Pediatric Cataract Surgery: Comparison between Ages at Surgery and Contrast Sensitivity Outcomes

Background: Pediatric cataracts are major causes of children’s blindness. Surgery has proven to be beneficial in terms of visual function prognosis. Contrast sensitivity evaluation after surgery is as important as visual acuity considering that natural world consists of various objects in low-to-medium contrasts. The purpose of this study is to analyze the difference of contrast sensitivity outcomes based on ages at surgery. Method: Retrospective data of children with pediatric developmental cataract from July 2013 to November 2015 were collected. All children who underwent cataract surgery at 60-months-old or less were randomized into two groups, ≤24 months and >24-to-60 months. Contrast sensitivity was then examined with preferential-looking method using Hiding Heidi low-contrast test face chart. The main outcome measures were contrast sensitivity of both groups. Age-at-evaluation, cataract onset, duration of follow-up, duration of deprivation and visual acuity were also noted. Result: Of 14 children (23 eyes), 11 eyes (47,8%) were in ≤24 months group, 12eyes (52,2%) were in >24-to-60 months group. All eyes underwent cataract extraction and similar type of intraocular lens implantation. Mean age-at-surgery was 28,2 months±16,8 (SD). Mean contrast sensitivity for each group was 47,50 %±42,29 and 18,33%±27,38, respectively, with p-value 0,031. Further analysis of Spearman’s correlation test demonstrated significant negative correlation (rs = -0,559; p = 0,006) between the two groups. Conclusion: There was statistically significant difference in contrast sensitivity between those who underwent surgery at ≤24 months and >24-to-60 months. Children who underwent surgery at older ages tend to have better contrast sensitivity afterwards.

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Visual outcome of conventional extracapsular cataract extraction with posterior chamber intraocular lens implantation versus manual small-incision cataract surgery

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v1i1.3668 ◽

1970 ◽

Vol 1 (1) ◽

pp. 13-19 ◽

Cited By ~ 4

Author(s):

A Gurung ◽

DB Karki ◽

S Shrestha ◽

AP Rijal

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Postoperative Period ◽

Cataract Extraction ◽

Posterior Chamber ◽

P Value ◽

Extracapsular Cataract Extraction ◽

Small Incision Cataract Surgery ◽

Small Incision ◽

Posterior Chamber Intraocular Lens

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

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Hospital-based community cataract surgery: comparison of visual outcomes between conventional extra-capsular cataract extraction and small incision cataract surgery

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v1i2.3686 ◽

1970 ◽

Vol 1 (2) ◽

pp. 118-122 ◽

Cited By ~ 1

Author(s):

P Karki ◽

JK Shrestha ◽

JB Shrestha

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Visual Outcome ◽

Cataract Extraction ◽

P Value ◽

Small Incision Cataract Surgery ◽

Mean Values ◽

Visual Outcomes ◽

Small Incision ◽

Statistical Program

Introduction: The small-incision cataract surgery is gaining popularity among the ophthalmic surgeons. Objective: To compare the visual outcome of conventional extra-capsular cataract extraction (ECCE) and small-incision cataract surgery (SICS) in a hospital based community cataract program. Materials and methods: A prospective interventional study without randomization was carried out including the patients undergoing cataract surgery by either conventional ECCE or manual SICS. They were followed up for 6 weeks postoperatively. The visual outcomes were compared between the two groups. Statistics: The statistical program Epi-Info version 2000 was used to analyze the data. Mean values with standard deviations, 95% CI and p value were calculated. The p value of <0.05 was considered significant. Results: Of 85 patients, 44 (M: F=10:34) underwent ECCE and 41 (M: F=15:26) SICS (RR= 0.71, 95% CI=0.42-1.2, p value=0.16). Unaided visual acuity on the 1st postoperative day in the ECCE group was e"6/ 18 in 22.7%,<6/18-6/60 in 63.6 %,< 6/60 in 13.7%, whereas in the SICS group, the same was e"6/18 in 70.7%,<6/18-6/60 in 22 %,< 6/60 in 7.3% (95% CI = 0.23 - 0.48, p=0.001). Best corrected visual acuity on the 6th week follow-up in the ECCE group was e"6/18 in 79.5%,<6/18-6/60 in 18.2 %,< 6/60 in 2.3% and in the SICS group the same was 6/18 in 90.5% and <6/18-6/60 in 4.9% (95% CI=0.44 - 0.73; p=0.0012). Conclusion: Both ECCE and SICS are good procedures for hospital based community cataract surgery but within the 6 weeks postoperative period SICS gives better visual outcome. Remarkably higher number of female patients can be provided service in a hospital based community cataract programme as compared to males. Keywords: cataract; small incision; extra-capsular DOI: 10.3126/nepjoph.v1i2.3686 Nep J Oph 2009;1(2):118-122

