Cataract Intraocular Lens Research Articles

Modeling monocular form deprivation in rabbits using a simulated-cataract intraocular lens.

To establish an animal model of form deprivation amblyopia based on a simulated cataract intraocular lens (IOLs). Poly(dimethyl siloxane)-SiO2 thin films (PSF) with different degrees of opacity as IOL materials were prepared. The light transmission of the PSF-IOL was measured, and its in vitro biosafety was determined by cell counting kit (CCK)-8 assay using the HLEC-B3 cell line and ARPE-19 cell line. Subsequently, the in vivo safety was determined by implanting the PSF-IOL with 10% wt SiO2 into the right eyes of New Zealand white rabbits (PSF-IOL group), and compared with two control groups: contralateral comparison group and normal control (NC) group (Contralateral comparison group: the fellow eye; NC group: a group of binocular normal rabbits without intervention). The flash visual-evoked potentials (F-VEPs) were measured to verify amblyopia. PSFs containing 0, 2%, and 10% wt SiO2 were successfully constructed. The 0 SiO2 PSF was transparent, while the 10% wt SiO2 PSF was completely opaque. It was found that PSF did not induce unwanted cytotoxicity in HLECs and ARPE19 cells in vitro. In vitro, PSF-IOL with 10% wt SiO2 was also non-toxic, and no significant inflammation or structural changes occurred after four weeks of PSF-IOL implantation. Finally, our IOL-simulated congenital cataract rabbit detected by F-VEPs suggested tentative amblyopia. A PSF-IOL that mimics cataracts is created. A novel form deprivation model is created by the IOL-simulated congenital cataract rabbit. It can be developed fast and stable and holds great potential for future study.

Efficacy and Safety of Intravitreal Injection of Triamcinolone Acetonide and Conbercept for Intraocular Lens after Cataract Surgery.

Objective To investigate the effect of intravitreal injection of triamcinolone acetonide and conbercept on the efficacy and safety of diabetic macular edema (DME) after cataract intraocular lens (IOL) surgery. Methods A total of 350 patients with cataract complicated with diabetic macular edema in our hospital from January 2017 to July 2021 were randomly divided into conbercept group and triamcinolone acetonide group. Patients in the conbercept group were given intravitreal injection of conbercept during IOL surgery, and patients in the triamcinolone acetonide group were given injection of triamcinolone acetonide during surgery. Results Three months after treatment, the best-corrected visual acuity of the two groups was significantly higher than before, the corrected visual acuity of the conbercept group was more significant than the triamcinolone acetonide group, and the intraocular pressure of the triamcinolone acetonide group was higher than the conbercept group. The foveal thickness and macular volume were significantly reduced in both groups, and was reduced more in the conbercept group than in the triamcinolone acetonide group. The contents of VEGF, SDF-1, and IL-6 in both groups were significantly decreased, and the decrease was more significant in the conbercept group than in the triamcinolone acetonide group. The patients with elevated intraocular pressure, headache and vomiting, orbital swelling pain, eye swelling pain, and eye pain in the triamcinolone acetonide group were significantly higher than those in the conbercept group (P < 0.05). Conclusions Conbercept and triamcinolone acetonide has a good therapeutic effect on DME in pseudophakic eyes after cataract IOL surgery, which can reduce the degree of macular edema and improve the visual function. However, the therapeutic effect of injection therapy with conbercept is safe, the prognosis is better, and the complication rate is low.

Development and Validation of a Visual Symptom–Specific Patient-Reported Outcomes Instrument for Adults With Cataract Intraocular Lens Implants

To develop a patient-reported outcome measure for capturing visual and ocular symptoms before and after implantation of intraocular lenses (IOLs) for treatment of cataracts. Questionnaire development and validation study. The Questionnaire for Visual Disturbances (QUVID) was developed based on a literature and instrument review; 13 clinician interviews among ophthalmologists in the United States and Europe; and 67 hybrid qualitative patient interviews among adult patients in the United States and Australia before and/or after monofocal, traditional multifocal, or trifocal IOL implantation. Assessment of the QUVID's psychometric properties was conducted via a noninterventional cross-sectional study of previously treated cataract patients in the United States, Canada, and Australia (n=150), and assessment of ability to detect meaningful change via 2 pivotal US clinical trials among patients with trifocal or extended vision IOL compared with monofocal IOL controls (n=457). The QUVID includes subitems about the bothersomeness of 7 visual symptoms: starburst, halo, glare, hazy vision, blurred vision, double vision, and dark areas. The postoperative version contains 1 item asking the respondents whether their symptoms bothered them enough to want another surgery, if the IOL was the cause. The QUVID was reviewed by the US Food and Drug Administration and found appropriate as a fit-for-purpose measure, demonstrating requisite evidence for content validity, construct validity, reliability, and ability to detect change.

