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Agard E, Levron A, Billant J, Douma I, Dot C. Comparison of refractive outcomes obtained with two swept-source OCT-based optical biometers after cataract surgery: A study of 152 eyes. J Fr Ophtalmol 2024; 47:104186. [PMID: 38663226 DOI: 10.1016/j.jfo.2024.104186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/05/2023] [Accepted: 11/21/2023] [Indexed: 06/12/2024]
Abstract
PURPOSE To compare two swept-source OCT optical biometers, the Anterion® (Heidelberg Engineering GmbH, Heidelberg, Germany) and the IOLMaster 700® (Carl Zeiss Meditec AG, Jena, Germany), in the analysis of biometric data, intraocular lens (IOL) calculation and postoperative spherical equivalent predictability. METHODS This was a real-life, single-center, retrospective study including 152 eyes of 81 consecutive patients referred for cataract surgery. All patients were examined with the IOLMaster 700® and the Anterion®. Biometric data (axial length [AL], anterior chamber depth [ACD], mean keratometry [Km], K1 [flat keratometry], K2 [steep keratometry] and axis, TK1 [flat total keratometry], TK2 [steep total keratometry], central pachymetry, lens thickness [LT], white-to-white distance [WTW]), IOL calculation with the SRK/T formula, and postoperative refractive outcome at 1 month were compared. RESULTS All biometric measurements were significantly different between the two biometers. Correlations were excellent for AL, pachymetry, ACD, LT and keratometry measurements, and for the IOL calculation (r>0.96, intraclass correlation coefficient=1). The IOL power for emmetropia was similar between both biometers when the SRK/T formula was used (20.84±3.24D versus 20.86±3.29D, P=0.61). The mean postoperative spherical equivalent prediction error calculated using the SRK/T formula was 0.03±0.5D for the IOLMaster 700® versus 0.01±0.47D for the Anterion® (P=0.12). CONCLUSIONS This study showed excellent correlation and agreement for the biometric measurements and the IOL power calculation with the SRK/T formula between both biometers.
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Affiliation(s)
- E Agard
- Department of Ophthalmology, Desgenettes Military Hospital, 108, boulevard Pinel, 69003 Lyon, France.
| | - A Levron
- Department of Ophthalmology, Desgenettes Military Hospital, 108, boulevard Pinel, 69003 Lyon, France
| | - J Billant
- Department of Ophthalmology, Desgenettes Military Hospital, 108, boulevard Pinel, 69003 Lyon, France
| | - I Douma
- Department of Ophthalmology, Desgenettes Military Hospital, 108, boulevard Pinel, 69003 Lyon, France
| | - C Dot
- Department of Ophthalmology, Desgenettes Military Hospital, 108, boulevard Pinel, 69003 Lyon, France; French Military Health Service Academy, Val de Grâce, Paris, France; FEBO (Fellow of European Board of Ophthalmology), France
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Lau J, Koh WL, Ng JS, Lee D, Peh CH, Lam J, Tan KK, Koh V. How can we better evaluate paediatric progression of myopia and associated risk factors? Lessons from the COVID-19 pandemic: A systematic review. Acta Ophthalmol 2024; 102:e257-e271. [PMID: 37786939 DOI: 10.1111/aos.15773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/29/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE During the COVID-19 pandemic, home-based and remote learning-particularly using electronic devices-was rapidly pushed out. Increased near-work, screen time exposure and lack of outdoor time are risk factors that contribute to childhood myopia, but it is difficult to adopt recommendations from prior publications as a consistent limitation in the literature is the heterogeneity of research methodology. This review seeks to systematically evaluate how observational studies published during the pandemic have quantified and measured risk factors and myopia in school-going children and adolescents. METHODS Three scientific databases (PubMed, CINAHL, Scopus) were systematically searched from March 2020 to April 2022. Findings from relevant studies were descriptively summarised in relation to the PICOS-based objective of the review. RESULTS The final sample of 13 studies included research from six countries and comprised 1 411 908 children and adolescents. The majority of studies (N = 10; 76.9%) used spherical equivalent refraction (SER) of -0.5 dioptres or lower as a common definition of myopia. Most studies (77.8%) measuring screen time exposure found it higher during COVID-19 compared to pre-COVID, but only one study used objective measurement of screen time. The average critical appraisal score of the sample was only 66.1%, with a considerable number of studies failing to identify and adjust for potential confounders. CONCLUSION Future studies should consider emergent objective and validated measures of risk factors, account for potential a priori confounders and covariates and ensure more representativeness in the sociodemographic makeup of their samples.
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Affiliation(s)
- Jerrald Lau
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Wei-Ling Koh
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janelle Shaina Ng
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Daphne Lee
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cherie Hui Peh
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janice Lam
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ker-Kan Tan
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Victor Koh
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Zedan R, Farag CS, Gouda J, Awadein A, Elhilali H, Hassanein DH. Outcome of intraocular lens exchange for the management of myopic shift in pseudophakic children. Eur J Ophthalmol 2023:11206721231218299. [PMID: 38055956 DOI: 10.1177/11206721231218299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
PURPOSE To evaluate the visual outcome of intraocular lens (IOL) exchange for the management of myopic shift in pseudophakic children. METHODS The medical records of children who underwent IOL exchange for myopic shift were examined. The preoperative data, operative details and the postoperative outcome were analyzed. RESULTS Twenty-one eyes (16 patients) were identified. Mean age at cataract extraction was 20 ± 26 months (range, 2-84 months). Twelve patients (6 unilateral, 6 bilateral) had primary IOL implantation. Mean age at IOL exchange was 7.3 ± 3.2 years. Mean spherical equivalent (SE) at IOL exchange was -14 ± 5 D (range, -7 to -21 D): Mean SE at IOL exchange was -13.64 ± 4.99 D, -12 ± 1.53 D, and -15.5 ± 4.7 D in unilaterally pseudophakic cases (8 patients), in the eye that underwent unilateral IOL exchange (3 patients) in bilaterally pseudophakic cases, and in bilateral IOL exchange cases (5 patients), respectively. Mean axial length at IOL exchange was 24 ± 1.3 mm (range, 23 to 27 mm). Following IOL exchange, mean SE was reduced to -2 ± 1.8 D (range, -4 to +2.5 D). An average of three logMAR line improvement in the best-corrected visual acuity was observed in 12/16 eyes of patients for whom pre- and post-exchange visual acuity were available, while visual acuity remained unchanged in 4 eyes. Mean logMAR visual acuity improvement was 0.35 and 0.49 in unilateral and bilateral pseudophakic cases, respectively. CONCLUSIONS IOL exchange is a safe procedure that should be considered to improve visual rehabilitation in pseudophakic patients with myopic shift.
