scholarly journals Clinical Characteristics of Intraocular Lens Dislocation in Chinese Han Populations

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Qi Fan ◽  
Xiaoyan Han ◽  
Xiangjia Zhu ◽  
Lei Cai ◽  
Xiaodi Qiu ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Clinical Characteristics ◽  
Time Interval ◽  
Chinese Han ◽  
Open Globe ◽  
Significant Difference ◽  
Pars Plana ◽  
Iol Dislocation

Purpose. To investigate the clinical characteristics of patients with intraocular lens (IOL) dislocation after IOL implantation in Chinese Han populations. Methods. The medical records of patients with IOL dislocation were retrospectively reviewed from January 2007 to December 2017, and a total of 312 patients (male: 231, female: 97) (328 eyes) were included in this study. The axial length (AL), IOL power, and the time interval between cataract surgery and IOL dislocation as well as the ocular conditions associated with IOL dislocation were recorded. The IOL dislocation was classified and graded based on its relationship with the capsule and the position of the dislocated IOL. Results. The mean time between original cataract surgery and IOL dislocation was 5.63 ± 5.13 years; IOL dislocation occurred in up to 56.1% (184 eyes) of the eyes within 5 years. Trauma was found in 136 eyes (41.5%); pars plana vitrectomies were performed in 61 eyes (18.6%), and high myopia was detected in 108 eyes (32.9%). A total of 243 eyes (74.1%) had out-of-the-bag IOL dislocations, while 85 eyes (25.9%) had in-the-bag IOL dislocations. There was a statistically significant difference in the constituent ratio of trauma between in-the-bag dislocation and out-of-the-bag dislocation (Pearson’s chi2 = 33.3992, P<0.001); ocular blunt traumas were significantly higher in in-the-bag dislocations, while open-globe injuries were significantly higher in out-of-the-bag dislocations. A statistically significant difference was found for the ratio of patients with AL longer than 30 mm between in-the-bag dislocation and out-of-the-bag dislocation (Pearson’s chi2 = 9.7355, P<0.002). Conclusions. In Chinese Han populations, the most common IOL dislocation is out-of-the-bag dislocation; the most common risk factors were trauma, long axial length, and eyes undergoing pars plana vitrectomy; a minimum follow-up of 5 years is suggested for IOL dislocation-predisposed eyes undergoing cataract surgery.

scholarly journals Predictive Refractive Error Post Congenital and Developmental Cataract Surgery

2021 ◽  
Vol 17 (2) ◽  
pp. 179
Author(s):  
Eva Imelda ◽  
Feti Karfiati ◽  
Maya Sari Wahyu ◽  
Irawati Irfani ◽  
Primawita Oktarima ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Axial Length ◽  
Prediction Error ◽  
Visual Rehabilitation ◽  
Predictive Error ◽  
Age At Surgery ◽  
Significant Difference ◽  
Developmental Cataract

Abstract: Cataract is one of the leading treatable causes of visual impairment in children. Visual rehabilitation is crucial for the development of good visual function after cataract surgery in children. The research aimd to describe post-operative Predictive Refractive Error (PRE) in congenital and developmental cataracts in Cicendo National Eye Hospital from January 2017 to December 2018. This is a retrospective analytic observational study from medical records. We found 107 eyes of 62 children with congenital and developmental cataracts had had cataract surgery and primary implantation of Intraocular Lens (IOL) in Pediatric Ophthalmology and Strabismus Unit, Cicendo National Eye Hospital. The patients were divided into two groups, with axial length (AXL) of ≤ 24 mm and > 24 mm. The paired t-test was used to compare Predictive Error (PE) in SRK/T, SRK II, and Showa SRK formula. Mean age at surgery was 6.7 ± 4.0 years.  Ninety-five eyes had AXL ≤ 24 mm, and 12 eyes had AXL > 24 mm. Prediction Error from patients with AXL ≤ 24 mm was 0.29 D, and from patients with AXL > 24 mm was 2.40 D in SRK/T formula (P < 0.05). There was no significant difference between PE and Absolute Predictive Error (APE) in SRK/T, SRK II, and Showa SRK in patients with AXL > 24 mm (P > 0.05). SRK/T is the most predictable formula in patients with AXL ≤ 24 mm. There is no significant difference in patients with AXL > 24 mm in all formulas. Keywords: congenital and developmental cataract, axial length, Prediction Error, intraocular lens

scholarly journals Myopic Shift After Intraocular Lens Implantation in Children Less Than Two Years of Age