Brain Functional Network Architecture Reorganization and Alterations of Positive and Negative Affect, Experiencing Pleasure and Daytime Sleepiness in Cataract Patients after Intraocular Lenses Implantation.

Background: Cataracts are associated with progressive blindness, and despite the decline in prevalence in recent years, it remains a major global health problem. Cataract extraction is reported to influence not only perception, attention and memory but also daytime sleepiness, ability to experience pleasure and positive and negative affect. However, when it comes to the latter, the magnitude and prevalence of this effect still remains uncertain. The current study aims to evaluate the hemodynamic basis of daytime sleepiness, ability to experience pleasure and positive and negative affect in cataract patients after the intraocular lens (IOL) implantation. Methods: Thirty-four cataract patients underwent resting-state functional magnetic resonance imaging evaluation before and after cataract extraction and intraocular lens implantation. Both global and local graph metrics were calculated in order to investigate the hemodynamic basis of excessive sleepiness (ESS), experiencing pleasure (SHAPS) as well as positive and negative affect (PANAS) in cataract patients. Results: Eigenvector centrality and clustering coefficient alterations associated with cataract extraction are significantly correlated with excessive sleepiness, experiencing pleasure as well as positive and negative affect. Conclusions: The current study reveals the hemodynamic basis of sleepiness, pleasure and affect in patients after cataract extraction and intraocular lens implantation. The aforementioned mechanism constitutes a proof for changes in functional network activity associated with postoperative vision improvement.

The effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4\u20138\u2009years

BackgroundThe present study sought to observe the effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4–8 years.MethodsThis is a retrospective case control study. Seventy-seven children (130 eyes) aged from 4 to 8 years who underwent cataract surgery were divided into two groups. In Group A, 50 eyes underwent phacoemulsification, intraocular lens implantation and posterior capsule capsulotomy combined with anterior vitrectomy. In Group B, 80 eyes underwent cataract phacoemulsification and intraocular lens implantation. The postoperative visual acuity and the rate of complications were compared.ResultsIn all patients, cataract surgeries were performed evenly without intraoperative complications. The follow-up time ranged from 6 months to 42 months. No apparent visual axis opacity was detected in group A during the follow-up. By the last visit, apparent visual axis opacity was detected in 31 eyes (38.75%) in group B. Among them, 9 eyes (29.03%) with mild posterior capsule opacification (PCO) were treated with Nd:YAG laser, 3 eyes (9.68%) with thick proliferative membranes were treated with posterior capsule capsulotomy combined with anterior vitrectomy and proliferative membranes in 19 eyes (61.29%) were completely aspired and the posterior capsule was retained. During follow-up, only 2 (6.45%) eyes had PCO recurrence and were treated with Nd:YAG laser. The visual acuity was significantly higher than that before surgery in all patients.ConclusionsFor older children, the incidence of PCO will be low even if intact posterior capsule is retained. Either Nd:YAG laser or surgical treatment for PCO will be able to maintain good vision.

Femtosecond laser semi-assisted Descemet stripping endothelial keratoplasty: 2-year outcomes of endothelial cell loss and graft survival

PurposeTo assess 2-year endothelial cell loss and graft survival after femtosecond laser semi-assisted Descemet stripping endothelial keratoplasty (FLS-DSEK).MethodsIn this prospective and noncomparative study carried out at Eye Hospital of Shandong First Medical University, 85 eyes (84 patients) with endothelial dysfunction receiving FLS-DSEK (n=62, 75.9%) or FLS-DSEK combined with phacoemulsification cataract surgery and intraocular lens implantation (n=23, 27.1%) from 2013 through 2016 were included. The graft endothelial cell loss, endothelial graft thickness, visual acuity, and complications after surgery were evaluated.ResultsThin endothelial grafts were all successfully prepared, with no occurrence of perforation. The rate of endothelial cell loss was 17.4%, 18.8%, 19.9%, and 26.7%, and the central graft thickness was 113±54 μm, 102±40 μm, 101±28 μm, and 96±23 μm at 3, 6, 12, and 24 months, respectively. The median best-corrected visual acuity was 0.4 logMAR (range, 0–2 logMAR) at 24 months, demonstrating a significant difference from that before surgery (2 logMAR; range, 0.2–3 logMAR) (T=187.5, P<.001). Partial graft dislocation was the most common postoperative complication, with an occurrence rate of 14% (n=12), and it was associated with an abnormal iris-lens diaphragm (r=.35, P<.001). The other complications included a high intraocular pressure (n=5, 6%), endothelial graft rejection (n=4, 5%), and pupillary block (n=1, 1%). Endothelial graft decompensation occurred in the two eyes, and 98% (n=83) of the grafts survived at 24 months.ConclusionsData of the study suggest that the treatment using FLS-DSEK seems to be promising and might be considered a feasible choice in patients with endothelial dysfunction.Trial registration1. Date of registration: 2021-02-182. Trial registration number: ChiCTR21000440913. Registration site: https://www.chictr.org.cn/

