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Akmaz B, Kilic D, Duru N. The safety and efficacy of phacoemulsification surgery in uncomplicated cataracts with and without an ophthalmic-viscosurgical-device. Eur J Ophthalmol 2023; 33:269-277. [PMID: 35895295 DOI: 10.1177/11206721221116701] [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: 01/11/2023]
Abstract
PURPOSE To compare and evaluate the results of phacoemulsification surgery involving and not involving an ophthalmic-viscosurgical-device (OVD). METHODS A prospective, randomized controlled trial included 60 eyes of 60 patients scheduled to receive phacoemulsification surgery. In order of presentation, patients were randomized into two groups to undergo different surgical techniques: the OVD-free group (n = 30) and the OVD group (n = 30). Each patient's operating time, total ultrasonography (U/S) time, cumulative dissipated energy (CDE), aspiration time, and volume of balanced salt solution (BSS) aspirated were recorded. At 1 day, 1 week, and 1 and 3 months postoperation, measurements of endothelial cell density (ECD) and intraocular pressure (IOP), were taken and compared between the groups. RESULTS Total U/S time (p = .567) and CDE (p = .168) were similar between the groups. In the OVD group, operating time (p = .011), aspiration time (p < .001), and volume of BSS aspirated (p < .001) were greater than in the OVD-free group. The change in ECD between the groups was not statistically significant at all visits (p = .433, p = .147, p = .379, p = .534; respectively). Although IOP increased in the OVD group at 1 day postoperation (p = .001), no difference emerged between the groups at 3 months postoperation (p = .121). CONCLUSION Phacoemulsification surgery without an OVD took less time than with the OVD and caused no significant loss in ECD. Surgeons concerned about elevated IOP following cataract surgery should apply the OVD-free method.
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Affiliation(s)
- Berkay Akmaz
- Department of Ophthalmology, 169317Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Deniz Kilic
- Department of Ophthalmology, Health Science University, 147026Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Necati Duru
- Department of Ophthalmology, Ideal Eye Center, Kayseri, Turkey
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Byun ZY, Lee JH, Lee SM, Hwang DDJ. Long-term Analysis of Surgically Induced Astigmatism after Combined Vitrectomy and Cataract Surgery versus Cataract Surgery Alone. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.8.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To compare the long-term changes in surgically induced astigmatism (SIA) in patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together with patients who underwent cataract surgery only.Methods: We retrospectively reviewed SIA changes for 1 year after surgery in patients who received only cataract surgery using phacoemulsification (group 1) and patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together (group 2). Flat keratometry (K1), steep keratometry (K2), and astigmatism axis were measured with automatic keratometry before and after the surgery. Vector analysis was used to calculate SIA at 1, 3, 6, and 12 months postoperatively. We then examined whether the SIA values at each time point were different between the two groups.Results: A total of 86 eyes were included in this study (group 1, n = 45; group 2, n = 41). The mean SIA values calculated at 1, 3, 6, and 12 months after surgery in group 1 were 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, and 0.59 ± 0.33, respectively. In group 2, the values were 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, and 0.61 ± 0.30, respectively. Over time, SIA decreased in both groups (all p < 0.001). There was no significant difference in the mean SIA between the two groups at each follow-up time point after surgery (p = 0.296, p = 0.728, p = 0.361, and p = 0.356, respectively).Conclusions: When 23-gauge sutureless vitrectomy and cataract surgery were performed together, the astigmatism change caused by surgery did not show a significant difference compared with that of the group who received cataract surgery only. Thus, 23-gauge sutureless vitrectomy may not significantly affect corneal astigmatism.
