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 Congenital and developmental cataract surgery with undercorrected Intraocular lens (IOL) power implantation targeting emmetropia at 8 years of age and post-operative refractive status

2021 ◽  
Vol 12 (9) ◽  
pp. 126-129
Author(s):  
Kabindra Bajracharya ◽  
Anjita Hirachan ◽  
Kriti Joshi ◽  
Bimala Bajracharya
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Iol Implantation ◽  
Refractive Status ◽  
Developmental Cataract ◽  
Iol Power ◽  
The Mean ◽  
One Year

Background: In congenital and developmental cataract primary undercorrection of intraocular lens (IOL) power is a common practice. However, long-term refractive status of these children is largely unknown. Aims and Objective: To analyse refractive status after cataract surgery with undercorrected IOL power implantation in congenital and developmental cataract. Materials and Methods: This study was descriptive, retrospective conducted for three years from 1st January 2013 to 31st December 2015. The children (> 6 months to <=7 years of age) who underwent cataract surgery for congenital and developmental cataract with a primary IOL implantation and had reached the age of 8 years were studied. The data were collected in terms of demography, axial length, biometry, IOL implanted, hyperopic correction and postoperative refractive status at 8 years. Results: Total numbers of children operated were 181 with total eyes 288. Unilateral cases were 74 (40.88%) and bilateral 107 (59.12%). Male were 121 (66.85%) and female were 60 (33.15%) with male is to female ratio of 2:1. Right eye was involved in 152 (52.8%) and left eye 136 (47.2%). The mean axial length at the age of one year was 20.75 mm, and gradually increased as age increased which was 22.47 mm at 6 years. The mean biometry was 27.9 diopter (D) at the age of one year which gradually decreased as age increased. Of the total 288 congenital cataract operated, complete follow-up documents were available for 77 (26.74%) eyes up to 8 years which showed emmetropia achieved in 25.97%, myopia in 28.57% and hypermetropia in 45.45%. Conclusion: Primary IOL implantation with hyperopic correction is accepted practice in congenital and developmental cataract. Emmetropia can be achieved however some hyperopic or myopic refractive status at the age of 8 years is not a surprise. Myopic shift continues as the age increases. Parent awareness for early detection and surgery, optical correction and regular follow-up are essential for good outcome.

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 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.

Effect of capsular tension ring on refractive results in cases with pseudoexfoliation syndrome

2020 ◽  
pp. 112067212096546
Author(s):  
Nilay Kandemir Besek ◽  
Gulsah Gumus ◽  
Gamze Ozturk Karabulut ◽  
Senay Asik Nacaroglu ◽  
Ahmet Kirgiz ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Capsular Tension Ring ◽  
Significant Difference ◽  
Hyperopic Shift ◽  
The Mean ◽  
Group 2 ◽  
Lens Power ◽  
Group 1

Purpose: To investigate the effect of capsular tension rings (CTRs) on postoperative refractive results in patients with pseudoexfoliation (PSX) syndrome. Materials and Methods: Sixty-nine patients with PSX syndrome who had uncomplicated cataract surgery between March 2016 and February 2019 were reviewed retrospectively. The patients were divided into two groups. The 35 patients in Group 1 received CTRs prior to intraocular lens implantation during cataract surgery, and the 34 patients in Group 2 had cataract surgery without CTRs. Significant zonular weakness, uncontrolled glaucoma, and ocular pathologies causing low visual acuity were excluded. The preoperative and postoperative keratometry and autorefraction measurements, preoperative expected refractive values, and absolute refractive error were recorded. Results: The mean ages of patients were 73.54 ± 9.78 years in Group 1 and 72.23 ± 6.72 years in Group 2 ( p = 0.521). There was no statistically significant difference between Group 1 and Group 2 in terms of expected preoperative refraction values (–0.52 ± 0.12,–0.56 ± 0.08, respectively, p = 0.118). There was a statistically significant difference in postoperative spherical equivalent values between Group 1 and Group 2 (–0.05 ± 0.97 and −0.92 ± 0.57, respectively, p < 0.01). A statistically significant difference was found between the two groups in terms of absolute refractive error (0.46 ± 0.74 in Group 1 and −0.34 ± 0.59 in Group 2 p < 0.01). Conclusion: CTR implantation causes hyperopic shift, which should be taken into consideration when calculating the lens power of intraocular lens in patients with PSX syndrome.

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 Comparative study between conventional extra capsular cataract extraction versus manual small incision cataract surgery

2017 ◽  
Vol 5 (3) ◽  
pp. 996 ◽  
Author(s):  
Gannaram Laxmiprasad ◽  
Chhaya Shori ◽  
Rakesh Shori ◽  
Ashalatha Alli
Keyword(s):  
Cataract Surgery ◽  
Tertiary Care ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Visual Rehabilitation ◽  
Surgically Induced Astigmatism ◽  
Small Incision ◽  
Significant Difference ◽  
Induced Astigmatism ◽  
Surgically Induced

