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Gambrill Y, Commins P, Schramm S, Lui NM, AlNeyadi SS, Naumov P. Natural Product Isolation of the Extract of Cleome rupicola Fruits Exhibiting Antioxidant Activity. Chem Biodivers 2024; 21:e202301382. [PMID: 38366916 DOI: 10.1002/cbdv.202301382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 02/19/2024]
Abstract
Cataracts are the leading cause of blindness worldwide, however, there is currently no drug-based treatment. Plants that exhibit antioxidant properties have shown promising anticataract effects, likely because they supplement the activity of glutathione, the major antioxidant in lens cells. An extract of Cleome rupicola, a desert plant found in the United Arab Emirates, has traditionally been used to treat cataracts. Phytochemical screening of the aqueous extract established the presence of flavonoids, tannins, steroid derivatives, and reducing sugars. Fractioning of extracts from the fruits using high-performance liquid chromatography (HPLC) yielded the isolation of the anthelmintic compound cleomin, and its structure was confirmed using mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy.
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Affiliation(s)
- Yumi Gambrill
- Smart Materials Lab, New York University Abu Dhabi, PO Box, 129188, Abu Dhabi, United Arab Emirates E-ail
| | - Patrick Commins
- Smart Materials Lab, New York University Abu Dhabi, PO Box, 129188, Abu Dhabi, United Arab Emirates E-ail
| | - Stefan Schramm
- Chair of Applied Organic Chemistry, University of Applied Sciences Dresden, Friedrich-List-Platz 1, 01069, Dresden, Germany
| | - Nathan M Lui
- Smart Materials Lab, New York University Abu Dhabi, PO Box, 129188, Abu Dhabi, United Arab Emirates E-ail
| | - Shaikha S AlNeyadi
- Department of Chemisty, College of Science, United Arab Emirates University, PO Box, 15551, Al-Ain, United Arab Emirates
| | - Panče Naumov
- Smart Materials Lab, New York University Abu Dhabi, PO Box, 129188, Abu Dhabi, United Arab Emirates E-ail
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Sun Y, Zhang Z, Wei Y, Chi W, Zhang S. Intraocular Lens Fixation Technique Without Corneal Incision in Minimally Invasive Vitrectomized Eyes. Ophthalmol Ther 2022; 11:729-737. [PMID: 35122608 PMCID: PMC8927512 DOI: 10.1007/s40123-022-00464-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/12/2022] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION To introduce a modified technique for primary/secondary intraocular lens (IOL) fixation without corneal incision in vitrectomized eyes. METHODS Consecutive case series who had undergone previous or concomitant pars plana vitrectomy (PPV) to have primary/secondary IOL fixation were prospectively included. A self-sealing scleral incision was made underneath the superior scleral flap, through which the IOL was inserted into the anterior chamber. The suture tied with the IOL passed through the sclera to fix the IOL in the ciliary sulcus. Patients were followed up for at least 3 months. Main outcomes were best corrected visual acuity (BCVA), intraocular pressure (IOP), surgically induced astigmatism (SIA), and intraoperative and postoperative complications. RESULTS A total of 31 patients were included in the study. The mean follow-up time was 5.35 ± 4.14 months. The BCVA (log MAR unit) improved from 0.97 ± 0.58 preoperative to 0.42 ± 0.36 postoperative (P < 0.001). Mean IOP remained unchanged (preoperative IOP 14.03 ± 2.90 mmHg, postoperative IOP 13.26 ± 3.46 mmHg, P = 0.130). The mean SIA was 0.91 ± 0.76 diopters. No obvious intraoperative and postoperative complications were observed. CONCLUSION This method has favorable postoperative visual recovery and IOP control. This modified method could be taken into account as an option by surgeons in vitreoretinal surgery.
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Affiliation(s)
- Yimeng Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Zhaotian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Yantao Wei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Wei Chi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Shaochong Zhang
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, 18 Zetian Road, Shenzhen, 518040, Guangdong, China.
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Sarkar S, Bardoloi N, Deb AK. Comparison between 0.1% Nepafenac and 1% Prednisolone Eye Drop in Postoperative Management Following Micro-incisional Cataract Surgery. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 35:188-197. [PMID: 34120417 PMCID: PMC8200587 DOI: 10.3341/kjo.2020.0135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/11/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the efficacy of 0.1% nepafenac and 1% prednisolone acetate eye drop in postoperative inflammation control in micro-incisional cataract surgery. Methods We conducted a prospective, randomized, comparative, single-blind study. All the patients underwent temporal 2.2-mm micro-incisional cataract surgery. They were randomized into two groups (group A and B). Group A received 0.1% nepafenac eye drops 4 times/day for 4 weeks and group B received 1% prednisolone acetate eye drops in tapering doses for 4 weeks after surgery. Both the groups received moxifloxacin 0.5% eye drops 4 times/day for 2 weeks. Patients were examined on 1st, 7th, and 30th postoperative days and parameters of postoperative inflammation were evaluated and noted at each visit. Results A total of 200 patients were enrolled in the study. However, five patients lost to follow up, group A had 97 and group B had 98 patients respectively. Results were statistically insignificant in terms of the difference in lid edema, conjunctival congestion, corneal edema, anterior chamber cells and flare between the two groups with p-values >0.05 for each parameter at each visit. However, the difference in mean central macular thickness between the groups was significant (205.713 ± 17.14 vs. 220.984 ± 32.83 in group A and B, respectively, p ≤ 0.001) at 1 month. Also, the mean pain score was significantly lower (p = 0.018) in the nepafenac group at day 7 of surgery. Conclusions Nepafenac is equally effective and non-inferior to prednisolone acetate in suppression and prevention of inflammation in postoperative period.
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Affiliation(s)
- Sandip Sarkar
- Cataract & Cornea Services, Chandraprabha Eye Hospital, Jorhat, India.,Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Narayan Bardoloi
- Cataract & Cornea Services, Chandraprabha Eye Hospital, Jorhat, India
| | - Amit Kumar Deb
- Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Can İ, Takmaz T, Özdamar A, Kamış Ü, Aydın Akova Y, Arslan OŞ, Baykara M, Devranoğlu K, Günenç Ü, Mutlu FM, Özcan AA, Taşındı E. Evaluation of the Cataract Surgery 2018 Survey in Terms of Achieving Refractive Cataract Surgery Targets. Turk J Ophthalmol 2021; 51:7-18. [PMID: 33631897 PMCID: PMC7931655 DOI: 10.4274/tjo.galenos.2020.46020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives The aim of this study was to show at what rate the technological equipment used in cataract surgery by Turkish ophthalmologists and their knowledge are reflected in practice and how up to date they are. Materials and Methods A questionnaire conducted using SurveyMonkey was used to evaluate the answers to 17 questions from 823 members of the Turkish Ophthalmological Association. Results were evaluated in subgroups according to the participants' age, occupational status, institutions, and whether they conducted relevant academic activities, and the data were compared as inadequate, standard, and contemporary approaches according to the determined criteria. Results Optical biometry devices were used at rates of 77.7% and 67.3% for intraocular lens (IOL) power calculations and keratometric measurements in preparation for cataract surgery, respectively. For IOL power calculation, third-generation formulas, especially the SRK-T, were used most commonly (46.2%), followed by second-generation formulas (21.9%), and fourth/fifth-generation formulas and multiple evaluations for different axial lengths (31.9%). The most common incision size was 2.8 mm (51.6%), while the percentage of 2.2 mm and shorter incisions considered to be neutral in terms of surgically induced astigmatism was 18.8%. When selecting incision location, approaches to reduce corneal astigmatism were reported by 28.9%, neutral approaches by 26.2%, and insensitive approaches by 44.9%. Additionally, 55.6% of participants never implanted toric IOLs and 50.7% did not use presbyopia-correcting IOLs. The proportion of surgeons who have experience with femtosecond laser-assisted cataract surgery was 10.3% and the rate of intracameral antibiotic injection at the end of the operation was 89.4%. Conclusion It was seen that Turkish cataract surgeons were able to use high technology for surgical preparation and surgery at high rates, but this was not reflected in practice at same rate in terms of achieving contemporary standards of refractive cataract surgery.
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Affiliation(s)
| | - Tamer Takmaz
- Ankara City Hospital, Clinic of Ophthalmology, Ankara, Turkey
| | - Akif Özdamar
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | | | | | - Osman Şevki Arslan
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | - Mehmet Baykara
- Uludağ University Faculty of Medicine, Department of Ophthalmology, Bursa, Turkey
| | | | - Üzeyir Günenç
- Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Fatih Mehmet Mutlu
- University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Turkey
| | - Altan Atakan Özcan
- Çukurova University Faculty of Medicine, Department of Ophthalmology, Adana, Turkey
| | - Emrullah Taşındı
- Okan University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
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Hirabayashi M, Virdi G, King J, Lee D, Nguyen V, An J. <p>Effect of Excisional Goniotomy with the Kahook Dual Blade (KDB) on Surgically Induced Astigmatism</p>. Clin Ophthalmol 2020; 14:4297-4303. [PMID: 33324035 PMCID: PMC7733437 DOI: 10.2147/opth.s279073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/03/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the effect of Kahook Dual Blade goniotomy with phacoemulsification (Phaco-KDB) compared to phacoemulsification alone (Phaco) on surgically induced astigmatism (SIA). Design Prospective study. Participants Forty eyes of 28 patients treated with Phaco-KDB and 20 eyes of 13 patients treated with Phaco between 12/27/16 and 7/23/19 with a minimum 1 month follow-up were prospectively enrolled. Methods Corneal astigmatism was assessed pre- and post-operatively using the simulated K (simK) values from the Pentacam Holladay report. Main Outcome Measures SIA was compared between Phaco-KDB and Phaco groups using mean magnitude SIA, rate of ≥0.50 D SIA, and SIA centroids. Results The difference in mean magnitude SIA was not statistically significant between Phaco-KDB and Phaco (mean = 0.28 D and 0.25 D, respectively, P = 0.621). The difference in the rate of ≥0.50 D SIA was not statistically significant between Phaco-KDB and Phaco (11.6% and 10.0%, respectively, P = 1.00). The SIA centroid for Phaco-KDB was 0.05 D @ 51° ± 0.40 D and 0.07 D @ 3° ± 0.32 D for Phaco. Conclusion Neither the mean magnitude SIA nor the rate of astigmatic change ≥0.50 D was significantly different between Phaco-KDB and Phaco groups. SIA centroids between groups showed comparable and negligible effect on corneal astigmatism. KDB combined with phacoemulsification may not significantly affect SIA compared to phacoemulsification alone based on postoperative topography and is likely an astigmatically neutral procedure.