Cataract Phacoemulsification and Intraocular Lens Implantation in a Small Pupil Case

Cataract Phacoemulsification and Intraocular Lens Implantation in a Small Pupil Case

Analysis of the Effect of Intraocular Lens Implantation on Retinal Nerve and Postoperative Nursing Outcome Based on Ultrasound Imaging

Traumatic cataract is a common complication of ocular contusion. Caused by various forms of trauma, the course and prognosis of traumatic cataract are also different. Intraocular lens (IOL) implantation is the most effective treatment at the present time and can provide good visual quality and near, medium, and far vision. In this study, an adaptive medical ultrasound image denoising algorithm was constructed based on the biological vision mechanism and was applied to observe IOL implantation and postoperative care of 30 patients with traumatic cataract. Results showed that eyesight could be restored to the original healthy state after IOL implantation, and eyesight was close to normal 3 months after surgery. The corresponding noise pixel block of the noise reduction algorithm was obviously the lowest. A total of 30 patients (9 patients with contusion, 13 patients with intraocular foreign body, and 8 patients with perforation) were treated with aspheric and multifocal IOL to achieve the expected outcome. The noise reduction algorithm constructed in this study effectively reduced the speckle noise of ultrasound images, improved the clarity of ultrasound images, and achieved the effective observation of medical nursing outcome after traumatic cataract IOL implantation. After IOL implantation, the retinal nerves of patients with traumatic cataract were affected to different degrees.

Retinal Detachment After Cataract Surgery and Posterior Laser Capsulotomy in a Young Healthy Male Patient: Case Report

Background: The onset of cataract formation is normally experienced in senile age. The process of lens opacification can also be influenced by other factors, including systemic diseases, infection, trauma, medication, ultraviolet light exposure, genetic predisposition and environmental sources. Gradual vision loss accompanied by a myopic refractive shift can be caused by nuclear cataract formation, even in young patients. Phacoemulsification cataract removal and intraocular lens insertion surgery is indicated when visual acuity loss and/or myopic anisometropia becomes a problem. Surgical and laser treatments are risk factors in developing retinal detachment, especially in myopic patients. Case Presentation: This is a case of an early onset nuclear cataract in a young male. A 44-year-old man visited the hospital complaining of gradual vision loss in his right eye. History study revealed no systemic or ophthalmic diseases or trauma. The patient underwent phacoemulsification nuclear cataract removal and intraocular lens insertion surgery in his right eye, followed by Nd:YAG laser posterior capsulotomy 3 years later. He underwent phacoemulsification nuclear cataract surgery in his left eye at the age of 48 years, followed by laser capsulotomy treatment 2 years later. At the age 50, a routine eye examination revealed retinal detachment in his right eye. He underwent vitrectomy surgery twice. Conclusion: Nuclear lens opacification is seldom of clinical importance in young healthy adult patients; however, it can be the cause of progressive visual acuity loss, especially in the presence of a myopic refractive shift. Surgery, laser treatment and myopia are all risk factors in retinal detachment. This case shows that thorough and periodic routine eye examinations are a must when dealing with patients with unexpected and atypical signs and symptoms, especially having underwent surgery and laser treatments.