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Affiliation(s)
- Rasha Zedan
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Christina S Farag
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Jylan Gouda
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Awadein
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hala Elhilali
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina H Hassanein
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Ugalahi M, Adediran O, Olusanya B, Baiyeroju A. Management of childhood cataract: practice patterns among ophthalmologists in Nigeria. Eye (Lond) 2023:10.1038/s41433-023-02755-x. [PMID: 37749375 DOI: 10.1038/s41433-023-02755-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE To describe the practice patterns for the management of paediatric cataracts among ophthalmologists practising in Nigeria. METHODS A cross-sectional study of fully trained Nigerian ophthalmologists who perform cataract surgery in children aged 16 years and below. An online questionnaire was distributed via e-mail and social media platforms to respondents. Data on socio-demographic characteristics, type, location and years of practice, status and preferred approach to management of childhood cataracts were obtained and analysed. RESULTS A total of 41 ophthalmologists responded that they perform paediatric cataract surgery. Of these, 25 (61.0%) were paediatric ophthalmologists while 7 (17.0%) were general ophthalmologists. Most respondents (92.7%) practise in urban settings and 30 (73.2%) work in tertiary hospitals. Most respondents (90.2%) routinely insert intraocular lenses (IOLs) in children aged 2 years and above while 32 (78.0%) routinely under-correct the IOL power. Thirty-four (82.9%) have an anterior vitrectomy machine, 31 (75.6%) routinely perform posterior capsulotomy and anterior vitrectomy, and 17 (58.5%) routinely perform same-day sequential bilateral cataract surgery. Twenty-six (63.4%) respondents routinely give near correction in aphakic children, while 24 (58.5%) respondents routinely give bifocals in pseudophakic children. Compared to other sub-specialists, paediatric ophthalmologists were 24 times more likely to routinely under-correct IOL power (p = 0.001) and 4 times more likely to routinely correct near vision in aphakic children (0.036) as well as prescribe bifocals for pseudophakic children respectively (0.029). CONCLUSION The practice of paediatric cataract surgery in Nigeria is mainly in line with expected standards, but there is a need for the development of detailed practice guidelines.
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Affiliation(s)
- Mary Ugalahi
- Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | | | - Bolutife Olusanya
- Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.
| | - Aderonke Baiyeroju
- Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
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Mazur R, Wylęgała A, Wylęgała E, Dobrowolski D. Comparative Analysis of Corneal Parameters Performed with GalileiG6 and OCT Casia 2. Diagnostics (Basel) 2023; 13:diagnostics13020267. [PMID: 36673077 PMCID: PMC9857403 DOI: 10.3390/diagnostics13020267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUNDS To compare keratometry (Ks and Kf), astigmatism (Ast.), and the astigmatism axes (Ax.) of the posterior surface of the cornea; the total, central cornea thickness (CCT); and the thinnest corneal thickness (TCT) measured using two different measurement methods. METHODS Patients qualified for cataract surgery at the Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, Katowice, Poland, were included in the study and monitored with the following two devices: OCT-CASIA2 and Dual Scheimpflug Analyzer GalileiG6. Our work was a randomized, prospective study in which compliance with the agreement of measurements between the devices was evaluated using the Bland-Altman method. RESULTS A total of 110 patients (62 females and 48 males) were examined. Overall, 100 eyes of patients that qualified for cataract surgery were enrolled in the study. No statistically significant difference was observed for Total-Ks and Total-Kf. A significant difference was observable for the following parameters: total Ks-ax, total Kf-ax, the total power of astigmatism, and in all parameters of the part of the cornea and corneal thickness (CCT and TCT). CONCLUSIONS The measurements obtained using Casia2 and the Dual Scheimpflug Analyzer GalileiG6 were significantly different and not interchangeable except for total Ks and Kf.
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Affiliation(s)
- Robert Mazur
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence:
| | - Adam Wylęgała
- Pathophysiology Department, School of Medicine, Medical University of Silesia, 40-055 Katowice, Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Dariusz Dobrowolski
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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McLintock C, Niyazmand H, Seo S, Barrett G, Kumar Nilagiri V, Karimian S, McKelvie J. Agreement between a new swept-source ocular coherence tomography and a Placido disc-dual Scheimpflug ocular biometric devices. Eur J Ophthalmol 2022; 33:11206721221143160. [PMID: 36475915 DOI: 10.1177/11206721221143160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE To evaluate the agreement between two biometry devices, the Heidelberg Anterion and the Galilei G6 Lens Professional. METHODS Eyes were scanned with both biometry devices. Analysis of inter-device agreement was conducted for the following metrics: flat (K1), steep (K2) and mean K (Km) for anterior, posterior and total cornea, lens thickness (LT), central corneal thickness (CCT), anterior chamber depth (ACD), white to white (WTW) and axial length (AL). Generalised Estimating Equations were used to account for inter-eye correlation. Bland-Altman analysis was conducted to derive the mean difference (MD) and limits of agreement (LoA) between devices. Differences were deemed clinically significant if they would result in a change in post-operative refraction of 0.25D or more. RESULTS 159 eyes of 91 patients were included. For the anterior cornea, no significant MD was found for K1 (-0.11D) and K2 (-0.10D), although a significant MD was found for Km (-0.10D). For posterior cornea, while there were no significant MDs between devices, the LoAs were wide for both posterior K1(-0.70, 0.68) and posterior K2 (-1.01, 1.29). For total corneal power, significant MDs were found in K1 (0.36D), and Km (0.26D) but not for K2 (0.17D). Significant MDs were found for LT (0.179mm), CCT (-0.005mm), ACD (-0.111mm) and WTW (-0.158mm), but not for AL (-0.021mm, p > 0.05).Conclusion: There are statistically but not clinically significant differences between Anterion and Galilei G6 Lens Professional in anterior Km, LT, CCT, ACD and WTW. Measurements of the posterior and total cornea are not interchangeable between devices.