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DIFFERENCES IN REFRACTIVE OUTCOMES BETWEEN PHACOEMULSIFICATION FOR CATARACT ALONE AND COMBINED PHACOEMULSIFICATION AND VITRECTOMY FOR EPIRETINAL MEMBRANE. Retina 2019; 39:1410-1415. [DOI: 10.1097/iae.0000000000002153] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhou D, Sun Z, Deng G. Accuracy of the refractive prediction determined by intraocular lens power calculation formulas in high myopia. Indian J Ophthalmol 2019; 67:484-489. [PMID: 30900579 PMCID: PMC6446621 DOI: 10.4103/ijo.ijo_937_18] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Purpose: Our study was conducted to evaluate and compare the accuracy of the refractive prediction determined by the calculation formulas for different intraocular lens (IOL) powers for high myopia. Methods: This study reviewed 217 eyes from 135 patients who had received cataract aspiration treatment and IOL implantation. The refractive mean numerical error (MNE) and mean absolute error (MAE) of the IOL power calculation formulas (SRK/T, Haigis, Holladay, Hoffer Q, and Barrett Universal II) were examined and compared. The MNE and MAE at different axial lengths (AL) were compared, and the percentage of every refractive error absolute value for each formula was calculated at ±0.25D, ±0.50D, ±1.00D, and ±2.00D. Results: In all, 98 patients were recruited into this study and 98 eyes of them were analyzed. We found that Barrett Universal II formula had the lowest MNE and MAE, SRK/T and Haigis formulas arrived at similar MNE and MAE, and the MNE and MAE calculated by Holladay and Hoffer Q formula were the highest. Barrett Universal II formulas have the lowest MAE among different AL patients, whereas it reached the highest percentage of refractive error absolute value within 0.5D in this study. The MAE of each formula is positively correlated with AL. Conclusion: Barrett Universal II formula rendered the lowest predictive error compared with SRK/T, Haigis, Holladay, and Hoffer Q formulas. Thus, Barrett Universal II formula may be regarded as a more reliable formula for high myopia.
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Affiliation(s)
- Dong Zhou
- Department of Ophthalmology, The Third People's Hospital of Changzhou, Changzhou, Jiangsu Province, China, India
| | - Zhuo Sun
- Department of Ophthalmology, The Third People's Hospital of Changzhou, Changzhou, Jiangsu Province, China, India
| | - Guohua Deng
- Department of Ophthalmology, The Third People's Hospital of Changzhou, Changzhou, Jiangsu Province, China, India
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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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de Araújo RB, Azevedo BMS, Andrade TS, Abalem MF, Monteiro MLR, Carricondo PC. Subconjunctival 0.1% epinephrine versus placebo in maintenance of mydriasis during vitrectomy: a randomized controlled trial. Int J Retina Vitreous 2018; 4:38. [PMID: 30349740 PMCID: PMC6192114 DOI: 10.1186/s40942-018-0142-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/28/2018] [Indexed: 12/20/2022] Open
Abstract
Background Pupil dilation and mydriasis maintenance throughout vitreoretinal surgeries are important to allow satisfactory fundus visualization and reduce risk of complications. The purpose of this study is to evaluate the role of subconjunctival epinephrine 0.1% injection in mydriasis maintenance during vitrectomy. Methods Ninety-nine consecutive patients undergoing vitrectomy were enrolled. All subjects were preoperatively dilated with tropicamide 1%. Each patient was randomly allocated either in the epinephrine or placebo group. In epinephrine group, patients were submitted to a 0.2 cc subconjunctival injection of a 0.1% epinephrine solution just before first incisions. In placebo group, the same procedure was performed with 0.2 cc of saline 0.9%. Horizontal pupil diameter was measured with calipers before and in the end of the procedure. Results Patients in the epinephrine group showed a significantly larger mean pupil diameter in the end of the surgery compared to placebo. There was a significant increase of mean pupil diameter from the beginning to the end of the surgery in such patients. Blood pressure was significantly higher in the epinephrine group than in placebo group. No other adverse effects were noted. Conclusion Subconjunctival epinephrine is effective for maintaining and increasing pupil size during vitrectomy, compared to placebo. Caution should be taken regarding intraoperative blood pressure levels. Trial registration RBR; RBR-3qzhvg; Registered 8 May 2018—Retrospectively registered, http://www.ensaiosclinicos.gov.br/rg/RBR-3qzhvg/.