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Phacoemulsification versus small incision cataract surgery (SICS): which one is a better surgical option for immature cataract in developing countries?

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v1i2.3682 ◽

1970 ◽

Vol 1 (2) ◽

pp. 95-100 ◽

Cited By ~ 7

Author(s):

SK Singh ◽

I Winter ◽

L Surin

Keyword(s):

Developing Countries ◽

Visual Acuity ◽

Cataract Surgery ◽

Controlled Trial ◽

Visual Outcome ◽

P Value ◽

Small Incision Cataract Surgery ◽

Mean Values ◽

Small Incision ◽

Significant Difference

Background: Several studies have shown comparable visual outcomes of SICS and phacoemulsification (Gogate et al 2007, Ruit et al 2007). Objective: To compare the safety and efficacy of different types of surgical procedures (phacoemulsification versus SICS) for cataract surgery in immature cataract. Material and methods: A prospective randomized controlled trial was carried out involving 93 and 89 patients with immature senile cataract selected for phacoemulsification and SICS respectively. Statistics: Mean values with standard deviations were calculated. P value of less than 0.05 was considered significant. Results: There was no difference between the groups in terms of gender, age and pre-operative visual acuity (p = 0.09). In phacoemulsification group (n=93) more than two thirds and in SICS group (n=89) more than three quarters of the patients had good visual outcome (6/6-6/18) on first postoperative day (p=0.065). Poor outcome (<6/60) was recorded in 6% (phacoemulsification group) and 1% (small incision cataract surgery group). Mean visual acuity was 0.43 ± 0.27 in phacoemulsification group and 0.47 ± 0.24 in SICS group. Mean surgery time was significantly shorter in SICS group (p=0.0003). Statistics: Data were computed and analyzed using the SPSS software program vs 10. The p value of < 0.05 was considered significant. Conclusion: There was no significant difference in visual outcome on first post operative day in between phacoemulsification and SICS technique. However, performing SICS was significantly faster. Small incision cataract surgery with implantation of rigid PMMA lens is a suitable surgical technique to treat immature cataract in developing countries. Keywords: phacoemulsification; small incision cataract surgery (SICS) DOI: 10.3126/nepjoph.v1i2.3682 Nep J Oph 2009;1(2):95-100

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Changes of anthropometric parameters of an eye during the implantation of toric intraocular lenses in children with congenital cataracts.

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-2-101-104 ◽

2021 ◽

pp. 101-104

Author(s):

