Posts Tagged by cataract

Micro-Stent Safe With Cataract Surgery for Glaucoma

AsianOphthalmology Alliance logo Micro-Stent Safe With Cataract Surgery for Glaucoma

The CyPass Micro-Stent procedure for glaucoma can be safely combined with cataract surgery, according to 2-year results from the CYCLE trial. Investigators report that the procedure provided sustained control of intraocular pressure and reduced medication use.

“This procedure is an attempt to have surgeries for glaucoma that are safer and easier for the patient,” said investigator Brian Flowers, MD, from Fort Worth, Texas. “Current surgical treatments for glaucoma are associated with events such as suprachoroidal hemorrhage and bleb-related complications. Microinvasive surgical stenting of the supraciliary space may improve aqueous flow, with fewer complications,” he explained here at the American Academy of Ophthalmology (AAO) 2013 Annual Meeting.

There are 2 main approaches to minimally invasive glaucoma surgery, (more…) (520)

Surgical simulators in cataract surgery training

AOA logo Surgical simulators in cataract surgery training Sikder S, Tuwairqi K, Al-Kahtani E, Myers W, Banerjee P; British Journal of Ophthalmology (BJO) (Oct 2013)

BACKGROUND Virtual simulators have been widely implemented in medical and surgical training, including ophthalmology. The increasing number of published articles in this field mandates a review of the available results to assess current technology and explore future opportunities.

METHOD A PubMed search was conducted and a total of 10 articles were reviewed.

RESULTS Virtual simulators have shown construct validity in many modules, successfully differentiating user experience levels during simulated phacoemulsification surgery. Simulators have also shown improvements in wet-lab performance. The implementation of simulators in the residency training has been associated with a decrease in cataract surgery complication rates.

CONCLUSIONS Virtual reality simulators are an effective tool in measuring performance and differentiating trainee skill level. Additionally, they may be useful in improving surgical skill and patient outcomes in cataract surgery. Future opportunities rely on taking advantage of technical improvements in simulators for education and research. (566)

“Spotlight on Cataract Complications” – AAO Meeting

AOA logo Learning from mistakes

Even in the hands of experts, not all cataract surgeries go as planned, as attendees at a “Spotlight on Cataract Complications” session found out during the second day of the American Academy of Ophthalmology meeting here in New Orleans. Session co-chair David F. Chang, MD, said the key is to remain calm.

“Don’t panic—take a deep breath,” he said, adding that even unwelcome events during surgery can result in good visual outcomes.

For instance, if there is a break in the anterior capsule, (more…) (1000)

Removing Retained Lens Fragments: Now or Later?

AOA logo Retained Lens Fragments After Cataract Surgery: Outcomes of Same-Day Versus Later Pars Plana Vitrectomy

Lens fragments, or even the entire lens, can become displaced into the vitreous cavity during the course of cataract surgery, as a consequence of a break in the posterior capsule or a loss of the intact peripheral zonular barrier. Although this complication is usually apparent during surgery, retained lens material may not be recognized for days or weeks after surgery.

When lens material begins to drop into the vitreous cavity, (more…) (1671)

Femto vs. phaco: technology trumps tradition

AOA logoFemto vs. phaco: technology trumps tradition (News from AAO meeting)

In a mock trial, complete with Eric D. Donnenfeld, MD, as a bewigged judge, it was decided that phacoemulsification cataract surgery will inevitably be replaced by laser. But many cataract surgeons still hold a place in their hearts—and their offices—for phaco, at least until femtosecond technology (more…) (433)

Triamcinolone acetonide can reduce inflammation after phacotrabeculectomy

AOA logo Triamcinolone acetonide can reduce inflammation after phacotrabeculectomy

Investigators randomized 126 patients undergoing combined trabeculectomy and cataract surgery to receive intracameral triamcinolone acetonide (0.5 mg, 1.0 mg or 2.0 mg) or no injection. They found that eyes treated with triamcinolone acetonide had better visual acuity and less anterior chamber inflammation than the control eyes, with 1.0 mg providing the best postoperative result.

Journal of Cataract & Refractive Surgery, November 2013 (431)

Delayed-onset endophthalmitis associated with better visual outcomes

AO LogoDelayed-onset endophthalmitis associated with better visual outcomes
This large retrospective series included all patients treated for culture-proven endophthalmitis after cataract surgery at a single university center between 2000 and 2009. Patients with delayed-onset endophthalmitis (>6 weeks after surgery) generally presented with better initial visual acuities, had a lower frequency of hypopyon, and better visual outcomes compared to acute-onset patients (≤6 weeks after surgery). Propionibacterium acnes and coagulase-negative Staphylococcus species were the most common organisms cultured in both groups and were associated with the best visual acuity outcomes in both groups.

American Journal of Ophthalmology, March 2012 (530)

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 (422)

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. (572)

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 (1254)

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