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Affiliation(s)
- Matthew Hirabayashi
- School of Medicine, University of Missouri, Columbia, MO, USA
- Mason Eye Institute, Department of Ophthalmology, University of Missouri, Columbia, MO, USA
| | - Gurpal Virdi
- School of Medicine, University of Missouri, Columbia, MO, USA
| | - Joshua King
- School of Medicine, University of Missouri, Columbia, MO, USA
| | - Dayeong Lee
- School of Medicine, University of Missouri, Columbia, MO, USA
| | - Van Nguyen
- School of Medicine, University of Missouri, Columbia, MO, USA
- Mason Eye Institute, Department of Ophthalmology, University of Missouri, Columbia, MO, USA
| | - Jella An
- School of Medicine, University of Missouri, Columbia, MO, USA
- Mason Eye Institute, Department of Ophthalmology, University of Missouri, Columbia, MO, USA
- Correspondence: Jella An Mason Eye Institute, Department of Ophthalmology, University of Missouri, 3215 Wingate Court, Columbia, MO65201, USATel +1 573-884-1311Fax +1 573-884-3330 Email
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Comparison of Outcomes after Phacoemulsification with Two Different Corneal Incision Distances Anterior to the Limbus. J Ophthalmol 2019; 2019:1760742. [PMID: 31531233 PMCID: PMC6721498 DOI: 10.1155/2019/1760742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 08/05/2019] [Indexed: 11/28/2022] Open
Abstract
Purpose To compare visual performance and visual quality outcomes after phacoemulsification with two different clear corneal incision (CCI) distances anterior to the limbus in senile cataract patients. Methods Retrospective case series. Patients who had undergone phacoemulsification were divided into two groups according to the CCI distances anterior to the limbus. The CCI distances in group A range from 1 mm to 1.5 mm, while those in group B range from 0.5 mm to 1 mm. The visual acuity, refraction, surgically induced astigmatism (SIA), corneal aberrations, anterior segment parameters, and subjective vision quality were evaluated. Results This study enrolled 54 eyes, with 27 eyes per group. Both groups had significant improvement in postoperative uncorrected visual acuity (UCVA) and corrected distance visual acuity (CDVA) (P < 0.05). There were no statistically significant between-group differences in postoperative UDVA, CDVA, SIA, corneal aberrations, anterior segment parameters, or VF-QOL questionnaire performance (P > 0.05). Conclusions The phacoemulsification with CCI distances ranging from 0.5 mm to 1.5 mm is an effective and safe therapy to senile cataract. The CCI distance anterior to the limbus that ranges from 0.5 mm to 1.5 mm is recommended for routine phacoemulsification.
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Kim TG, Moon SW. Hyperopic shift caused by capsule contraction syndrome after microincision foldable intraocular Lens implantation: case series. BMC Ophthalmol 2019; 19:116. [PMID: 31109308 PMCID: PMC6528267 DOI: 10.1186/s12886-019-1117-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/26/2019] [Indexed: 12/02/2022] Open
Abstract
Background Increasing interest in microincision cataract surgery has led to the use of more flexible intraocular lens (IOL). Flexible IOL may cause more IOL deformation and refractive error when capsule contraction syndrome (CCS) occurred. In this retrospective observational case series study, the aim was to report four cases of hyperopic shift caused by CCS after phacoemulsification with microincision foldable intraocular lens implantation. Case presentation All of four patients underwent phacoemulsification and in-the-bag implantation of an Akreos MI60 (Bausch and Lomb) IOL from 2010 to 2016 in our clinic. These patients had been diagnosed with CCS and had undergone Nd:YAG laser anterior capsulotomy. The mean age of the patients with CCS was 66.8 ± 6.7 years and the mean time for development of CCS after the cataract surgery was 9.3 ± 6.9 months. The mean spherical equivalent (SE) value at the time of the CCS diagnosis was 0.88 ± 0.91 D, which had shown a hyperopic shift compared to the SE value of − 0.91 ± 1.29 D after cataract surgery. The mean SE decreased by − 0.47 ± 1.14 D after Nd:YAG laser anterior capsulotomy. The mean age, axial length, anterior chamber depth, and preoperative SE were not significantly different between the patient with CCS and the patients without CCS. Conclusions In the case of IOL implantation with flexible materials in microincision cataract surgery, CCS can cause a hyperopic shift. Refractive error caused by CCS can be effectively corrected by Nd:YAG laser anterior capsulotomy.
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Affiliation(s)
- Tae Gi Kim
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, # 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Sang Woong Moon
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, # 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
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Su D, Stephens JD, Obeid A, Borkar D, Storey PP, Khan MA, Hsu J, Garg SJ, Gupta O. Refractive Outcomes after Pars Plana Vitrectomy and Scleral Fixated Intraocular Lens with Gore-Tex Suture. Ophthalmol Retina 2019; 3:548-552. [PMID: 31277795 DOI: 10.1016/j.oret.2019.02.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/08/2019] [Accepted: 02/19/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To evaluate refractive outcomes after combined pars plana vitrectomy (PPV) and scleral fixation of an intraocular lens (IOL) using Gore-Tex suture. DESIGN Retrospective cohort study. PARTICIPANTS Fifty-five eyes from 53 patients who underwent PPV with a Gore-Tex sutured IOL from June 2013 through December 2017. METHODS Patients who underwent combined PPV and scleral fixation of an IOL with Gore-Tex suture were identified. All eyes underwent scleral fixation of either an Akreos A060 or enVista MX60 IOL and were fixated either 2 mm or 3 mm posterior to the limbus. Postoperative manifest refractions were performed at least 3 months after surgery and were compared with preoperative predicted target refraction based on in-the-bag IOL calculations. Subgroup analyses based on sclerotomy placement and IOL models were performed. MAIN OUTCOME MEASURES Postoperative manifest refraction and difference with sclerotomy placement and IOL model. RESULTS The mean postoperative spherical equivalent (SEQ) was -0.99±1.00 diopters (D). The mean difference in SEQ (ΔSEQ) from preoperative predicted target was -0.64±1.00 D. The IOL was fixated 2 mm posterior to the limbus in 14 eyes and 3 mm in 41 eyes. Within these 2 subgroups, the mean postoperative SEQ was -1.53±1.35 D for fixation 2 mm posterior to the limbus and -0.82±0.83 D for fixation 3 mm posterior to the limbus (P = 0.09). The mean ΔSEQ was -0.43±0.71 D for fixation 3 mm posterior to the limbus and -1.35±1.32 D for fixation 2 mm posterior to the limbus (P = 0.03). The mean amount of surgically induced astigmatism in the overall cohort was 0.77±0.65 D. The mean ΔSEQ and induced astigmatism were similar between IOL models. CONCLUSIONS After combined PPV and Gore-Tex-sutured IOL implantation, mean postoperative refractive outcomes were more myopic when the IOL was fixated 2 mm from the limbus compared with 3 mm from the limbus. No significant difference was found between IOL models. Based on these results, future implant power calculations may be adjusted to approximate preoperative target refraction more accurately.
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Affiliation(s)
- Daniel Su
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - John D Stephens
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Anthony Obeid
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Durga Borkar
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Philip P Storey
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - M Ali Khan
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Retina Division, Doheny and Stein Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Jason Hsu
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Sunir J Garg
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Omesh Gupta
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania.
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Wang L, Yang X, Zhang Y, Liao D, Zhao L, Wang J. [Effect of different clear corneal incision sites on surgery efficacy and anterior segment parameters in patients undergoing phacoemulsification]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:1492-1497. [PMID: 30613019 DOI: 10.12122/j.issn.1673-4254.2018.12.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the safe distance range of clear corneal incision (CCI) from the corneal limbus and how different CCI sites affect surgery efficacy and anterior segment parameters in patients undergoing phacoemulsification. METHODS This retrospective case-control study was conducted in 44 patients (44 eyes) undergoing phacoemulsification and IOL implantation. The patients were divided into two groups with CCI distances ranging from 1 mm to 1.5 mm (group A, n= 22) and from 0.5 mm to 1.0 mm (group B, n= 22). The visual acuity, surgically induced astigmatism (SIA), corneal aberration, and anterior segment parameters were analyzed. RESULTS Compared with the preoperative data, all the patients showed significant improvements in the postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), anterior chamber depth (ACD), and anterior chamber angle (ACA) after the surgery (P < 0.05). No significant differences were found between the two groups in postoperative UCVA, BCVA, SIA, total corneal aberration RMS, lower- and higher-order aberration RMS, spherical aberration (Z40), horizontal three leaf clover (Z33), vertical three leaf clover(Z3-3), horizontal coma(Z31), vertical coma(Z3-1), ACD, ACA, anterior chamber volume, or central corneal thickness (P>0.05). CONCLUSIONS Phacoemulsification is an effective therapy for cataract with a CCI distance range either of 1-1.5 mm or 0.5-1.0 mm. These two CCI distance ranges produce no significant differences in the visual quality following phacoemulsification, indicating that a CCI distance range of 0.5-1.5 mm can be safe for phacoemulsification.
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Affiliation(s)
- Lijun Wang
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Xiting Yang
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Yi Zhang
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Dingying Liao
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Lin Zhao
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Jianming Wang
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
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Li P, Wu J, Guan Y, Lu Z, Xue Y, Ji M, Guan H. Comparative Analysis of One-Handed and Two-Handed Coaxial Phacoemulsification with 2.4-mm Clear Corneal Incision. Curr Eye Res 2018; 44:237-242. [PMID: 30373403 DOI: 10.1080/02713683.2018.1542733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE To compare the efficiency and safety of one-handed and two-handed coaxial phacoemulsification Material and Methods: Patients with cataracts underwent one-handed (one-handed group) or two-handed coaxial phacoemulsification (two-handed group) with a 2.4-mm clear corneal incision. Intraoperative phaco parameters, total surgical time, postoperative visual acuity, surgically induced astigmatism (SIA), corneal volume (CV), central corneal thickness (CCT) and corneal endothelial cell counts/size were compared between the two groups. RESULTS Each group comprised 105 eyes. There were no significant differences in the intraoperative phaco parameters and total surgical time between the two groups (all p > 0.05). Visual outcomes were significantly better in the one-handed group than in the two-handed group 1 week postoperatively (all p< 0.05) but not 1 month postoperatively. There was no significant difference in SIA between the two groups 1 week (p = 0.695) or 1 month postoperatively (p = 0.772). CV, CCT and endothelial cell loss were significantly lower in the one-handed group than in the two-handed group 1 week postoperatively (CV: p = 0.004; CCT: p = 0.046; endothelial cell loss: p = 0.021), but the above differences were absent 1 month postoperatively except for endothelial cell loss (endothelial cell loss: p = 0.038). CONCLUSIONS Both one-handed and two-handed coaxial phacoemulsification were effective and safe surgical techniques. However, the one-handed technique had the advantages of less trauma to the cornea and better early clinical outcomes than the two-handed technique for cataract patients within nuclear opalescence (NO) 3 grade ≤ 3.