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Affiliation(s)
- Rafael B de Araújo
- 1Division of Ophthalmology, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Rua Mipibu, 741 apt 1402A, Natal, RN 59014-480 Brazil
| | - Breno M S Azevedo
- 2Division of Ophthalmology, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225, 05403-010 São Paulo, SP Brazil
| | - Thais S Andrade
- 2Division of Ophthalmology, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225, 05403-010 São Paulo, SP Brazil
| | - Maria F Abalem
- 2Division of Ophthalmology, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225, 05403-010 São Paulo, SP Brazil
| | - Mário L R Monteiro
- 2Division of Ophthalmology, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225, 05403-010 São Paulo, SP Brazil
| | - Pedro C Carricondo
- 2Division of Ophthalmology, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225, 05403-010 São Paulo, SP Brazil
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Fan F, Jia Z, Li K, Zhao X, Ma Q. Cataract surgery combined with micro-incision vitrectomy in patients with behcet's disease uveitis. BMC Ophthalmol 2018; 18:158. [PMID: 29954349 PMCID: PMC6022418 DOI: 10.1186/s12886-018-0813-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 06/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study sought to report the outcomes of a combined cataract extraction, intraocular lens (IOL) insertion and micro-incision vitrectomy (MIVS) procedure for the treatment of Behcet uveitis. METHODS This investigation involved the retrospective evaluation of a case series of patients with Behcet uveitis who underwent cataract extraction, IOL insertion and MIVS in a single surgical session at the same institution between January 2013 and November 2016. Outcome measures included visual acuity, inflammatory reaction, systemic anti-inflammatory medications, intraocular pressure (IOP) and complications. RESULTS Seven eyes of seven patients with a mean age of 39.00 ± 5.54 years (range, 32 to 48 years) and a mean follow-up duration of 13.57 ± 5.83 months (range, 6 to 24 months) were studied; five patients with a history of well-controlled uveitis were included. All patients underwent cataract extraction and IOL implantation combined with MIVS. All patients received postoperative steroids, which were slowly tapered during the weeks after surgery. There were no significant complications related to the surgery. Overall, best-corrected visual acuity (BCVA) was improved from log MAR (logarithm of the minimum angle of resolution) 1.67 ± 0.67 preoperatively to log MAR 0.74 ± 0.35 postoperatively; this improvement was statistically significant (p < 0.05). All eyes were deemed quiet at follow-up, and no patients required the escalation of therapy for long-term uveitis control. CONCLUSIONS This retrospective series indicates that a procedure that combines phacoemulsification, IOL implantation and MIVS is a feasible technique for the removal of cataracts and pathologic vitreous in eyes with Behcet uveitis. This approach can restore vision without obvious complications.
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Affiliation(s)
- Fang Fan
- Department of Ophthalmology, Hebei general hospital, Shijiazhuang, Hebei, 050000, People's Republic of China
| | - Zhiyang Jia
- Department of Ophthalmology, Hebei general hospital, Shijiazhuang, Hebei, 050000, People's Republic of China
| | - Kejun Li
- Department of Ophthalmology, Hebei general hospital, Shijiazhuang, Hebei, 050000, People's Republic of China
| | - Xiaobin Zhao
- Department of Ophthalmology, Hebei general hospital, Shijiazhuang, Hebei, 050000, People's Republic of China
| | - Qingmin Ma
- Department of Ophthalmology, Hebei general hospital, Shijiazhuang, Hebei, 050000, People's Republic of China.
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Hamoudi H, Correll Christensen U, La Cour M. Epiretinal membrane surgery: an analysis of 2-step sequential- or combined phacovitrectomy surgery on refraction and macular anatomy in a prospective trial. Acta Ophthalmol 2018; 96:243-250. [PMID: 28926197 DOI: 10.1111/aos.13572] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 07/30/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the impact of combined phacoemulsification-vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology. METHODS In this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery and subsequent pars plana vitrectomy (PPV) (CAT group), (2) PPV and subsequent cataract surgery (VIT group) or (3) phaco-vitrectomy (COMBI group). Examinations were at baseline, one month after each surgery, and at 3 months and 12 months of follow-up. Primary outcome was the RE (the difference between predicted and achieved spherical equivalent); secondary outcomes were best-corrected visual acuity (BCVA), and incidence of cystoid macular oedema (CME) defined as >10% increment of central subfield macular thickness (CSMT). RESULTS Sixty-two eyes were enrolled. The mean RE showed a small myopic shift of -0.36D in all groups 1 month after surgery, decreasing after 12 months to -0.17D. The absolute value of the RE (ARE) ranged 0.49-0.68D after 12 months. In the immediate postoperative period, there was a higher incidence of CME in the CAT group. There was no significant difference in final RE, ARE, BCVA and CSMT between the groups. Four cases (17%) in the CAT group had resolved visual complaints and improved BCVA after cataract surgery resulting in no need for PPV within the follow-up period. CONCLUSION Surgery for idiopathic ERM in phakic eyes with either phaco-vitrectomy or sequential surgery are equal approaches with respect to functional- (RE, BCVA) and anatomical outcomes (CME, CSMT). However, if starting with cataract surgery, 17% of the cases may not need subsequent PPV.
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Affiliation(s)
- Hassan Hamoudi
- Department of Ophthalmology; Rigshospitalet-Glostrup; Copenhagen University Hospital; Glostrup Denmark
| | - Ulrik Correll Christensen
- Department of Ophthalmology; Rigshospitalet-Glostrup; Copenhagen University Hospital; Glostrup Denmark
| | - Morten La Cour
- Department of Ophthalmology; Rigshospitalet-Glostrup; Copenhagen University Hospital; Glostrup Denmark
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