PURPOSE: To compare the outcomes after phacoemulsification performed with the AquaLase(R) and phacoemulsification in MicroFlow(R) system, including surgically induced astigmatism (SIA), corneal endothelial cell damage and postoperative recovery of visual acuity. METHODS: The cataracts of Lens Opacities Classification System, version III (LOCS III) nuclear grade below 2 were subjected in this study. Nineteen eyes underwent cataract operation using AquaLase(R) (Alcon Laboratories, Fort Worth, Texas, U.S.A.). A control group (19 eyes) used the MicroFlow(R) system (Millenium, Stortz, U.S.A.) and was selected by matching age, sex, systemic disease, corneal astigmatism and corneal endothelial cell density. All the surgeries were performed by the same operator. SIA, corneal endothelial cell loss, visual acuity, and corneal thickness were evaluated postoperatively. RESULTS: SIA in the group using AquaLase(R) was less than that of the group using MicroFlow(R) system (P=0.022) at 2 months postoperatively. Evaluation of corneal endothelial cell loss, recovery of visual acuity and corneal thickness found no statistically significant differences between the two groups. CONCLUSIONS: Cataract surgery using AquaLase(R) induces less surgically induced astigmatism in mild to moderate cataracts.
Astigmatism/etiology ; Cataract Extraction/adverse effects/*methods/*standards ; Humans ; Phacoemulsification/adverse effects/*standards ; Prospective Studies ; Treatment Outcome

PURPOSE: This study was performed to assess efficiency and stability of astigmatic change by incision size after cataract surgery. METHODS: This work was designed as a retrospective, comparative, nonrandomized interventional study. A total of 121 cases of cataract surgery were reviewed in 98 patients performed by one surgeon at the Oregon Eye Institute in Eugene, OR, USA with 3-year follow-ups. All procedures were performed with the temporal approach of self-sealing incisions. The serial change in surgically induced astigmatisms were examined in all cases of three groups: Group A, cartridge injection of a foldable IOL through a 2.5 mm self-sealing incision; Group B, cartridge injection of a foldable IOL through a 3.0 mm self-sealing incision; Group C, cartridge injection of a foldable IOL through a 3.5 mm self-sealing incision. Keratometric data were obtained preoperatively, and 3 weeks, 3 months, 6 months, 9 months, 12 months, 24 months and 36 months postoperatively. Polar value analysis was performed to calculate the surgically induced astigmatism. RESULTS: The astigmatic change decreased over time in Group B (P<0.05). The other groups tended to remain in induced astigmatism. All groups showed anticlockwise torque at 3 weeks following surgery. Group B showed a decrease in deviation, but the other groups showed increases in their torque value at postoperative 12 months (P<0.05). CONCLUSIONS: The 3.0 mm incision size correlated with the least surgically induced astigmatism.
Retrospective Studies ; Phacoemulsification ; Lens Implantation, Intraocular ; Humans ; Cornea/*surgery ; Cataract Extraction/*adverse effects/*methods ; Astigmatism/*etiology

BACKGROUNDPhacoemulsification yields successful outcomes in eyes with standard cataract. Though techniques have been improved, it is still challenging to perform phacoemulsification in cases of hard cataracts for difficulty in nuclear management and much more complications. This study aimed at describing and evaluating the efficacy and safety of a peripheral radial chop technique to remove hard cataracts.

METHODSIn this prospective study conducted between January 2003 and January 2004, 107 consecutive eyes with hard cataract underwent modified phacoemulsification surgery with peripheral radial chop technique by the Bausch & Lomb Millennium phacoemulsifier with preset parameters of power less than 30%; vaccum, 150 mmHg; and bottle height, 85 cm when a DP8145 phaco tip was used, and vaccum, 380 mmHg; bottle height, 95 cm when a DP8245 phaco tip was used.

RESULTSThe mean ultrasonic power was 14.7% (range 9% to 19%), ultrasonic time was 1.98 minutes (range 1.55 to 3.18 minutes). At 1, 7 and 30 days postoperatively, the eyes with uncorrected visual acuity 0.5 or better accounted for 76.42%, 87.16% and 90.67% respectively. At 1 month, the endothelial cell loss rate was 9.74% (range 8% to 17%). There were 6 cases of posterior capsule rupture in an early period of study. No serious intraoperative or postoperative complications were noted.

CONCLUSIONSThe peripheral radial chop technique was effective without serious complications in hands of an experienced surgeon.

