1
|
Toro MD, Milan S, Tognetto D, Rejdak R, Costagliola C, Zweifel SA, Posarelli C, Figus M, Rejdak M, Avitabile T, Carnevali A, Giglio R. Intraoperative Anterior Segment Optical Coherence Tomography in the Management of Cataract Surgery: State of the Art. J Clin Med 2022; 11:jcm11133867. [PMID: 35807152 PMCID: PMC9267602 DOI: 10.3390/jcm11133867] [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: 04/02/2022] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 01/27/2023] Open
Abstract
Background: The introduction of non-invasive diagnostic tools in ophthalmology has significantly reshaped current clinical practice in different settings. Recently, different anterior segment (AS) intraoperative optical coherence tomography (i-OCT) systems have been employed for different interventional procedures including cataract surgery. Materials and Methods: A review on the use of AS i-OCT in the management of cataract surgery, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). The level of evidence according to the Oxford Centre for Evidence-Based Medicine (OCEM) 2011 guidelines, and the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were assessed for all included articles. Results: Out of 6302 articles initially extracted, 6302 abstracts were identified for screening and 32 of these met the inclusion/exclusion criteria for full-text review; 19 articles were excluded. Conclusions: The use of AS i-OCT in cataract surgery, even if only a few studies have a high level or grade of evidence, may represent a useful tool for novel surgeons approaching phacoemulsification but also for expert ones for teaching purposes and to plan and manage complicated cases.
Collapse
Affiliation(s)
- Mario Damiano Toro
- Eye Clinic, Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
| | - Serena Milan
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy; (D.T.); (R.G.)
- Correspondence:
| | - Daniele Tognetto
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy; (D.T.); (R.G.)
| | - Robert Rejdak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
| | - Ciro Costagliola
- Eye Clinic, Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | | | - Chiara Posarelli
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.P.); (M.F.)
| | - Michele Figus
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.P.); (M.F.)
| | - Magdalena Rejdak
- Faculty of Medicine, Medical University of Warsaw, 02091 Warsaw, Poland;
| | - Teresio Avitabile
- Department of Ophthalmology, University of Catania, 95124 Catania, Italy;
| | - Adriano Carnevali
- Department of Ophthalmology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Rosa Giglio
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy; (D.T.); (R.G.)
| |
Collapse
|
2
|
Yeu E, Gomes JAP, Ayres BD, Chan CC, Gupta PK, Beckman KA, Farid M, Holland EJ, Kim T, Starr CE, Mah FS. Posterior lamellar keratoplasty: techniques, outcomes, and recent advances. J Cataract Refract Surg 2021; 47:1345-1359. [PMID: 33769774 DOI: 10.1097/j.jcrs.0000000000000634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/22/2021] [Indexed: 10/21/2022]
Abstract
Over the past 2 decades, posterior lamellar keratoplasty (PLK) has emerged as an alternative to penetrating keratoplasty in the treatment of corneal endothelial disorders. The reasons for this trend include the search for a safer procedure to replace diseased endothelium that provides faster and better visual rehabilitation and reduces the need for postoperative care. Different surgical techniques, surgical instruments, devices, and lasers have been introduced to overcome technical difficulties, thus improving clinical outcomes. Yet, surgeons and eye banks must address the complications and limitations that arise during the transition to these new techniques. This review discusses the most significant aspects of the evolution of PLK, including a detailed description of current techniques and the direction of future treatment for corneal endothelial disease with the use of laser-assisted surgery, bioengineered corneas, cell therapy, and new pharmacologic therapy.