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Affiliation(s)
- Panpan Li
- a Eye Institute , Affiliated Hospital of Nantong University , Nantong , Jiangsu , China.,b Department of Ophthalmology , The First People's Hospital of Nantong , Nantong , Jiangsu , China
| | - Jian Wu
- a Eye Institute , Affiliated Hospital of Nantong University , Nantong , Jiangsu , China
| | - Yu Guan
- a Eye Institute , Affiliated Hospital of Nantong University , Nantong , Jiangsu , China
| | - Zhirong Lu
- a Eye Institute , Affiliated Hospital of Nantong University , Nantong , Jiangsu , China
| | - Ying Xue
- a Eye Institute , Affiliated Hospital of Nantong University , Nantong , Jiangsu , China
| | - Min Ji
- a Eye Institute , Affiliated Hospital of Nantong University , Nantong , Jiangsu , China
| | - Huaijin Guan
- a Eye Institute , Affiliated Hospital of Nantong University , Nantong , Jiangsu , China
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Jiménez R, Valero A, Fernández J, Anera RG, Jiménez JR. Optical quality and visual performance after cataract surgery with biaxial microincision intraocular lens implantation. J Cataract Refract Surg 2018; 42:1022-8. [PMID: 27492101 DOI: 10.1016/j.jcrs.2016.03.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 03/11/2016] [Accepted: 03/29/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the time course of the optical quality and visual performance with a microincision monofocal intraocular lens (Incise). SETTING Hospital Torrecárdenas, Almería, Spain. DESIGN Prospective study. METHODS The visual and refractive outcomes were evaluated in eyes with the microincision IOL preoperatively and 1, 3, and 6 months postoperatively. The modulation transfer function (MTF) cutoff frequency, Strehl ratio, and objective scatter index (OSI) were used to measure optical quality. The contrast sensitivity function (CSF) and the visual disturbance index characterized visual performance. RESULTS In the 32 study eyes, the mean values preoperatively and 6 months postoperatively, respectively, were MTF cutoff frequency (11.40 cycles per degree [cpd] ± 8.39 [SD] and 23.33 ± 11.68 cpd; P < .001), Strehl ratio (0.078 ± 0.32 and 0.15 ± 0.07; P < .05), and OSI (7.44 ± 3.25 and 1.57 ± 0.26; P < .001). At each spatial frequency, the CSF significantly differed between preoperatively and postoperatively (P < .001). The mean visual disturbance index changed from 0.70 ± 0.28 to 0.31 ± 0.17 (P < .001). For all parameters studied, statistically significant differences were found between the preoperative and postoperatively values, with no differences between the results 1, 3, and 6 months after surgery (P > .05). CONCLUSIONS Biaxial microincision cataract surgery provided optimum clinical outcomes. The optical quality and visual performance improved significantly 1 month after surgery, with the results remaining stable at 6 months. The postoperative visual function was similar to that in subjects of the same age with healthy eyes. FINANCIAL DISCLOSURE None of the authors has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Raimundo Jiménez
- From the Laboratory of Vision Sciences and Applications (R. Jiménez, Anera, J.R. Jiménez), University of Granada, Department of Optics, Granada, and the Department of Ophthalmology (Valero, Fernández), Hospital Torrecárdenas, Almería, Spain.
| | - Almudena Valero
- From the Laboratory of Vision Sciences and Applications (R. Jiménez, Anera, J.R. Jiménez), University of Granada, Department of Optics, Granada, and the Department of Ophthalmology (Valero, Fernández), Hospital Torrecárdenas, Almería, Spain
| | - Joaquín Fernández
- From the Laboratory of Vision Sciences and Applications (R. Jiménez, Anera, J.R. Jiménez), University of Granada, Department of Optics, Granada, and the Department of Ophthalmology (Valero, Fernández), Hospital Torrecárdenas, Almería, Spain
| | - Rosario G Anera
- From the Laboratory of Vision Sciences and Applications (R. Jiménez, Anera, J.R. Jiménez), University of Granada, Department of Optics, Granada, and the Department of Ophthalmology (Valero, Fernández), Hospital Torrecárdenas, Almería, Spain
| | - José R Jiménez
- From the Laboratory of Vision Sciences and Applications (R. Jiménez, Anera, J.R. Jiménez), University of Granada, Department of Optics, Granada, and the Department of Ophthalmology (Valero, Fernández), Hospital Torrecárdenas, Almería, Spain
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12
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Li P, Zhang Y, Kang L, Guan Y, Wu J, Guan H. Comparison of variations in cornea after one-handed and two-handed coaxial phacoemulsification. Clin Ophthalmol 2018; 12:1815-1822. [PMID: 30275677 PMCID: PMC6157994 DOI: 10.2147/opth.s172160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose To compare corneal variations in patients undergoing one-handed and two-handed coaxial phacoemulsification. Setting Eye Institute, Affiliated Hospital of Nantong University, Nantong, China. Design Prospective consecutive nonrandomized comparative cohort study. Methods Patients with cataracts were subject to one-handed (one-handed group) or two-handed coaxial phacoemulsification (two-handed group). Intraoperative phaco parameters and postoperative outcomes, such as visual acuity, surgically induced astigmatism (SIA), corneal volume, central corneal thickness, and corneal endothelial cell counts/size were compared. Results No significant differences in the intraoperative phaco parameters were noted between the 2 groups. At postoperative week 1, visual outcomes were significantly improved in the one-handed compared with the two-handed group (all P<0.05). Corneal volume, central corneal thickness, and average cell size were significantly decreased in the one-handed group compared with two-handed group (all P<0.05), but the aforementioned differences were ameliorated at 1 month and 3 months postoperatively. Endothelial cell loss was significantly decreased in the one-handed group compared with the two-handed group at any follow-up point (all P<0.05). No significant differences in SIA on the anterior surface were noted between the 2 groups. SIA on the posterior surface was significantly decreased in the one-handed group compared with the two-handed group at 1 week postoperatively (P=0.043) but not at 1 month and 3 months postoperatively. Conclusion One-handed phacoemulsification has the advantages of less trauma to the cornea and better early visual outcomes compared with the two-handed technique.
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Affiliation(s)
- Panpan Li
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, China, ; .,Department of Ophthalmology, The First People's Hospital of Nantong, Nantong, China
| | - Yujian Zhang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, China, ;
| | - Lihua Kang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, China, ;
| | - Yu Guan
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, China, ;
| | - Jian Wu
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, China, ;
| | - Huaijin Guan
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, China, ;
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13
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Wang L, Xiao X, Zhao L, Zhang Y, Wang J, Zhou A, Wang J, Wu Q. Comparison of efficacy between coaxial microincision and standard-incision phacoemulsification in patients with age-related cataracts: a meta-analysis. BMC Ophthalmol 2017; 17:267. [PMID: 29284444 PMCID: PMC5747124 DOI: 10.1186/s12886-017-0661-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 12/12/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Incision size plays a critical role in the efficacy of cataract surgery, but the available evidence on ideal incision size is inconsistent. In this study, we conducted a meta-analysis to evaluate the efficacy of coaxial microincisional phacoemulsification surgery (MICS) compared with that of standard-incision phacoemulsification surgery (SICS) in patients with age-related cataracts. METHODS The Cochrane Library (Wiley Online Library), PubMed, Medline, National Knowledge Infrastructure (CNKI), and VIP databases were searched to identify reports of clinical randomized controlled trials (RCTs) comparing MICS to SICS for the treatment of age-related cataracts. The outcomes of interest included surgically induced astigmatism (SIA), effective phacoemulsification time (EPT), central corneal thickness (CCT), endothelial cell count (ECC), endothelial cell count loss (ECC Loss %), and average ultrasonic energy (AVE). RESULTS Eleven RCT studies were included in this meta-analysis. No statistically significant differences were observed in EPT (Z = 1.29, P > 0.05), CCT (1 day: Z = 1.37, P > 0.05; 7 days: Z = 0.75, P > 0.05; 30 days: Z = 0.38, P > 0.05; 90 days: Z = 0.29, P > 0.05), ECC (7 days: Z = 1.13, P > 0.05; 30 days: Z = 1.42, P > 0.05) or ECC Loss % (7 days: Z = 0.24, P > 0.05; 30 days: Z = 0.06, P > 0.05; 90 days: Z = 0.10, P > 0.05) between MICS and SICS. However, statistically significant differences were found in AVE (Z = 4.19, P < 0.0001) and SIA (1 day: Z = 10.33, P < 0.00001; 7 days: Z = 10.71, P < 0.00001; 30 days: Z = 10.95, P < 0.00001; 90 days: Z = 2.21,- P < 0.01) between MICS and SICS. CONCLUSION Compared with SICS, MICS can reduce short-term and long-term SIA, but it does not differ in safety outcomes or in the time required for surgery.
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Affiliation(s)
- Lijun Wang
- Department of Ophthalmology, the Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, 710004 China
| | - Xiao Xiao
- Department of Ophthalmology, the Central Hospital of Shaanxi Xi’an, 161 Xiwu Road, Xi’an, 710004 China
| | - Lin Zhao
- Department of Ophthalmology, the Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, 710004 China
| | - Yi Zhang
- Department of Ophthalmology, the Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, 710004 China
| | - Jianming Wang
- Department of Ophthalmology, the Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, 710004 China
| | - Aiyi Zhou
- Department of Ophthalmology, the Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, 710004 China
| | - Jianchao Wang
- Department of Ophthalmology, the Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, 710004 China
| | - Qian Wu
- School of Public Health, Xi’an Jiaotong University Health Science Center, 76 West Yanta Road, Xi’an, 710061 China
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Mojzis P, Kukuckova L, Majerova K, Ziak P, Piñero DP. Postoperative visual performance with a bifocal and trifocal diffractive intraocular lens during a 1-year follow-up. Int J Ophthalmol 2017; 10:1528-1533. [PMID: 29062771 DOI: 10.18240/ijo.2017.10.08] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 04/21/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens (IOL) during a 12-month follow-up. METHODS Prospective comparative study including 75 eyes of 38 patients (44-70y) undergoing uneventful cataract surgery. Each patient was randomly assigned to one type of IOL, bifocal (35 eyes) or trifocal (40 eyes). Visual, refractive, and contrast sensitivity changes were evaluated in a 12-month follow-up. The binocular defocus curve was also measured at 12mo postoperatively. RESULTS No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities (P≥0.276). Postoperative corrected near visual acuity (33 cm) was significantly better in the trifocal group during all follow-up (P≤0.004) as well as 6-month uncorrected near (P=0.008) and distance-corrected near visual acuities (P=0.016) (33/40 cm). Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group (P<0.001), which was consistent with differences among groups in binocular defocus curve. Differences among groups in contrast sensitivity were minimal, being only significant at 6 months for some low to medium spatial frequencies (P≤0.006). CONCLUSION Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up, with a clear benefit of the trifocal IOL for the intermediate vision.
