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Effects of Cataract Extraction on the Outcomes of Automated Perimetry and Retinal Nerve Fiber Layer Thickness Measurements by Optical Coherence Tomography in Primary Angle Closure Glaucoma
摘要： Objective: To evaluate the effect of cataract extraction on both visual field and retinal nerve fiber layer thickness measurements in primary angle closure glaucoma (PACG) eyes. Methods: Retrospective cohort study on 30 PACG eyes underwent cataract extraction. Changes in RNFL thickness and visual field parameters including mean deviation (MD), visual field index (VFI) and pattern standard deviation (PSD) were analyzed within 6 months before and after cataract extraction. Results: Overall, MD (p=0.003) and VFI (p=0.004) improved significantly after cataract extraction, whereas PSD showed no significant change (p=0.6). In the 10 eyes with MD worse than -20 dB, mean MD improved by 3.4 ± 3.56 dB (from -24.36 ± 3.06 dB to -20.96 ± 5.06 dB, p=0.01) and mean VFI improved by 16.25 ± 15.66% (from 23.38 ± 9.65% to 39.63 ± 20.83%, p=0.02). PSD showed no significant change after cataract extraction (p=0.07). In the 20 eyes with MD better than -20 dB, MD and VFI also improved postoperatively, but the changes did not reach statistical significance: mean MD improved by 1.64 ± 3.65 dB (from -11.57 ± 5.57 dB to -9.92 ± 5.36 dB, p=0.05) whilst mean VFI improved by 4.57 ± 12.29% (from 74.95 ± 17.95% to 79.52 ± 17.26%, p=0.07). RNFL thickness did not show any significant changes after cataract extraction (p=0.13). Conclusions: Both MD and VFI improved after cataract extraction, especially in eyes with pre-operative MD worse than -20 dB. PSD and RNFL thickness showed no significant change after cataract extraction.
关键词： Perimetry,Visual field,Extraction,Retinal nerve fiber layer thickness,Optical coherence tomography,Primary angle closure glaucoma,Cataract
更新于2025-09-10 09:29:36
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Comparison of variation of intraocular pressure in noncontact tonometry in patients subjected to phacoemulsification and trabeculectomy with phacoemulsification
摘要： Objective: Evaluate the pattern of intraocular pressure (IOP) variations through the pneumatic tonometer, between two specific surgical techniques, and the possible variables that may influence the behavior of this pressure. Methods: Retrospective cross-sectional study carried out through the review of electronic medical records of a private ophthalmological reference hospital in the city of Goiania, Goiás, Brazil, from 2012 to 2016, comprising of a sample of 550 eyes. The analyzed variables were, age, gender, IOP, axis, pachymetry, anterior chamber depth, and axial length. Results: In the end, the study consisted of 231 eyes, represented by 179 patients. Of these, 182 eyes were operated on by isolated cataract surgery, with a mean age of 72.0±9.5 years. The combined surgery represented a total of 49 eyes, 34 patients with a mean age of 71.9±8.14 years. There was statistical significance (P,0.05) in correlating the pre- and postoperative IOP values in the 24-hour, 7-, 15-day, and 12-month postoperative periods. Conclusion: A standard of variation of IOP was found through the pneumatic tonometer in both surgical techniques, but a more significant reduction was observed in combined surgery than in isolated cataract surgery, and further studies with a greater epidemiological impact are required for confirmation of this conclusion.
关键词： pneumatic tonometer,cataract,glaucoma,intraocular pressure
更新于2025-09-10 09:29:36
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Erufosine Coated Hydrophilic Intraocular Lenses Attenuate PCO Formation in Vitro
摘要： Purpose: To assess the impact of laminin and collagen IV on the proliferation of human lens epithelial cells (LECs) and the performance of two hydrophilic and one hydrophilic IOL with a hydrophobic surface coated with erufosine on their properties to inhibit LEC proliferation and migration in a well-established in vitro anterior chamber model of PCO. Setting: Research Laboratory for Experimental Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. Design: Experimental study. Methods: Three IOLs were selected after pre-evaluation for their properties to inhibit LEC proliferation in vitro. All three IOLs were then coated with erufosine while uncoated IOLs of the same type and lot served as controls. Twelve well cell culture inserts were coated with either laminin or collagen IV and erufosine coated or uncoated IOLs were placed on these inserts into the wells. The wells were inserted into 12 well plates and kept under standard cell culture conditions for 6 days. After removal of the IOLs, the cell culture inserts were analyzed for LEC proliferation and migration. Conclusions: Collagen IV has a stronger impact on LEC proliferation in vitro than laminin has. All tested erufosine coated IOLs were able to significantly decrease the formation of PCO in an in vitro anterior chamber model.
