Intraoperative Complications in Cataract Surgery (Phacoemulsification)

Author(s):  
Luis Lu ◽  
Guido Puican-Navarro ◽  
Blanca Barrios
2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Tomoichiro Ogawa ◽  
Takuya Shiba ◽  
Hiroshi Tsuneoka

Purpose.This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC) (Abbott Medical Optics Inc.), a new cataract surgery recording device, for training of cataract surgery.Methods.We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on the surgical video. We examined whether use of SMC is able to demonstrate the differences in technique between experienced and trainee operators, to identify inappropriate phacoemulsification techniques from analyzing the graphs, and to elucidate the cause of intraoperative complications.Results. Significant differences in the time taken to reach maximum vacuum and the speed of increase in vacuum during irrigation and aspiration were observed between experienced and trainee operators. Analysis of the graphs displayed by SMC detected inappropriate phacoemulsification techniques mostly in cases operated by trainee operators.Conclusions. Using SMC, it was possible to capture details of cataract surgery objectively. This recording device allows surgeons to review cataract surgery techniques and identify the cause of intraoperative complication and is a useful education tool for cataract surgery.


2020 ◽  
Author(s):  
Clemence Bonnet ◽  
Saba Al-Hashimi ◽  
Antoine P. Brézin ◽  
Dominique Monnet

Cataract is a leading cause of blindness in the world, and cataract extraction is one of the most commonly performed surgeries. Preferred surgical techniques have changed over the past decades with associated improvements in outcomes and safety. Phacoemulsification is a highly successful technique first introduced over 40 years ago. It is the current method of cataract surgery, with a very low reported rate of major complications and a frequency of overall intraoperative complications of less than 2%. Application of the femtosecond laser evolved to now assist in cataract surgery and has been termed FLACS (femtosecond laser-assisted cataract surgery) and occurs in three steps: corneal incisions (including optional limbal relaxing incisions to reduce astigmatism), anterior capsulotomy, and lens fragmentation. The remaining surgical steps still require the surgeon’s hands. The FLACS technique may have some advantages compared with conventional phacoemulsification. It remains however unclear whether FLACS is globally more efficient and safer than conventional surgery. The popularity of FLACS may also be limited by its higher cost compared with conventional surgery. The potential advantages of laser-assisted surgery are yet to be determined as FLACS technology is relatively new and in continuous evolution. This chapter reports scientific data as well as our own experience with this new technology. All the platforms currently available are described.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Yu Jeong Kim ◽  
Su Jin Park ◽  
Jong Yeon Lee ◽  
Dae Yeong Lee ◽  
Dong Heun Nam

Purpose. To evaluate intraoperative complications and utilization of adjunctive devices between microscope and intracameral illuminations during cataract surgery in the elderly over 75 years. Design. A retrospective, consecutive, interventional case series Participants. Two hundred eighty-six eyes of 184 patients older than 75 years who underwent cataract surgery using microscope and intracameral illuminations. Methods. A chart review was performed on an advanced cataract surgery group of 141 consecutive cases in which the intracameral illumination was used and on a standard cataract surgery group of 145 consecutive cases in which the intracameral illumination was not used. Main Outcome Measures. Intraoperative complications (posterior capsule rupture, radial tear of the anterior capsule, dropped nucleus, or sulcus-implanted/sclera-fixated IOL) and utilization of adjunctive devices (pupil expansion device or anterior capsule staining). Results. The frequency of use of the pupil expansion device was lower in the advanced cataract surgery group than that in the standard cataract surgery group (0.7% vs 6.9%; p=0.007). Furthermore, the rates of a posterior capsule rupture and at least one intraoperative complication were lower in the advanced cataract surgery group than those in the standard cataract surgery group (0.7% vs 4.8%; p=0.067) (0.7% vs 7.6%; p=0.004). Conclusions. In the current cohort of patients over 75 years, the rate of intraoperative complications was lower when using the intracameral illumination than that when using the conventional method. Cataract surgery using intracameral illumination would be good option for elderly people.


Author(s):  
Georgia Cleary ◽  
David Spalton

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.


2006 ◽  
Vol 90 (12) ◽  
pp. 1516-1518 ◽  
Author(s):  
S J Robbie ◽  
M Muhtaseb ◽  
K Qureshi ◽  
C Bunce ◽  
W Xing ◽  
...  

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Abiola T. Owolabi ◽  
Susannah T. Adepoju ◽  
Olawale Oladejo ◽  
Kunle I. Oreagba

Background: Cataract surgery is the most common operation performed in ophthalmology. It is the commonest cause of reversible blindness globally, in Sub-Saharan Africa and Nigeria. The study examined some factors affecting the outcome of cataracts surgery measured by Visual acuity after 6 weeks. Methods: Data was collected from the records of ophthalmic patients who had cataract surgery at LAUTECH Teaching Hospital Ogbomoso, from the period of January 2013 to December 2018. Two hundred and twenty-seven patients’ records were retrieved for the study. Logistic Regression was used to investigate factors associated with the outcome of Cataracts Surgery. The goodness of fit test was used to determine the fit of the model to the data. Results: Two variables; intraoperative complication, and unaided visual acuity on the fir st postoperative day were statistically significant (p-value < 0.05). The outcome of surgery using unaided visual acuity after six weeks of surgery showed that 47.1% of the patients had a good visual outcome (6/18) or better and 52.9% had a poor outcome (worse than 6/60). Factors such as complications within six weeks, presence of ocular and systemic comorbidity, and presence of intraoperative complications were found to increase the likelihood of poor outcomes in cataract surgery. Conclusion: This study has shown that Intraoperative complications and unaided visual acuity on the first postoperative day are important to the outcome of cataract surgery. Therefore, the two factors should be given attention during cataract surgery


2021 ◽  
Author(s):  
Colleen C Yard ◽  
Kayla R Walter ◽  
Ning O Zhao ◽  
Alice Z Chuang ◽  
Kimberly A Mankiewicz ◽  
...  

Background/Aims: Investigate the role of language barriers in cataract surgery outcomes at a county hospital. Methods: Retrospective chart review of patients who underwent cataract surgery March 2018-February 2019 at Lyndon B. Johnson Hospital. Patients who underwent cataract surgery combined with another procedure or had severe glaucoma or proliferative diabetic retinopathy were excluded. Patients were classified into limited English proficient (LEP) or English proficient (non-LEP) groups based on language preferences. Demographics, baseline ocular characteristics, intraoperative complications, postoperative BCVA (best-corrected visual acuity), complications, and compliance were recorded. The primary outcome was incidence of poor visual outcomes (BCVA<20/40) at the postoperative 1-month visit. Results: 354 patients (199 [56%] LEP and 155 [44%] non-LEP) with 125 (35%) males and a mean age 66.1 (+/- 10.9) years were included. LEP patients were about 5 years older than non-LEP patients (P<0.001) and were mostly Hispanic (172 [86%] LEP vs. 36 [26%] non-LEP, P<0.001). The baseline ocular characteristics were similar (P >0.05), except severity of cataract (125 [63%] NSC grade >2+ for LEP vs 70 [51%] for non-LEP, P =0.03). No significant differences in intraoperative complications (P =0.18), incidence of poor vision (P =0.59), postoperative cystoid macular edema (P =0.32), and compliance with the postoperative drop regimen (P =0.11) were noted. Conclusion: There were no statistically significant differences in incidence of poor vision, complications, or compliance. However, there was a trend toward significance, showing that language barriers may lead to more advanced disease and compliance issues with postoperative medications.


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