A.I. Shilov ◽

◽

K.K. Shefer ◽

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lenses ◽

Pediatric Cataract ◽

Congenital Cataracts ◽

Positive Effects ◽

Postoperative Astigmatism ◽

Toric Iols ◽

Significant Difference ◽

Pediatric Cataract Surgery

Aim. The aim of the study is to examine changes in the anthropometric and refractive parameters of the eyeball in children with congenital cataracts who have been implanted with various types of IOLs (toric or classic monofocal). Materials and methods. In this work, we retrospectively studied the medical history of 34 children (42 eyes) aged 4 to 15 years, who underwent phacoemulsification of congenital cataracts with implantation of various types of IOLs: toric and simple monofocal. Further, in these groups, by statistical methods, the dynamics of refraction in the first three years after the operation, the incidence of postoperative astigmatism, and its dynamics were assessed. We also assessed the rate of change in the anteroposterior axis of the eyeball, the dynamics of refraction in terms of the total spheroequivalent and maximum visual acuity in 3 years after the operation. Results. According to the results of the study, it was shown that toric IOLs significantly better stimulate the process of emmetropization of the eyeball, and also have a significant tendency to completely eliminate postoperative astigmatism, within 3 years after surgery. However, there were no significant differences in maximally corrected visual acuity between the 2 compared groups. There were also no data showing a significant difference in the more frequent development of myopia in the group receiving the toric IOL. Conclusion. The correct choice and calculation of the IOL remains one of the most difficult tasks in pediatric cataract surgery. New technologies are introduced annually and require constant testing. In this study, we have shown the possibility of using toric IOLs and their positive effects in pediatric cataract surgery and in the prevention and treatment of obscuration amblyopia. Key words: pediatric cataract, intraocular lenses, myopia, refraction, phacoemulsification, amblyopia.

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Analysis of visual outcome of Neodymium: Yttrium-Aluminum -Garnet (Nd: YAG) laser capsulotomy in patients with Posterior Capsule Opacification

Tropical Journal of Ophthalmology and Otolaryngology ◽

10.17511/jooo.2020.i08.03 ◽

2020 ◽

Vol 5 (8) ◽

pp. 216-223

Author(s):

Dr. Deepa R. ◽

◽

Dr. V. Panimalar A. Veeramani ◽

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Yttrium Aluminum Garnet ◽

Visual Outcome ◽

Posterior Capsular Opacification ◽

P Value ◽

Yag Laser ◽

Significant Difference ◽

Yttrium Aluminum ◽

Neodymium Yttrium

Objective: Posterior capsular opacification (PCO) is a postoperative complication causing decreasedvisual acuity. This study aims to study the efficacy of Nd: YAG laser capsulotomy in posteriorcapsular opacification following cataract surgery by analyzing the visual outcome. Material andMethods: A prospective study included a sample size of 50 eyes of 37 patients with Posteriorcapsular opacification following uneventful cataract surgery with significantly decreased visual acuity.Detailed anterior and posterior segment examination was done, best-corrected visual acuity (BCVA)was recorded along with measurement of IOP. Posterior capsulotomy was performed using Nd: YAGlaser (Neodymium: Yttrium-aluminum–garnet) and patients were followed up. Visual acuity wasassessed and complications if any were recorded. Results: It was noted that 74% of the patients atthe end of 1st week and 78% of the patients at the end of 1st and 3rd month had significant visualimprovement following Nd: YAG laser capsulotomy. There was a statistically significant difference inPost Nd: YAG laser BCVA on follow up with P-value <0.001. Complications encountered were the risein IOP in 6% of the population at the end of 1 hour and 1st day of the procedure, iris bleeding wasnoted in 4% of the population, intraocular lens damage in 2 %, and cystoid macular edema in 2 %of the study population.

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Efficacy and safety of extended depth of focus intraocular lenses in cataract surgery: a systematic review and meta-analysis

10.21203/rs.2.11472/v2 ◽

2019 ◽

Author(s):