2018 ◽  
Vol 10 (1) ◽  
pp. 11-15
Author(s):  
Suma Ganesh ◽  
Reena Gupta ◽  
Sumita Sethi ◽  
Chandra Gurung ◽  
Raman Mehta
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Early Years ◽  
P Value ◽  
Group I ◽  
Significant Difference ◽  
Myopic Shift ◽  
Second Year ◽  
Group Ii

Purpose: The purpose of this study was to evaluate the myopic shift over a period of 2 years following implantation of intraocular lens (IOL) in children less than 2 years of age with axial length less than 22 mm.Method: A retrospective analysis of records of children below 2 years of age with axial length less than 22 mm who had undergone cataract surgery with primary IOL implantation over a period of 7 years was undertaken. Mean myopic shift was analyzed at 6 months, in first year, second year and end of 2 years following surgery.Results: Total 40 eyes of 23 children were included (mean age 13.55±7.38 months); with mean myopic shift at end of 2 years -2.35±2.15. Myopic shift in eyes with undercorrection in range of 3-4 D (group-I) and 5-7 D (group-II) was compared using Mann-Whitney test. Mean myopic shift at end of 2 years was -2.93±2.55 in group-I and -1.88±1.77 in group-II (p value not significant). There was no significant difference in myopic shift between two groups at 6 months and 1 year; a borderline significant difference was found in second year (p= 0.04).Conclusion: In our study amount of myopic shift in first two years in children with axial length less than 22 mm is below the expected normal. There was not much significant difference in the myopic shift over a period of 2 years in eyes, which were undercorrected by 3-4 D against those with 5-7 D. Thus aiming for less residual hyperopia by less undercorrection did not increase myopic shift. Thus high-level hyperopic glasses in the early years could be avoided and help in prevention of amblyopia after paediatric cataract surgery.

scholarly journals A comparison of axial length measurement by using applanation A- Scan and IOL master for accuracy of predicting postoperative refraction

2021 ◽  
Vol 7 (3) ◽  
pp. 477-481
Author(s):  
Harish R Trivedi ◽  
Bhavik C Zala ◽  
Nitesh S Pancholi
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Length Measurement ◽  
Power Calculation ◽  
Spherical Equivalent ◽  
Significant Difference ◽  
Group A ◽  
Iol Power ◽  
Group B

The higher cost of IOL master is an issue in developing countries and hence it cannot be widely used for calculation of IOL power in such countries. Thus, the aim of the current study is to evaluate a cheaper alternative for the calculation of IOL power by comparing the axial length measurement obtained using applanation A-scan with that of IOL Master for accuracy of predicting postoperative refraction.A prospective, randomized, comparative study was done with 100 patients who were posted for cataract surgery. The patients were randomly divided into two groups of 50 patients each using computerized random number method. In Group A (n=50) axial length was measured with applanation A-scan and in Group B (n=50) axial length was measured with IOL Master. Before cataract surgery keratometry reading was taken with auto keratometer and intraocular lens (IOL) power calculation was done using SRK 2 formula in all patients. All patients were operated for cataract surgery by phacoemulsification and foldable intraocular lens were implanted in the bag. Postoperatively, best accepted refraction at 8th week was taken and mean spherical equivalent was calculated. 100 patients of cataract were subjected for cataract surgery by phacoemulsification.Corrected spherical equivalent on 8th postoperative week showed: 88% patients in Group A and 96% patients of Group B were within ± 1.00 D.56% patients of Group A and 76% patients of Group B were within ± 0.50 D.There was no statistically significant difference (p &#62; 0.05) in axial length and corrected spherical equivalent between the two groups. There is no extra advantage of IOL Master over applanation A-scan for measuring Axial Length between 21 and 24.50 and predicting post-operative refractive outcome.

