-
Retina (Philadelphia, Pa.) Aug 2019
Topics: Cataract Extraction; Lenses, Intraocular; Ophthalmology; Phacoemulsification; Vitreoretinal Surgery
PubMed: 31259815
DOI: 10.1097/IAE.0000000000002577 -
Klinische Monatsblatter Fur... Jan 2024Cataract is among the leading causes of visual impairment worldwide. Innovations in treatment have drastically improved patient outcomes, but to be properly implemented,... (Review)
Review
Cataract is among the leading causes of visual impairment worldwide. Innovations in treatment have drastically improved patient outcomes, but to be properly implemented, it is necessary to have the right diagnostic tools. This review explores the cataract grading systems developed by researchers in recent decades and provides insight into both merits and limitations. To this day, the gold standard for cataract classification is the Lens Opacity Classification System III. Different cataract features are graded according to standard photographs during slit lamp examination. Although widely used in research, its clinical application is rare, and it is limited by its subjective nature. Meanwhile, recent advancements in imaging technology, notably Scheimpflug imaging and optical coherence tomography, have opened the possibility of objective assessment of lens structure. With the use of automatic lens anatomy detection software, researchers demonstrated a good correlation to functional and surgical metrics such as visual acuity, phacoemulsification energy, and surgical time. The development of deep learning networks has further increased the capability of these grading systems by improving interpretability and increasing robustness when applied to norm-deviating cases. These classification systems, which can be used for both screening and preoperative diagnostics, are of value for targeted prospective studies, but still require implementation and validation in everyday clinical practice.
Topics: Humans; Prospective Studies; Photography; Cataract; Lens, Crystalline; Visual Acuity; Phacoemulsification
PubMed: 38242135
DOI: 10.1055/a-2003-2369 -
European Journal of Ophthalmology Mar 2024Practical advancements in phacoemulsification techniques and intraocular lenses and the wide availability of phacoemulsification machines have led refractive lens...
Practical advancements in phacoemulsification techniques and intraocular lenses and the wide availability of phacoemulsification machines have led refractive lens exchange (RLE) to increase in popularity. Ethical boundaries in RLE have subsequently been pushed to include patients at higher risk of complications. In this editorial, we consider RLE outcomes and complications per type of refractive error, together with preoperative, intraoperative and postoperative ethical obligations for refractive surgeons. In the conclusions section, we propose an algorithm for ethics-guided indications to RLE.
Topics: Humans; Visual Acuity; Astigmatism; Lens Implantation, Intraocular; Refraction, Ocular; Lenses, Intraocular; Phacoemulsification
PubMed: 38062638
DOI: 10.1177/11206721231218909 -
European Journal of Ophthalmology Jan 2022
Topics: Cataract Extraction; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Phacoemulsification
PubMed: 32545990
DOI: 10.1177/1120672120936478 -
Retina (Philadelphia, Pa.) Aug 2019
Topics: Cataract Extraction; Lenses, Intraocular; Ophthalmology; Phacoemulsification; Vitreoretinal Surgery
PubMed: 31136463
DOI: 10.1097/IAE.0000000000002578 -
Current Opinion in Ophthalmology Jan 2024This review aims to clarify the advantages and disadvantages of immediately sequential bilateral cataract surgery (ISBCS) based on recent studies, illustrate the safety... (Review)
Review
PURPOSE OF REVIEW
This review aims to clarify the advantages and disadvantages of immediately sequential bilateral cataract surgery (ISBCS) based on recent studies, illustrate the safety of this approach, the cost-effectiveness, and present the importance of inclusion protocols for the best results.
RECENT FINDINGS
In recent studies, the authors found no evidence of an increased risk of bilateral devastating complications such as endophthalmitis with ISBCS based on descriptive evidence compared to delayed sequential bilateral cataract surgery (DSBCS). Furthermore, recent studies on cost analyses showed that ISBCS resulted in fewer costs and significant cost savings to third-party payers, patients, and society compared to DSBCS.
SUMMARY
The ISBCS surgical approach decreases hospital visits, reduces costs, and provides rapid visual rehabilitation and neuro adaptation. The risk of bilateral simultaneous complications is now recognized to be very rare with intracameral antibiotics and compliance with correct protocols. With new generations of optical biometry and lens calculation formulas, refractive surprises are occasional for normal eyes. However, refractive surprise is controversial, especially in the implantation of presbyopia correction intra-ocular lenses, which must be evaluated carefully in the ISBCS approach.
Topics: Humans; Phacoemulsification; Lens Implantation, Intraocular; Cataract Extraction; Visual Acuity; Cataract
PubMed: 38390776
DOI: 10.1097/ICU.0000000000001003 -
The New Zealand Medical Journal Aug 2019To assess the impact of anticoagulation on patients having cataract surgery.