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Affiliation(s)
- Peter Mojzis
- Premium Clinic, Teplice 41501, Czech Republic.,Eye Department of Regional Hospital in Havlickuv Brod, Havlickuv Brod 58001, Czech Republic
| | - Lucia Kukuckova
- Eye Department of Regional Hospital in Havlickuv Brod, Havlickuv Brod 58001, Czech Republic
| | - Katarina Majerova
- Eye Department of Regional Hospital in Havlickuv Brod, Havlickuv Brod 58001, Czech Republic
| | - Peter Ziak
- Eye Clinic of Jessnius Faculty of Medicine, Martin 41736, Slovakia
| | - David P Piñero
- Premium Clinic, Teplice 41501, Czech Republic.,Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante 03690, Spain
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15
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Jin C, Chen X, Law A, Kang Y, Wang X, Xu W, Yao K. Different-sized incisions for phacoemulsification in age-related cataract. Cochrane Database Syst Rev 2017; 9:CD010510. [PMID: 28931202 PMCID: PMC5665700 DOI: 10.1002/14651858.cd010510.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Age-related cataract is the principal cause of blindness and visual impairment in the world. Phacoemulsification is the main surgical procedure used to treat cataract. The comparative effectiveness and safety of different-sized incisions for phacoemulsification has not been determined. OBJECTIVES The aim of this systematic review was to assess the effectiveness and safety of smaller versus larger incisions for phacoemulsification in age-related cataract. The primary outcome of this review was surgically induced astigmatism at three months after surgery. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 10), MEDLINE Ovid (1946 to 28 October 2016), Embase Ovid (1947 to 28 October 2016), PubMed (1948 to 28 October 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 28 October 2016), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com; last searched 13 May 2013), ClinicalTrials.gov (www.clinicaltrials.gov; searched 28 October 2016), and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp; searched 28 October 2016). We did not use any date or language restrictions in the electronic searches for trials. SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing different-sized incisions in people with age-related cataract undergoing phacoemulsification. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 26 RCTs with a total of 2737 participants (3120 eyes). These trials were conducted in Bosnia and Herzegovina, China, France, India, Italy, Korea, Spain, Switzerland, and Turkey. Half of the 26 trials were conducted in China. We judged all trials as mostly at unclear to low risk of bias. The included RCTs compared four different-sized incisions:<= 1.5 mm, 1.8 mm, 2.2 mm, and approximately 3.0 mm. These incisions were performed using three different techniques: coaxial and biaxial microincision phacoemulsification (C-MICS and B-MICS) and standard phacoemulsification. Not all studies provided data in a form that could be included in this review. Five studies had three arms.Fifteen trials compared C-MICS (2.2 mm) with standard phacoemulsification (about 3.0 mm). Very low-certainty evidence suggested less surgically induced astigmatism in the C-MICS group at three months compared with standard phacoemulsification (mean difference (MD) -0.19 diopters (D), 95% confidence interval (CI) -0.30 to -0.09; 996 eyes; 8 RCTs). There was low-certainty evidence that both groups achieved similar best-corrected visual acuity (MD 0.00 logMAR, 95% CI -0.02 to 0.02; 242 eyes; 3 RCTs). There was low-certainty evidence of little or no difference in endothelial cell loss and central corneal thickness comparing C-MICS with standard phacoemulsification (MD -7.23 cells/mm2, 95% CI -78.66 to 64.20; 596 eyes; 4 RCTs) and (MD -0.68 μm, 95% CI -3.26 to 1.90; 487 eyes; 5 RCTs).Nine trials compared C-MICS (1.8 mm) with standard phacoemulsification (about 3.0 mm). Very low-certainty evidence suggested less astigmatism at three months in the C-MICS group compared with standard phacoemulsification group (MD -0.23 D, 95% CI -0.34 to -0.13; 561 eyes; 5 RCTs). Low-certainty evidence suggested little or no difference in best-corrected visual acuity, endothelial cell loss, and central corneal thickness in the two groups at three months (MD -0.02 logMAR, 95% CI -0.03 to -0.00; 192 eyes; 3 RCTs), (MD 7.56 cells/mm2, 95% CI -67.65 to 82.77; 380 eyes; 5 RCTs), and (MD -1.52 μm, 95% CI -6.29 to 3.25; 245 eyes; 3 RCTs).Six studies compared C-MICS (1.8 mm) with C-MICS (2.2 mm). There was low-certainty evidence that astigmatism, visual acuity, and central corneal thickness were similar in the two groups at three months (MD 0.04 D, 95% CI -0.09 to 0.16; 259 eyes; 3 RCTs), (MD 0.01 logMAR, 95% CI -0.01 to 0.04; 200 eyes; 3 RCTs), and (MD 0.45 μm, 95% CI -2.70 to 3.60; 100 eyes; 1 RCT). Very low-certainty evidence suggested higher endothelial cell loss in the 1.8 mm group (MD 213.00 cells/mm2, 95% CI 11.15 to 414.85; 70 eyes; 1 RCT).Four studies compared B-MICS (<= 1.5 mm) with standard phacoemulsification (about 3.0 mm). Astigmatism was similar in the two groups at three months (MD -0.01 D, 95% CI -0.03 to 0.01; 368 eyes; 2 RCTs; moderate-certainty evidence). There was low-certainty evidence on visual acuity, suggesting little or no difference between the two groups (MD -0.02 logMAR, 95% CI -0.04 to -0.00; 464 eyes; 3 RCTs). Low-certainty evidence on endothelial cell loss and central corneal thickness also suggested little or no difference between the two groups (MD 55.83 cells/mm2, 95% CI -34.93 to 146.59; 280 eyes; 1 RCT) and (MD 0.10 μm, 95% CI -14.04 to 14.24; 90 eyes; 1 RCT).None of the trials reported on quality of life. One trial reported that no participants experienced endophthalmitis or posterior capsule rupture; they also reported little or no difference between incision groups regarding corneal edema (risk ratio 1.02, 95% CI 0.40 to 2.63; 362 eyes). AUTHORS' CONCLUSIONS Phacoemulsification with smaller incisions was not consistently associated with less surgically induced astigmatism compared with phacoemulsification with larger incisions. Coaxial microincision phacoemulsification may be associated with less astigmatism than standard phacoemulsification, but the difference was small, in the order of 0.2 D, and the evidence was uncertain. Safety outcomes and quality of life were not adequately reported; these should be addressed in future studies.
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Affiliation(s)
- Chongfei Jin
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University88 Jiefang RoadHangzhouChina310009
- National Eye Institute, National Institutes of HealthOphthalmic Genetics and Visual Function Branch5635 Fishers LaneRockvilleMarylandUSA20852
- Brookdale University Hospital and Medical CenterDepartment of Internal MedicineOne Brookdale PlazaBrooklynNew YorkUSA11212
| | - Xinyi Chen
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University88 Jiefang RoadHangzhouChina310009
| | - Andrew Law
- Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology615 N. Wolfe StreetBaltimoreMarylandUSA21205
| | - Yunhee Kang
- Johns Hopkins Bloomberg School of Public HealthInternational Health DepartmentBaltimoreMarylandUSA
| | - Xue Wang
- Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology615 N. Wolfe StreetBaltimoreMarylandUSA21205
| | - Wen Xu
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University88 Jiefang RoadHangzhouChina310009
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University88 Jiefang RoadHangzhouChina310009
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16
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Bimanual Microincision Cataract Surgery versus Coaxial Microincision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials and Cohort Studies. J Ophthalmol 2017; 2017:3737603. [PMID: 28912968 PMCID: PMC5587976 DOI: 10.1155/2017/3737603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/24/2017] [Indexed: 11/17/2022] Open
Abstract
PURPOSE This meta-analysis was conducted to compare the intraoperative and postoperative outcomes of bimanual microincision cataract surgery (B-MICS) and coaxial microincision cataract surgery (C-MICS). METHODS Three databases were searched for papers that compared B-MICS and C-MICS from inception to June 2016. The following intraoperative and postoperative outcomes were included in the final meta-analysis: ultrasound time (UST), effective phacoemulsification time (EPT), balanced salt solution use (BSS use), mean surgery time, best-corrected visual acuity (BCVA), central corneal thickness (CCT), and increased CCT. RESULTS There were no statistically significant differences in mean surgery time, UST, BSS use, BCVA, CCT, or increased CCT (one subgroup at postoperative day 7-8 and another subgroup at postoperative day 30). However, there was less EPT needed during surgery (p < 0.01) and lower levels of increased CCT at postoperative day 1 (p = 0.02) in the B-MICS group compared with the C-MICS group. CONCLUSIONS The EPT was shorter and increased CCT was less at postoperative day 1 in the B-MICS group. There were no statistically significant differences in other intraoperative and postoperative outcomes between the B-MICS group and the C-MICS group. B-MICS is an efficient and safe cataract surgery procedure.
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17
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Theodoulidou S, Asproudis I, Athanasiadis A, Kokkinos M, Aspiotis M. Comparison of surgically induced astigmatism among different surgeons performing the same incision. Int J Ophthalmol 2017; 10:1004-1007. [PMID: 28730095 DOI: 10.18240/ijo.2017.06.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 12/29/2016] [Indexed: 11/23/2022] Open
Abstract
To compare surgically induced astigmatism (SIA) of different surgeons, who perform the same main incision. Two hundred and seventy eyes underwent cataract surgery with phacoemulsification by four different surgeons (A, B, C, and D). A 3-step, 3.0 mm, superotemporal for the right eye and superonasal for the left eye clear corneal incision was performed. A comparison in SIA among A, B, C and D surgeon was made. No significant difference was found in SIA at both first and sixth postoperative month between different surgeons (P>0.05). SIA is more dependent on incisional characteristics and preoperative astigmatism and less on the surgeon.