scholarly journals Rapid Capsular Contraction with Secondary Intraocular Lens Dislocation Associated with Unspecified Rod-Cone Dystrophy: A Case Report

2018 ◽  
Vol 9 (1) ◽  
pp. 155-159 ◽  
Author(s):  
Jocelyn Lam ◽  
Bradley Sifrig ◽  
Hoon Jung
Keyword(s):  
Case Report ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Cone Dystrophy ◽  
Capsular Contraction ◽  
Intraocular Lens Dislocation ◽  
History Of ◽  
Blurry Vision ◽  
Pars Plana ◽  
Iol Dislocation

Purpose: We report an unusual case of rapid and severe anterior capsular contraction associated with secondary intraocular lens (IOL) dislocation following cataract surgery in a patient with unspecified rod-cone dystrophy. Case Report: A 68-year-old woman with a history of uncharacterized bilateral rod-cone dystrophy presented with blurry vision 1 month after cataract surgery. Best corrected visual acuity was 20/40 in the operative eye. Slit-lamp exam showed severe anterior capsular phimosis limiting view of the fundus. Our patient underwent 2 sessions of Nd:YAG anterior capsulotomy with limited success. Limited anterior vitrectomy was then performed without success due to densely adherent capsular tissue to the anterior surface of the IOL and additional secondary IOL dislocation. She ultimately underwent pars plana vitrectomy, removal of the capsular bag, and IOL exchange with a scleral fixated IOL. Conclusion: Rapid and severe anterior capsular contraction following cataract surgery is rare but appears to be associated with rod-cone dystrophy.

Comparison of Five Intraocular Lens Power Formulas to Predict Postoperative Refraction Accuracy

2021 ◽  
Vol 11 (1) ◽  
pp. 129-134
Author(s):  
Tiecheng Wang ◽  
Shaochong Bu ◽  
Fang Tian ◽  
Hong Zhang
Keyword(s):  
Intraocular Lens ◽  
Axial Length ◽  
Prediction Accuracy ◽  
Short Axis ◽  
Post Surgery ◽  
Age Related ◽  
Large Patient ◽  
Significant Difference ◽  
Hyperopic Shift ◽  
Intraocular Lens Calculation

