Objectives: Video-based learning of surgical skills is a useful complement in training programs. This is more evident where direct patient exposure is limited due to multiple factors. In ophthalmic surgery, access to high quality ocular surgery videos such as for cataract operations, can provide significant learning points for trainees in an institutional program. Creation therefore of a local, curated, and indexed library of cataract surgery would support alternative means to maximize training of new ophthalmic surgeons. The objective of the project was to develop a local library of cataract surgery videos as an adjunct teaching tool for resident trainees in a Philippine tertiary eye care center. Methods: A collection of cataract surgery videos from 2013-2020 were compiled into a single workstation. Videos were reviewed and catalogued using set keywords for easy searchability and labelling. Results: 256 videos of cataract surgeries were compiled into the library. 6 main headings for the keywords, with 159 total subheadings were established to provide robust tagging and search options to index the video. Conclusion Particularly in Ophthalmic surgery, refinement of surgical technique is essential in ensuring better postoperative visual outcomes. This is achieved through repetition and careful dissection of operative technique. The use of a library with multiple videos of a similar procedure allows trainees more exposure to certain cases. This ultimately affords trainees, better experience and confidence in their own surgeries.
Cataract ; Library ; Surgery

Posterior capsule opacification (PCO), a common complication after cataract surgery, impacts a patient's long-term visual quality to various degrees. Although a neodymium:yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy is a very effective treatment, it may lead to a serial of complications. Accordingly, the search for simple, safe, and effective methods to prevent PCO has received widespread attention. Various researchers are committed to the interdisciplinary collaboration between medicine and engineering fields, such as functionalizing the surface of the intraocular lens (IOL) via supercritical fluid impregnation, coating the surface of the IOL, high-concentration drug immersion, and application of a drug delivery system, to effectively reduce the incidence and severity of PCO.
Humans ; Capsule Opacification/surgery* ; Lens Implantation, Intraocular ; Cataract/etiology* ; Lens Capsule, Crystalline/surgery* ; Lenses, Intraocular/adverse effects* ; Treatment Outcome ; Postoperative Complications ; Prosthesis Design

OBJECTIVE: To investigate the value of hand-held retinal optometer and optical coherence tomography (OCT) in predicting postoperative visual acuity in patients with age-related cataract and idiopathic macular epiretinal membrane. METHODS: We retrospectively analyzed the data of patients undergoing phacoemulsification combined with intraocular lens implantation for age-related cataract in our hospital from January, 2019 to April, 2020.Preoperative examination detected idiopathic macular epiretinal membrane in 45 of the patients (52 eyes) with lens opacity grade C2N2P1 according to LOCSⅡ lens opacity classification criteria.Based on the thickness of the macular fovea, the eyes were divided into group A (9 eyes) with macular thickness < 300 μm by OCT examination, group B (25 eyes) with macular thickness of 300 to 400 μm, and group C (18 eyes) with macular thickness >400 μm.The best corrected visual acuity and retinal visual acuity before operation and the best corrected visual acuity on the first day and at 3 months after the surgery were compared among the 3 groups.The consistency between the preoperative retinal vision and the best corrected vision at 3 months after the surgery was analyzed. RESULTS: The best corrected visual acuity at one day and 3 months after the surgery differed significantly from that before the surgery in all the 3 groups ( CONCLUSIONS For patients with cataract and idiopathic macular epiretinal membrane, phacoemulsification combined with intraocular lens implantation can improve postoperative vision.Hand-held retinal optometer can accurately assess postoperative vision in patients with stage C2N2P1 cataract.Patients with a macular thickness >400 μm caused by idiopathic macular epiretinal membrane are likely to have poor postoperative visual outcomes.
Cataract/diagnostic imaging* ; Epiretinal Membrane/surgery* ; Humans ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

No abstract available.
Aged ; Cataract Extraction ; Choroidal Neovascularization/diagnosis/*etiology ; Epiretinal Membrane/*surgery ; Female ; Fluorescein Angiography ; Humans ; Iatrogenic Disease ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy/*adverse effects