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Affiliation(s)
- Sofia Theodoulidou
- University Eye Clinic, Medical School of Ioannina, Ioannina 45110, Greece
| | - Ioannis Asproudis
- University Eye Clinic, Medical School of Ioannina, Ioannina 45110, Greece
| | | | - Michael Kokkinos
- Ophthalmology Clinic, General Hospital of Rhodes, Rhodes 85100, Greece
| | - Miltiadis Aspiotis
- University Eye Clinic, Medical School of Ioannina, Ioannina 45110, Greece
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18
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Kunita D, Inoue M, Itoh Y, Matsuki N, Nagamoto T, Hirakata A. Effects of optical diameter of intraocular lenses with intrascleral fixation on higher-order aberrations. BMC Ophthalmol 2017; 17:82. [PMID: 28578676 PMCID: PMC5457586 DOI: 10.1186/s12886-017-0478-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/26/2017] [Indexed: 11/17/2022] Open
Abstract
Background Intrascleral fixation of an intraocular lens (IOL) is used in eyes that lack capsular support. The aim of the study is to determine whether a larger optical diameter IOL will decrease the higher-order aberrations (HOAs) when the haptics are extended for intrascleral fixation than a smaller diameter IOL. Methods Three-piece acrylic IOLs with 6.0 mm optics (X-60, VA-60BBR) and 7.0 mm optics (X-70, VA-70 AD) were fixed at lengths of 13, 14, 15, 16, or 17 mm. A wavefront analyzer was used to measure the HOAs within the central 3.0 and 5.2 mm optic diameter. Results The astigmatic aberration within the central 5.2 mm was greater than that within the central 3.0 mm for all IOLs. The HOAs increased significantly with an extension of the IOLs with both optical diameters (P < 0.001). The coma aberration within the central 5.2 mm was greater than that within the central 3.0 mm but it did not increase with an extension of the haptics. The astigmatic aberration of the X-60 IOL was significantly greater than that of the X-70 only at an extension of 17 mm. The astigmatic aberration of the VA-70 AD was not significantly different from that of the VA-60BBR. The cylindrical power changed from 0.047 D in the X-60 to 0.118 D in the VA-70 AD when the IOLs were extended from 13 to 17 mm. Conclusion When three-piece IOLs are highly extended for intrascleral fixation, the astigmatic aberration increases significantly. However, IOLs with 7 mm optics do not have less astigmatic and coma aberrations than IOLs with 6 mm optics.
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Affiliation(s)
- Daisuke Kunita
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Makoto Inoue
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Yuji Itoh
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Naoko Matsuki
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Toshiyuki Nagamoto
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Akito Hirakata
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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Park Y, Kim HS. Torsional and flattening effect on corneal astigmatism after cataract surgery: a retrospective analysis. BMC Ophthalmol 2017; 17:10. [PMID: 28178925 PMCID: PMC5299668 DOI: 10.1186/s12886-017-0399-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 01/09/2017] [Indexed: 11/10/2022] Open
Abstract
Background To evaluate the torsional and flattening effect of steep meridian incisions and influence of posterior corneal astigmatism (PCA) on total corneal astigmatism (TCA) after cataract surgery. Methods One hundred thirty-two eyes underwent cataract surgery with steep meridian 2.2 mm microcoaxial and 2.85 mm conventional clear corneal incisions. Eyes were divided into with-the-rule (WTR) astigmatism and against-the-rule (ATR) astigmatism groups depending on the steeper meridian and measured with autokeratorefractor and Pentacam® before surgery, at 1 day, 1 week, 1 and 2 months postoperatively. Polar vector analysis was used to evaluate torsional effect of steep meridian incisions. Results A decrease in astigmatic polar value (AKP) (+0) was observed in both keratometric and total astigmatism (TA) after 1 and 2 months, although the decrease was only statistically significant in TA (p < 0.05). The AKP(+45) was more significant in the conventional group than the microcoaxial group at 2 months postoperatively (p < 0.05, respectively). There was a significant correlation between corneal thickness of the superior quadrant and PCA in the WTR group (p = 0.028). In eyes with anterior corneal astigmatism smaller than 0.55D of WTR astigmatism and PCA greater than 0.35D of WTR astigmatism showed greater shifting of steep axis and also increment of refractive cylinder powers. Conclusions In eyes with superior corneal thickness greater than 714.5 μm and PCA greater than 0.35D of WTR astigmatism, steep meridian incision may cause a significant torsional effect and off-steep meridian change, contributing to an increment of postoperative residual manifest astigmatism after cataract surgery.
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Affiliation(s)
- Yuli Park
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 62 Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713, Korea
| | - Hyun Seung Kim
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 62 Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713, Korea.
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Belkin A, Abulafia A, Michaeli A, Ofir S, Assia EI. Wound temperature profiles of coaxial mini-incisionversussleeveless microincision phacoemulsification. Clin Exp Ophthalmol 2016; 45:247-253. [DOI: 10.1111/ceo.12851] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 10/04/2016] [Accepted: 10/05/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Avner Belkin
- Department of Ophthalmology; Meir Medical Center; Kfar Saba Israel
| | - Adi Abulafia
- Department of Ophthalmology; Meir Medical Center; Kfar Saba Israel
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
- Ein Tal Eye Center; Tel Aviv Israel
| | - Adi Michaeli
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
- Ein Tal Eye Center; Tel Aviv Israel
- Department of Ophthalmology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - Shay Ofir
- Department of Ophthalmology; Meir Medical Center; Kfar Saba Israel
| | - Ehud I Assia
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
- Ein Tal Eye Center; Tel Aviv Israel
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Tetikoğlu M, Yeter C, Helvacıoğlu F, Aktaş S, Sağdık HM, Özcura F. Effect of Corneal Incision Enlargement on Surgically Induced Astigmatism in Biaxial Microincision Cataract Surgery. Turk J Ophthalmol 2016; 46:99-103. [PMID: 27800270 PMCID: PMC5076300 DOI: 10.4274/tjo.52386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 06/30/2015] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To evaluate surgically induced astigmatism (SIA) in biaxial microincision cataract surgery with enlargement of one corneal incision during intraocular lens implantation (IOL). MATERIALS AND METHODS Data from 683 eyes with cataract that underwent biaxial microincision cataract surgery and IOL were retrospectively analyzed. The operated eyes were divided into 4 groups defined by final corneal incision length after IOL implantation. There were 83 eyes with 1.6 mm corneal incisions (group 1) and 200 eyes in each of the 2, 2.4, and 2.8 mm corneal incision groups (groups 2, 3 and 4, respectively). SIA was assessed using preoperative and postoperative keratometric values at one month. RESULTS The mean magnitude of SIA was 0.83±0.4 D in group 1, 0.93±0.5 D in group 2, 1.03±0.6 D in group 3 and 1.04±0.7 D in group 4. The SIA showed statistically significant differences between the four groups (p=0.05). Pairwise group comparisons revealed significant differences between groups 1 and 3 and groups 1 and 4 (p=0.005). CONCLUSION Biaxial microincision cataract surgery with an incision size of 1.6 mm resulted in the least SIA. Enlargement of the corneal incision beyond 2.0 mm during IOL implantation led to significant increases in SIA. We believe that with the development and dissemination of IOLs which can be inserted through small corneal incisions, biaxial microincision cataract surgery will be the best choice to prevent SIA and increase visual acuity.
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Affiliation(s)
- Mehmet Tetikoğlu
- Dumlupınar University Faculty of Medicine, Department of Ophthalmology, Kütahya, Turkey
| | - Celal Yeter
- Başakşehir State Hospital, Ophthalmology Clinic, İstanbul, Turkey
| | - Fırat Helvacıoğlu
- Maltepe University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | - Serdar Aktaş
- Dumlupınar University Faculty of Medicine, Department of Ophthalmology, Kütahya, Turkey
| | - Hacı Murat Sağdık
- Dumlupınar University Faculty of Medicine, Department of Ophthalmology, Kütahya, Turkey
| | - Fatih Özcura
- Dumlupınar University Faculty of Medicine, Department of Ophthalmology, Kütahya, Turkey
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Leon P, Umari I, Mangogna A, Zanei A, Tognetto D. An evaluation of intraoperative and postoperative outcomes of torsional mode versus longitudinal ultrasound mode phacoemulsification: a Meta-analysis. Int J Ophthalmol 2016; 9:890-7. [PMID: 27366694 DOI: 10.18240/ijo.2016.06.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 08/18/2015] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate and compare the intraoperative parameters and postoperative outcomes of torsional mode and longitudinal mode of phacoemulsification. METHODS Pertinent studies were identified by a computerized MEDLINE search from January 2002 to September 2013. The Meta-analysis is composed of two parts. In the first part the intraoperative parameters were considered: ultrasound time (UST) and cumulative dissipated energy (CDE). The intraoperative values were also distinctly considered for two categories (moderate and hard cataract group) depending on the nuclear opacity grade. In the second part of the study the postoperative outcomes as the best corrected visual acuity (BCVA) and the endothelial cell loss (ECL) were taken in consideration. RESULTS The UST and CDE values proved statistically significant in support of torsional mode for both moderate and hard cataract group. The analysis of BCVA did not present statistically significant difference between the two surgical modalities. The ECL count was statistically significant in support of torsional mode (P<0.001). CONCLUSION The Meta-analysis shows the superiority of the torsional mode for intraoperative parameters (UST, CDE) and postoperative ECL outcomes.