The present study sought to investigate and compare the accuracy of two third-generation intraocular lens calculation formulas contrasted against three new-generation intraocular lens calculation formulas regarding their ability to predict postoperative refraction following cataract surgery. A retrospective case study following 172 patients (172 eyes) exhibiting age-related cataracts in their eyes who were subject to phacoemulsification between September 2017 and September 2018 at the Department of Cataracts, Tianjin Medical University Eye Hospital, was carried out. Based upon ocular axial length, the sampled patients were grouped into a short axis group (ocular axial length ≤ 22 mm; 17 cases; 17 eyes), a normal axis group (22 mm < ocular axial length ≥ 24.5 mm; 132 cases; 132 patients), and a long axis group (ocular axial length > 24.5 mm; 23 cases; 23 eyes); mean absolute prediction error (MAE) postoperative refraction in each group was determined using five formulas, and the percentage of eyes displaying postoperative myopic shift symptoms, postoperative hyperopic shift symptoms, alongside the percentage of eyes displaying postoperative refractive shift symptoms in the range of (−0.25 to 0.25 D, −0.50 to 0.50 D, −1.00 to 1.00 D), were all calculated following the procedures of the five selected formulas. The MAE of the 172 patient cases was compared within the five selected formulas, and SRK/T possessed the highest prediction accuracy, exhibiting a significant difference from the other four formulas (P < 0.05), with accuracy levels subsequently followed by the Holladay 1 and Barrett Universal II formulas-however, the two formulas lacked a significant difference between them (P > 0.05). In addition, the MAE of the normal axial group was compared and analyzed within the five formulas, with analysis revealing that the SRK/T, Holladay 1, and Barrett Universal II formulas exhibited strong prediction accuracy, with no significant difference present among these three formulas (P > 0.05), and also revealing a significantly difference between the aforementioned formulas and remaining two formulas (P < 0.05). For further analysis, the MAE of the short axis group was compared, and the SRK/T and Haigis (Holladay 1, and Barrett Universal II) demonstrated stronger prediction accuracy when compared to the Olsen formula (P < 0.05). Finally, the MAE of the long axis group was compared, and it was found that the SRK/T and Barrett Universal II formulas exhibits the best prediction accuracy, followed by the Haigis and Holladay 1 formulas, with no significant difference (P > 0.05) between the former two formulas or the latter two. The majority of patients exhibited hyperopic shift post-surgery. Of the five formulas studied, the SRK/T and Barrett Universal II formulas possessed strong accuracy capable of predicting postoperative refraction. However, more long-term observation, including large patient samples, is necessary in order to corroborate our result.

scholarly journals Nd:YAG Capsulotomy after Phacoemulsification in Vitrectomized Eyes: Effects of Pars Plana Vitrectomy on Posterior Capsule Opacification

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Jong Hwa Jun ◽  
Kwang Soo Kim ◽  
Sung Dong Chang
Keyword(s):  
Cataract Surgery ◽  
Medical Records ◽  
Pars Plana Vitrectomy ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Time Interval ◽  
Time Intervals ◽  
Nd:Yag Laser Capsulotomy ◽  
Pars Plana ◽  
Hydrophobic Acrylic

To compare the progression of posterior capsule opacification (PCO) in patients who required Nd:YAG laser capsulotomy following either combined cataract surgery with pars plana vitrectomy (PPV; C-CV), sequential cataract surgery after PPV (S-CV), or cataract surgery alone (CA). The medical records of 321 patients (408 eyes) who underwent Nd:YAG capsulotomy were retrospectively evaluated. The CA group had a significantly longer time interval from cataract surgery to capsulotomy than that of both the CV group(P=0.006)and the S-CV(P=0.013)and C-CV(P=0.042)subgroups when age-matched comparisons were used. CV patients who implanted a hydrophobic acrylic IOL had shorter time intervals than those of CA patients(P=0.028). CV patients had larger hazard of earlier capsulotomy than CA patients (hazard ratio (HR) = 1.337; 95% confidence interval (CI) 1.100–1.625;P=0.004). C-CV and S-CV patients both had larger hazard than CA patients in earlier capsulotomy (HR=1.304; 95%CI=1.007–1.688;P=0.044,HR=1.361; 95%  CI=1.084–1.709;P=0.008, resp.). PCO progresses more rapidly in patients undergoing combined or sequential cataract surgery and PPV than in patients undergoing CA.

scholarly journals Comparison of Astigmatism Correction in Cataract Surgery Between Simultaneous Femtosecond Laser-Assisted Intrastromal Arcuate Keratotomy and Toric Intraocular Lens Implantation

2020 ◽  
Author(s):  
Hye Ji Kwon ◽  
Hun Lee ◽  
Jin Ah Lee ◽  
Jae Yong Kim ◽  
Hungwon Tchah
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Tertiary Care ◽  
Corneal Astigmatism ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Tertiary Care Medical Center ◽  
Significant Difference