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Affiliation(s)
- Cameron McLintock
- Department of Ophthalmology, 1966Princess Alexandra hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Hamed Niyazmand
- Division of Optometry, School of Allied Health, Faculty of Health and Medical Sciences, 2720The University of Western Australia, QEII Health Campus, Nedlands, 6009, Western Australia, Australia
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Shiney Seo
- Department of Ophthalmology, 1966Princess Alexandra hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia
| | - Graham Barrett
- 10111Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | | | - Sahar Karimian
- Rockingham Medical Research Centre, Rockingham, Perth, Australia
| | - James McKelvie
- Department of Ophthalmology, 1415University of Auckland, Auckland, New Zealand
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Orazbekov L, Smagulova S, Ruslanuly K. Long-term Results of Congenital Cataract Surgery with Primary Intraocular Lens Implantation: A Case-Control Study of Three Age Groups. J Curr Ophthalmol 2022; 34:290-296. [PMID: 36644457 PMCID: PMC9832465 DOI: 10.4103/joco.joco_245_21] [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: 08/06/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose To analyze the results of ocular refraction at the age of 7 years in children after congenital cataract surgery with intraocular lens (IOL) implantation. Methods A study of ocular biometric data of 143 eyes who underwent lens aspiration with IOL implantation in unilateral (23 eyes) and bilateral (60 eyes) congenital cataracts was performed. All children were divided into groups according to the age categories at the time of surgery: Group A (0-12 months) - 43 eyes; Group B (12-36 months) - 45 eyes; and Group C (older than 36 months) - 55 eyes. An empirical reduction of the implanted IOL power was performed: an undercorrection of 20% in children aged 0 to 36 months and 10% less in children aged 36 to 60 months. Results By age 7 years, the mean elongation ± standard deviation (SD) in Group A was 3.93 ± 1.64 mm, 2.13 ± 0.94 mm in Group B, and 0.95 ± 0.76 mm in Group C (18.7%, 9.5%, and 4.1% of the baseline axial length, respectively). There was no significant difference in axial elongation between unilateral and bilateral congenital cataracts (P = 0.32). The mean absolute refraction error (MAE) at last examination was 3.99 ± 2.12 diopter (D), 2.46 ± 1.48 D, and 1.59 ± 1.31 D in Groups A, B, and C, respectively. In infants younger than 7 months of age, by age 7 years, the mean elongation ± SD was 3.27 ± 2.86 mm (25.5%) and MAE was 3.44 ± 2.1 D. The prevalence of preoperative corneal astigmatism of 1.0 D or more was 48.95%, 2.0 D or more was 27.27%, and 3.0 D or more was 5.6%. There was no significant difference in preoperative corneal astigmatism between unilateral (1.62 ± 0.77 D) and bilateral (1.78 ± 0.90 D) congenital cataracts (P = 0.56, 95% confidence interval = -0.50-0.28). Best-corrected visual acuity (BCVA) more than 20/40 was in 53.49%, 55.55%, and 74.54% in Groups A, B, and C, respectively. Conclusions Although IOL power was calculated in accordance with children's age, at the age of 7 years, there was a different degree of ametropia because of the biometric changes of the growing eye, and a higher rate of ametropia was observed more in the younger age group than in the elder age groups.
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Affiliation(s)
- Lukpan Orazbekov
- First Ophthalmology Department, Kazakh Eye Research Institute, Almaty, Kazakhstan,Address for correspondence: Lukpan Orazbekov, First Ophthalmology Department, Kazakh Eye Research Institute, Tole Bi Street 95a, Almaty 050012, Kazakhstan. E-mail:
| | - Sabina Smagulova
- Department of Postgraduate Education, Kazakh Eye Research Institute, Almaty, Kazakhstan
| | - Kairat Ruslanuly
- Department of Postgraduate Education, Kazakh Eye Research Institute, Almaty, Kazakhstan
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Agreement between two swept-source ocular coherence tomography biometry devices. J Cataract Refract Surg 2022; 48:1107-1112. [PMID: 35333792 DOI: 10.1097/j.jcrs.0000000000000942] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 03/18/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the agreement between two swept-source ocular coherence tomography (SS-OCT) biometry devices, Anterion and IOLMaster 700. SETTING Tertiary referral centre, Brisbane, Australia. DESIGN Prospective comparative study. METHODS Bland Altman analysis was used to assess agreement between devices for flat (K1), steep (K2) and mean (Km) keratometry for anterior, posterior and total cornea, lens thickness (LT), anterior chamber depth (ACD), central corneal thickness (CCT), white to white (WTW) and axial length (AL). Generalised Estimating Equations were used to control for within-patient between-eye correlations. Inter-device differences were considered clinically significant if they were likely to alter the spherical refractive outcome by 0.25D or more. RESULTS 159 eyes of 91 patients (41 male, 50 female) were included. Statistically significant differences were found for K1, K2 and Km for anterior, posterior and total cornea. When Anterion was compared to IOLMaster 700, the mean differences were as follows: anterior K1: -0.17D, anterior K2: -0.18D, anterior Km: -0.17D, posterior K1: -0.38D, posterior K2: -0.36D, posterior Km: -0.37D, total K1: -0.65D, total K2: -0.82D, total Km: -0.74D. The difference in posterior and total K metrics were clinically significant. Statistically significant differences were noted for LT: 0.159mm, CCT: -0.004mm, ACD: 0.054mm and WTW: -0.152mm, although these were not found to be clinically significant. There was no significant difference between devices for AL. CONCLUSION This study found statistically and clinically significant differences for both posterior and total keratometry between Anterion and IOLMaster 700. Posterior and total corneal parameters cannot be considered interchangeable between devices.
