Category: cataract

Femtosecond laser pretreatment reduces effective phaco time

AO LogoFemtosecond laser pretreatment reduces effective phaco time
This prospective study compared the effective phacoemulsification (EPT) time between patients (150 eyes) who underwent pretreatment with the femtosecond laser followed by cataract extraction, and those who had conventional phaco surgery (51 eyes). Mean EPT was reduced by 84 percent in the femtosecond group compared with controls. Using improved lens fragmentation algorithms and a 20-gauge phaco tip in a subgroup, the percentage increased to 96.2 percent. Additionally, 30 in the laser group had 0 EPT, compared with no cases in the control group. The femtosecond group also experienced a 36.1 percent reduction in endothelial cell loss.

Ophthalmology, May 2013 (49)

No-assistant technique for glued IOL (7.05 min Video): Dr Priya Narang

No-assistant technique for glued IOL : Dr Priya Narang MS

An excellent demo video using animation and real surgery videos to explain the tricky concepts in general and the no-assistant technique in particular. (106)

Prior trabeculectomy may contribute to refractive surprise post cataract surgery

AO LogoPrior trabeculectomy may contribute to refractive surprise post cataract surgery
Investigators retrospectively compared outcomes in patients who underwent cataract surgery at least three months after trabeculectomy to those with either medically controlled glaucoma or no glaucoma. The trabeculectomy group had significantly greater refractive error than expected compared with each of the two control groups undergoing cataract surgery (P = .005). The refractive difference correlated to IOP change, with 2 mm Hg of IOP rise resulting in a −0.36-diopter shift, suggesting that IOP increase after phaco causes axial length to increase which results in myopic shift.

American Journal of Ophthalmology, May 2013 (40)

Phacosection Topical Cataract Surgery : Dr M.S.Ravindra (10.36 min Video)

Phacosection Topical Cataract Surgery (SICS) by Dr M.S.Ravindra (10.36 min Video)

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Trypan blue may reduce posterior capsule opacification

AO LogoTrypan blue may reduce posterior capsule opacification
This prospective, randomized, observer-masked study evaluated posterior capsule opacification rates following cataract surgery in which trypan blue was injected into the capsular bag after cortical-cleaving hydrodissection. Half of 300 eyes included received 0.2 mL of trypan blue 0.1% at two sites 180 degrees apart, while the other half were injected with balanced salt solution. Mean PCO scores were lower in the trypan group at 6 months (P=.042) and 12 months (P=.0227). Two eyes in the trypan group and 6 eyes in the control group required laser capsulotomy.
Journal of Cataract & Refractive Surgery, May 2013 (130)

TASS associated with intracameral antibiotic injection

AO LogoTASS associated with intracameral antibiotic injection
The ESCRS endophthalmitis study showed that intracameral cefuroxime reduced the incidence of endophthalmitis following cataract surgery. Preliminary studies have shown that intracameral injection of a 0.3% commercial preparation of moxifloxacin (Vigamox, Alcon, Fort Worth, Texas) shows no signs of toxicity and promise in the potential prevention of postoperative endophthalmitis, according to news from ASCRS. Vigamox is preservative free and has no other inactive ingredients that have been shown to affect the anterior segment of the eye when used in an off-label manner intracamerally. (more…) (133)

Dysphotopsia a leading cause of visual dissatisfaction in cataract patients

AO LogoDysphotopsia a leading cause of visual dissatisfaction in cataract patients
Investigators selected a cohort of pseudophakic patients based on uneventful surgery, good corrected visual acuity and lack of ocular complaints or pathology including dry-eye syndrome or posterior capsule opacification. They compared patients’ logMAR CDVA and mesopic contrast CDVA (with and without glare) with self-reported satisfaction and visual function. Pseudophakic dysphotopsia was the only significant factor associated with dissatisfaction. Additionally, dysphotopsia was highly correlated with the NEI VF-11R questionnaire, suggesting visual phenomena are also seen to have functional significance.

Journal of Cataract & Refractive Surgery, April 2013 (160)

Multifocal IOLs may affect assessment of common eye diseases

AO LogoMultifocal IOLs may affect assessment of common eye diseases
Investigators evaluated the influence of a diffractive multifocal IOL on standard automated perimetry (SAP) size III and size V test results. Patients had a clinically relevant reduction of visual sensitivity, manifested by a mean 2dB decrease in mean deviation on Humphrey visual field testing, compared to patients with monofocal IOLs and phakic controls. They conclude this reduction interferes with the assessment of common eye diseases such as glaucoma and comes on top of the decline of visual sensitivity due to normal aging or age-related eye diseases.

JAMA Ophthalmology, April 2012 (133)

Diclofenac appears equivalent to dexamethasone for combined phacotrab with MMC

AO LogoDiclofenac appears equivalent to dexamethasone for combined phacotrab with MMC
This prospective, double-masked clinical trial included 42 patients with glaucoma and cataract randomized to postop treatment with topical diclofenac sodium 0.1% or topical dexamethasone phosphate 0.1%. At 12 months, diclofenac was shown to be at least as good as the topical steroid. Investigators noted a trend toward a clinical advantage with diclofenac sodium 0.1%, the most potent NSAID, as patients exhibited a clinical tendency to do better than the dexamethasone group in terms of the number of glaucoma medications, IOP and bleb morphology.

Journal of Glaucoma, March 2013 (71)

Pseudophakic monovision may offer better intermediate vision than multifocal IOLs

AO LogoPseudophakic monovision may offer better intermediate vision than multifocal IOLs
Researchers prospectively compared visual function and patient satisfaction in 21 patients implanted with bilateral diffractive multifocal IOLs (AcrySof ReSTOR SN60D3) and 22 patients with monofocal IOL monovision (AcrySof SN60WF). Visual exam at three months showed bilateral uncorrected distance vision and near vision were slightly better in the multifocal group, but the difference was not statistically different. Monovision patients had significantly better intermediate vision and less difficulty using computers without glasses. Monovision patients also had a slightly higher overall satisfaction score and significantly fewer complaints of glare and halos.

Journal of Cataract & Refractive Surgery, March 2011 (75)

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