PURPOSE: To investigate the efficacy and safety of intravitreal dexamethasone implant for controlling postoperative inflammation among uveitis patients undergoing cataract extraction. METHODS: Ten eyes with noninfectious uveitis underwent phacoemulsification with intraocular lens implantation followed by intravitreal injection of 0.7-mg dexamethasone implant (implant group) between February 2011 and January 2014. Twenty age- and gender-matched controls who received cataract surgery without implantation during the same period were recruited (non-implant group). Medical records of the subjects were retrospectively reviewed and 6-month postoperative clinical outcomes were compared between the 2 groups. RESULTS: The mean age was 42.30 +/- 15.81 years in the implant group and 45.65 +/- 13.63 years in the non-implant group. The 2 groups were similar in terms of age, gender, preoperative inflammatory status, and preoperative visual acuity (p = 0.552, 1.000, 0.133 and 0.767, respectively). After surgery, oral steroid was used in the non-implant group (8.8 +/- 1.5 mg/day on average) and the implant group (3.5 +/- 1.3 mg/day; p = 0.029). Visual acuity (log MAR) improved significantly in both groups (p = 0.789) with no significant difference between the 2 groups. Postoperative recurrence rates of uveitis were reduced more (40%) in the implant group than in the non-implant group (50%) but without significance (p = 0.709). Elevated intraocular pressure > or =25 mm Hg occurred in 3 eyes (30%) in the implant group and 4 eyes (20%) in the non-implant group (p = 0.657), of which 1 in each group required a filtering surgery. Otherwise, no significant complications developed in either group. CONCLUSIONS: Intravitreal dexamethasone implants help reduce conventional oral steroid dosage for controlling postoperative inflammation. Dexamethasone implants could be an effective and safe alternative to control the inflammation after cataract surgery in uveitis patients.
Cataract Extraction ; Cataract* ; Dexamethasone* ; Filtering Surgery ; Humans ; Inflammation ; Intraocular Pressure ; Intravitreal Injections* ; Lens Implantation, Intraocular ; Medical Records ; Phacoemulsification ; Recurrence ; Retrospective Studies ; Surgery, Oral ; Uveitis* ; Visual Acuity

PURPOSE: To evaluate the accuracy of postoperative refractive outcomes of combined phacovitrectomy for epiretinal membrane (ERM) in comparison to cataract surgery alone. MATERIALS AND METHODS: Thirty-nine eyes that underwent combined phacovitrectomy with intraocular lens (IOL) implantation for cataract and ERM (combined surgery group) and 39 eyes that received phacoemulsification for cataract (control group) were analyzed, retrospectively. The predicted preoperative refractive aim was compared with the results of postoperative refraction. RESULTS: In the combined surgery group, refractive prediction error by A-scan and IOLMaster were -0.305+/-0.717 diopters (D) and -0.356+/-0.639 D, respectively, compared to 0.215+/-0.541 and 0.077+/-0.529 in the control group, showing significantly more myopic change compared to the control group (p=0.001 and p=0.002, respectively). Within each group, there was no statistically significant difference in refractive prediction error between A-scan and IOLMaster (all p>0.05). IOL power calculation using adjusted A-scan measurement of axial length based on the macular thickness of the normal contralateral eye still resulted in significant postoperative refractive error (all p<0.05). Postoperative refraction calculated with adjusted axial length based on actual postoperative central foveal thickness change showed the closest value to the actual postoperative achieved refraction (p=0.599). CONCLUSION: Combined phacovitrectomy for ERM resulted in significantly more myopic shift of postoperative refraction, compared to the cataract surgery alone, for both A-scan and IOLMaster. To improve the accuracy of IOL power estimation in eyes with cataract and ERM, sequential surgery for ERM and cataract may need to be considered.
Aged ; Biometry/methods ; Case-Control Studies ; Cataract Extraction ; Epiretinal Membrane/*surgery ; Eye ; Female ; Humans ; *Lens Implantation, Intraocular ; *Lenses, Intraocular ; Male ; Optics and Photonics ; Phacoemulsification/*methods ; Postoperative Period ; Refraction, Ocular/physiology ; Retrospective Studies ; Treatment Outcome ; Vision Tests ; Visual Acuity ; Vitrectomy/*methods