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Bhattacharjee H, Buragohain S, Javeri H, Deshmukh S. Optical biometry and influence of media opacity due to cataract on development of axial length in NorthEast Indian paediatric patients- A prospective study. BMC Ophthalmol 2021; 21:374. [PMID: 34686183 PMCID: PMC8539773 DOI: 10.1186/s12886-021-02138-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/28/2021] [Indexed: 11/10/2022] Open
Abstract
AIM To study the influence of media opacity due to cataract on the development of axial length in paediatric patients from North-East India, using optical biometry. METHOD This is a prospective, observational study, including consecutive patients attending the paediatric ophthalmology clinic, over a period of 1 year. Patients with other ocular and systemic diseases, unfit for optical biometry measurements due to dense cataract, nystagmus and strabismus were excluded and rest divided into three groups after proper age matching - 1. Group A (Bilateral cataract) 2. Group B (Unilateral cataract) 3. Group C (Bilateral normal). The axial length of the various groups was analysed using independent sample test (for bilateral cataract group) and paired t-test (for unilateral cataract group). Linear regression analysis between age and axial length was done. RESULTS A total of 177 patients were included.80 cases in Group A (bilateral cataract), 18 cases in Group B (unilateral cataract) and 79 in Group C (bilateral normal) The mean age of the patients in all the groups was 8.88 ± 3.51 years (range: 1-17 years). The bivariate analysis and simple linear regression revealed a statistically significant correlation between age and AL in case of cataractous eyes. (Pearson's coefficient: 0.341, p < 0.001). The mean AL was significantly longer (p = 0.013) in the cataractous eyes (mean = 23.38 ± 2.08 mm) of Group A(bilateral cataract) in the 7-12 years age group as compared to the bilaterally normal eyes (mean AL = 22.57 ± 0.70 mm) of patients in the same age group in Group C. The mean AL of cataractous eyes in group B (unilateral cataract) (mean = 22.46 ± 1.73 mm) as compared to the fellow normal eyes, (mean = 21.87 ± 0.97 mm) was not statistically significant. CONCLUSION Cataractous eyes have an abnormal axial length development. The influence of media opacity due to cataract on development of axial length in paediatric eyes in the North-East Indian population is variable, in line with global data on the same. Although there is some influence of media opacity, the exact nature is not clearly understood and may have a crucial interaction with genetic and other environmental factors. Genetic testing integrated with biometric analysis is recommended for further understanding of the ocular growth and development.
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Affiliation(s)
- Harsha Bhattacharjee
- Sri Sankaradeva Nethralaya, 96 Basistha Road, Saurabh Nagar, Beltola Tiniali, Guwahati, Assam, 781028, India
| | - Suklengmung Buragohain
- Sri Sankaradeva Nethralaya, 96 Basistha Road, Saurabh Nagar, Beltola Tiniali, Guwahati, Assam, 781028, India
| | - Henal Javeri
- Sri Sankaradeva Nethralaya, 96 Basistha Road, Saurabh Nagar, Beltola Tiniali, Guwahati, Assam, 781028, India.
| | - Saurabh Deshmukh
- Sri Sankaradeva Nethralaya, 96 Basistha Road, Saurabh Nagar, Beltola Tiniali, Guwahati, Assam, 781028, India
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Hashemi H, Heydarian S, Khabazkhoob M, Emamian MH, Yekta A, Fotouhi A. Anterior chamber depth measurement using Pentacam and Biograph in children. Clin Exp Optom 2021; 105:582-586. [PMID: 34486933 DOI: 10.1080/08164622.2021.1971043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
CLINICAL RELEVANCE Accurate measurement of the anterior chamber depth is very important. There is no report regarding the agreement between rotating Scheimpflug imaging (Pentacam HR) and biograph (Lenstar LS 900) in children. This study therefore explores the agreement between Pentacam and Biograph in measuring anterior chamber depth in children. BACKGROUND This study aims to determine the agreement between Pentacam and Biograph in measuring anterior chamber depth in children. METHODS The participants were students living in urban and rural areas of Shahroud, Iran, selected through cluster sampling. The students were transported to the examination site to undergo imaging and optometric tests. Pentacam imaging was then conducted, and biograph was used to measure biometric components. In this report, the anterior chamber depth was calculated from the corneal endothelium. RESULTS Of 6624 students selected randomly, 5620 participated in the study. After applying the exclusion criteria, 4882 eyes were included in the final analysis. The mean anterior chamber depth measured by the Pentacam (3.09 ± 0.26 mm) was higher than that of biograph (3.04 ± 0.24 mm) (p < 0.001). The 95% limit of agreement (LOA) between the two devices was -0.19 to 0.09 mm. The variation of the difference between the two devices decreased, LOA became narrower, and the correlation coefficient of the devices increased with ageing. The highest intraclass correlation coefficient was seen among myopic (0.974) participants. The 95% LOA was -0.20 to 0.12 mm in hyperopic, -0.17 to 0.07 mm in myopic and -0.19 to 0.09 mm in emmetropic participants. CONCLUSION The Pentacam and Biograph can be used interchangeably for measuring the anterior chamber depth in children.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Samira Heydarian
- Department of Rehabilitation Science, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Abbasali Yekta
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Chen ZX, Chen JH, Zhang M, Chen TH, Zheng JL, Deng M, Ji YH, Jiang YX. Analysis of axial length in young patients with Marfan syndrome and bilateral ectopia lentis by Z-scores. Ophthalmic Res 2021; 64:811-819. [PMID: 34034266 DOI: 10.1159/000517384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/12/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Ze-Xu Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jia-Hui Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Min Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Tian-Hui Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jia-Lei Zheng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Michael Deng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Ying-Hong Ji
