well as 2, 3, 6, and 12 months postoperatively. Surgical complications and interventions were compared between the procedures. The preoperative IOP and medications with µLOT (18.8 ± 5.7 mmHg and 3.0 ± 1.2, respectively) were higher than with the iStent (15.5 ± 3.4 mmHg and 2.7 ± 1.2, respectively) (p = 0.0001 and p = 0.0437, respectively). At 12 months, the µLOT values (12.6 ± 2.3 mmHg and 2.3 ± 0.9, respectively) were identical to iStent (12.8 ± 2.5 mmHg and 2.3 ± 0.9, respectively) (p = 0.0934 and p = 0.3251, respectively). At 12 months, the IOP decreased more with µLOT (6.2 mmHg, 29.5%) than iStent (2.7 mmHg, 15.6%) (p = 0.0003). The decrease in medications was greater with µLOT (0.7) than iStent (0.4) (p = 0.0437). Survival rate of IOP control ≤15 mmHg and IOP reduction ≥20% was significantly higher after µLOT (40.6% at 12 months) than iStent (18.8%) (p = 0.0277). The frequency of layered hyphema was significantly greater with µLOT (8 eyes, 25%) than iStent (0 eyes, 0%) (p = 0.0048). The increase in the ACF at 2 weeks postoperatively was significantly greater with µLOT than iStent (p = 0.0156), while changes in the BCVA and CECD were identical between groups. The fellow-eye comparison showed that the IOP reduction was greater with µLOT than iStent when combined with cataract surgery.

scholarly journals Changes in macular thickness post uncomplicated MSICS & phacoemulsification surgery

2022 ◽  
Vol 7 (4) ◽  
pp. 619-623
Author(s):  
Kartika Anand ◽  
Ashutosh Dokania
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Thickness ◽  
Posterior Chamber ◽  
Prospective Clinical Study ◽  
Small Incision Cataract Surgery ◽  
Corrected Visual Acuity ◽  
Clinically Significant ◽  
Clinically Significant Macular Oedema ◽  
Best Corrected Visual Acuity

To evaluate changes in macular thickness via-a-vis visual acuity post uncomplicated manual small incision cataract surgery (MSICS) & phacoemulsification surgery Prospective clinical study on 160 patients of uncomplicated immature senile cataract, aged 40-70yrs, patients were randomised into two groups, MSICS & phacoemulsification, by simple 1:1 randomization, who underwent uncomplicated cataract surgery with posterior chamber intraocular lens (PCIOL). Post-operatively, the patients were evaluated for best corrected visual acuity (BCVA) and changes in macular thickness by optical coherence tomography (OCT) at post-op Day 1, 7, 21, 48, and 12 weeks. Paired t-test was used for comparison across follow up. : At 12 weeks post-operative, mean logMAR BCVA was 0.01±0.02 for MSICS group and 0±0.02 for Phacoemulsification group. Macular thickness was not statistically significant (p=0.342) between MSICS group (219.19±17.88µm) and Phacoemlusification group (215.61±16.21µm), at the end of 12 weeks post-operative. Clinically significant macular oedema was not diagnosed in any of the patients at the follow-ups.: Both procedures achieved good post-operative Best Corrected visual acuity without significant differences in BCVA between both the groups at the end of 12 weeks.

scholarly journals The RELIEF study: Tolerability and efficacy of preservative-free latanoprost in the treatment of glaucoma or ocular hypertension

2018 ◽  
Vol 29 (2) ◽  
pp. 210-215 ◽  
Author(s):  
Marta Misiuk-Hojlo ◽  
Maria Pomorska ◽  
Malgorzata Mulak ◽  
Marek Rekas ◽  
Joanna Wierzbowska ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Standard Deviation ◽  
Ocular Hypertension ◽  
Benzalkonium Chloride ◽  
Tear Film ◽  
Corrected Visual Acuity ◽  
Break Up ◽  
Preservative Free ◽  
Best Corrected Visual Acuity