Abstract Objectives To compare the efficacy of astigmatic correction between simultaneous femtosecond laser-assisted intrastromal arcuate keratotomy (AK) combined with femtosecond laser-assisted cataract surgery (FLACS) and toric intraocular lens (IOL) implantation during cataract surgery in moderate astigmatism. Design: Retrospective observational study, tertiary care medical center Methods We retrospectively reviewed medical records of patients who underwent astigmatic correction via femtosecond laser-assisted intrastromal AK (AK group; 27 eyes of 27 patients) with FLACS or toric IOL implantation (toric IOL group; 21 eyes of 21 patients). All patients had senile cataracts with corneal astigmatism ranging from + 1.00 to + 2.00 diopters (D) before cataract surgery. We measured visual acuity, intraocular pressure, automated keratometry, manifest refraction and topography preoperatively and at 1-day, 1-month, 3-month, and 6-month postoperatively. Results Refractive astigmatism was significantly decreased in both groups. The mean preoperative and 6-month postoperative refractive astigmatism were 1.85 ± 1.07 and 0.99 ± 0.51 D, respectively, in the AK group (P = 0.028), and 1.84 ± 0.81 and 0.68 ± 0.21 D, respectively, in the toric IOL group (P < 0.001). There was no significant difference in refractive astigmatism between the two groups at 6-month postoperatively (0.99 ± 0.51 vs 0.68 ± 0.21 D, P = 0.057). At 6-month postoperatively, parameters for vector analysis of refractive astigmatism showed no statistical difference between the two groups. Corneal astigmatism was significantly decreased in the AK group. There was significant difference in corneal astigmatism from topography and automated keratometer between the two groups at 6-month postoperatively (0.94 ± 0.40 vs 1.53 ± 0.46 D, P = 0.018 for topography and 0.98 ± 0.69 vs 1.37 ± 0.41 D, P = 0.032 for automated keratometer). Conclusions Femtosecond laser-assisted intrastromal AK in FLACS could be an effective procedure for reducing astigmatism as well as toric IOL implantation in cataract surgery.

scholarly journals Nucleus Drop or Intraocular Lens Drop Underwent Pars Plana Vitrectomy due to Complication of Cataract Surgery

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Noviana Kurniasari Vivin ◽  
Ari Djatikusumo ◽  
Elvioza Elvioza ◽  
Gitalisa Andayani ◽  
Anggun Rama Yudantha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Choice Of Procedure ◽  
Department Of Ophthalmology ◽  
Pars Plana

Abstract Background: The incidence of nucleus drop or intraocular lens (IOL) drop as the complication of phacoemulsification increases due to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary IOL implantation is the choice of procedure for management. This study aims to determine the frequency, outcomes, and complication of PPV in the case of nucleus drop or IOL drop in the Department of Ophthalmology, Fakultas Kedokteran Universitas Indonesia – Rumah Sakit Cipto Mangunkusumo (FKUI-RSCM) Methods: This study is a retrospective descriptive study conducted in the Vitreoretinal Division of the Department of Ophthalmology, FKUI - RSCM. Research data was taken from the medical records of all nucleus drop or IOL drop patients underwent PPV in January 2017-December 2017. Results: There were 19 cases studied. The incidence of nucleus drop occurred in phacoemulsification surgery techniques (94.7%) and ECCE techniques (5.3%). Vitrectomy surgery was performed ≤2 weeks in 31.6% and >2 weeks in 68.4% after the patient first arrived at the vitreoretinal clinic. Most pre-PPV visual acuity was 1/60-6/60 (47.1%). In the final follow-up, visual acuity improved from 6/45 to 6/6 occurred in 42.2% of cases. Complication after PPV and secondary IOL implantation include elevated IOP (10.5%), IOL decentration (5.3%), corneal decompensation (5.3%), macular edema (5.3%), and retinal detachment (5.3%). Conclusion: Nucleus drop or IOL drop generally occurs in phacoemulsification cataract surgery techniques. Improved visual acuity was achieved after PPV and secondary IOL implantation at the end of the follow-up period. Most common post-PPV complication is elevated IOP.  

scholarly journals Late within the Capsular Bag Intraocular Lens Dislocation (Ten – Year Experience)