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yong-Xiang Jiang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Sritrakoon N, Karntip W, Niyom S, Khemton S, Pakpiboon P, Wongsirodkul K, Arunsri K, Thayananuphat A. A-scan biometry, phacoemulsification, and foldable intraocular lens implantation in a young orangutan ( Pongo pygmaeus). Open Vet J 2021; 11:121-127. [PMID: 33898293 PMCID: PMC8057203 DOI: 10.4314/ovj.v11i1.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Cataracts are the major cause of visual impairment in animals which can be curable by surgical treatment. Phacoemulsification is the standard technique for cataract treatment that is applied to almost all species with a high success rate. Case Description: A 2-year-old intact female orangutan (Pongo pygmaeus) was presented for the study having bilateral opacity of the lenses, for 2 weeks. Ophthalmic examination revealed mature cataract OU. Ocular biometry measurements using A-scan ultrasonography for appropriate intraocular lens (IOL) refractive power calculation were carried out. Electroretinography was applied to ensure retinal function is intact. The orangutan underwent phacoemulsification OU and +24 diopter IOL implantation OS to restore vision. IOL implantation was not carried out OD because of a posterior capsular tear. Retinoscopy after 3 weeks postoperatively revealed +2.0 diopters OS. The outcome of the cataract surgery was successful during 3 years follow-up. The orangutan lived with other orangutans and was alert with normal behavior such as catching food, climbing trees, and swinging hand over hand from one branch to another. Conclusion: Cataract surgery with phacoemulsification OU and adjusted IOL implantation OD was successful with few complications in this orangutan. Vision was restored with normal behavior, even though an adjusted IOL was inserted in only one eye.
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Affiliation(s)
- Natthanet Sritrakoon
- Ophthalmology Unit, Kasetsart University Veterinary Teaching Hospital, Bangkok, Thailand
| | - Winyu Karntip
- Ophthalmology Unit, Kasetsart University Veterinary Teaching Hospital, Bangkok, Thailand
| | - Sirirat Niyom
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | | | | | | | - Kanyarat Arunsri
- Ophthalmology Unit, Kasetsart University Veterinary Teaching Hospital, Bangkok, Thailand
| | - Aree Thayananuphat
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
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13
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Oh R, Oh JY, Choi HJ, Kim MK, Yoon CH. Comparison of ocular biometric measurements in patients with cataract using three swept-source optical coherence tomography devices. BMC Ophthalmol 2021; 21:62. [PMID: 33504333 PMCID: PMC7839224 DOI: 10.1186/s12886-021-01826-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Precise measurement of ocular biometry is critical for determining intraocular lens power. Newly developed swept-source optical coherence tomography (SS-OCT) - based ocular biometric devices, ANTERION and CASIA2 provide ocular biometric measurements as IOLMaster 700. This study aimed to assess agreement between three devices. METHODS This retrospective comparative study includes patients with cataract who underwent ocular biometric measurements with three devices, ANTERION, CASIA2, and IOLMaster 700, at Seoul National University Hospital, in April 2020. Anterior keratometry, total keratometry, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were the main parameters for the comparison. To assess the agreement between the devices, intraclass coefficient (ICC) and Bland-Altman analysis with 95% limits of agreement (LoA) were used. RESULTS A total of 47 eyes of 29 patients were measured with three devices. Average anterior keratometry showed excellent agreement (ICC ≥ 0.989), and the mean difference was less than 0.1 D. However, the ICC of the total average keratometry ranged from 0.808 to 0.952, and the difference was more than 0.43 D. The AL measured by ANTERION and IOLMaster 700 showed excellent agreement (ICC = 0.999), and the mean difference was 0.005 mm. The ANTERION and IOLMaster 700 did not obtain AL in six (12.8%) and three (6.4%) cases, respectively (P = 0.001 by Fisher's exact test). The CCT, ACD, and LT also showed excellent agreement (ICC > 0.9). CONCLUSIONS The new SS-OCT-based devices, ANTERION, and CASIA2 showed a good agreement with IOLMaster 700 in measuring ocular biometry except for the total keratometry. The AL of ANTERION and IOLMaster 700 showed excellent agreement.
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Affiliation(s)
- Richul Oh
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Joo Youn Oh
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
| | - Hyuk Jin Choi
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
| | - Chang Ho Yoon
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea.
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14
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Sun J, Zhang J, Dai Y, Wan X, Xie L. Cataract surgery contributes to ocular axis growth of aphakic eyes in infants with complex microphthalmos. Medicine (Baltimore) 2020; 99:e22140. [PMID: 32991407 PMCID: PMC7523844 DOI: 10.1097/md.0000000000022140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
To observe the ocular axis, visual acuity and intraocular pressure (IOP) of aphakic eye in infants with congenital cataract and complex microphthalmos after first-stage cataract surgery.This retrospective study included infants with congenital cataract and operated at the Qingdao Eye Hospital between January 2010 and December 2014. The infants were divided into 2 groups: preoperative axial length <18 mm (microphthalmos) or ≥18 mm (controls). Follow-up lasted 24 months; visual acuity, axial length, and IOP were evaluated.There were 28 infants (55 eyes) in the microphthalmos group and 35 (61 eyes) in the control group. The preoperative visual acuity was negative for optokinetic nystagmus, while the postoperative visual acuity was positive for optokinetic nystagmus in both groups. The growth rate was higher in the microphthalmos group (1.4 ± 0.8 vs 0.8 ± 0.4 mm/yr, P < .001 vs controls). The axial length was smaller in the microphthalmos group at all time points compared with the control group (all P < .001). There was no changes in IOP in the microphthalmos group from baseline to 24 months (P = .147), but the IOP was slightly decreased in the control group (P = .015).Cataract surgery may contribute to ocular axis growth in infants with complex microphthalmos.
