Relationship between early structural changes at cornea incision sites and surgical outcomes after phacoemulsification

Evaluating the safety and operability of asymmetric trapezoid and near-square side-port incision in cataract surgery

PURPOSE

To compare the accuracy, safety, and consistency of asymmetric trapezoid and near-square side-port incision in cataract surgery.

SETTING

Aier Eye Hospital of Wuhan University, Wuhan, Hubei Province, China.

DESIGN

Prospective pilot study.

METHODS

This study included patients who underwent phacoemulsification between January 2022 and August 2022. They were divided into Group A and Group B using the random number table method. Group A was given a near-square side-port incision and Group B was given an asymmetric trapezoid side-port incision. We contrasted the differences in incision length, width, and shape; surgical time; and postoperative intraocular pressure (IOP) between the 2 groups.

RESULTS

220 eyes of 220 patients were included. The mean external width of the incision in Group A was much smaller than that in Group B ( P < .01), and the consistency of the incision diameter in Group A was better than that in Group B. There was no statistically significant difference in incision length between the 2 groups ( P = .75). 1 day after surgery, there was no statistically significant difference in incision morphology between the 2 groups ( P = .72). The operating time for Group A was significantly shorter than that of Group B ( P < .01). There was no obvious incision leakage in both groups after surgery, and the IOP was generally elevated after surgery, but there was no significant statistical difference between the 2 groups ( P = .98).

CONCLUSIONS

The present study suggests that a near-square side-port results in better consistency of incision width and shorter surgical time.

Comparison of two one-piece acrylic foldable intraocular lenses: Short-term change in axial movement after cataract surgery and its effect on refraction

Purpose

To compare the change in intraocular lens (IOL) axial movement, corneal power, and postoperative refraction of eyes implanted with two different single-piece, open loop, acrylic foldable IOLs with planar-haptic design: one IOL with hinges vs. one IOL without hinges. The role of IOL axial movement on short-term refractive shift after cataract surgery was also evaluated.

Methods

This retrospective comparative study enrolled consecutive patients who had phacoemulsification with aspheric IOL implantation. The IOL depth (the distance from corneal endothelium to IOL surface) and corneal power were measured via anterior-segment optical coherence tomography at 4 days and 1 month postoperatively. The changes in axial movement of the IOL, corneal power, and manifest refractive spherical equivalent (MRSE) were compared among groups, and the correlations between each lens were evaluated.

Results

IOL with hinges was implanted in 42 eyes of 42 patients and IOL without hinges was implanted in 42 eyes of 42 patients. The change in axial movement between 4 days and 1 month was significantly smaller in the IOL with hinges group than in the IOL without hinges group (p < 0.001). The axial movement of IOL with hinges did not correlate with the MRSE change; however, the forward shift of IOL without hinges correlated with the myopic refractive change (Pearson r = 0.62, p < 0.001).

Conclusion

The postoperative axial movement of IOL was more stable in the IOL with hinges group than the IOL without hinges group between 4 days and 1 month after cataract surgery. Even though the two study IOLs with planar-haptic design are made of similar acrylic materials, other characteristics such as hinge structure may affect IOL stability in the bag.

The disposable bandage soft contact lenses therapy and anterior segment optical coherence tomography for management of ocular graft-versus-host disease

PURPOSE

To identify the ocular surface changes of ocular graft-versus-host disease (GVHD) using anterior segment optical coherence tomography (AS-OCT) and examine the efficacy of disposable bandage soft contact lens (BSCL) treatment in ocular GVHD patients.

METHODS

This study is a prospective, Phase II clinical trial. Nineteen patients diagnosed with chronic GVHD based on the NIH criteria and ocular symptoms of NIH eye score 2 or greater were enrolled. Disposable BSCL was applied to the GVHD-affected eyes with topical antibiotic coverage. Ocular exams, eye symptom surveys, and AS-OCT were performed with signed informed consent. Patients were followed for one to three months.

RESULTS

Thirty-eight eyes of 19 patients with ocular GVHD underwent BSCL treatment in this study. AS-OCT scans were done in 14 out of 19 patients. The mean best-corrected visual acuity at enrollment, 2-week, and 4-week visits was 0.180, 0.128, and 0.163 logMAR, respectively. Twenty-four out of 25 eyes (96 %) that initially presented with conjunctival inflammation, twenty-three out of 30 eyes (76.7 %) that initially presented with punctate epithelial erosion, and 8 out of 15 (53.3 %) eyes that initially presented with filamentous keratopathy showed improvement after wearing BSCL for 2 to 4 weeks. AS-OCT revealed corneal epithelial irregularity, abnormal meibomian gland orifice, and conjunctival hyperemia, in patients with ocular GVHD.

CONCLUSIONS

BSCL treatment provided significant subjective and objective improvements in ocular GVHD patients. Meanwhile, we found that AS-OCT can be a promising diagnostic tool to characterize the ocular surface changes associated with ocular GVHD.