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Munir Amjad Baig ◽  
Rabeeya Munir
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Inclusion Criteria ◽  
Lens Dislocation ◽  
Mature Cataract ◽  
Intraocular Lens Dislocation ◽  
Plate Design ◽  
Capsular Bag ◽  
Iol Dislocation

Purpose:  To find out the frequency and causes of within the bag intraocular lens dislocation. Study Design:  Descriptive, retrospective study. Place and Duration of Study:  Federal Government Services Hospital Islamabad, from 2008 to 2018. Methods:  Records of all the patients who underwent uneventful phacoemulsification were studied. Patients with Pseudoexfoliation and glaucoma were excluded. Out-of-the bag IOL dislocations and early dislocations that occurred within first three months after the cataract surgery were also not included. Percentage of patients with dislocated lens within the capsular bag after three months or more was calculated and the cause of dislocation was found. Results were presented in percentages. Results:  Three thousand patients underwent uneventful phacoemulsification. Two thousand nine hundred thirty two (2932) patients fulfilled the inclusion criteria while 68 patients did not return for follow up. Age ranged between 25 and 75 years. There were 1600 males and 1332 were females. One thousand seven hundred and sixty were right eyes and one thousand one hundred and seventy two were left eyes. Sixty one (2.08%) developed late IOL dislocations, 35 (57.3%) males and 26 (42.7%) females. Patients of age group 50 – 75 years had more IOL dislocations. Causes of dislocation included; advanced mature cataract 21.3%, 19.7% with postoperative trauma, uveitis 14.7%, Myopia 9.8%, Silicon plate design in 9.8%, eccentric capsulorhexis 8.1%, small capsulorhexis 6.5%, retinitis pigmentosa 3.2% and in 6.5% no cause was found. Conclusion:  Advanced mature cataract and postoperative trauma were the commonest causes of IOL dislocation. Key Words:  Cataract surgery, Phacoemulsification, Trauma, Capsulorhexis. Intra ocular lens dislocation.

scholarly journals Prognostic Factors for Low Visual Acuity after Cataract Surgery with Vitreous Loss

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Michael Mimouni ◽  
Michal Schaap-Fogler ◽  
Philip Polkinghorne ◽  
Gilad Rabina ◽  
Rita Ehrlich
Keyword(s):  
Visual Acuity ◽  
Prognostic Factors ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Visual Outcome ◽  
Multivariable Logistic Regression Analysis ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Vitreous Loss

Purpose. The purpose of this study is to find prognostic factors associated with low visual acuity in patients experiencing vitreous loss during cataract surgery. Methods. A retrospective, noncomparative, interventional, case study of patients experiencing vitreous loss during cataract surgery. Data collected included demographics, best corrected visual acuity (BCVA), axial length (AL), presence of ocular comorbidity affecting central vision, timing of intraocular lens (IOL) implantation, position of the implanted lens, and the presence of corneal sutures. Low visual outcome was defined as BCVA < 20/40. Results. Overall, 179 patients (60.3% males) with a mean age of 73 ± 12 years and axial length of 23.5 ± 1.3 mm with a mean follow-up of 12 ± 13 months were included. In multivariable logistic regression analysis, low visual outcome was independently associated with persisting postoperative complications (OR 6.25, 95% CI 1.378–30.9), preexisting ocular comorbidities (OR 4.45, 95% CI 1.1–18.00), and secondary intraocular lens (IOL) implant (OR 10.36, 95% CI 1.8–60.00). Conversely, pars plana vitrectomy (PPV) for dislocated fragments of lens material, age > 70 years, gender, axial length, degree of surgeon, corneal suturing, and anterior chamber lens implantation were not found to have significant associations with low visual outcomes ( P > 0.05 ). Conclusions. Low visual outcome after vitreous loss during cataract surgery was associated with ocular comorbidities, secondary IOL implantation, development of cystoid macular edema, and additional surgical complications.

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