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Affiliation(s)
- Jinfeng Sun
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao
- Department of Ophthalmology, Yantaishan Hospital, Yantai, Shandong
| | - Jing Zhang
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao
| | - Yunhai Dai
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao
| | - Xiaomei Wan
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao
| | - Lixin Xie
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao
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15
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Khamraeva LS, Narzullaeva DU. [Factors influencing target refraction in children with pseudophakia after extraction of congenital cataract]. Vestn Oftalmol 2020; 136:93-99. [PMID: 32504483 DOI: 10.17116/oftalma202013603193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The article describes the factors affecting the target refraction of pseudophakic eyes of children after extraction of congenital cataracts. The factors include features of the echobiometric parameters of the eye, refraction, comorbidity of congenital cataracts and ocular pathologies, margins of error in calculating strength of the intraocular lens, localization and structure of the artificial lens, as well as correction of obscure or refractive amblyopia in pseudophakic eyes. Development of the algorithm for correction of residual refraction of pseudophakic eyes in children both before and after IOL implantation with consideration of each of those factors currently remains a relevant problem.
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Affiliation(s)
- L S Khamraeva
- Tashkent Pediatric Medical Institute, Tashkent, Republic of Uzbekistan
| | - D U Narzullaeva
- Tashkent Pediatric Medical Institute, Tashkent, Republic of Uzbekistan
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16
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Khokhar SK, Tomar A, Pillay G, Agarwal E. Biometric changes in Indian pediatric cataract and postoperative refractive status. Indian J Ophthalmol 2019; 67:1068-1072. [PMID: 31238413 PMCID: PMC6611230 DOI: 10.4103/ijo.ijo_1327_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose: To prospectively evaluate the biometric changes in Indian pediatric cataract and postoperative refractive status. Methods: A total of 147 patients were recruited into three groups: age <6 months, age between 7 months and 18 months, and age between 19 and 60 months and prospectively observed for 6 months. Exclusion criteria were preterm birth, microphthalmia, microcornea, megalocornea, uveitis, glaucoma, and traumatic or complicated cataract. Axial length and keratometry, the primary outcome measures, were taken preoperatively under general anesthesia before surgery. These children were followed up for 6 months to look for refractive and biometric changes. T-test and linear regression with the logarithm of independent variables were done. Results: All unilateral cataractous eyes (n = 25) and randomly selected bilateral cases (n = 122) were included in the analysis, for a total of 147 eyes. Mean age was 17.163 ± 13.024 months; axial length growth was 0.21, 0.18, 0.06 mm/month, and keratometry decline was 0.083, 0.035, 0.001 D/month in age groups 0–6, 7–18, and 19–60 months, respectively. The visual acuity improved in log MAR from 1.020 to 0.745 at 6 months postoperatively. There was statistically significant (Spearman's correlation coefficient = –0.575, P < 0.001) between age and postoperative refraction. There were no intraocular lens (IOL)-related complications seen in the immediate postoperative period. Peripheral opacification was seen in 102 eyes and central opacification in 1 eye at a 6-month follow-up. Conclusion: Indian eyes have a lower rate of axial length growth and keratometry change in comparison with western eyes implying smaller undercorrection in emmetropic IOL power for Indian pediatric eyes to achieve a moderate amount of hyperopia.
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Affiliation(s)
- Sudarshan Kumar Khokhar
- Unit of Lens, Refractive and Pediatric Cataract, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Ankit Tomar
- Unit of Lens, Refractive and Pediatric Cataract, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Ganesh Pillay
- Unit of Pediatric Ophthalmology, ASG Eye Hospital, Arera Colony, Bhopal, Madhya Pradesh, India
| | - Esha Agarwal
- Unit of Lens, Refractive and Pediatric Cataract, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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17
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Mohammadpour M, Shaabani A, Sahraian A, Momenaei B, Tayebi F, Bayat R, Mirshahi R. Updates on managements of pediatric cataract. J Curr Ophthalmol 2018; 31:118-126. [PMID: 31317088 PMCID: PMC6611931 DOI: 10.1016/j.joco.2018.11.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 11/02/2018] [Accepted: 11/14/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose A comprehensive review in congenital cataract management can guide general ophthalmologists in managing such a difficult situation which remains a significant cause of preventable childhood blindness. This review will focus on surgical management, postoperative complications, and intraocular lens (IOL)-related controversies. Methods Electrical records of PubMed, Medline, Google Scholar, and Web of Science from January 1980 to August 2017 were explored using a combination of keywords: "Congenital", "Pediatric", "Childhood", "Cataract", "Lens opacity", "Management", "Surgery", "Complication", "Visual rehabilitation”, and "Lensectomy". A total number of 109 articles were selected for the review process. Results This review article suggests that lens opacity obscuring the red reflex in preverbal children and visual acuity of less than 20/40 is an absolute indication for lens aspiration. For significant lens opacity that leads to a considerable risk of amblyopia, cataract surgery is recommended at 6 weeks of age for unilateral cataract and between 6 and 8 weeks of age for bilateral cases. The recommended approach in operation is lens aspiration via vitrector and posterior capsulotomy and anterior vitrectomy in children younger than six years, and IOL implantation could be considered in patients older than one year. Most articles suggested hydrophobic foldable acrylic posterior chamber intraocular lens (PCIOL) for pediatrics because of lower postoperative inflammation. Regarding the continuous ocular growth and biometric changes in pediatric patients, under correction of IOL power based on the child's age is an acceptable approach. Considering the effects of early and late postoperative complications on the visual outcome, timely detection, and management are of a pivotal importance. In the end, the main parts of post-operation visual rehabilitation are a refractive correction, treatment of concomitant amblyopia, and bifocal correction for children in school age. Conclusions The management of congenital cataracts stands to challenge for most surgeons because of visual development and ocular growth. Children undergoing cataract surgery must be followed lifelong for proper management of early and late postoperative complications. IOL implantation for infants less than 1 year is not recommended, and IOL insertion for children older than 2 years with sufficient capsular support is advised.