Full thickness penetrating keratoplasty with cataract extraction and intraocular lens implantation in leprosy patients

Full thickness penetrating keratoplasty with cataract extraction and intraocular lens implantation in leprosy patients

Оцінювання гіпотензивного ефекту дозованої ендотрабекулоектомії як самостійної операції та в комбінації з факоемульсифікацією катаракти у хворих з первинною відкритокутовою глаукомою

Purpose. To evaluate the hypotensive effect of endotrabeculectomy as a standalone operation and in combination with cataract phacoemulsification in patients with primary open-angle glaucoma. Methods. There were 88 patients (88 eyes) with open-angle glaucoma under our observation. The patients of the first group (23 patients, 23 eyes) underwent standalone endotrabeculectomy. The patients of the second group (65 patients, 65 eyes) underwent endotrabeculectomy in combination with cataract phacoemulsification and intraocular lens implantation. Results. When comparing the IOP of the two groups, we found that no significant difference in its decrease depending on the type of surgery was detected, in all cases p &gt; 0.05. A significant difference was found only when comparing the “Before surgery” subgroups – p = 0.031. When comparing the usage of glaucoma medications, we found that at the first 6 months, no significant difference in quantities of drugs depending on the type of surgery was found (p &gt; 0.05), but in the next 6 months, there were significantly higher amounts of glaucoma medications used in the frst group to reach the target IOP than in the second group, which can be explained by the slightly lower baseline IOP and the lower number of glaucoma medications instilled during the preoperative period in the second group. Conclusion. Endotrabeculectomy is an effective operation for patients with primary open-angle glaucoma, both as an stand-alone surgery and in combination with cataract phacoemulsification.

Inhibition of Rho kinase suppresses capsular contraction following lens injury in mice.

PURPOSE:We investigated the effect of systemic fasudil hydrochloride and an inhibitor of nuclear translocation of myocardin-related transcription factor-A (MRTF-A) on capsular contraction in a puncture-injured lens in mice.MATERIALS AND METHODS:Lens injury of an anterior capsular break was achieved in male adult C57Bl/6 mice under general and topical anesthesia at 1 h after systemic fasudil hydrochloride (intraperitoneal, 10 mg/kg body weight) or vehicle administration. The mice were allowed to heal after instillation of ofloxacin ointment, for 5 and 10 days with daily administration of fasudil hydrochloride or vehicle. In another series of experiment, we examined the effect of systemic administration of an MRTF-A inhibitor (CCG-203971, 100 mg/kg twice a day) on fibrogenic reaction and tissue contraction in an injured lens on day 5 or 10. The eye was processed for histology and immunohistochemistry for SM22, proliferating cell nuclear antigen (PCNA), or MRTF-A. In hematoxylin and eosin - stained samples, the distance between each edge of the break of the anterior capsule was measured and statistically analyzed.RESULTS:A cluster of lens cell accumulation was formed adjacent to the edge of the capsular break on day 5. It contained cells labeled for SM22 and PCNA. The size of the cell cluster was larger in fasudil group of mice than in control mice on day 5. Systemic fasudil or CCG-203971 suppressed an excess contraction of the capsular break at certain time points.CONCLUSION:Systemic administration of fasudil hydrochloride could be a treatment strategy of postoperative capsular contraction following cataract-intraocular lens surgery.

Research advance on postoperative complications of diabetics with cataract

With the development of cataract surgery technology and intraocular lens, great progress has been made in the prevention and treatment of postoperative complications of cataract.The risk of complications after cataract surgery in diabetic patients is significantly higher than that in non-diabetic patients. This article reviews the progress in prevention and treatment of macular edema, diabetic retinopathy, corneal and ocular surface abnormalities after cataract surgery in diabetic patients. Key words: Cataract; Diabetics; Conplication

Observation of the effect of extracapsular cataract extraction and intraocular lens implantation through small scleral tunnel incision

Observation of the effect of extracapsular cataract extraction and intraocular lens implantation through small scleral tunnel incision

Incidence and risk factors of macular edema after cataract surgery in patients with type 2 diabetes mellitus

Objective To investigate the incidence and risk factors of macular edema (ME) after cataract surgery in patients with type 2 diabetes mellitus (T2DM), and to provide a reference for clinical treatment. Methods From March 2014 to April 2017, 128 cases of cataract phacoemulsification and intraocular lens implantation in Jincheng Ophthalmology Hospital were retrospectively analyzed, of whom 36 cases(36 eyes) without diabetes were A group, 41 patients(41 eyes) with no retinopathy were B group, 51 cases(51 eyes) of T2DM patients with retinopathy were C group.The incidence of ME, the BCVA and the CSMT of the three groups were compared, and the Logistic multiple factor regression analysis was used to analyze the risk factors of DME after T2DM cataract surgery. Results The incidence rates of ME in A, B and C group were 5.56%, 29.27% and 50.98%, respectively, and the difference was statistically significant (χ2=6.567, P B group > A group (χ2=4.419, 19.951, all P group B > group C (t=4.950, 2.030, P<0.05). The CSMT after operation in A group, B group and C group was (246.35±23.73)μm, (249.52±20.95)μm and (289.31±43.82)μm, respectively, the difference was statistically significant (F=9.352, P<0.001). Logistic multivariate regression analysis showed that preoperative retinopathy[3.672 (0.261-0.961), P=0.000], preoperative ME[3.862 (0.136-0.769), P=0.001]were independent risk factors for the occurrence of ME after T2DM. Conclusion The incidence of ME is higher after T2DM cataract surgery, and the risk of ME is higher in patients with preoperative ME and preoperative diabetic retinopathy. Key words: Diabetes mellitus, type 2; Phacoemulsification; Macular edema; Risk factors; Lens implantation, intraocular