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Affiliation(s)
- Pia Leon
- University Eye Clinic of Trieste, Ospedale Maggiore, Trieste 34125, Italy
| | - Ingrid Umari
- University Eye Clinic of Trieste, Ospedale Maggiore, Trieste 34125, Italy
| | - Alessandro Mangogna
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Andrea Zanei
- University Eye Clinic of Trieste, Ospedale Maggiore, Trieste 34125, Italy
| | - Daniele Tognetto
- University Eye Clinic of Trieste, Ospedale Maggiore, Trieste 34125, Italy
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Cavallini GM, Verdina T, Forlini M, Volante V, De Maria M, Torlai G, Benatti C, Delvecchio G. Long-term follow-up for bimanual microincision cataract surgery: comparison of results obtained by surgeons in training and experienced surgeons. Clin Ophthalmol 2016; 10:979-87. [PMID: 27307701 PMCID: PMC4888734 DOI: 10.2147/opth.s103540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose To determine the efficacy of bimanual microincision cataract surgery (B-MICS) performed by surgeons in training, evaluating clinical results, posterior capsule opacification (PCO) incidence, and clear corneal incision (CCI) architecture in a long-term follow-up and comparing results with those obtained by experienced surgeons. Patients and methods Eighty eyes of 62 patients operated on by three surgeons in training who used B-MICS technique for the first time were included in the study (Group A). Eighty eyes of 59 patients who underwent B-MICS by three experienced surgeons were included as a control group (Group B). Best corrected visual acuity, astigmatism, corneal pachymetry, and endothelial cell count were evaluated before surgery and at 1 month and 18 months after surgery. Anterior segment optical coherence tomography images were obtained to study the morphology of CCIs. PCO incidence was evaluated using EPCO2000 software. Results Out of 160 surgeries included in the study, mean best-corrected visual acuity improvement at 18 months was 0.343±0.246 logMAR for Group A, and 0.388±0.175 logMAR for Group B, respectively. We found no statistically significant induced astigmatism nor corneal pachymetry changes in either group, while we noticed a statistically significant endothelial cell loss postoperatively in both groups (P<0.05). In Group A, mean PCO score was 0.163±0.196, while for Group B, it was 0.057±0.132 (P=0.0025). Mean length and inclination of the CCIs for Group A and Group B were, respectively, 1,358±175 µm and 1,437±256 µm and 141.8°±6.4° and 148.7°±5.1°. As regards corneal architecture in the 320 CCIs considered, we found posterior wound retractions and endothelial gaps, respectively, 9.8% and 11.6% for Group A and 7.8% and 10.8% for Group B. Conclusion B-MICS performed by surgeons in training is an effective surgical technique even when assessed after a long-term follow-up. PCO incidence resulted in being higher for less experienced surgeons. Corneal incisions were shorter and less angled in surgeons in training in comparison with results obtained by expert surgeons.
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Affiliation(s)
- Gian Maria Cavallini
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Verdina
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Matteo Forlini
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Veronica Volante
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Michele De Maria
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giulio Torlai
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Benatti
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giancarlo Delvecchio
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Coaxial Microincision Cataract Surgery versus Standard Coaxial Small-Incision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials. PLoS One 2016; 11:e0146676. [PMID: 26745279 PMCID: PMC4706354 DOI: 10.1371/journal.pone.0146676] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 12/20/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We conducted this meta-analysis to compare the outcomes of coaxial microincision cataract surgery (C-MICS) and standard coaxial small incision cataract surgery (C-SICS). METHODS The outcomes of randomized controlled trials (RCTs) reporting C-MICS and C-SICS were collected from PubMed, Web of Science, and The Cochrane Library in May 2015. The final meta-analysis was conducted on the following intraoperative and postoperative outcomes: ultrasound time (UST), effective phacoemulsification time (EPT), balanced salt solution use (BSS use), cumulative dissipated energy (CDE), mean surgery time, endothelial cell loss percentage (ECL%), best corrected visual acuity (BCVA), increased central corneal thickness (CCT), laser flare photometry values and surgically induced astigmatism (SIA). RESULTS A total of 15 RCTs, involving 1136 eyes, were included in the final meta-analysis. No significant between-group differences were detected in EPT, BSS use, CDE, BCVA, laser flare photometry values or increased CCT. However, the C-MICS group showed less SIA (at postoperative day 7: p<0.01; at postoperative day 30 or more: p<0.01) and greater ECL% (at postoperative day 60 or more: p<0.01), whereas the C-SICS group required a shorter UST (p<0.01). CONCLUSIONS The present meta-analysis suggested that the C-MICS technique was more advantageous than C-SICS in terms of SIA, but C-MICS required a longer UST and induced a higher ECL%. Further studies should be done to confirm our results.
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Microincision versus Standard Corneal Incision Phacoemulsification: Visual Outcome. Optom Vis Sci 2015; 92:796-803. [PMID: 26002004 DOI: 10.1097/opx.0000000000000626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To compare the visual outcome of microincision (2.2 mm) with standard (2.75 mm) corneal incision phacoemulsification. METHODS In this prospective, randomized comparative study, patients with senile cataract and less than 1 diopter (D) of astigmatism were divided into two groups. Group 1 included patients undergoing phacoemulsification with 2.2 mm clear corneal incision and group 2 included those undergoing phacoemulsification with 2.75 mm incision. The steep axis measured on keratometry was marked preoperatively. Phacoemulsification was performed through clear corneal incision on this steep axis. Assessment of visual acuity (distance and near), keratometry, keratometric cylinder, contrast sensitivity by Functional Acuity Contrast Test, and surgically induced astigmatism (SIA) was performed at 1 day, 1 week, and 1, 3, and 6 months. RESULTS Fifty eyes of 50 patients were included in the study (29 were male). There were 25 patients in each group. The mean (±SD) SIA calculated by vector analysis method (Holladay-Cravy-Koch) using keratometry value, at the end of 6 months, was 0.54 (±0.18) D and 0.58 (±0.14) D in groups 1 and 2, respectively (p = 0.27). No significant differences were found in the distance and near uncorrected visual acuity, mean keratometry, keratometric cylinder, contrast sensitivity, and SIA at any follow-up visit between two groups. CONCLUSIONS In patients with less than 1 D astigmatism undergoing phacoemulsification, both 2.2-mm and 2.75-mm clear corneal incisions result in similar postoperative visual outcome in terms of SIA, keratometry, and contrast sensitivity.
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Theodoulidou S, Asproudis I, Kalogeropoulos C, Athanasiadis A, Aspiotis M. The role of sideport incision in astigmatism change after cataract surgery. Clin Ophthalmol 2015; 9:1421-8. [PMID: 26346741 PMCID: PMC4531009 DOI: 10.2147/opth.s86213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To study the changes in corneal astigmatism after cataract surgery when the sideport incision is performed at a predetermined location away from the tunnel incision. SETTING General Hospital of Piraeus "Tzaneio", Attiki, Greece. MATERIALS AND METHODS A total of 333 eyes with corneal astigmatism ≤1.5 diopters (D) underwent cataract surgery. A three-step superotemporal clear corneal incision for the right eye and a superonasal clear corneal incision for the left eye (3.0 mm) was made, while the sideport incision was located at <90°, 90°-110°, and >110°. Keratometric data were measured with corneal topography EyeSys Vista 2000 pre- and postoperatively at the 1st and 6th month. Surgically induced astigmatism was calculated by vector analysis. We noted all cases in which a change >0.5 D in corneal astigmatic power occurred, as well as a change >20° in axis torque, despite axis direction. RESULTS After multiple logistic regression analysis was conducted, cases with >110° distance between the tunnel and sideport incision had 2.22 times (P=0.021) greater likelihood for having changed >0.5 D in astigmatic power at the 1st month and 3.45 times (P=0.031) at the 6th month postoperatively, as compared with cases with a 90°-110° distance between the tunnel and sideport incision. As for the change in the astigmatic axis, cases with <90° distance had a 4.18 times greater likelihood for having a change >20° (P<0.001) (preoperative to 1st month) as compared with cases having 90°-110° of distance. CONCLUSION For surgeons that operate only from the superior position, we propose that in order to produce an incision that is as "astigmatically neutral" as possible, they should perform the sideport incision at a 90°-110° distance.
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Affiliation(s)
- Sofia Theodoulidou
- Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece
| | - Ioannis Asproudis
- Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece
| | | | | | - Miltiadis Aspiotis
- Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece
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Cavallini GM, Volante V, Verdina T, Forlini M, Bigliardi MC, De Maria M, Torlai G, Delvecchio G. Results and complications of surgeons-in-training learning bimanual microincision cataract surgery. J Cataract Refract Surg 2014; 41:105-15. [PMID: 25532638 DOI: 10.1016/j.jcrs.2014.04.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/06/2014] [Accepted: 04/11/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate visual outcomes and complications of bimanual microincision cataract surgery performed by surgeons in training. SETTING Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy. DESIGN Prospective case series. METHODS The corrected distance visual acuity (CDVA), astigmatism, corneal pachymetry, and endothelial cell count were evaluated before and 7 and 30 days after bimanual MICS performed by surgeons in training. Intraoperative and postoperative complications were also recorded. RESULTS Three surgeons in training performed bimanual MICS in 150 eyes of 131 patients. There were 18 intraoperative complications (12.0%) (10 iris traumas [6.6%]; 4 capsule ruptures without vitreous loss [2.7%]; 3 capsule ruptures with vitreous loss [2.0%]; 1 intraocular lens [IOL] implantation in the sulcus due to zonular laxity [0.7%]). There were 5 postoperative complications (3.3%) (2 iris prolapses [1.3%]; 1 IOL loop malposition [0.7%]; 1 narrowing of anterior chamber [0.7%]; 1 capsulorhexis phimosis [0.7%]). Thirty days postoperatively, the mean CDVA improvement was 0.53 ± 0.20 (Snellen decimal) (P < .05), the mean decrease in astigmatism was 0.09 ± 0.54 diopter (P = .29), and the mean increase in corneal pachymetry was 7.42 ± 22.01 μm (P = .12). There was statistically significant endothelial cell loss (mean 496.50 ± 469.66 cells/mm(2)) (P < .05). CONCLUSIONS Bimanual MICS performed by surgeons in training was safe and effective. Visual outcomes and complication rates were similar to those reported for coaxial cataract surgery performed by surgeons in training. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Gian Maria Cavallini
- From the Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy.
| | - Veronica Volante
- From the Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Verdina
- From the Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Matteo Forlini
- From the Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Chiara Bigliardi
- From the Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Michele De Maria
- From the Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giulio Torlai
- From the Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giancarlo Delvecchio
- From the Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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von Sonnleithner C, Bergholz R, Gonnermann J, Klamann MK, Torun N, Bertelmann E. Clinical Results and Higher-Order Aberrations after 1.4-mm Biaxial Cataract Surgery and Implantation of a New Aspheric Intraocular Lens. Ophthalmic Res 2014; 53:8-14. [DOI: 10.1159/000364808] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/16/2014] [Indexed: 11/19/2022]
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Alio JL, Grzybowski A, El Aswad A, Romaniuk D. Refractive lens exchange. Surv Ophthalmol 2014; 59:579-98. [DOI: 10.1016/j.survophthal.2014.04.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 04/16/2014] [Accepted: 04/22/2014] [Indexed: 10/25/2022]
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Balestrazzi A, Malandrini A, Martone G, Marigliani D, Caporossi T, Tosi GM. Capsule contraction syndrome with a microincision foldable hydrophilic acrylic intraocular lens: two case reports and review of the literature. Case Rep Ophthalmol 2014; 5:329-35. [PMID: 25473400 PMCID: PMC4241644 DOI: 10.1159/000368344] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Here we present 2 cases of capsule contraction syndrome (CCS). In both cases, a hydrophilic acrylic Akreos MI60 (Bausch and Lomb) intraocular lens (IOL) was implanted in the capsular bag through microincision cataract surgery, and the literature on the subject is reviewed. Since CCS has been described after the implantation of every IOL type, it is unlikely that the Akreos MI60 chemical and physical properties may cause CCS. When CCS occurs with IOLs composed of increasingly flexible materials that are inserted through incisions of decreasing size, a severe dislocation and deformation of IOL optics and haptics may develop. In both cases illustrated here, Nd:YAG laser anterior capsulotomy was highly effective. Hence, also based on the literature, which reports severe complications as a result of surgical intervention, it is suggested that Nd:YAG laser anterior capsulotomy be the first line of CCS treatment when the luxation of an IOL capsular bag is absent.