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Affiliation(s)
- Mehrdad Mohammadpour
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirreza Shaabani
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sahraian
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Momenaei
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Tayebi
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Bayat
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mirshahi
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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18
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Koch CR, Kara-Junior N, Serra A, Morales M. Long-term results of secondary intraocular lens implantation in children under 30 months of age. Eye (Lond) 2018; 32:1858-1863. [PMID: 30154574 PMCID: PMC6292907 DOI: 10.1038/s41433-018-0191-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 06/27/2018] [Accepted: 07/27/2018] [Indexed: 11/12/2022] Open
Abstract
Purpose To report the long-term outcome of early secondary intraocular lens (IOL) implantation following congenital cataract extraction in a large number of eyes. Methods Data of aphakic children under 30 months of age who underwent secondary IOL implantation and had at least one year of follow-up after the surgery was reviewed. In all of the patients, a foldable three-piece acrylic IOL was implanted in the ciliary sulcus by the same surgeon using the same technique. The database studied included refractive and visual acuity (VA) outcomes and complications. Results Fifty patients (75 eyes) were included. The average age at the time of cataract extraction was 94.20 ± 44.94 days and 20.7 ± 6.0 months in the secondary IOL implantation. After 82.32 ± 48.91 months, the VA was 0.58 ± 0.35 LogMAR and the spherical equivalent was −2.20 ± 4.19 D. There was a negative correlation between a longer follow-up period and myopia at the SE measured (P = .001). The most frequent complications included glaucoma and corectopia. Performing the secondary IOL implantation ≤ 20 months of age was not a risk factor for glaucoma development (P = 0.095). Conclusion Secondary IOL implantation under 30 months of age is an option for children with unsatisfactory management of the optic treatment. A predictable IOL power calculation and satisfactory visual outcomes compared to results of later secondary IOL implantation are possible.
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Affiliation(s)
- Camila R Koch
- University of São Paulo (USP), São Paulo, Brazil. .,Sant Joan de Déu Hospital, Barcelona, Spain.
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19
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Šimunović M, Paradžik M, Škrabić R, Unić I, Bućan K, Škrabić V. Cataract as Early Ocular Complication in Children and Adolescents with Type 1 Diabetes Mellitus. Int J Endocrinol 2018; 2018:6763586. [PMID: 29755521 PMCID: PMC5883981 DOI: 10.1155/2018/6763586] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/28/2018] [Indexed: 12/19/2022] Open
Abstract
Cataract is a rare manifestation of ocular complication at an early phase of T1DM in the pediatric population. The pathophysiological mechanism of early diabetic cataract has not been fully understood; however, there are many theories about the possible etiology including osmotic damage, polyol pathway, and oxidative stress. The prevalence of early diabetic cataract in the population varies between 0.7 and 3.4% of children and adolescents with T1DM. The occurrence of diabetic cataract in most pediatric patients is the first sign of T1DM or occurs within 6 months of diagnosis of T1DM. Today, there are many experimental therapies for the treatment of diabetic cataract, but cataract surgery continues to be a gold standard in the treatment of diabetic cataract. Since the cataract is the leading cause of visual impairment in patients with T1DM, diabetic cataract requires an initial screening as well as continuous surveillance as a measure of prevention and this should be included in the guidelines of pediatric diabetes societies.
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Affiliation(s)
- Marko Šimunović
- Department of Pediatrics, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
| | - Martina Paradžik
- Department of Ophthalmology, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
| | - Roko Škrabić
- School of Medicine, University of Split, Šoltanska 2, Split, Croatia
| | - Ivana Unić
- Department of Pediatrics, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
| | - Kajo Bućan
- Department of Ophthalmology, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
| | - Veselin Škrabić
- Department of Pediatrics, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
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20
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Abstract
Pediatric cataract is a leading cause of childhood blindness. Untreated cataracts in children lead to tremendous social, economical, and emotional burden to the child, family, and society. Blindness related to pediatric cataract can be treated with early identification and appropriate management. Most cases are diagnosed on routine screening whereas some may be diagnosed after the parents have noticed leukocoria or strabismus. Etiology of pediatric cataract is varied and diagnosis of specific etiology aids in prognostication and effective management. Pediatric cataract surgery has evolved over years, and with improving knowledge of myopic shift and axial length growth, outcomes of these patients have become more predictable. Favorable outcomes depend not only on effective surgery, but also on meticulous postoperative care and visual rehabilitation. Hence, it is the combined effort of parents, surgeons, anesthesiologists, pediatricians, and optometrists that can make all the difference.
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Affiliation(s)
| | - Ganesh Pillay
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Chirakshi Dhull
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Esha Agarwal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Manish Mahabir
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Pulak Aggarwal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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21
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Abstract
Advances in technology have made surgery in children safer and faster. The management of pediatric cataract has made rapid progress in the past decade with the availability of safer anesthesia, newer technique's, more predictable intraocular lens (IOL) power calculation, a better understanding of neurobiology, genetics, amblyopia management, improved IOL designs for preventing visual axis opacification, and adjuvant postoperative care. Modern vitrectomy machines with minimally invasive instruments, radiofrequency, diathermy, and plasma blades help immensely in complicated cases. Preoperative evaluation with ultrasound biomicroscopy and optical coherence tomography (OCT) allows better planning of surgical procedure. The future holds good for stem cell research, customized OCT, and Zepto (precision pulse capsulotomy).