关键词： Erufosine,Cataract surgery,Intraocular lenses
更新于2025-09-10 09:29:36
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Ultra-Late Onset Capsular Bag Distension Syndrome: Risk Factors and Characteristics on Scheimpflug Imaging
摘要： Background: To provide insights into the characteristic of ultra-late onset capsular bag distension syndrome (CBDS) after phacoemulsification. Design: An interventional, retrospective case series at a tertiary care institute. Participants: 5 Post-cataract surgery patients who presented with the retrolenticular fluid collection. Methods: This is an interventional, retrospective case series of 5 cases who presented with clinical signs of ultra- late CBDS>7 years after uneventful phacoemulsification with in-the-bag posterior chamber intraocular lens implantation at a tertiary care institute. Scheimpflug imaging was used in all cases in addition to slit lamp biomicroscopic examination to assess and diagnose the condition. Neodymium:Yttrium Aluminium Garnet (Nd:YAG) posterior capsulotomy was performed in all to treat the condition. Main outcome measure: Results: All 5 patients presented with a milky fluid collection within the distended capsular bag without raised intraocular pressure or a shallow anterior chamber. Scheimpflug imaging confirmed the diagnosis in all cases and all eyes revealed a hyper-reflective space between the intraocular lens optic and the posterior capsule. Nd:YAG posterior capsulotomy was performed in all patients, with resolution of fluid and improvement of visual acuity. Conclusion: Our case series showed that Scheimpflug imaging is a useful modality to diagnose ultra-late onset CBDS and to differentiate this condition from intraocular lens opacification and posterior capsule opacification (PCO). Nd:YAG posterior capsulotomy proved to be successful treatment for ultra-late CBDS with no significant change in biometric or refractive parameters.
关键词： YAG capsulotomy,Ultra-late capsular bag distension syndrome,Post- cataract complication
更新于2025-09-10 09:29:36
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Evaluation of life quality of patients submitted to cataract surgery with implants of monofocal, bifocal and multifocal lenses
摘要： Purpose: Providing an objective and subjective evaluation of life quality and satisfaction level of the patients who underwent cataract surgery with implant of bifocal, multifocal and monofocal lenses. Methods: Bifocal lenses were implanted in 72 patients, aspheric multifocal lenses in 16 patients, apodized multifocal lenses in 20 patients and Monofocal lenses were implanted in 63 patients. The patients answered a 47 question questionnaire, whose results were evaluated and analyzed. Results: The level of satisfaction of the patients implanted with bifocal and multifocal lenses was significantly higher than of those with monofocal lenses (kruskal – Wallis test, p< 0.001 followed by the Dunn test, p< 0.05). As to the comparison of monofocal lenses with bifocal and multifocal lenses, the near vision without correction was considerably lower in patients with monofocal lenses (Z test p< 0.001). The patients with monofocal lenses without correction presented a much lower capacity of reading newspapers or books and as far as manual work than the ones with bifocal and multifocal lenses (Z test, p<0.001). Conclusion: The result of this study shows that the patients who received the bifocal and multifocal lenses had a remarkable improvement in their visual acuity for the near vision, being pleased with their general vision without wearing glasses. This is because they were able to read books and newspapers, write checks, fill out forms, do sports, shave or put on make-up, hence having high quality of life without correction.
关键词： Life quality,Questionnaires,Cataract extraction,Intraocular lenses
更新于2025-09-10 09:29:36
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Relationships between retinal break locations and the shapes of the detachments
摘要： Purpose: Detecting primary breaks and confirming detachment preoperatively are important. Lincoff stated that retinal detachments progress according to gravity; his law has become popular. We evaluated Lincoff’s law with a slight modification to determine whether it remains suitable for present cases independent of refractive error and previous cataract surgery. Patients and methods: Group 1 included superior region detachments not exceeding the 12 o’clock midline; the original break was within 1 1/2 clock hours of the highest detachment border. Group 2 included shallow inferior detachment; the original break corresponded to the more spread side of the 6 o’clock midline. Group 3 detachments were beyond 12 o’clock; the original break was within a triangle with a 12 o’clock apex (A) or within 1 1/2 hours of 12 o’clock (B); (A) and (B) were stated in the original report. Another five classifications were applied for small numbers of detachments. Consecutive initial rhegmatogenous retinal detachment surgery patients were included; medical records and detachment charts were examined. Eyes were classified into categories and rates were calculated. Eyes that had never undergone previous cataract surgery besides those in which the macula remained attached were divided into groups at a –6 D cutoff (Groups 1, 2, and 3[B]); we compared groups in each category. We compared phakic eyes, pseudophakic eyes, and eyes ruptured at the posterior capsule (Groups 1, 2, and 3[B]). Results: Finally, 747 eyes were categorized. In Groups 1, 2, 3(A), and 3(B), corresponding rates were 92, 86, 70, and 89%, respectively. Between the above and below -6 D groups, there was no significant difference in rate in any category. There were no significant differences between phakic, pseudophakic, and ruptured eyes. Conclusion: Lincoff’s law was suitable for the present cases and independent of refractive error and previous cataract surgery.
