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

PURPOSE: In this study, we examined the stability of the lens-angle supporter (LAS) for accommodation restoration by comparing intraocular lens (IOL) location, after-cataract and ciliary body damage after cataract surgery in rabbits. METHODS: Eight rabbits were divided into experimental and control groups of four rabbits each. Phacoemulsification and irrigation and aspiration were performed in all rabbits. This was followed by an LAS and IOL insertion in the four experimental rabbits. In the four control rabbits, only an IOL insertion was performed. Six months after the surgery, the location of the IOL, the conditions of the lens capsule and ciliary body were evaluated using a slitl-amp examination and Miyake-Apple view. RESULTS: For the experimental group, the ultrasound biomicroscope results showed normal LAS and IOL positioning in all four cases. According to the slitlamp examination and Miyake-Apple view, the IOL was positioned at the center, with less after-cataract and damage to the ciliary body. For the control group, ultrasound biomicroscope results indicated a higher IOL position than normal, as well as a single case of IOL decentering. According to the slit-lamp examination and Miyake-Apple view, the IOL was decentered with more severe after-cataract and ciliary body damage. CONCLUSIONS: The LAS has the potential to maintain a stable IOL position while producing less after-cataract when used in lens-angle reconstruction for correction of presbyopia. Moreover, LAS implantation incurs less damage to the ciliary body.
Accommodation, Ocular/physiology ; Animals ; Anterior Eye Segment ; Ciliary Body/injuries ; Disease Models, Animal ; Eye Injuries/*surgery ; Lens Capsule, Crystalline/*surgery ; *Lens Implantation, Intraocular ; Microscopy, Acoustic ; *Phacoemulsification ; Rabbits ; *Reconstructive Surgical Procedures

PURPOSE: To evaluate changes over time of the anterior capsule opening size after phacoemulsification, based on haptic number and composition of three acrylic intraocular lenses (IOLs). METHODS: Fifty-five patients (70 eyes) were included. All underwent phacoemulsification followed by implantation of either an acrylic IOL with two-haptic (one-piece, 26 eyes; three-piece, 22 eyes), or four-haptic (one-piece, 22 eyes). The area of the anterior capsule opening size was measured one week postoperatively (baseline) and at three months. RESULTS: There was a significant reduction in the area of the anterior capsule opening from one week as compared to three months postoperatively in all groups (p < 0.001). However, there was no significant difference in the reduction in the anterior capsule opening between the IOLs (p = 0.36). CONCLUSIONS: The number and material of the haptic of the three acrylic IOLs did not influence the degree of anterior capsule opening shrinkage.
*Acrylic Resins ; Aged ; Cataract Extraction/*methods ; Female ; Follow-Up Studies ; Humans ; Lens Capsule, Crystalline/*physiopathology ; *Lenses, Intraocular ; Male ; *Polymethyl Methacrylate ; Postoperative Period ; Prosthesis Design ; Retrospective Studies ; *Silicone Elastomers

PURPOSE: To investigate the long-term characteristics of cataracts among adults aged 30 to 49 years in Korean over a span of 10 years. METHODS: Subjects between the ages of 30 to 49 years who underwent cataract surgery at St. Mary's Hospital from 1995 to 2004 (n = 976) were included. Patients with a history of ocular trauma, uveitis, other ocular or systemic diseases, and congenital cataracts were excluded. Additional information including type of lens opacity, urban/rural region, and pre- and postoperative visual acuities were analyzed. Lens opacity grading was conducted using Lens Opacity Classification System III. The Cochran-Armitage proportion trend test was used to analyze vision changes with the passage of time. RESULTS: Among the patients who had undergone cataract surgeries, 8.8% (976 / 11,111) met the inclusion criteria. The mean age was 41.7 +/- 5.45 years. Gender breakdown of the patient population included 79.0% male and 21.0% female. In terms of home environment, 60.9% were from an urban region and 39.1% from a rural region. Opacity type included anterior polar (AP), posterior subcapsular (PSC), AP and PSC, cortical, and nuclear in 35.7%, 35.1%, 7.0%, 6.0%, and 5.4% of patients, respectively. At a 2-month postoperative follow-up appointment, 92.7% of patients showed a best-corrected visual acuity of more than 20 / 40. CONCLUSIONS: Predominance of AP and PSC opacities as well as male patients was observed in this study population.
Adult ; Age Distribution ; Age Factors ; Cataract/*epidemiology/pathology ; *Cataract Extraction ; Female ; *Forecasting ; Humans ; Incidence ; Lens Capsule, Crystalline/*pathology ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies

PURPOSE: Postoperative endophthalmitis is a dreaded outcome of any intraocular surgery. Fungal endophthalmitis is a particularly severe complication that poses a significant threat of blindness. We experienced seven consecutive cases of postoperative fungal endophthalmitis stemming from a single local clinic in which extensive early intervention resulted in favorable final visual acuity. METHODS: The present study is retrospective observational case series of fungal endophthalmitis. The initial case, as diagnosed by fungal culture, resulted in blindness. In the ensuing eight months, seven consecutive cases were referred to our institution. All were presumed to be fungal endophthalmitis as the cases possessed similar inflammatory findings to the preceding case and occurred in the same environment. Extensive surgical and antifungal treatment was immediately administered, including complete vitrectomy with removal of the intraocular lens and lens capsule and Amphotericin B injections. RESULTS: Retinal infiltration was identified in three cases and the lesion site was photocoagulated with an endolaser. All cases were confirmed fungal endophthalmitis by culture (4 cases: Candida parapsilosis, one case each: Fusarium, Acremonium, Candida tropicalis) and five cases required secondary intraocular lens implantation. Final corrected visual acuity ranged from 20/20 to 40/200 by the Snellen chart. CONCLUSIONS: Early extensive surgical intervention and antifungal agent administration may result in favorable visual outcomes in patients with fungal endophthalmitis following cataract surgery.
Aged ; Aged, 80 and over ; Antifungal Agents/therapeutic use ; Blindness/etiology ; *Candidiasis/drug therapy ; Device Removal ; Endophthalmitis/complications/*microbiology/*surgery ; Female ; Humans ; Laser Coagulation ; Lens Capsule, Crystalline/surgery ; Lenses, Intraocular ; Male ; Middle Aged ; *Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; *Vitrectomy

PURPOSE: Several articles have been published on the successful elimination of iridolenticular synechiae after cataract extraction with a neodymium YAG laser (Nd:YAG laser) and surgical synechiolysis during cataract surgery, but the indications recommending which method is proper to use for specific kinds of adhesions have not yet been established. METHODS: We retrospectively reviewed the medical records of 106 patients who had undergone Nd:YAG laser or surgical synechiolysis between January 2002 and December 2007 in our clinic. Laser synechiolysis was performed in the synechiae not exceeding the extent of one clock hour and reaching only to the iris sphincter, whereas surgical synechiolysis was performed in other diffuse and/or thick synechiae. RESULTS: Surgical synechiolysis was performed in 93 eyes, and YAG laser synechiolysis was done in 21 eyes. Increases in best-corrected visual acuity (BCVA) were observed in 61 eyes (53.51%). Intraocular pressure spikes after the procedure were present in only 4 eyes, and all of them were transient except for 1 eye, which needed additional glaucoma eyedrops. CONCLUSIONS: With suitable indications, laser or surgical synechiolysis can be performed safely, and a small rise in visual acuity may also be expected.
Adult ; Aged ; Aged, 80 and over ; Cataract Extraction ; Female ; Humans ; Iris Diseases/*surgery ; Lasers, Solid-State/*therapeutic use ; Lens Capsule, Crystalline/*surgery ; Lens Diseases/*surgery ; Male ; Middle Aged ; Postoperative Complications/*surgery ; Retrospective Studies ; Tissue Adhesions/surgery ; Visual Acuity

Animals ; Apoptosis ; Cataract ; etiology ; Cattle ; Cell Proliferation ; Cells, Cultured ; Epithelial Cells ; cytology ; Lens Capsule, Crystalline ; cytology

INTRODUCTIONThe aim of this study was to determine if racial differences exist in the rate of posterior capsule rupture (PCR) during cataract surgery in Singapore.