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Affiliation(s)
- Sudarshan Kumar Khokhar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi, India
| | - Ganesh Pillay
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi, India
| | - Esha Agarwal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi, India
| | - Manish Mahabir
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi, India
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22
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Li J, Xia CH, Wang E, Yao K, Gong X. Screening, genetics, risk factors, and treatment of neonatal cataracts. Birth Defects Res 2017; 109:734-743. [PMID: 28544770 DOI: 10.1002/bdr2.1050] [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: 04/12/2017] [Accepted: 04/15/2017] [Indexed: 12/21/2022]
Abstract
Neonatal cataracts remain the most common cause of visual loss in children worldwide and have diverse, often unknown, etiologies. This review summarizes current knowledge about the detection, treatment, genetics, risk factors, and molecular mechanisms of congenital cataracts. We emphasize significant progress and topics requiring further study in both clinical cataract therapy and basic lens research. Advances in genetic screening and surgical technologies have improved the diagnosis, management, and visual outcomes of affected children. For example, mutations in lens crystallins and membrane/cytoskeletal components that commonly underlie genetically inherited cataracts are now known. However, many questions still remain regarding the causes, progression, and pathology of neonatal cataracts. Further investigations are also required to improve diagnostic criteria for determining the timing of appropriate interventions, such as the implantation of intraocular lenses and postoperative management strategies, to ensure safety and predictable visual outcomes for children. Birth Defects Research 109:734-743, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Jinyu Li
- Eye Center, Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, China.,Key Laboratory of Ophthalmology of Zhejiang Province, China
| | - Chun-Hong Xia
- School of Optometry and Vision Science Program, University of California, Berkeley, California, USA
| | - Eddie Wang
- School of Optometry and Vision Science Program, University of California, Berkeley, California, USA
| | - Ke Yao
- Eye Center, Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, China.,Key Laboratory of Ophthalmology of Zhejiang Province, China
| | - Xiaohua Gong
- School of Optometry and Vision Science Program, University of California, Berkeley, California, USA
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Lin H, Lin D, Chen J, Luo L, Lin Z, Wu X, Long E, Zhang L, Chen H, Chen W, Zhang B, Liu J, Li X, Chen W, Liu Y. Distribution of Axial Length before Cataract Surgery in Chinese Pediatric Patients. Sci Rep 2016; 6:23862. [PMID: 27022004 PMCID: PMC4810521 DOI: 10.1038/srep23862] [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: 10/02/2015] [Accepted: 03/15/2016] [Indexed: 12/02/2022] Open
Abstract
Axial length (AL) is a significant indicator of eyeball development, but reports on the overall status of axial development in congenital cataract (CC) patients and its relationship with patient demographics, such as age, sex, and laterality, are rare. We prospectively investigated the AL of 1,586 patients ≤18 years old and undergoing cataract surgery in China from January 2005 to December 2014. Of these 3,172 eyes, a logarithmic correlation between AL and age in CC patients was calculated, and an age of approximately 2 years was found to be a turning point in the growth rate of AL. A considerable variation was observed in CC patients of the same age. Furthermore, 2–6 years old boys had longer AL than girls. The AL of affected eye in unilateral patients was longer than that of the contralateral eye in 2–6 years age group and longer than that of eye in bilateral CC patients in all age groups. These findings indicate that the development of the length of eyeballs in CC patients is influenced by multiple factors in addition to age. A full understanding of the distribution of AL may provide a useful reference for judging the timing of surgery in CC patients.
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Affiliation(s)
- Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Erping Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Li Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Hui Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Wan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Bo Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Jinchao Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Xiaoyan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People´s Republic of China
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Phatak S, Lowder C, Pavesio C. Controversies in intraocular lens implantation in pediatric uveitis. J Ophthalmic Inflamm Infect 2016; 6:12. [PMID: 27009616 PMCID: PMC4805676 DOI: 10.1186/s12348-016-0079-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 03/13/2016] [Indexed: 11/10/2022] Open
Abstract
Cataract is one of the most common and visually debilitating complications of pediatric uveitis. It develops as a consequence of chronic inflammation and steroid use and is seen most often in juvenile idiopathic arthritis (JIA)-associated uveitis. Cataract extraction with intraocular lens (IOL) insertion has been carried out with a measure of success in non-uveitic pediatric eyes, but in cases of uveitis, multiple factors affect the final outcome. Chronic inflammation and its sequelae such as band keratopathy, posterior synechiae, and cyclitic membranes make surgical intervention more challenging and outcome less certain. Postoperative complications like increased inflammation, glaucoma, posterior capsular opacification, retrolental membranes, and hypotony may compromise the visual outcome. Early refractive correction is imperative in pediatric eyes to prevent amblyopia. The use of contact lenses and intraocular lenses in pediatric uveitic eyes were fraught with complications in the past. Surgical interventions such as vitreo-lensectomy followed by contact lens fitting and small incision cataract surgery followed by different types of intraocular lenses have been utilized, and many reports have been published, albeit in small patient groups. This review analyzes and discusses the existing literature on intraocular lens implantation in cases of pediatric uveitic cataract surgery.
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Affiliation(s)
- Sumita Phatak
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK.
| | - Careen Lowder
- Cleveland Clinic Cole Eye Institute, 9500 Euclid Ave, Cleveland, OH, 44106, USA
| | - Carlos Pavesio
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK.,Inflammation and Immunotherapy Theme, National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, London, EC1V 2PD, UK
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