Purpose: To assess tolerability and efficacy following a switch from benzalkonium chloride–latanoprost to preservative-free latanoprost in patients with glaucoma or ocular hypertension. Methods: A total of 140 patients with glaucoma or ocular hypertension controlled with benzalkonium chloride-latanoprost for at least 3 months were switched to treatment with preservative-free latanoprost. Assessments were made on days 15, 45, and 90 (D15, D45, and D90) and included best-corrected visual acuity, intraocular pressure, slit lamp examination, fluorescein staining, tear film break-up time, patient symptom evaluation, and subjective estimation of tolerability. Results: Mean best-corrected visual acuity remained unchanged during the study. Mean intraocular pressure compared with baseline (D0) remained stable throughout the study (D0, 15.9 mmHg (standard deviation = 2.6); D90, 15.3 mmHg (standard deviation = 2.4); p < 0.006). Tear film break-up time improved or remained unchanged relative to baseline in 92% of patients at D45 and in 93% at D90. Moderate-to-severe conjunctival hyperemia was seen in 56.8% of patients at D0, but this figure decreased to 13.7%, 2.2%, and 1.6% at D15, D45, and D90, respectively. Subjective assessment of tolerability (0–10 scale) indicated improvement with change of therapy (mean score: 5.3 (standard deviation = 2.2) at D0 versus 1.9 (standard deviation = 1.7) at D90; p < 0.0001). Conclusion: Preservative-free latanoprost has at least the same intraocular pressure-lowering efficacy as benzalkonium chloride–latanoprost, with a better tolerability profile. This may translate into greater control of treatment and improved quality of life.

scholarly journals Dry eye syndrome and cataract surgery

2019 ◽  
Vol 72 (3-4) ◽  
pp. 105-109
Author(s):  
Stefan Brunet ◽  
Vladimir Canadanovic ◽  
Nikola Babic ◽  
Aleksandar Miljkovic ◽  
Sandra Jovanovic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Dry Eye ◽  
Dry Eye Syndrome ◽  
Schirmer Test ◽  
Corrected Visual Acuity ◽  
Body Sensation ◽  
Eye Symptoms ◽  
Best Corrected Visual Acuity ◽  
Dry Eye Symptoms

Introduction. Dry eye syndrome has become a common problem after ocular surgeries with a significant impact on the quality of life. Many patients, who have undergone cataract surgery, postop?eratively developed dry eye symptoms. Dry eye syndrome is one of the risk factors associated with cataract surgery. Material and Methods. The prospective study included 80 patients. We recorded the self-reported dry eye symptoms, the values of Schirmer test, tear breakup time, and best corrected visual acuity preoperatively, as well as 7 days and 1 month after the surgery. Results. A total of 80 patients were included in the study, 45 (56.2%) females and 35 (43.8%) males. The mean age of patients was 61.5 years (SD ? 6.2, range 57 - 70 years). The best corrected visual acuity at the time of surgery was 0.4 or less in 70 patients (87.5%). Most patients reported a significant improvement in visual acuity after surgery; 68 (85%) eyes achieved a best corrected visual acuity of 0.5 or higher (median 0.7; range 0.5 - 1.0). The mean tear breaking time in cata?ract patients before surgery was 12.4 sec, 7 days after the surgery it was 8.2 sec (p < 0.05) and 1 moth after the surgery 11.1 sec. The majority of patients had mild (47.5%) and moderate (33.75%) Schirmer test values. Dry eye with wetting < 5 mm after 5 minutes was found in 16.2% of patients before cataract surgery; 7 days after the surgery (p < 0.05) it was found in 23.75% of patients and one month after surgery 11.1 sec. A foreign body sensation and watery eye were the most reported symptoms before cataract surgery. Seven days after the surgery foreign body sensation was present in 48.75% and watery eyes in 40% of patients. Conclusion. Significant increase in dry eye symptoms after cataract surgery was found with increasing age. Self reported dry eye problems are more common in patients with lower Schirmer test and best corrected visual acu?ity values before cataract surgery. Patients with concomitant dry eye disease require preoperative and postoperative treatment of dry eye to prevent aggravation of the existing symptoms that may affect the visual outcome after cataract surgery.