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Affiliation(s)
| | - Alex Malandrini
- Department of Ophthalmology, University of Siena, Siena, Italy
| | | | | | | | - Gian Marco Tosi
- Department of Ophthalmology, University of Siena, Siena, Italy
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Bimanual microincision versus standard coaxial small-incision cataract surgery: meta-analysis of randomized controlled trials. Eur J Ophthalmol 2014; 25:119-27. [PMID: 25363858 DOI: 10.5301/ejo.5000521] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE This meta-analysis aimed to evaluate the outcomes of bimanual microincision cataract surgery (B-MICS) through a 1.2- to 1.5-mm incision versus standard coaxial small-incision cataract surgery (C-SICS) through a 2.8- to 3.2-mm incision. METHODS A comprehensive literature search was performed according to the Cochrane Collaboration methodology to identify randomized controlled clinical trials comparing B-MICS with standard C-SICS. Main outcome measures were mean surgical time, mean phacoemulsification power, effective phacoemulsification time, best-corrected visual acuity, surgically induced astigmatism (SIA), mean laser flare photometry values, mean endothelial cell loss, mean increased central corneal thickness, and intraoperative and postoperative complications. RESULTS We identified 14 randomized controlled clinical trials that included 1235 eyes diagnosed with cataracts. No statistically significant differences were detected between the 2 surgical procedures in terms of best-corrected visual acuity (p>0.05), SIA at postoperative 1 month (p = 0.09), laser flare photometry values (p = 0.38), mean endothelial cell loss (p = 0.53), increased central corneal thickness at postoperative 1 month (p = 0.64) or 3 months (p = 0.88), intraoperative complications (p = 0.68), and postoperative complications (p = 0.30); however, statistically significant differences were apparent for mean surgical time (p<0.00001), mean phacoemulsification power (p = 0.008), effective phacoemulsification time (p = 0.0009), SIA at postoperative 3 months (p = 0.02), and increased central corneal thickness at postoperative 1 day (p = 0.04). CONCLUSIONS The meta-analysis shows that the 2 techniques have similar outcomes in terms of final visual acuity and complications. Bimanual MICS has the advantage of less SIA and phaco time whereas C-SICS has the advantage of quicker surgery and less likelihood of early-onset corneal edema.
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Schriefl SM, Stifter E, Menapace R. Impact of low versus high fluidic settings on the efficacy and safety of phacoemulsification. Acta Ophthalmol 2014; 92:e454-7. [PMID: 23782595 DOI: 10.1111/aos.12200] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare intraoperative efficiency and postoperative outcomes of cataract surgery with low and high fluidic settings. METHODS In this prospective, randomized, single-blinded study, 114 eyes of 57 patients were operated with low fluidic settings for one eye (group I) and high fluidic settings for the other eye (group II). Efficiency was judged as metred surgery time, effective phacoemulsification time (EPT) and the amount of balanced salt solution used. Visual outcome and endothelial cell count were determined 1 week and 18 months postoperatively. RESULTS The overall effective phacoemulsification energy was statistically significantly lower (p = 0.003) in group II than in group I. Conquest of the nuclei was achieved with about two-thirds of the energy needed in group I, with 6.59 ± 4.79 effective ultrasound energy compared with 3.99 ± 3.18 (p = 0.001). Overall, about 12% more solution was used in group II than in group I. Median visual acuity was 1.0 for both groups 18 months after surgery. The mean endothelial cell loss was 5.0% in eyes in group I compared with 6.3% in eyes in group II (p > 0.5). CONCLUSION Switching from low fluidic settings with a conventional coaxial 20G phacoemulsification tip to higher fluidic settings with a microcoaxial phaco tip statistically significantly decreases EPT. As only marginally more solution was used with the higher aspiration flow, occlusion must be accomplished more often with high than with low fluidics. Aspiration of the quadrants was therefore more efficient with high fluidic settings. The enhanced pump speed did not result in more tissue damage.
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Affiliation(s)
- Sabine M Schriefl
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
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Alió JL, Soria F, Abdou AA, Peña-García P, Fernández-Buenaga R, Javaloy J. Comparative outcomes of bimanual MICS and 2.2-mm coaxial phacoemulsification assisted by femtosecond technology. J Refract Surg 2014; 30:34-40. [PMID: 24864326 DOI: 10.3928/1081597x-20131217-04] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the efficacy and safety outcomes of bimanual microincision cataract surgery (MICS) versus 2.2-mm coaxial phacoemulsification assisted by Femtosecond LenSx (Alcon-LenSx Inc., Aliso Viejo, CA). METHODS This prospective, randomized, observational, comparative case series comprised 50 cataractous eyes of 50 patients receiving femtosecond laser refractive lens surgery followed by a bimanual MICS technique with two 1-mm incisions (25 patients) (FemtoMICS group) and a coaxial phacoemulsification technique with a 1-mm paracentesis and a 2.2-mm principal incision (25 patients) (FemtoCoaxial group). The main outcomes measures were: ultrasound power, effective phacoemulsification time, postoperative spherical equivalent, higher-order aberrations (corneal and internal), corneal thickness, endothelial cell count, macular thickness, and complications during and after surgery. Both groups were absolutely comparable for all variables preoperatively. RESULTS Mean ultrasound power was 1.8% ± 0.9% for MICS and 14.7% ± 4.9% for 2.2-mm incisions (P < .001). Effective phacoemulsification time values for MICS and 2.2-mm incisions were 1.5 ± 0.9 and 4.5 ± 2.9 sec, respectively (P = .002). Mean postoperative spherical equivalent was −0.26 for FemtoMICS and −0.33 for FemtoCoaxial (P > .05). The efficacy index at 1 month postoperatively was 160.2% for FemtoMICS and 149% for FemtoCoaxial. No significant differences were found in corneal thickness, endothelial cell count, and macular thickness. Complications included posterior capsule rupture (4%) and anterior capsule rupture with no posterior capsule tear (4%) for FemtoMICS and bridges due to incomplete capsulorhexis (4%) for FemtoCoaxial. CONCLUSIONS MICS and coaxial phacoemulsification techniques assisted by the Femtosecond LenSx achieved excellent safety and efficient outcomes. The FemtoMICS technique was surgically and statistically more efficient than the FemtoCoaxial technique.
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Kim YK, Kim YW, Woo SJ, Park KH. Comparison of surgically-induced astigmatism after combined phacoemulsification and 23-gauge vitrectomy: 2.2-mm vs. 2.75-mm cataract surgery. KOREAN JOURNAL OF OPHTHALMOLOGY 2014; 28:130-7. [PMID: 24688255 PMCID: PMC3958628 DOI: 10.3341/kjo.2014.28.2.130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/28/2013] [Indexed: 12/01/2022] Open
Abstract
Purpose The 2.2-mm microincision cataract surgery and small-gauge vitrectomy system is known to result in less surgically-induced astigmatism (SIA) in comparison to conventional surgical methods. We compared the amounts of SIA after combined phacoemulsification and 23-gauge transconjunctival sutureless vitrectomy (23G-TSV) using the 2.2-mm microincision and 2.75-mm standard incision methods. Methods We studied 59 patients (61 eyes) who underwent combined phacoemulsification and 23G-TSV from November 2008 to September 2012. Twenty-eight patients (28 eyes) underwent 2.2-mm microincision coaxial phacoemulsification, and 31 patients (33 eyes) underwent 2.75-mm standard incision phacoemulsification. SIA was evaluated using Naeser's polar method with the simulated keratometric values obtained from corneal topography. Preoperative and 1-week and 1-month postoperative KP (Naeser's polar value along the specific axis) and ΔKP values were compared between the 2.2-mm microincision and 2.75-mm standard incision groups. Results One week after surgery, both groups exhibited similar amounts of SIA (-ΔKP[120], 0.40 ± 0.41 vs. 0.51 ± 0.56 diopters [D]; p = 0.390). One month after surgery, however, the amount of SIA was significantly smaller in the 2.2-mm microincision group as compared to the 2.75-mm standard incision group (-ΔKP[120], 0.31 ± 0.54 vs. 0.56 ± 0.42 D; p = 0.045). Conclusions In combined phacoemulsification with 23G-TSV, 2.2-mm microincision coaxial phacoemulsification induces less SIA than does 2.75-mm standard coaxial phacoemulsification.
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Affiliation(s)
- Yong-Kyu Kim
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yong Woo Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyu Hyung Park
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Femtosecond laser assisted cataract surgery followed by coaxial phacoemulsification or microincisional cataract surgery: differences and advantages. Curr Opin Ophthalmol 2014; 25:81-8. [PMID: 24310376 DOI: 10.1097/icu.0000000000000017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review outlines the advantages and the differences of femtosecond laser-assisted cataract surgery (FLACS) following a coaxial or microincision cataract surgery phacoemulsification in the surgical outcome and greater control of cataract surgery. RECENT FINDINGS FLACS offers minimal tissue damage and extreme precision during corneal incision creation, continuous circular capsulorhexis (CCC) and nuclear fragmentation. It also allows diminishing the mean average ultrasound power to emulsify the nucleus followed by a coaxial or a biaxial procedure. The impact of reduced phacoemulsification energy on the corneal endothelium is an interesting topic that is being investigated. Despite its benefits, this technology has relevant financial issues and a high learning curve. SUMMARY FemtoMICS appears to be surgically and statistically more efficient than the FemtoCoaxial technique and Femtoincisions prove to be stable and do not change the corneal high order aberration significantly with favorable results of the triplanar configuration.