PURPOSE: To compare the astigmatic power of toric intraocular lenses (IOLs) obtained from the AcrySof, TECNIS, and iTrace toric calculator in patients with preoperative with-the-rule (WTR) or against-the-rule (ATR) corneal astigmatism. MATERIALS AND METHODS: Fifty eyes with cataract and corneal astigmatism greater than 0.75 diopters were enrolled in each group (WTR and ATR). Keratometric values were measured using autokeratometry, an IOLMaster, and an iTrace, which incorporated corneal topography and ray-tracing aberrometry. Based on measured keratometric values, the astigmatic power of each toric IOL was calculated using three toric calculators. RESULTS: Bland-Altman plots showed good agreement between six pairwise corneal astigmatism values in both groups. The TECNIS calculator tended to suggest a higher astigmatic power of the toric IOL than the AcrySof calculator. With the higher astigmatism and keratometric values from the IOLMaster, in both groups, calculations from the AcrySof and TECNIS calculators resulted in higher calculated astigmatic powers than those from same calculators with autokeratometry-measured values, demonstrating good agreement. With the higher calculated astigmatic power values, the values from the iTrace toric calculator using keratometric values obtained from iTrace ray tracing wavefront aberrometry or iTrace simulated keratometry showed fair to moderate agreement with those from the other calculator-keratometry pairs in both groups. CONCLUSION: To achieve the best refractive outcome after toric IOL implantation, understanding the differences in keratometric values between instruments and in calculated astigmatic power among toric calculator programs is necessary. Moreover, systemic analysis of each toric calculator in conjunction with postoperative data is required.
Aberrometry ; Aged ; Aged, 80 and over ; Astigmatism/physiopathology/surgery ; *Cataract ; Cornea/surgery ; Corneal Topography ; Eye ; Female ; Humans ; *Lens Implantation, Intraocular ; *Lenses, Intraocular ; Male ; Middle Aged ; Phacoemulsification/*methods ; Postoperative Period ; Refraction, Ocular/*physiology ; Visual Acuity/physiology

PURPOSE: To analyze healing changes of corneal wounds of different corneal incision sizes with or without stromal hydration in cataract surgery using anterior segment optical coherence tomography. METHODS: Cataract surgeries were performed by a single surgeon and 2.2- and 2.8-mm corneal incisions were made using a diamond blade (ME-759; Meyco, Biel-Bienne, Swiss). Patients were divided into four groups according to incision size (2.2 and 2.8 mm), and with/without stromal hydration. Fifteen eyes were assigned to each group and incision wounds were measured using anterior segment optical coherence tomography at 2 hours, 1 day, 1 week, 1 month, and 3 months postoperatively. Corneal thickness, incision length and incision angle were measured and existence of epithelial, endothelial gaping and Descemet's membrane detachment was evaluated. RESULTS: Incision thickness was greater in the group with stromal hydration than in the group without on operation day (p < 0.05). Stromal hydration exerted greater influence in the 2.2-mm incision group than in the 2.8-mm incision group. Corneal thickness decreased more rapidly in the stromal hydration group than in the group with no hydration (p = 0.022). Endothelial gaping was greater in the 2.2-mm incision group than in the 2.8-mm incision group 1 day, 1 month, and 3 months after surgery (p = 0.035, p = 0.009, and p = 0.008, respectively). No other statistical significance was observed between the two groups (2.2 and 2.8 mm) during follow-up regarding corneal thickness, epithelial gaping and Descemet's membrane detachment. CONCLUSIONS: Corneal wounds with a smaller incision could be more vulnerable to external stimuli such as stromal hydration and are less stable than those with a larger incision.
Aged ; Anterior Eye Segment ; Cataract Extraction/*methods ; Corneal Stroma/pathology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Surgical Wound Dehiscence/diagnosis/*prevention & control ; Tomography, Optical Coherence/*methods ; *Wound Healing

PURPOSE: To evaluate the risk factors for the development of posterior capsule opacification (PCO) after cataract surgery or combined cataract and vitreoretinal surgery. METHODS: In the present study all surgical procedures were performed by the same surgeon. We retrospectively reviewed 272 consecutive eyes that received cataract surgery or combined cataract and vitreoretinal surgery. The risk factors including gender, age, diabetes, continuous curvilinear capsulorhexis (CCC) size, intraocular lens shape, intraoperative intravitreal bevacizumab, gas, and silicone oil injections were evaluated using multiple logistic regression analysis. RESULTS: PCO developed in 55 (20.2%) out of 272 eyes. The mean age was 63.3 +/- 12.1 years (range 23-85 years) and mean follow-up period was 17.3 +/- 3 months. A correlation existed between the development of the PCO and age (p < 0.05), CCC size (p = 0.009), vitreoretinal surgery (p = 0.014), intraoperative intravitreal gas (p = 0.009) and silicone oil injections (p = 0.005). However, no statistical correlation with gender, diabetes, intraocular lens shape, or intraoperative intravitreal bevacizumab injection was observed (p > 0.05). CONCLUSIONS: The risk factors associated with PCO included young age, large CCC size, combined cataract and vitreoretinal surgery, intraoperative intravitreal gas and silicone oil injections.
Capsule Opacification* ; Capsulorhexis ; Cataract* ; Follow-Up Studies ; Lenses, Intraocular ; Logistic Models ; Retrospective Studies ; Risk Factors* ; Silicone Oils ; Vitreoretinal Surgery* ; Bevacizumab

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