1
|
Lighthizer N, Johnson S, Holthaus J, Holthaus K, Cherian B, Swindell R, Weber B, Weise K, Cockrell D, Lewis S, Wroten C, Anastasio J, Ellen J, Miller JM. Nd:YAG Laser Capsulotomy: Efficacy and Outcomes Performed by Optometrists. Optom Vis Sci 2023; 100:665-669. [PMID: 37594749 PMCID: PMC10662619 DOI: 10.1097/opx.0000000000002057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/28/2023] [Indexed: 08/19/2023] Open
Abstract
SIGNIFICANCE An increasing number of optometrists are performing Nd:YAG laser capsulotomy procedures; however, there is limited published information on the outcomes of these procedures. PURPOSE This study aimed to assess the efficacy and safety of capsulotomy procedures performed by optometrists. METHODS Subjects diagnosed with posterior capsule opacification causing reduced vision and subjective visual complaints were recruited for this study. A baseline examination was performed to ensure that the subjects met all the necessary criteria. The procedure was performed by a licensed doctor of optometry at six different clinics, and each subject was monitored for visual outcome and any potential complications. RESULTS Subjects' Snellen visual acuity improved from an average of 20/40 to 20/23 ( P < .001) with no complications of increased intraocular pressure, inflammation, visually significant lens pitting, macular edema, or retinal detachment. Of 78 subjects who responded to a post-procedure survey, 77 (99%) reported subjective improvement in vision after capsulotomy. CONCLUSIONS Based on the outcomes of this study, YAG laser capsulotomies are effective treatments to improve patient vision that can be safely and effectively performed by optometrists.
Collapse
Affiliation(s)
- Nathan Lighthizer
- Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma
| | - Spencer Johnson
- Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma
| | - Jared Holthaus
- Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma
| | - Kathleen Holthaus
- Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma
| | - Bibin Cherian
- Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma
| | - Ryan Swindell
- Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma
| | - Brianna Weber
- Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma
| | - Karli Weise
- Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma
| | | | - Stephen Lewis
- Willis-Knighton Eye Institute, Shreveport, Louisiana
| | | | | | | | - Jeffrey M. Miller
- Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma
| |
Collapse
|
2
|
Chan HW, Van den Broeck F, Cools A, Walraedt S, Joniau I, Verdin H, Balikova I, Van Nuffel S, Delbeke P, De Baere E, Leroy BP, Nerinckx F. Paediatric cataract surgery with 27G vitrectomy instrumentation: the Ghent University Hospital Experience. Front Med (Lausanne) 2023; 10:1197984. [PMID: 37601772 PMCID: PMC10435324 DOI: 10.3389/fmed.2023.1197984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/03/2023] [Indexed: 08/22/2023] Open
Abstract
Objective To describe a cohort of paediatric patients who underwent unilateral or bilateral lens extractions at Ghent University hospital using the Dutch Ophthalmic Research Center (D.O.R.C.) ultra-short 27G vitrectomy system. Methods Retrospective analysis of the medical and surgical records of all children that underwent lens extraction between September 2016 and September 2020 using the D.O.R.C. ultra-short 27G vitrectomy system. Results Seventy-two eyes of 52 patients were included. The most important aetiologies in this study were of secondary (25.5%), developmental (13.7%), or genetic (13.7%) nature. No definitive cause could be established in more than a quarter of cases (27.5%) despite extensive work-up, them being deemed idiopathic. The remainder of cases (19.6%) was not assigned a final aetiologic designation at the time of the study due to contradicting or missing diagnostic data. This study could not identify any cataract cases related to infection or trauma. Surgical complications rate was 61.1% of which posterior capsule opacification was the most frequent with a rate of 25%. A significant short-term postoperative best-corrected visual acuity gain (≤ -0.2 LogMAR) was observed in 60.5% of eyes for which usable acuity data were available (n = 38). Conclusion Many different instruments and techniques have been described and used in the context of paediatric lens extractions, each with its advantages and disadvantages. This study illustrates that an ultra-short 27G vitrectomy system can be used to perform paediatric lens extractions with good surgical outcomes. Further studies and comparative trials are needed to ascertain this further.