AIM
To assess the impact of anticoagulation on patients having cataract surgery.
METHODS
Patients who underwent cataract surgery with phacoemulsification and intraocular lens insertion between 1 January 2015 and 31 December 2015 at Christchurch Hospital were identified and retrospectively audited. The outcome measures were the occurrence of intraoperative and postoperative haemorrhage, and thromboembolic events within two weeks after surgery. A control group was included to assess the outcome measures in a sample of patients who were not on anticoagulants or antiplatelets.
RESULTS
Forty-four anticoagulated patients (46 eyes) and 41 controls (46 eyes) were identified. Seventy-four percent of those anticoagulated were on warfarin and 26% were on dabigatran. The incidence of haemorrhagic complications was 18%, 25% and 11% in the warfarin, dabigatran and control groups, respectively, although these differences were not statistically significant. Apart from one vitreous haemorrhage, which may have been present preoperatively, the haemorrhages that occurred were minor and not visually significant. No thromboembolic events were noted in any of the groups.
CONCLUSION
There is no statistically significant increase in haemorrhagic complications in cataract surgery patients who were on warfarin or dabigatran. Therefore, continuing the anticoagulation in this setting may be appropriate.
Topics: Adult; Aged; Aged, 80 and over; Anticoagulants; Dabigatran; Female; Humans; Male; Middle Aged; Phacoemulsification; Postoperative Complications; Postoperative Hemorrhage; Retrospective Studies; Thromboembolism; Warfarin
PubMed: 31415496
DOI: No ID Found -
Eye (London, England) Jan 2022To determine the patient-related factors that contribute to intraoperative corticocapsular adhesions (CCA) during phacoemulsification cataract extraction (PCE).
OBJECTIVES
To determine the patient-related factors that contribute to intraoperative corticocapsular adhesions (CCA) during phacoemulsification cataract extraction (PCE).
METHODS
Prospective, single surgeon, multi-year study of consecutive patients undergoing PCE was performed. At the conclusion of each procedure, the surgeon recorded the CCA and perceived surgeon stress score. Patient variables included gender, age, diabetes mellitus, intake of oral alpha blockers, floppy iris, laterality, pseudo-exfoliation, and intraocular lens power.
RESULTS
During the 10-year study, 1097 eyes underwent surgery and CCA was diagnosed intraoperatively in 41 eyes. On multi-variable analysis, the following patient characteristics were associated with intraoperative CCA: diabetes mellitus (p = 0.002), age >80 years (p = 0.002), presence of posterior capsular cataract (p = 0.046), severe nuclear sclerosis (p = 0.004), and absence of pseudo-exfoliation (p = 0.043).
CONCLUSION
Diabetes mellitus, advanced age and posterior subcapsular cataract are associated with CCA necessitating generous repetitive hydrodissection.
Topics: Aged, 80 and over; Cataract; Humans; Intraoperative Complications; Lens Implantation, Intraocular; Phacoemulsification; Prospective Studies; Tissue Adhesions
PubMed: 33674725
DOI: 10.1038/s41433-021-01482-5 -
Indian Journal of Ophthalmology May 2024This article reports a novel surgical technique in the management of soft posterior polar cataracts. This technique avoids hydro procedures, trenching, and chopping....
This article reports a novel surgical technique in the management of soft posterior polar cataracts. This technique avoids hydro procedures, trenching, and chopping. Viscodissection is avoided or minimal, and polar opacity is removed last. These modifications minimize the risk of intraoperative complications.
Topics: Humans; Phacoemulsification; Cataract; Visual Acuity
PubMed: 38324265
DOI: 10.4103/IJO.IJO_1329_23 -
Vestnik Oftalmologii 2022This article reviews scientific literature analyzing the history of ultrasound and laser phaco surgery of combined or isolated designs: erbium YAG laser, 1.064 μm... (Review)
Review
This article reviews scientific literature analyzing the history of ultrasound and laser phaco surgery of combined or isolated designs: erbium YAG laser, 1.064 μm Nd:YAG laser for dissection of the lens capsule and nucleus, exclusively-laser technique of lens destruction with 1.44 µm Nd:YAG laser without manual, vacuum or ultrasonic action, femtosecond laser assistance with automated transcorneal delivery of radiation into the eye cavity.
Topics: Cataract; Cataract Extraction; Humans; Laser Therapy; Lasers, Solid-State; Lens Capsule, Crystalline; Lens Implantation, Intraocular; Phacoemulsification
PubMed: 35801886
DOI: 10.17116/oftalma202213803188