MATERIALS AND METHODSAll intraoperative complications during cataract surgery were prospectively reported as part of a clinical audit programme. A retrospective review of all patients who sustained a PCR during cataract surgery between July 1995 and December 1998 was performed.

RESULTSOf 8230 consecutive eyes which underwent cataract surgery, 6951 (84.5%) were Chinese, 597 (7.3%) were Malay, 524 (6.4%) were Indian, and 158 (1.9%) were of other races. The overall incidence of PCR was 1.9%. The PCR rates were 1.8% [125 of 6951; 95% confidence interval (CI), 1.49 to 2.11] in Chinese, 2.0% (12 of 597; 95% CI, 1.01 to 3.57) in Malay, 2.7% (14 of 524; 95% CI, 1.13 to 3.56) in Indian, and 2.5% (4 of 158; 95% CI, 0.00 to 4.98) in other races. There was no statistical difference between the PCR rates (P = 0.62, chi-square test).

CONCLUSIONRacial differences in Singapore do not have an effect on the rates of PCR during cataract surgery.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; Capsulorhexis ; adverse effects ; Cataract Extraction ; adverse effects ; Eye Injuries ; ethnology ; etiology ; Female ; Humans ; Incidence ; Intraoperative Complications ; epidemiology ; Lens Capsule, Crystalline ; Lens Implantation, Intraocular ; adverse effects ; Logistic Models ; Male ; Medical Audit ; Middle Aged ; Phacoemulsification ; adverse effects ; Prospective Studies ; Retrospective Studies ; Rupture ; ethnology ; etiology ; Singapore ; epidemiology

PURPOSE: Ocular perforation during lid anesthesia is rarely reported. We describe here a case of inadvertent corneal perforation and traumatic cataract that occurred during lid anesthesia in a procedure for hordeolum removal. METHODS: A 33-year-old woman presented with a sudden visual loss of her left eye. She had undergone hordeolum removal the day before at a local clinic. On ophthalmologic examination, the cornea was perforated and the lens cortex was extruded into the anterior chamber. After cataract removal and IOL implantation, antibiotics were injected into the vitreous. RESULTS: Her final visual acuity of the left eye was 20/20. Postoperative specular microscopic examination revealed a normal-range endothelial cell count, coefficient of variation, and hexagonality despite the intracameral lidocaine injection. CONCLUSIONS: Anesthetic injection of an infected lid should be done with great caution. Although there are possibilities of corneal endothelial toxicity and endophthalmitis in case of intracameral lidocaine injection through the infected lid, yet proper management may save the patient's vision without complications.
Lidocaine/administration & dosage ; Lens Implantation, Intraocular ; Lens Capsule, Crystalline/injuries ; Injections/adverse effects ; Humans ; Hordeolum/*surgery ; Follow-Up Studies ; Female ; Eyelids ; Eyelid Diseases/*surgery ; Eye Injuries, Penetrating/diagnosis/*etiology/surgery ; Diagnosis, Differential ; Cornea/injuries ; Cataract Extraction ; Anesthetics, Local/administration & dosage ; Anesthesia, Local/*adverse effects ; Adult

Alport syndrome is a hereditary, progressive disease characterized by progressive nephritis, sensorineural deafness, and ocular abnormalities, including anterior lenticonus. The ultrastructure of the lens capsule abnormalities in Alport syndrome is reported. Four anterior lens capsules from 31-year-old patient and 26-year-old patient with lenticonus who were affected by the Alport syndrome were obtained at capsulectomy. And all four anterior lens capsules were examined by transmission electron microscopy. The histopathologic findings showed that the thickness of the anterior lens capsules was decreased (4~13 micrometer) and that there were many vascular dehiscences localized at the inner part of the lens capsule. There were large numbers of capsular dehiscences containing fibrillar materials and vacuoles. The anterior capsules were clearly fragile in this disease, forming the basis for the progressive lenticonus and anterior polar cataract.
Adult ; Epithelial Cells/ultrastructure ; Humans ; Lens Capsule, Crystalline/*ultrastructure ; Lens Diseases/genetics/*pathology ; Lens Implantation, Intraocular ; Male ; Nephritis, Hereditary/genetics/*pathology ; Phacoemulsification