20G Vitrectomy; Current Usage, Indications, and Practices

Vitreoretinal surgery is evolving to a smaller size since first described. After the first vitrectomy probe defined as 17 Gauge (G), a smaller gauge (20G, 23G, 25G, and 27G) vitrectomy probes and trocars were identified. Even though 20G vitrectomy has been used for many years, thinner and less traumatic vitrectomy systems are developed and 20G has lost popularity. Hybrid use of 20G and other systems remains current, especially in cases such as endophthalmitis, intraocular foreign body removal, and cataract surgery complications.

Application of Artificial Intelligence in the Analysis of Features Affecting Cataract Surgery Complications in a Teaching Hospital

Aims: To evaluate the ocular and systemic factors involved in cataract surgery complications in a teaching hospital using artificial intelligence.Methods: One eye of 1,229 patients with a mean age of 70.2 ± 10.3 years old that underwent cataract surgery was selected for this study. Ocular and systemic details of the patients were recorded and then analyzed by means of artificial intelligence. A total of 1.25 billion simulations of artificial intelligence learning and testing were conducted on several variables and a customized model of analysis was developed.Results: A total of 73 complications were recorded in this study. According to the analysis performed, the main factors involved in cataract surgery complications were: a surgeon in training, axial length and intraocular lens power. The model predicted how long surgery would last with an error of <6 min compared to the effective time needed.Conclusions: According to the data here obtained, artificial intelligence could be an interesting option to build customized models able to prevent complications and to predict actual surgery time. The customized algorithm option allows the development of better models adaptable to different units as well as the possibility to be calibrated for the same unit along time.

Visual Outcome of Cataract Surgery Complications Repair at a Cataract Training Centre of Western Central India

Introduction: Cataract is a major cause of blindness, but it can be eliminated by surgical management. The visual outcome depends upon the competency of the surgeon, and quality training can contribute to the creation of such skilled surgeons. Methods: This is a retrospective study in which we enrolled all the cataract cases operated between 2004 and 2018, any complication and its repair reported in pretested online form, and all documented post-operative data. All these data were exported to excel sheet from EMR and analysed using SPSS22. Results: Our cohort involved 2998(2.49%) cases out of 120,000 total cataract operated cases. Out of complications documented for45.5% did not require surgical intervention, 30% eyes required secondary implant and remaining cases required other surgeries. Intervention medical and surgical has made significant difference in visual outcome. (p=0.002) 43.9% complications reported during stage of cortical clean up. Primary surgery and trainee categories did not cause significant differences in the visual outcome. Conclusion: Cataract surgeries done by trainee surgeons caused complications at various stages. However, interventions by vitreo-retinal surgeons led to a significant difference in the final visual outcome.

27-gauge trocar-assisted transconjunctival sutureless intraocular lens scleral fixation

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.