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

scholarly journals Cataract Surgery and Uveitis

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.

scholarly journals Macular edema after cataract surgery in eyes with and without pseudoexfoliation syndrome

2018 ◽  
Vol 29 (5) ◽  
pp. 504-509 ◽  
Author(s):  
Lotta Ilveskoski ◽  
Claudia Taipale ◽  
Emil J Holmström ◽  
Raimo Tuuminen
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Pseudoexfoliation Syndrome ◽  
National Guidelines ◽  
Aqueous Flare ◽  
Corrected Visual Acuity ◽  
Department Of Ophthalmology ◽  
Anti Inflammatory ◽  
Best Corrected Visual Acuity

Background:The purpose of the study was to identify macular edema after cataract surgery in eyes with and without pseudoexfoliation syndrome. The study was a post-hoc analysis of a randomized, double-blind, prospective single-center study. Patients were enrolled between January 2016 and October 2016 as per the national guidelines for the management of cataract in the Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland.Methods:One hundred and fifty-six eyes of 149 patients undergoing routine cataract surgery. Postoperatively anti-inflammatory medication was either dexamethasone (N = 78) or diclofenac (N = 78). Spectral domain optical coherence tomography imaging and laser flare meter measurement of the anterior chamber were conducted before surgery and at the control visit 28 days postoperatively.Results:Baseline variables were comparable between eyes with pseudoexfoliation syndrome (N = 32) and those without (N = 124), except for intraocular pressure ( P = 0.002) and glaucoma medication ( P < 0.001). In patients having pseudoexfoliation syndrome, central retinal thickness increase (mean ± standard error of the mean) was 63.3 ± 35.5 μm for dexamethasone and 17.6 ± 5.8 μm for diclofenac, compared to 28.9 ± 8.0 μm ( P = NS) and 6.9 ± 1.3 μm ( P = 0.014) in eyes without pseudoexfoliation syndrome, respectively. Aqueous flare at 28 days was 25.8 ± 5.4 pu/ms for patients with pseudoexfoliation syndrome and 18.3 ± 1.8 pu/ms for those without ( P = 0.030). Best corrected visual acuity gain and best corrected visual acuity at 28 days were less in patients having pseudoexfoliation syndrome compared to those without (0.39 ± 0.07 vs 0.59 ± 0.03 decimals, P = 0.007; and 0.77 ± 0.06 vs 0.92 ± 0.03 decimals, P = 0.008, respectively).Conclusion:Eyes with pseudoexfoliation syndrome may be predisposed to an increased aqueous flare and macular edema after cataract surgery. This study outlines the need to determine the optimal anti-inflammatory medication after cataract surgery in patients with pseudoexfoliation syndrome.

Subthreshold micropulse yellow laser for the management of refractory cystoid macular edema consequent to complicated cataract surgery

2020 ◽  
pp. 112067212092800
Author(s):  
Tommaso Verdina ◽  
Cecilia Ferrari ◽  
Edoardo Valerio ◽  
Alberto Brombin ◽  
Andrea Lazzerini ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Laser Treatment ◽  
Cystoid Macular Edema ◽  
Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Complicated Cataract ◽  
Yellow Laser ◽  
Best Corrected Visual Acuity

Purpose: To report the safety and efficacy of subthreshold micropulse yellow laser of 577 nm for a complex case of refractory pseudophakic cystoid macular edema. Methods: A retrospective chart review of an interventional case report of three subthreshold micropulse yellow laser interventions for refractory pseudophakic cystoid macular edema. Patient: A 77-year-old healthy female underwent pseudoexfoliative cataract surgery complicated by posterior capsule rupture and sulcus intraocular lens implantation. After 3 months, she required a scleral fixation of the same lens, due to a lack of capsular support and decentration of the intraocular lens. One month later, she experienced a severe pseudophakic cystoid macular edema (foveal thickness of 399 µm and best-corrected visual acuity of 20/80 Snellen). The condition was refractory to conventional treatments prior to subthreshold micropulse yellow laser interventions, including non-steroidal anti-inflammatory eye drops, topical steroids, oral indomethacin and three sub-Tenon’s triamcinolone injections, attempted over a 14-month period. Results: Subthreshold micropulse yellow laser treatment was performed and immediate resolution was achieved and maintained for 2 months. Two cases of edema relapse were observed at 3 months from initial laser treatment and again at 4 months from the second laser treatment. Final patient’s follow-up at 6 months from the third laser treatment evidenced the absence of edema, improved visual acuity (foveal thickness of 265 µm/best-corrected visual acuity of 20/30 Snellen) and the absence of complications. Conclusions: Subthreshold micropulse yellow laser seems to be a safe and effective treatment for short-term resolution of refractory pseudophakic cystoid macular edema after complicated cataract surgery and represents a useful alternative to expensive and invasive therapies. A trend towards a longer duration of edema resolution with every subthreshold micropulse yellow laser repetition was observed.

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