EBOV-RNA test with RT-PCR in ocular fluids of Ebola survivors can help to safely perform cataract surgery

Application of a prechop technique using a reverse chopper in small pupil cataract surgery

Background

To analyze the value of a prechop technique for splitting the nucleus of the lens using a reverse chopper in small-pupil cataract surgeries. A prospective case-control study. Thirty-four cataract patients (34 eyes) who were treated in our center from March 2019 to December 2019 were enrolled and then divided into two groups: small pupil group (18 patients; 18 eyes) and normal pupil group (16 patients; 16 eyes).

Methods

The prechop technique was applied in both groups, and the patients were followed up for three months. The best-corrected visual acuity (BVCA), surgical complications, corneal endothelial cell loss, pupil function, operative time, and cumulative dissipated energy (CDE) were compared between these two groups, and the safety of the nucleus-chopping technique was evaluated. Data were analyzed using the SPSS 23.0 software packages. BVCA, surgical complications, rate of corneal endothelial cell loss, pupil function, operative time, and CDE.

Results

The surgery was smooth in all cases. The operative time, intraoperative ultrasound energy consumption, BVCA, and surgical complications indicated no significant difference between the two groups (all P>0.05). In the small pupil group, BVCA was significantly improved after surgery and achieved its optimal value three months after surgery (χ²=49.38; P=0). The diameter of the pupil was about 3.22 mm in the small pupil group before nucleus chopping. The postoperative pupil morphology was not statistically different from that before surgery (pupil morphology: χ²=0.131; P=0.717); however, the pupillary light reflex was significantly improved after surgery (χ²=8.378; P=0.004), and the pupil diameter was significantly increased (T=-3.494; P=0.003). The rate of corneal endothelial cell loss was higher in small pupil group than in the normal pupil group in the 3rd postoperative month, but the difference was not statistically significant (T=-0.023; P=0.982).

Conclusions

The prechop technique using a reverse chopper in small-pupil cataract surgery occupies a similar operative time, cumulative energy consumption during operation, BVCA, pupil morphology, and rate of corneal endothelial cell loss, comparing with those in normal-pupil cataract surgery. To such a degree, it is a safe, high-efficiency, a simple and easy-to-operate nucleus-chopping technique that can be used in small-pupil cataract surgery.

Optical coherence tomography-based deep learning algorithm for quantification of the location of the intraocular lens

Background

Cataract surgery has been recently developed from sight rehabilitating surgery to accurate refractive surgery. The precise concentration of intraocular lens (IOL) is crucial for postoperative high visual quanlity. The three-dimentional (3D) images of ocular anterior segment captured by optial coherence tomography (OCT) make it possible to evaluate the IOL position in 3D space, which provide insights into factors relavant to the visual quanlity and better design of new functional IOL. The deep learning algorithm potentially quantify the IOL position in an objective and efficient way.

Methods

The region-based fully convolutional network (R-FCN) was used to recogonize and delineate the IOL configuration in 3D OCT images. Scleral spur was identified automatically. Then the tilt angle of the IOL relative to the scleral spur plane along with its decentration with respect to the pupil were calculated. Repeatability and reliability of the method was evaluated by the intraclass correlation coefficient.

Results

After improvement, the R-FCN network recognition efficiency of IOL configuration reached 0.910. The ICC of reliability and repeatability of the method is 0.867 and 0.901. The average tilt angle of the IOL relative to scleral spur is located in 1.65±1.00 degrees. The offsets dx and dy occurring in the early X and Y directions of the IOL are 0.29±0.22 and 0.33±0.24 mm, respectively. The IOL offset distance is 0.44±0.33 mm.

Conclusions

We proposed a practical method to quantify the IOL postion in 3D space based on OCT images and assisted by an algorithm.

Comparison of the accuracy of intraocular lens power calculation formulas for eyes after corneal refractive surgery

Background

In cataract surgery, calculating intraocular lens (IOL) power in patients who have previously received corneal refractive surgery on the same eye presents a clinical challenge. This study aims to compare the accuracy of the Haigis-L, Barrett True-K, and Shammas-PL formulas in predicting the IOL power in eyes following corneal refractive surgery.

Methods

This study analyzed 32 eyes belonging to 28 patients who underwent cataract surgery and IOL implantation after previously undergoing myopic corneal refractive surgery. The IOL power was calculated using the Haigis-L, Barrett True-K, and Shammas-PL formulas, and the accuracy of the three formulas was compared.

Results

The Haigis-L, Barrett True-K, and Shammas-PL formulas had a mean arithmetic IOL prediction error of -0.65, -0.39, and -0.46, respectively. The mean numerical errors of the three formulas were significantly different from zero (P<0.001). The smallest median absolute refraction prediction error (median =0.40) belonged to the Barrett True-K formula, which was significantly smaller than that of the Haigis-L formula (median =0.57, P<0.05) but similar to that of the Shammas-PL formula (median =0.49, P>0.05). There was no significant difference in the percentage of eyes within either ±0.50 D or ±1.00 D of the predicted refraction error across the three formulas.

Conclusions

The Barrett True-K formula can predict IOL power in eyes that have previously undergone myopic corneal refractive surgery better than the Haigis-L formula.