Collapse
Affiliation(s)
- Hwei Wuen Chan
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
- Department of Ophthalmology, National University Singapore, Singapore, Singapore
| | - Filip Van den Broeck
- Department of Head and Skin, Ghent University, Ghent, Belgium
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - Axelle Cools
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - Sophie Walraedt
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - Inge Joniau
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - Hannah Verdin
- Center for Medical Genetics, Ghent University Hospital, Ghent University, Ghent, Belgium
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Irina Balikova
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Elfride De Baere
- Center for Medical Genetics, Ghent University Hospital, Ghent University, Ghent, Belgium
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Bart P. Leroy
- Department of Head and Skin, Ghent University, Ghent, Belgium
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent University, Ghent, Belgium
- Division of Ophthalmology, The Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Fanny Nerinckx
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
3
|
Chen ZX, Zhao ZN, Sun Y, Jia WN, Zheng JL, Chen JH, Chen TH, Lan LN, Jiang YX. Phacoemulsification Combined With Supra-Capsular and Scleral-Fixated Intraocular Lens Implantation in Microspherophakia: A Retrospective Comparative Study. Front Med (Lausanne) 2022; 9:869539. [PMID: 35492301 PMCID: PMC9047048 DOI: 10.3389/fmed.2022.869539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/23/2022] [Indexed: 01/19/2023] Open
Abstract
BackgroundMicrospherophakia (MSP) is a rare ocular condition, the lens surgery of which is complicated by both insufficient zonules and undersized capsule.MethodsThis study included MSP eyes managed with phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens implantation (SCSF-IOL) and made the comparison with those treated by transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation (MCTR-IOL).ResultsA total of 20 MSP patients underwent SCSF-IOL, and 17 patients received MCTR-IOL. The postoperative best corrected visual acuity was significantly improved in both groups (P < 0.001), but no difference was found between the groups (P = 0.326). The IOL tilt was also comparable (P = 0.216). Prophylactic Nd:YAG laser posterior capsulotomy was performed 1 week to 1 month after the SCSF-IOL procedure. In the SCSF-IOL group, two eyes (10.00%) needed repeated laser treatment and one eye (5.00%) had a decentered capsule opening. Posterior capsule opacification was the most common complication (6, 35.29%) in the MCTR group. No IOL dislocation, secondary glaucoma, or retinal detachment was observed during follow-up.ConclusionsSCSF-IOL is a viable option for managing MSP and is comparable with the MCTR-IOL. Nd:YAG laser posterior capsulotomy was necessary to prevent residual capsule complications after the SCSF-IOL procedure.
Collapse
Affiliation(s)
- Ze-Xu Chen
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Zhen-Nan Zhao
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yang Sun
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wan-Nan Jia
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jia-Lei Zheng
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jia-Hui Chen
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Tian-Hui Chen
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Li-Na Lan
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yong-Xiang Jiang
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- *Correspondence: Yong-Xiang Jiang
| |
Collapse
|
4
|
Çakmak K, Erbil H, Mesci C, Korkmaz Ş. Comparing the effects and safety of dorzolamide hydrochloride + timolol maleate versus brimonidine after neodymium-doped yttrium aluminium garnet laser capsulotomy posterior capsule opacification. Eur J Ophthalmol 2021; 32:2928-2934. [PMID: 34791912 DOI: 10.1177/11206721211052163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM Posterior capsular opacification is treated using neodymium-doped yttrium aluminium garnet laser capsulotomy that leads to increased intraocular pressure. Here, we compare the effects of dorzolamide hydrochloride + timolol maleate versus brimonidine on intraocular pressure. We also investigate their side effects after neodymium-doped yttrium aluminium garnet laser capsulotomy. In these patients, there are no prior studies comparing the results of these two drugs. MATERIALS Ninety patients with posterior capsule opacification contributed to the study. They received yttrium aluminium garnet laser capsulotomy. After yttrium aluminium garnet laser capsulotomy, they were randomized into three groups. Group 1 received dorzolamide hydrochloride + timolol maleate; Group 2 took brimonidine; and Group 3, the control group, took no drug. Group 1 took dorzolamide hydrochloride + timolol maleate eye drops 1 h before the procedure and on the third hour of the first day and two times per day between the second and the seventh days. Group 2 took brimonidine eye drops 1 h before the procedure and on the third hour of the first day, two times per day between the second and the seventh days. RESULTS Brimonidine had a similar side effect profile to the fix combination. Intraocular pressure on the first (p = 0.87) and third days (p = 0.124) were similar in Group 1 (dorzolamide hydrochloride + timolol maleate), Group 2 (brimonidine) and the control group. The mean intraocular pressure value of the control group was significantly higher than Groups 1 and 2 because the anti-glaucomatous effects of the drugs become prominent on the seventh day (p = 0.041). In Group 1 and Group 2, intraocular pressure was significantly lower than the control group on the seventh day (p = 0.041). Stinging, itching, hyperemia and Tyndall rates were similar in Group 1, Group 2 and the control group. Watery eyes were less common in the brimonidine group than in the dorzolamide hydrochloride-timolol maleate and the control groups on the seventh day (p = 0.02). Brimonidine also significantly lowered the chemosis rate on the third (p = 0.04) and seventh (p = 0.03) days. CONCLUSION We suggest that brimonidine and a combination of dorzolamide + timolol are similarly effective at reducing eye pressure for routine cases. In cases where intraocular pressure attacks might be at higher risk, using the dorzolamide + timolol combination would be more appropriate.