Histopathology of a retrocorneal membrane after Descemet membrane endothelial keratoplasty: a case report

BackgroundWe report the first histopathologically proven occurrence of a retrocorneal membrane after Descemet’s membrane endothelial keratoplasty.Case presentationA white Caucasian 76-year-old woman received penetrating keratoplasty on her right eye 2 years after Descemet’s membrane endothelial keratoplasty surgery with combined cataract extraction and intraocular lens implantation for Fuchs’ endothelial corneal dystrophy due to an allograft rejection with ensuing graft failure.Her preoperative vision was counting fingers (20/2000) caused by immunological debris, corneal edema, and secondary membrane formation. Her postoperative vision at 3 months was 20/125.The histopathological evaluation showed a membranous structure overlying the denuded Descemet membrane.ConclusionsWe report a case of a histopathologically proven retrocorneal membrane after Descemet’s membrane endothelial keratoplasty surgery.

Efficacy of small incision non-phacoemulsification cataract extraction for the treatment of hard nucleus cataract

Objective To evaluate the efficacy of small incision non-phacoemulsification cataract extraction and intraocular lens implantation for the treatment of hard nucleus cataract. Methods The data of 198 eyes of 198 cases with hardness nucleus grades Ⅳ-Ⅴwere collected and they received small incision cataract extraction by manual nuclear fragmentation and implantation of intraocular lens. Results The eyes with best corrected visual acuity(BCVA) ≥0.5 accounted for 67.17% and BCVA≥1.0 for 36.36% 1 week after surgery.Three months after surgery the eyes of BCVA≥0.5 were in 93.43% and ≥1.0 in 75.76% .The astigmatism was (1.50 ± 0.75)D 1 week after surgery, and(0.75 ± 0.50)D 3 months after surgery .Postoperative complications were mild corneal edema in 19 eyes(9.60%), iritis in 13 eyes(6.57%), and posterior capsule mild turbidity in 14 eyes(7.07%). No serious complication occurred. Conclusion Small incision non-phacoemulsification cataract surgery is effective with low astigmatism, less complications and fast vision recovery .It avoides corneal injury caused by the ultrasonic energy. Key words: Cataract, hard nucleus; Cataract extraction, non-phacoemulsification, small incision

Choice of operative time and method for pseudoexfoliation syndrome combined cataract with zonular defect