Jing Liu ◽

Yi Dong ◽

Yan Wang

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Contrast Sensitivity ◽

Intraocular Lenses ◽

Control Group ◽

Efficacy And Safety ◽

Depth Of Focus ◽

Extended Depth Of Focus ◽

Significant Difference ◽

Near Visual Acuity

Abstract Background : This study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery. Methods: All comparative clinical trials that involved bilaterally implanting EDOF IOLs in patients with cataract were retrieved from the literature database. We used random effects models to pool weighted mean differences (WMD) and risk ratio (RR) for continuous and dichotomous variables, respectively. Results: Nine studies with a total of 1336 eyes were identified. The subgroup analysis was conducted according to the type of IOLs used in the control group. Compared with monofocal IOLs, EDOF IOLs produced better uncorrected intermediate visual acuity (WMD: -0.17, 95% CI: -0.26 to -0.08, P = 0.0001) and uncorrected near visual acuity (WMD: -0.17, 95% CI: -0.21 to -0.12, P < 0.00001). EDOF IOLs resulted in reduced contrast sensitivity, more frequent halos, however, higher spectacle independence (RR: 2.81, 95% CI: 1.06 to 7.46, P = 0.04) than monofocal IOLs. Compared with trifocal IOLs, EDOF IOLs produced worse near visual acuity (MD: 0.10, 95% CI: 0.07 to 0.13, P<0.0001). EDOF IOLs performed better than trifocal IOls in contrast sensitivity, and there were no significant difference in halos and spectacle independence. Serious postoperative complications were rare, with no adverse events were reported in most studies. Conclusions: Increasing the risk of contrast reduction and more frequent halos, EDOF IOLs provided better intermediate and near VAs than monofocal IOLs. At the expense of near vision, patients receiving EDOF IOLs have better contrast sensitivity than those receiving trifocal IOLs. Halo incidence and spectacle independence of EDOF IOLs were similar to those of trifocal IOLs.

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Effect of Yellow-Tinted Lenses on Visual Attributes Related to Sports Activities

Journal of Human Kinetics ◽

10.2478/hukin-2013-0003 ◽

2013 ◽

Vol 36 (1) ◽

pp. 27-36 ◽

Cited By ~ 2

Author(s):

Yoshimitsu Kohmura ◽

Shigeki Murakami ◽

Kazuhiro Aoki

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Depth Perception ◽

Dynamic Visual Acuity ◽

Low Contrast ◽

Visual Attributes ◽

Light Yellow ◽

Significant Difference ◽

Hand Eye Coordination ◽

Sports Activities

The purpose of this study was to clarify the effect of colored lenses on visual attributes related to sports activities. The subjects were 24 students (11 females, 13 males; average age 21.0 ±1.2 years) attending a sports university. Lenses of 5 colors were used: colorless, light yellow, dark yellow, light gray, and dark gray. For each lens, measurements were performed in a fixed order: contrast sensitivity, dynamic visual acuity, depth perception, hand-eye coordination and visual acuity and low-contrast visual acuity. The conditions for the measurements of visual acuity and low-contrast visual acuity were in the order of Evening, Evening+Glare, Day, and Day+Glare. There were no significant differences among lenses in dynamic visual acuity and depth perception. For hand-eye coordination, time was significantly shorter with colorless than dark gray lenses. Contrast sensitivity was significantly higher with colorless, light yellow, and light gray lenses than with dark yellow and dark gray lenses. The low-contrast visual acuity test in the Day+Glare condition showed no significant difference among the lenses. In the Evening condition, lowcontrast visual acuity was significantly higher with colorless and light yellow lenses than with dark gray lenses, and in the Evening+Glare condition, low-contrast visual acuity was significantly higher with colorless lenses than with the other colors except light yellow. Under early evening conditions and during sports activities, light yellow lenses do not appear to have an adverse effect on visual attributes.

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Evaluation of a Public Child Eye Health Tertiary Facility for Pediatric Cataract in Southern Nigeria I: Visual Acuity Outcome

The Open Ophthalmology Journal ◽

10.2174/1874364101610010119 ◽

2016 ◽

Vol 10 (1) ◽

pp. 119-125

Author(s):

Roseline E. Duke ◽

Adedayo Adio ◽

Sidney K. Oparah ◽

Friday Odey ◽

Okon A. Eyo

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Visual Outcome ◽

P Value ◽

Delayed Presentation ◽

Small Incision Cataract Surgery ◽

Pediatric Cataract ◽

Eye Health ◽

Co Morbidity ◽

Southern Nigeria

Purpose: A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation. Materials and Method: Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery. Results: Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000). Conclusion: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit.