Aged ; Female ; Humans ; Male ; Middle Aged ; Phacoemulsification ; adverse effects ; methods ; Prospective Studies

This study evaluated the surgical outcome and complications of phacoemulsification and the implantation of an acryl foldable intraocular lens (IOL) with a squared edge in dogs with cataracts. Thirty-two eyes from 26 dogs were examined. The mean follow up period was 75.9 days ranging from 23 to 226 days. The complications after phacoemulsification were posterior capsular opacity (PCO) around the IOL (n = 11), ocular hypertension (n = 4), focal posterior synechia (n = 4), hyphema (n = 3) and corneal ulcer (n = 2). The complications associated with the IOL were decenteration of the optic (n = 2) and ventral haptic displacement (n = 1). Most cases of PCO were found only around the margin of the IOL, and all eyes had vision during the observation period. In conclusion, the implantation of an acryl-foldable lens with a squared edge at the time of phacoemulsification is an effective method for preserving the central visual field of dogs with cataract.
Animals ; Cataract/*veterinary ; Dog Diseases/*surgery ; Dogs/*surgery ; Female ; Lens Implantation, Intraocular/adverse effects/*veterinary ; Male ; Phacoemulsification/adverse effects/*veterinary ; Retrospective Studies

PURPOSE: To determine sequential intraocular pressure (IOP) changes after pars plana vitrectomy (PPV) with or without combined phacoemulsification and intraocular lens implantation (PE & IOL). METHODS: Consecutive patients who underwent PPV with PE & IOL (combined group) or without PE & IOL (vitrectomy group) were reviewed for postoperative sequential IOPs and the number of IOP lowering medications used. Of the 68 patients (68 eyes) who underwent simple PPV, 41 eyes were allocated to the vitrectomy group, and 27 eyes to the combined group. RESULTS: The mean IOPs were higher on postoperative days one and two, as compared to preoperative values, in both groups. The mean IOP changes on postoperative day one (10.0 mmHg vs. 5.3 mmHg, p = 0.02) and day two (3.7 mmHg vs. 1.3 mmHg, p = 0.02) were significantly higher in the combined group. CONCLUSIONS: Phacovitrectomy is associated with a higher risk of IOP elevation during the early postoperative period than PPV alone. Caution should be exercised in patients who are vulnerable to IOP fluctuations when combined surgery is indicated.
Aged ; Female ; Humans ; *Intraocular Pressure ; *Lens Implantation, Intraocular ; Male ; Middle Aged ; Phacoemulsification/*adverse effects ; *Postoperative Complications ; Risk Assessment ; Vitrectomy/*adverse effects/methods

BACKGROUNDTrabeculectomy has become a mainstream treatment in intraocular pressure (IOP) reduction for primary angle-closure glaucoma (PACG); combined trabeculectomy and cataract surgery was reported to reduce IOP and simultaneously improve vision for patients with PACG and coexisting cataract. This study was specialized to compare the efficacy and safety of combined phacotrabeculectomy with that of trabeculectomy only in the treatment of PACG with coexisting cataract.

METHODSThis is a comparative case series study. Thirty-one patients (31 eyes) with PACG and coexisting cataract were enrolled. Of these, 17 underwent phacotrabeculectomy and 14 underwent trabeculectomy alone. IOP, filtering blebs, and complications were compared at the final follow-up. Complete success was defined as a final IOP less than 21 mmHg without IOP-lowering medication.

RESULTSAfter 10 months of postoperative follow-up, the phacotrabeculectomy and trabeculectomy groups showed no significant differences regarding IOP reduction ((20.59 ± 7.94) vs. (24.85 ± 14.39) mmHg, P = 0.614), complete success rate (88% vs. 71%, P = 0.370), formation rate of functioning blebs (65% (11/17) vs. 93% (13/14), P = 0.094), and complications (41% (7/17) vs. 57% (8/14), P = 0.380). IOP-lowering medication was not required for most of the patients in both groups. Additional surgery interventions, including anterior chamber reformation and phacoemulsification, were needed in the trabeculectomy group, whereas no surgery was needed postoperatively in the phacotrabeculectomy group.

CONCLUSIONPhacotrabeculectomy and trabeculectomy treatments exhibit similar IOP reduction, successful rates, and complications when it comes to treating PACG patients with coexisting cataract, although additional surgery intervention may be needed for a few cases with cataract and complications after trabeculectomy.

Aged ; Cataract Extraction ; Female ; Glaucoma, Angle-Closure ; physiopathology ; surgery ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Phacoemulsification ; adverse effects ; methods ; Postoperative Complications ; etiology ; Trabeculectomy ; adverse effects ; methods ; Visual Acuity

No abstract available.
Anesthesia, Local/*adverse effects ; Anesthetics, Local/administration & dosage/*adverse effects ; Eye Movements/*drug effects ; Female ; Humans ; Middle Aged ; Ocular Motility Disorders/*chemically induced/diagnosis/physiopathology ; Oculomotor Muscles/drug effects/*physiopathology ; Phacoemulsification/*adverse effects ; *Postoperative Complications