Background: Recent reports indicate that both manual small incision cataract surgery and extra capsular cataract excision surgery with posterior chamber intraocular lens implantation are safe and effective for treatment of cataract surgery, however, manual small incision cataract surgery gives better uncorrected vision. Objectives of the study were to compare intraoperative and postoperative complications, to compare induced astigmatism and to compare the visual rehabilitation.Methods: This is a prospective study of 100 consecutive patients assigned to undergo conventional extra capsular cataract excision surgery (50 cases) and manual small incision cataract surgery (50 cases). Study was done for a period of two years at a tertiary care referral hospital. Institutional Ethics Committee permission was taken. Also the informed consent was obtained from each patient.Results: In conventional ECCE, the most common surgically induced astigmatism was WTR in 73.4% of cases with mean of 2.79 D±1.3 on first day. 70% of cases with mean 2.1 D±1.28 and 64% of cases with mean of 1.86 D±1.14 at six weeks. ATR was common in MSICS group, 83.67% of cases with mean of 1.5 D±0.72 on first day, 86% of cases with mean of 1.03 D±0.6 at one week and 88% of cases with mean of 1.27 D±0.81 at six weeks. The induced astigmatism was less in MSICS group compared to ECCE group at first day but after six weeks there was no much significant difference found. Early visual recovery was better in MSICS groupConclusions: MSICS has definitive advantages over conventional ECCE in terms of early visual rehabilitation, minimal surgically induced astigmatism; no suture related complications and reduced surgical time.

scholarly journals Post Cataract Surgery Refractive Error in Myopic Patients Using SRK/T Versus Holladay 1 Formula for IOL Power Calculation

2019 ◽  
Vol 34 (2) ◽  
Author(s):  
Sidra Anwar, Atif Mansoor Ahmad, Irum Abbas, Zyeima Arif
Keyword(s):  
Intraocular Lens ◽  
Refractive Error ◽  
Axial Length ◽  
Power Calculation ◽  
Mean Error ◽  
Iol Power Calculation ◽  
Group A ◽  
Iol Power ◽  
The Mean ◽  
Group B

Purpose: To compare post-operative mean refractive error with SandersRetzlaff-Kraff/theoretical (SRK-T) and Holladay 1 formulae for intraocular lens (IOL) power calculation in cataract patients with longer axial lengths. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Ophthalmology, Shaikh Zayed Hospital Lahore from 01 January 2017 01 January, 2018. Material and Methods: A total of 80 patients were selected from Ophthalmology Outdoor of Shaikh Zayed Hospital Lahore. The patients were randomly divided into two groups of 40 each by lottery method. IOL power calculation was done in group A using SRK-T formula and in group B using Holladay1 formula after keratomery and A-scan. All patients underwent phacoemulsification with foldable lens implantation. Post-operative refractive error was measured after one month and mean error was calculated and compared between the two groups. Results: Eighty cases were included in the study with a mean age of 55.8 ± 6.2 years. The mean axial length was 25.63 ± 0.78mm, and the mean keratometric power was 43.68 ± 1.1 D. The mean post-operative refractive error in group A (SRK/T) was +0.36D ± 0.33D and in group B (Holladay 1) it was +0.68 ± 0.43. The Mean Error in group A was +0.37D ± 0.31D as compared to +0.69D ± 0.44D in group B. Conclusion: SRK/T formula is superior to Holladay 1 formula for cases having longer axial lengths. Key words: Phacoemulsification, intraocular lens power, longer axial length, biometry.

scholarly journals Glaucoma following cataract surgery in the first 2 years of life: frequency, risk factors and outcomes from IoLunder2

2019 ◽  
Vol 104 (7) ◽  
pp. 967-973 ◽  
Author(s):  
Ameenat Lola Solebo ◽  
Jugnoo S Rahi
Keyword(s):  
Adverse Events ◽  
Cataract Surgery ◽  
Axial Length ◽  
Multivariable Analysis ◽  
Population Based ◽  
Secondary Glaucoma ◽  
Bilateral Cataract ◽  
Younger Age ◽  
Age At Surgery ◽  
Unilateral Disease

BackgroundWe investigated glaucoma related adverse events, predictors and impact at 5 years following surgery in the IoLunder2 cohortMethodsPopulation based observational cohort study of children undergoing cataract surgery aged 2 years or under between January 2009 and December 2010. Glaucoma was defined using internationally accepted taxonomies based on the consequences of elevated intraocular pressure (IOP). Glaucoma related adverse events were any involving elevated IOP. Multivariable analysis was undertaken to investigate potential predictors of secondary glaucoma with adjustment for within-child correlation in bilateral cataract. Unilateral and bilateral cataract were analysed separately.ResultsComplete follow-up data were available for 235 of 254, 93% of the inception cohort. By 5 years after primary cataract surgery, 20% of children with bilateral cataract and 12% with unilateral had developed secondary glaucoma. Glaucoma related complications had been diagnosed in 24% and 36% of children, respectively. Independent predictors of glaucoma were younger age at surgery (adjusted OR for reduction of week in age: 1.1, 95%C I 1.1 to 1.2, p<0.001); the presence of significant ocular comorbidity (adj OR 3.2, 95% CI 1.1 to 9.6, p=0.01); and shorter axial length (adj OR for each mm 1.7, 95% CI 10.0 to 1, p=0.05) for bilateral cataract. Shorter axial length was the single independent factor in unilateral disease (adj OR 9.6, 95% CI 1.7 to 52, p=0.009)ConclusionsBoth younger age at surgery (the strongest marker of ocular ‘immaturity’) and smaller ocular size (a marker of both immaturity and developmental vulnerability) can be used to identify those at greatest risk of glaucoma due to early life cataract surgery.

scholarly journals Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Takayuki Baba ◽  
Tomohiro Nizawa ◽  
Toshiyuki Oshitari ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Surgical Outcomes ◽  
Case Series ◽  
Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

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