Collapse
Affiliation(s)
- Elizabeth Yeu
- From the Eastern Virginia Medical School and Virgina Eye Consultants, Norfolk, Virginia (Yeu); Department of Ophthalmology, UNIFESP/EPM and Instituto Suel Abujamra, Sao Paulo, Brazil (Gomes); Wills Eye Hospital, Philadelphia, Pennsylvania (Ayres); University of Toronto, Ontario, and the Eye Bank of Canada, Ontario Division, Ontario, Canada (Chan); Duke Eye Center, Durham, North Carolina (Gupta); Comprehensive Eyecare of Central Ohio, Westerville (Beckman); Department of Ophthalmology, Ohio State University, Columbus (Beckman); Gavin Herbert Eye Institute, University of California, Irvine (Farid); Department of Ophthalmology, University of Cincinnati, and Cincinnati Eye Institute, Cincinnati, Ohio (Holland); Duke Eye Center and Duke University School of Medicine, Durham, North Carolina (Kim); Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York (Starr); Scripps Clinic Medical Group, La Jolla, California (Mah)
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Doi A, Akagi T, Tsujikawa A. Successful Treatment of Post-Phacoemulsification Descemet's Membrane Detachment Assessed by Anterior Segment Optical Coherence Tomography: A Case Report. Case Rep Ophthalmol 2021; 12:611-615. [PMID: 34326761 PMCID: PMC8299404 DOI: 10.1159/000517351] [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: 03/05/2021] [Accepted: 05/08/2021] [Indexed: 11/19/2022] Open
Abstract
Descemet's membrane detachment (DMD) is a rare but serious complication of phacoemulsification surgery. A small DMD may resolve spontaneously, but extensive DMD often requires intracameral injection of air, nonexpansile gases, or expansile gases. A 92-year-old man who underwent phacoemulsification and aspiration with intraocular lens placement in the right eye had significantly reduced visual acuity, with a hazy cornea after surgery. Anterior segment optical coherence tomography (AS-OCT) examination revealed extensive DMD throughout the cornea. He was treated with intracameral injection of 20% sulfur hexafluoride. As a result, the Descemet membrane was successfully reattached, and the corneal edema resolved. AS-OCT was helpful in confirming the presence and extent of DMD, provided useful information to determine the appropriate treatment, and was useful for monitoring DMD.
Collapse
Affiliation(s)
- Ayaka Doi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tadamichi Akagi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
4
|
González AL, Silva F, Barrientos R, Paredes F. Descemet's Membrane Detachment: An Intraoperative Complication in Cataract Surgery with Phacoemulsification. Int Med Case Rep J 2020; 13:673-677. [PMID: 33293873 PMCID: PMC7718970 DOI: 10.2147/imcrj.s283770] [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: 09/24/2020] [Accepted: 11/19/2020] [Indexed: 11/23/2022] Open
Abstract
Descemet’s membrane detachment (DMD) is a complication fundamentally associated with cataract surgery, the subclinical presentation being higher than expected. There are many varied treatments, from simple observation to penetrating keratoplasty. We present a case report of a 78-year-old male patient, without comorbidities, who underwent cataract surgery with phacoemulsification plus intraocular lens implantation in the capsular bag of the left eye. During the intraoperative procedure, he presented a DMD (height of 350 um and length of 3 mm in Zone 1 according to the HELP algorithm), managed with adaptive viscoelastic under the soft-shell technique in the same operative act, injection of iso-expansile SF6 (20%) intracameral plus postural positioning for 2 hours carried out 48 hours after surgery plus intensive topical treatment with hypertonic sodium chloride and steroidal anti-inflammatory drugs. At 72 hours after the operation of the application of the gas bubble, he presented with a transparent cornea and a best-corrected visual acuity of 20/80, which finally for his ophthalmological control at 8 weeks presented definitive resolution of the case in the AS-OCT and with a BCVA of 20/30.
Collapse
Affiliation(s)
- Ana Luisa González
- Department of Ophthalmology, Research Department Clínica La Luz, 1148 Lima, Peru
| | - Fermín Silva
- Department of Ophthalmology, Research Department Clínica La Luz, 1148 Lima, Peru
| | - Robinson Barrientos
- Department of Ophthalmology, Research Department Clínica La Luz, 1148 Lima, Peru
| | - Fabricio Paredes
- Department of Ophthalmology, Research Department Clínica La Luz, 1148 Lima, Peru
| |
Collapse
|