PURPOSE: The 2.2-mm microincision cataract surgery and small-gauge vitrectomy system is known to result in less surgically-induced astigmatism (SIA) in comparison to conventional surgical methods. We compared the amounts of SIA after combined phacoemulsification and 23-gauge transconjunctival sutureless vitrectomy (23G-TSV) using the 2.2-mm microincision and 2.75-mm standard incision methods. METHODS: We studied 59 patients (61 eyes) who underwent combined phacoemulsification and 23G-TSV from November 2008 to September 2012. Twenty-eight patients (28 eyes) underwent 2.2-mm microincision coaxial phacoemulsification, and 31 patients (33 eyes) underwent 2.75-mm standard incision phacoemulsification. SIA was evaluated using Naeser's polar method with the simulated keratometric values obtained from corneal topography. Preoperative and 1-week and 1-month postoperative KP (Naeser's polar value along the specific axis) and DeltaKP values were compared between the 2.2-mm microincision and 2.75-mm standard incision groups. RESULTS: One week after surgery, both groups exhibited similar amounts of SIA (-DeltaKP[120], 0.40 +/- 0.41 vs. 0.51 +/- 0.56 diopters [D]; p = 0.390). One month after surgery, however, the amount of SIA was significantly smaller in the 2.2-mm microincision group as compared to the 2.75-mm standard incision group (-DeltaKP[120], 0.31 +/- 0.54 vs. 0.56 +/- 0.42 D; p = 0.045). CONCLUSIONS: In combined phacoemulsification with 23G-TSV, 2.2-mm microincision coaxial phacoemulsification induces less SIA than does 2.75-mm standard coaxial phacoemulsification.
Aged ; Astigmatism/diagnosis/*etiology ; *Cataract ; Cornea/surgery ; Corneal Topography/methods ; Female ; Humans ; Lens Implantation, Intraocular/*adverse effects/methods ; Male ; Middle Aged ; Phacoemulsification/*adverse effects/methods ; Postoperative Complications/diagnosis/etiology ; Sclera/surgery ; Vitrectomy/*adverse effects/instrumentation/methods

PURPOSE: To evaluate the visual outcome of combined phacoemulsification, intraocular lens implantation, and vitrectomy for macula-sparing rhegmatogenous retinal detachment. METHODS: The results of combined vitrectomy with cataract extraction were retrospectively analyzed in patients with preexisting cataracts and new-onset rhegmatogenous retinal detachment. To qualify, patients must also have had macular sparing in a region 6,000 microm in diameter on optical coherence tomography. The anatomical success rate, visual outcomes, and postoperative complications relating to visual acuity were evaluated. RESULTS: In 56 patients followed postoperatively for more than 12 months, the initial and final surgical success rate was 96.4% and 100%, respectively. The mean preoperative logarithm of the minimum angle of resolution visual acuity was 0.05 and decreased to 0.11 postoperatively (p < 0.001). Of the 56 patients, 20 (35.7%) had worse visual acuity postoperatively, compared with preoperatively (0.06 vs. 0.27, p < 0.001); these cases were comprised of six patients with epiretinal membranes, 12 patients with a posterior capsule opacity, and two patients with cystoid macular edema. In the remaining 36 patients, there were no significant differences in visual acuity preoperatively and postoperatively (0.04 vs. 0.03, p = 0.324). CONCLUSIONS: In patients with cataracts who develop macula-sparing rhegmatogenous retinal detachment and whose visual prognosis is excellent assuming the retina can be reattached successfully, combined phacoemulsification, intraocular lens implantation, and vitrectomy might be an effective treatment. However, the visual prognosis is significantly affected by postoperative complications such as an epiretinal membranes, posterior capsule opacity, and cystoid macular edema. Therefore, further studies should examine methods to prevent these postoperative complications.
Adult ; Female ; Humans ; *Lens Implantation, Intraocular/adverse effects ; Male ; Middle Aged ; *Phacoemulsification/adverse effects ; Postoperative Complications/prevention & control ; Retinal Detachment/physiopathology/*surgery ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity ; *Vitrectomy/adverse effects

BACKGROUNDThe endothelium should be carefully evaluated when choosing a surgical technique for cataract removal. Therefore, we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted corneal grafts.

METHODSA total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty (PKP) eyes at the Shandong Eye Institute between February 2001 and June 2014 were included, and clinical records were reviewed. Baseline demographic details, clinical characteristics, endothelial cell density (ECD), and best-corrected visual acuity (BCVA) were recorded. Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians. A regression model was constructed to compare the reduced rate of ECD.

RESULTSOf the 54 eyes included in this study, extracapsular cataract extraction (ECCE) was performed in 34 eyes of 33 patients (ECCE group) whereas phacoemulsification was performed in 20 eyes of 20 patients (phacoemulsification group). There was no significant difference in the median age (P = 0.081) or preoperative ECD (P = 0.585) between the two groups. At 6 months after cataract surgery, ECD in ECCE group was significantly higher than that in phacoemulsification group (P = 0.043). In addition, the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months (P = 0.018), 4 months (P < 0.001), and 6 months (P < 0.001) after cataract surgery. Endothelial cell loss rate after cataract surgery increased over the 6-month study duration in both ECCE group (P < 0.001) and phacoemulsification group (P < 0.001), but phacoemulsification resulted in a greater reduction in ECD than that of ECCE in transplanted corneal grafts (P < 0.001). There was no significant difference in postoperative BCVA between the two groups (P = 0.065).

CONCLUSIONECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.

Adolescent ; Adult ; Aged ; Cataract ; pathology ; Cataract Extraction ; adverse effects ; Corneal Endothelial Cell Loss ; diagnosis ; etiology ; pathology ; Endothelium, Corneal ; pathology ; Female ; Humans ; Keratoplasty, Penetrating ; adverse effects ; Male ; Middle Aged ; Phacoemulsification ; adverse effects ; Retrospective Studies ; Young Adult