Posts Tagged by cataract

Intra-cameral moxifloxacin appears safe in cataract surgery : Abstract

AsianOphthalmology Alliance logo Intracameral moxifloxacin appears safe in cataract surgery

This retrospective study evaluated the safety of intracameral moxifloxacin 0.5% (500 mg/0.1 ml) in 244 patients (353 eyes) who underwent uncomplicated cataract surgery. At three months postop, there was minimal anterior chamber reaction, and no significant change was noted in corneal thickness or endothelial cell density.

Philippine Journal of Ophthalmology, January-June 2014 (213)

IOL injector should match corneal incision size

AsianOphthalmology Alliance logo IOL injector should match corneal incision size

Using an experimental model for calculating induced stress on corneal incisions during intraocular lens implantation, researchers compared the nozzles of common injectors using two incision sizes, 2.4- or 2.2-mm. They showed major differences (greater than 38%) between the lowest and highest levels of induced stress when different injectors and different incision sizes were compared. They suggest that better surgical results may be achieved if surgeons match the injector with the incision size. If the surgeon prefers a specific injector system, the incision size should be matched to the size of the injector’s nozzle. 

American Journal of Ophthalmology, July 2014

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Lid scrubbing increases contamination risk during cataract surgery

AsianOphthalmology Alliance logo Lid scrubbing increases contamination risk during cataract surgery

This randomized, controlled, double-masked trial evaluated two preop sterilization techniques: In one group (153 eyes), the lid margin was compressed and scrubbed for 360 degrees five times with a dry sterile cotton-tipped applicator immediately after ocular sterilization and before povidone–iodine irrigation of the conjunctival sac. The second group (153 eyes) had identical sterilization but no lid scrubbing. The rate of positive bacterial culture in liquid in the collecting bag was significantly higher with mechanical compression of the lid margin (P=.001), perhaps due to secretions from the lid margin glands. 

Journal of Cataract & Refractive Surgery, August 2014 (1156)

Multifocal IOLs can significantly reduce central visual field

AsianOphthalmology Alliance logo Multifocal IOLs can significantly reduce central visual field

This is the first study to use Humphrey Visual Field 10-2 testing to compare the effects of multifocal and monofocal IOLs on the central 10 degrees of vision. The multifocal group demonstrated a significant depression in MD, by approximately 2 dB, that did not improve with time or neuroadaptation. The authors suggest multifocal IOLs may be inadvisable in patients who cannot tolerate central visual field reduction, such as those with macular degeneration, retinal pigment epithelium changes or glaucoma. 

American Journal of Ophthalmology, August 2014

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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…) (1147)

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. (659)

“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…) (2019)

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…) (1826)

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…) (654)

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 (750)

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