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Torres-Moreno AJ. Faco microcoaxial con ultrasonido longitudinal. REVISTA MEXICANA DE OFTALMOLOGÍA 2014. [DOI: 10.1016/j.mexoft.2014.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Ahn YJ, Kim EC. Change in Central Macular Thickness after 2.2-mm Microincision Coaxial versus 2.75-mm Small Incision Cataract Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.10.1460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ye Jin Ahn
- Department of Ophthalmology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea
| | - Eun Chul Kim
- Department of Ophthalmology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea
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Özyol E, Özyol P. Analyses of surgically induced astigmatism and axis deviation in microcoaxial phacoemulsification. Int Ophthalmol 2013; 34:591-6. [PMID: 24081915 DOI: 10.1007/s10792-013-9858-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 09/15/2013] [Indexed: 11/25/2022]
Abstract
To evaluate surgically induced astigmatism (SIA) and axis deviation after coaxial microincision superotemporal clear corneal phacoemulsification incision in eyes with differently located steep axis. This prospective, comparative study included four groups of 45 eyes with age-related cataracts; each group underwent 2.2-mm superotemporal clear corneal incision (CCI) cataract surgery. The four groups of patients were divided by location of the steep axis. Groups were matched according to symmetry of the steep axis for both right and left eyes as follows--0°-45° of steep axis for right eyes, and 136°-180° for left eyes (group 1); 46°-90° for right eyes and 91°-135° for left eyes (group 2); 91°-135° for right eyes and 46°-90° for left eyes (group 3); and 136°-180° for right eyes and 0°-45° for left eyes (group 4). Outcome measures included changes in mean total astigmatism, SIA, and axis deviation. Astigmatism was measured by manual keratometry readings before surgery and week 1, week 4, week 8, and week 12 postoperatively. SIA was calculated by the vector analysis (Holladay-Cravy-Koch method). The magnitude of mean total astigmatism was lowest in group 3 and highest in group 1 at week 12. SIA was 0.39 diopters (D), 0.22 D, 0.17 D, and 0.28 D in group 1, group 2, group 3, and group 4, respectively. The change in astigmatic axis deviation was highest in group 3 (23.6 ± 16.6) (P < 0.05). Axis deviation and SIA were stable after week 4. Planning of CCI on or near the steep axis can help decrease corneal astigmatism.
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Affiliation(s)
- Erhan Özyol
- Department of Ophthalmology, Ünye State Hospital, Ordu, Turkey,
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Jeong JH, Lee HJ, Lee SH. Comparison of Phacodynamic Effects on Postoperative Corneal Edema Between 2.8 mm and 2.2 mm Microcoaxial Torsional Phacoemulsification. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.5.709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jin Ho Jeong
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
| | - Hye Jin Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
| | - Sun Ho Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
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Luo L, Lin H, Liu Y. Reply. Am J Ophthalmol 2012. [DOI: 10.1016/j.ajo.2012.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Özyol E, Özyol P. The relation between superior phacoemulsification incision and steep axis on astigmatic outcomes. Int Ophthalmol 2012; 32:565-70. [PMID: 22825889 DOI: 10.1007/s10792-012-9612-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 07/10/2012] [Indexed: 10/28/2022]
Abstract
To evaluate the relation between superior phacoemulsification incision and different steep axis on astigmatism outcomes. This prospective, randomized study comprised three groups each with 24 eyes with age-related cataracts and underwent 3.0 mm superior clear corneal incision (CCI). The three groups of the patients were divided by the location of the steep axis. The steep axis was between 0 and 30° in group 1, 31-60° in group 2, 61-90° in group 3. The degree was accepted as the distance from the steep axis to the distal aspect of the wound. Outcome measures were including the changes in mean total astigmatism, surgically-induced astigmatism (SIA), axis deviation, uncorrected visual acuity (UCVA), and best corrected visual acuity (BCVA). Astigmatism was measured by manuel keratometry readings before surgery and day-1, week-1, week-2, week-4 and week-8 postoperatively. The surgically-induced astigmatism was calculated by the vector analysis using the Holladay-Cravy-Koch method. The magnitude of mean total astigmatism was lowest in group 1 and highest in group 3 at 8th week. Surgically-induced astigmatism was 0.52 diopter (D), 0.88 D, 1.03 D in group 1, group 2, and group 3 respectively. The change in SIA was significant in group 1 (P < 0.05). The change in the astigmatic axis deviation was highest in group 1 (31.5 ± 31.3, P < 0.05). The mean UCVA and BCVA were not significant pre and postoperatively between groups (P > 0.05). Axis deviation and SIA were stable after the week-1 and week-2 examinations respectively. Cataract surgery with CCI on or near the steep axis is resulted in decreased SIA and increased axis deviation.
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Affiliation(s)
- Erhan Özyol
- Ünye State Hospital Department of Ophthalmology, Gölevi Mahallesi Çöremez Sokak Anatolia Konakları C/30, 52300 Ünye, Ordu, Turkey.
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Luo L, Lin H, He M, Congdon N, Yang Y, Liu Y. Clinical evaluation of three incision size-dependent phacoemulsification systems. Am J Ophthalmol 2012; 153:831-839.e2. [PMID: 22310081 DOI: 10.1016/j.ajo.2011.10.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 10/22/2011] [Accepted: 10/26/2011] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare the outcomes of cataract surgery performed with 3 incision size-dependent phacoemulsification groups (1.8, 2.2, and 3.0 mm). DESIGN Prospective randomized comparative study. METHODS One hundred twenty eyes of 120 patients with age-related cataract (grades 2 to 4) were categorized according to the Lens Opacities Classification System III. Eligible subjects were randomly assigned to 3 surgical groups using coaxial phacoemulsification through 3 clear corneal incision sizes (1.8, 2.2, and 3.0 mm). Different intraoperative and postoperative outcome measures were obtained, with corneal incision size and surgically induced astigmatism as the main clinical outcomes. RESULTS There were no statistically significant differences in most of the intraoperative and postoperative outcome measures among the 3 groups. However, the mean cord length of the clear corneal incision was increased in each group after surgery. The mean maximal clear corneal incision thickness in the 1.8-mm group was significantly greater than for the other groups at 1 month. The mean surgically induced astigmatism in the 1.8- and 2.2-mm groups was significantly less than that in the 3.0-mm group after 1 month, without significant difference between the 1.8- and 2.2-mm groups. CONCLUSIONS With appropriate equipment, smaller incisions may result in less astigmatism, but the particular system used will influence incision stress and wound integrity, and may thus limit the reduction in incision size and astigmatism that is achievable.
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Affiliation(s)
- Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
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Biaxial microincision cataract surgery versus conventional coaxial cataract surgery: Metaanalysis of randomized controlled trials. J Cataract Refract Surg 2012; 38:894-901. [PMID: 22424804 DOI: 10.1016/j.jcrs.2012.02.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 12/20/2011] [Accepted: 12/20/2011] [Indexed: 11/27/2022]
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Intraoperative performance and postoperative outcome comparison of longitudinal, torsional, and transversal phacoemulsification machines. J Cataract Refract Surg 2012; 38:234-41. [DOI: 10.1016/j.jcrs.2011.08.035] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2011] [Revised: 08/21/2011] [Accepted: 08/23/2011] [Indexed: 11/20/2022]
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Kim TK, Kim MS, Kim EC. One-Year Outcome of Microcoaxial Cataract Surgery Using 1.8 mm and 2.2 mm Incisions Versus that of Conventional Cataract Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.7.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Tai Kyong Kim
- Department of Ophthalmology, Bucheon St. Mary's Hospital, The Catholic University College of Medicine, Bucheon, Korea
| | - Man Soo Kim
- Department of Ophthalmology, Bucheon St. Mary's Hospital, The Catholic University College of Medicine, Bucheon, Korea
| | - Eun Chul Kim
- Department of Ophthalmology, Bucheon St. Mary's Hospital, The Catholic University College of Medicine, Bucheon, Korea
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Can İ, Bayhan HA, Çelik H, Ceran BB. Comparison of corneal aberrations after biaxial microincision and microcoaxial cataract surgeries: a prospective study. Curr Eye Res 2011; 37:18-24. [PMID: 22029714 DOI: 10.3109/02713683.2011.622851] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To compare the effects of biaxial microincision cataract surgery (B-MICS) and microcoaxial cataract surgery (C-MICS) techniques on corneal optical quality. MATERIALS AND METHODS In this prospective study, 40 eyes underwent B-MICS and 40 eyes C-MICS. Corneal aberrations were derived from conversion of the corneal elevation profile into corneal wavefront data with 6.0 mm aperture diameter using Zernike polynomials by corneal topography preoperatively and 1 month postoperatively. Both magnitude and axes of surgically induced corneal aberrations were calculated. RESULTS Mean final incision widths were 1.80 ± 0.09 mm and 1.89 ± 0.11 mm (p = 0.062) in B-MICS and C-MICS groups, respectively. There were no significant changes in total and higher order root mean square in both groups postoperatively. In B-MICS group, all aberration terms were similar, before and after surgery. However, vertical coma (p = 0.002), vertical trefoil (p < 0.001) and primary trefoil (p = 0.042) significantly increased postoperatively in the C-MICS group. Except surgically induced trefoil (p = 0.047), there was no significant difference in all surgically induced corneal aberrations between groups. The axes of the induced trefoil were found to be mostly related and close to the incision site in both groups which was more prominent in the C-MICS group. CONCLUSIONS Microincision cataract surgery techniques performed through sub-1.9 mm clear corneal incisions do not generally degrade optical quality of the cornea while only small amount of higher order aberrations seem to be induced with C-MICS technique.
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Affiliation(s)
- İzzet Can
- Eye Department, Bozok University Faculty of Medicine, Yozgat, Turkey.
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Accuracy of toric intraocular lens implantation in cataract and refractive surgery. J Cataract Refract Surg 2011; 37:1394-402. [DOI: 10.1016/j.jcrs.2011.02.024] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 02/01/2011] [Accepted: 02/03/2011] [Indexed: 11/23/2022]
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Can I, Bayhan HA, Celik H, Bostancı Ceran B. Anterior segment optical coherence tomography evaluation and comparison of main clear corneal incisions in microcoaxial and biaxial cataract surgery. J Cataract Refract Surg 2011; 37:490-500. [PMID: 21333873 DOI: 10.1016/j.jcrs.2010.09.024] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Revised: 09/23/2010] [Accepted: 09/23/2010] [Indexed: 11/28/2022]
Affiliation(s)
- Izzet Can
- Atatürk Training and Research Hospital, 2nd Ophthalmology Department, Ankara, Turkey.
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