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Astigmatism Correction in Cataract Surgery with Foldable Toric IOL

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2014/v1/i2/824 ◽

2014 ◽

Vol 1 (2) ◽

pp. 93

Author(s):

Mrunal Suresh Patil ◽

Dhiraj Namdeo Balwir ◽

Sonal Dua ◽

Swapnil Shivaji Vidhate

Keyword(s):

Visual Acuity ◽

Statistical Analysis ◽

Cataract Surgery ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Toric Iol ◽

Iol Implantation ◽

Astigmatism Correction ◽

Significant Difference

Aim: To evaluate correction of pre-existing astigmatism after foldable Toric IOL implantation in patients undergoing cataract surgery.Materal & Methods: In this prospective observational study we included 10 eyes of 10 patients with astigmatism between 2.00D to 6.00D &undergoing cataract surgery. Phacoemulsification was performed with Toric IOL implantation through 2.8mm clear corneal temporal incision. Patients were examined post operatively for Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA) & residual refractive astigmatism.Statistical Analysis: Statistical analysis was performed by the SPSS program for Windows, ver.16.0.Continuous variables are expressed as mean ± SD, and categorical variables are presented as absolute numbers and percentage. For the statistical test, a p value less than 0.05 was taken to indicate a significant difference.Results: The UCVA was 6/9 or better in 90% of eyes. 80% eyes achieved 6/6 BCVA. The mean refractive cylinder corrected from -3.4 ± 1.4 D to -0.60 ± 0.27 D which was statistically significant. (p value=0.0001).Conclusion: Toric IOL implantation is an effective, safe surgical option to manage pre-existing corneal astigmatism during cataract surgery.

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Influence of Intraocular Lens Asphericity and Blue Light Filtering on Visual Outcome, Contrast Sensitivity, and Aberrometry after Uneventful Cataract Extraction

Journal of Ophthalmic and Vision Research ◽

10.18502/jovr.v15i3.7449 ◽

2020 ◽

Author(s):

Argyrios Tzamalis ◽

Myron Kynigopoulos ◽

Grigoris Pallas ◽

Ioannis Tsinopoulos ◽

Nikolaos Ziakas

Keyword(s):

Cataract Surgery ◽

Contrast Sensitivity ◽

Blue Light ◽

Visual Outcome ◽

Cataract Extraction ◽

Light Filter ◽

Intraocular Lenses ◽

Visual Performance ◽

Spatial Frequencies ◽

Significant Difference

Purpose: To evaluate the effect of asphericity and blue light filter (BLF) of three different intraocular lenses (IOLs) on the visual performance, second- and third-order aberrations (defocus, coma, trefoil), and contrast sensitivity after uneventful cataract surgery. Methods: One hundred and twenty eyes of 60 patients with clinically significant cataract were randomly assigned to receive one of the three IOL types: Bioline Yellow Accurate (aspheric, with BLF, i-medical, Germany), BioAcryl 60125 (spherical, without BLF, Biotech, France), and H65C/N (aspheric, without BLF, PhysIOL, Belgium). Each IOL was implanted in 40 eyes. Complete ophthalmologic examination, functional acuity contrast testing and wavefront analysis were performed 60 days postoperatively. Results: The mean postoperative best-corrected visual acuity (BCVA) was 0.95 ± 0.08, not differing statistically among the IOL groups (P = 0.83). Mean defocus and coma values did not yield any statistically significant difference through the IOL groups varying from –0.784 to –0.614 μm and 0.129 to 0.198 μm (P = 0.79 and 0.34, respectively). Bioline Yellow Accurate IOL presented less trefoil aberrations, 0.108 ± 0.05 μm, compared to the other two IOL types (BioAcryl [0.206 ± 0.19 μm] and Physiol [0.193 ± 0.17 μm], P < 0.05). Contrast sensitivity values did not differ among the groups under all lighting conditions. Bioline Yellow IOL showed a statistically higher loss of contrast sensitivity (between mesopic and mesopic with glare conditions) compared to the BioAcryl and PhysIOL in 12 and 3 cpd spatial frequencies, respectively (P < 0.05). Conclusion: Bioline Yellow IOL indicated lower contrast sensitivity under mesopic conditions when glare was applied but resulted in less trefoil aberrations after uneventful cataract surgery. No further differences were noted in postoperative visual performance among three IOL groups.

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