关键词： rhegmatogenous retinal detachment,shapes of detachments,retinal break locations,refractive error,previous cataract surgery
更新于2025-09-10 09:29:36
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Analysis of Internal Optical Aberrations in Eyes with Different Types of Cataract
摘要： Purpose: The present study investigates the patterns of internal optical aberrations in eyes with different types of cataract. Methods: Eighty eyes of 70 cataract patients were included in the present study. Internal optical aberrations were measured with a KR-1W wavefront aberrometer before cataract operation. Types of cataract were classified into three groups; cortical, nuclear and posterior subcapsular cataracts. The differences in the results of the wavefront data of 6-mm pupil diameter zones were compared among three groups. The Kruskal-Wallis test and Mann-Whitney U test were used for comparing data. Results: A total of 80 eyes consisting of 30 cortical cataracts, 30 nuclear cataracts and 20 posterior subcapsular cataracts were found. In the 6-mm pupil diameter zone, the average internal spherical aberrations by original value were 0.042 μm of cortical cataracts, -0.092 μm of nuclear cataracts and -0.109 μm of posterior subcapsular cataracts. The average internal spherical aberrations by absolute value were 0.122 μm of cortical cataracts, 0.533 μm of nuclear cataracts and 0.202 μm of posterior subcapsular cataracts. The internal spherical aberrations by original value were not statistically significantly different, but by absolute value were statistically significantly different (p = 0.003, Kruskal-Wallis test). Nuclear cataracts have a much higher positive or negative value than other cataract groups in the distribution of internal spherical aberrations by original value for each type of cataract. Other than this difference, the internal astigmatism and internal high order aberrations were not statistically significantly different. Conclusions: The change in internal spherical aberrations of nuclear cataract from the original value was larger than cortical and posterior subcapsular cataract. Therefore, nuclear cataracts have much higher positive or negative values than other cataract groups.
关键词： Different types of cataract,Internal spherical aberrations,Internal optical aberrations
更新于2025-09-10 09:29:36
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Phacoemulsification with coexisting corneal opacities
摘要： The treatment of choice for cases of corneal opacity with significant cataract is often a triple procedure. However, in certain situations the chances of graft survival are poor, for example in cases with deep vascularization, secondary glaucoma, and healed viral keratitis. Under these circumstances, performing cataract surgery only might improve the visual acuity enough to maintain the patient’s day-to-day activities. Performing cataract surgery, especially phacoemulsification, in these cases is challenging. Proper case selection, choosing the right technique, and a thorough idea about the difficulties and methods of tackling such cases is paramount to achieving optimum visual outcomes. In this review, we discuss the case selection and surgical modifications of performing phacoemulsification in cases with coexisting corneal opacities.
关键词： keratoplasty,Phacoemulsification,corneal opacities,triple procedure,cataract
更新于2025-09-10 09:29:36
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Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands
摘要： To evaluate the cost-effectiveness of toric versus monofocal intraocular lens (IOL) implantation in cataract patients with bilateral corneal astigmatism. Setting: Two ophthalmology clinics in the Netherlands. Design: Prospective cost-effectiveness analysis. Methods: Resource-use data were collected over a 6-month postoperative period. Consecutive patients with bilateral age-related cataract and 1.25 diopters or more of corneal astigmatism were included in the economic evaluation. Patients were randomized to phacoemulsification with bilateral toric or monofocal IOL implantation. All relevant resources were included in the cost analysis. The base-case analysis was performed from a societal perspective based on quality-adjusted life years (QALYs). The main outcome was the incremental cost-effectiveness ratio. Results: The analysis comprised 77 consecutive patients (33 toric IOL; 44 monofocal IOL). Societal costs were higher in the toric IOL group (V3203 [$3864]) than in the monofocal IOL group (V2796 [US$3373]). QALYs were slightly lower in the toric IOL group (0.30 versus 0.31; P Z .75). Toric IOLs were therefore inferior to monofocal IOLs from a cost-effectiveness perspective. The cost-effectiveness probability ranged from 1% to 15%, assuming a ceiling ratio for the incremental cost-effectiveness ratio of V2500 to V20 000 per QALY. Conclusions: From a societal perspective, bilateral toric IOL implantation in cataract patients with corneal astigmatism was not cost-effective compared with monofocal IOL implantation. Copayment by patients should therefore be considered.
关键词： monofocal intraocular lens,corneal astigmatism,cost-effectiveness,toric intraocular lens,cataract
更新于2025-09-10 09:29:36
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Pr?zisionspulskapsulotomie; Precision pulse capsulotomy;
摘要： The manual capsulorhexis created by Neuhann is still the standard procedure for opening the anterior capsule for cataract surgery. A limitation is the inaccuracy in the size and placement of the opening due to manual execution. In addition to the femtosecond laser a possible improvement in the standardization of capsulorhexis is provided by the Zepto procedure (precision pulse capsulotomy, PPC). In this case a 5.25 mm rhexis is created in a standardized fashion with a flexible suction adapter in which a nitinol ring is located. Whether the strength of PPC is comparable or better than that of the manual technique and how it behaves in terms of capsule shrinkage has not yet been finally clarified.
关键词： Standardization,Rhexis,Capsule shrinkage,Nitinol,Cataract surgery
更新于2025-09-10 09:29:36