Collapse
Affiliation(s)
- Kaan Çakmak
- Department of Ophthalmology, 121595Düzce State Hospital, Düzce, Turkey
| | - Hasan Erbil
- Department of Ophthalmology, 64071Goztepe Training and research Hospital, İstanbul, Turkey
| | - Cem Mesci
- Department of Ophthalmology, 162155Kavacık Hospital, İstanbul, Turkey
| | - Şafak Korkmaz
- Department of Ophthalmology, 121595Düzce State Hospital, Düzce, Turkey
| |
Collapse
|
5
|
Chen Z, Zhang M, Deng M, Chen T, Chen J, Zheng J, Jiang Y. Surgical outcomes of modified capsular tension ring and intraocular lens implantation in Marfan syndrome with ectopia lentis. Eur J Ophthalmol 2021; 32:11206721211012868. [PMID: 33887970 DOI: 10.1177/11206721211012868] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate surgical outcomes of modified capsular tension ring (MCTR) and intraocular lens (IOL) implantation in eyes of Marfan syndrome (MFS). METHODS This retrospective case series included MFS patients receiving MCTR transscleral fixation and IOL in-the-bag implantation. The MCTR was sutured to the sclera through a sulcus by 9-0 polypropylene with the modified knotless Z-suture technique. Main outcomes were visual acuity and postoperative complications. RESULTS A total of 109 MFS patients (187 eyes) had the surgery. Patients were 15.47 ± 14.36 years old and followed up for 10.07 ± 8.99 months. MCTR and IOL implantations were performed in 174 eyes (93.05%). The postoperative BCVA (LogMAR) was 0.24 ± 0.24 (1 month), 0.26 ± 0.20 (3 months), 0.22 ± 0.20 (6 months), 0.20 ± 0.19 (12 months) and 0.25 ± 0.32 (over 12 months), which was significantly better than preoperatively (0.63 ± 0.35) (p < 0.001). Major complications included posterior capsular opacification (PCO) in 41 eyes (23.56%) and decentered anterior capsular opacification (ACO) in 15 eyes (8.62%). The mean occurrence time was 9.44 ± 7.08 and 8.87 ± 15.08 months respectively. Other complications included transient intraocular pressure elevation in seven eyes (4.02%), retinal detachment in two eyes (1.15%), cystoid macula edema in one eye (0.57%), and endophthalmitis in one eye (0.57%). No eye had suture breakage or IOL dislocation. CONCLUSIONS The visual improvement is significant in eyes of MFS undergoing MCTR transscleral fixation and IOL in-the-bag implantation. The long-term monitoring of complications is warranted, especially in the first-two years.
Collapse
Affiliation(s)
- Zexu Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Min Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Michael Deng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Tianhui Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jiahui Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jialei Zheng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yongxiang Jiang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| |
Collapse
|
6
|
Cataract management in children: a review of the literature and current practice across five large UK centres. Eye (Lond) 2020; 34:2197-2218. [PMID: 32778738 PMCID: PMC7784951 DOI: 10.1038/s41433-020-1115-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/02/2020] [Accepted: 07/16/2020] [Indexed: 01/21/2023] Open
Abstract
Congenital and childhood cataracts are uncommon but regularly seen in the clinics of most paediatric ophthalmology teams in the UK. They are often associated with profound visual loss and a large proportion have a genetic aetiology, some with significant extra-ocular comorbidities. Optimal diagnosis and treatment typically require close collaboration within multidisciplinary teams. Surgery remains the mainstay of treatment. A variety of surgical techniques, timings of intervention and options for optical correction have been advocated making management seem complex for those seeing affected children infrequently. This paper summarises the proceedings of two recent RCOphth paediatric cataract study days, provides a literature review and describes the current UK 'state of play' in the management of paediatric cataracts.
Collapse
|
7
|
Molecular genetics of congenital cataracts. Exp Eye Res 2019; 191:107872. [PMID: 31770519 DOI: 10.1016/j.exer.2019.107872] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 12/18/2022]
Abstract
Congenital cataracts, the most common cause of visual impairment and blindness in children worldwide, have diverse etiologies. According to statistics analysis, about one quarter of congenital cataracts caused by genetic defects. Various mutations of more than one hundred genes have been identified in hereditary cataracts so far. In this review, we briefly summarize recent developments about the genetics, molecular mechanisms, and treatments of congenital cataracts. The studies of these pathogenic mutations and molecular genetics is making it possible for us to comprehend the underlying mechanisms of cataractogenesis and providing new insights into the preventive, diagnostic and therapeutic approaches of cataracts.
Collapse
|
8
|
Kumawat D, Sahay P, Sachan A. Concerns Regarding Nd:YAG Laser Posterior Capsulotomy in Children. Am J Ophthalmol 2019; 202:151-152. [PMID: 31030896 DOI: 10.1016/j.ajo.2019.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 11/29/2022]
|
9
|
Choi SH, Kim YD, Yu YS, Kim MK, Choi HJ. Reply. Am J Ophthalmol 2019; 202:152-153. [PMID: 31014541 DOI: 10.1016/j.ajo.2019.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 02/13/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
|