Background Pseudoexfoliation syndrome (PEX) is often complicated with cataract, accompanied by zonular defects.Zonular related complications easily happened intraoperatively and postoperatively.It is very important to choose the operating timing and method to reduce the complications and improve curative effects.However, relative study is rare. Objective This study was to analyze the curative effects of cataract extraction and intraocular lens (IOL) implantation for PEX combined cataract (PEXC) with zonular defect and discuss the appropriate operation timing and method. Methods A serial cases-observational study was performed, and written informed consent was obtained from each patient prior to ocular surgery.Twenty-three eyes of 21 patients with PEXC and zonular defect were included and received PEXC surgery inSecond People's Hospital of Kashi from July 2012 to December 2015.The patients were divided into phacodonesis type (18 eyes) and subluxation of lens (5 eyes) based on the severity of zonular defect and grade Ⅱ (4 eyes), grade Ⅲ (9 eyes), grade Ⅳ(7 eyes) and grade Ⅴ(3 eyes) nuclei based on the hardness of lens nuclei.Phacoemulsification combined capsular tension ring (CTR) or modified CTR (MCTR) insertion and IOL implantation was carried out for gradeⅡ and Ⅲ nuclei with phacodonesis eyes.or extracapsular cataract extraction combined CTR and IOL implantation was carried out for grade Ⅳ and Ⅴ nuclei with phacodonesis eyes, and phacoemulsification combined MCTR insertion and IOL implantation, or lens loop nucleus-deliver, anterior vitrectomy combined suspensory IOL implantation were performed for subluxation eyes.The patients were followed up for consecutive 3 months, and optimal operation timing, best corrected visual acuity (BCVA), intraocular pressure (IOP), complications and anterior capsular opening, IOL position were assessed. Results In the patients with phacodonesis, CTR was inserted in 10 eyes, and MCTR was inserted in 3 eyes, and extracapsular cataract extraction combined CTR and IOL implantation was carried out in 4 eyes and 1 eye received anterior vitrectomy combined suspensory IOL implantation.In the patient with subluxation of lens, only 1 eye finished successful phacoemulsification combined anterior vitrectomy and suspensory IOL implantation, and other 4 eyes received lens loop nucleus-deliver, anterior vitrectomy combined suspensory IOL implantation.The BCVA of the operated eyes was >0.5 in 4 eyes, >0.3-≤0.5 in 6 eyes, >0.1-≤0.3 in 8 eyes, ≤0.1 in 5 eyes, which was better than that before surgery (χ2=17.29, P 0.05). The intra- and post-operative complications included small pupil, corneal edema, residual cortex and posterior capsular opacification. Conclusions The operative process of PEXC eyes with zonular defect is complex.The choice of operative time and methods depends upon the type of zonular defect, hardness of lens nuleus, with or without subluxation of lens.A carefully ocular examination before operation is crucial for the therapy of PEXC. Key words: Pseudoexfoliation syndrome/complications; Cataract; Lens nucleus, crystalline/pathology; Zonular defect; Phacoemulsification; Lens implantation, intraocular; Operative time; Operative method; Capsular tension ring

Viscoless Manual Small Incision Cataract Surgery with Trabeculectomy

ABSTRACTPurpose: To compare the efficacy of combined manual small incision cataract and glaucoma surgery with anterior chamber maintainer (ACM) alone versus that with intraoperative viscoelastics. Methods: Hospital electronic medical records of patients who underwent small incision cataract and trabeculectomy and intraocular lens implantation without Mitomycin-C from 2014 to 2016 were identified from the hospital operation theater database for this retrospective, hospital-based comparative study. All MSICS surgeries were performed by a single surgeon under peribulbar block. Data retrieved from all patients undergoing surgery with viscoelastic (group 2) or under AC maintainer without viscoelastic (group 1) included preoperative visual acuity, preoperative treated intraocular pressure, number of anti-glaucoma medications before surgery, total surgical time, intraoperative complications, postoperative best-corrected visual acuity and IOP at one week and one month, need for additional procedures, and corneal clarity. Differences in surgical time and postoperative course in both groups were compared. Results: Of 268 manual combined cataract and glaucoma surgeries done from 2014–2016, we identified 147 eyes of 130 age-matched patients, which included 51 PACG, 50 POAG, 12 NTG, and 24 PXG eyes with a mean age of 66 ±11.2 years and 64± 10.8 years in group 2 (n=74) and group 1 (n=73), respectively; p=0.9. The surgical time was significantly lower in group 1 (16±4.8 minutes compared to 44±14.6 minutes for group 2; p<0.001) with transient edema seen <1 week after surgery in 24 eyes of group 2 and seven eyes of group 1; p=0.02. The postoperative IOP at all postoperative visits dropped to >50% in both groups with 11 eyes (PXG n=6, PACG n=5) requiring medications for rise in intraocular pressure at a median time of 1.2 months (r=0.2–3 months). The final visual acuity improved >4 snellen lines in all cases with two patients with advanced damage having 1 line improvement in Snellen acuity at final follow-up. Conclusion: The ACM can help completely avoid the use of viscoelastic during surgery, which can be an effective technique for MSICS with trabeculectomy in low resource stings. Training for such procedures should be incorporated into residency training programs.

Topografia corneana na cirurgia de catarata

Advancements in cataract surgery and intraocular lens (IOL) design have improved the quality of vision for patients subjected to cataract surgery. For the measurement of IOLs, the topographer can provide simulated keratometry, a parameter that simulates the keratometry of the automated refractor. In cases of corneal irregularities, the topography of semimeridians is used, disregarding the keratometric measurements of the ectatic area. Therefore, the measure of convergence of IOL will not be underestimated because the average keratometry obtained will be lower, avoiding the effect of postoperative hypermetropization. Corneal topography allows the quantitative determination of astigmatism and its classification into regular (symmetric and asymmetric) and irregular, guiding the cataract surgeon for the implantation of monofocal, multifocal, toric, or multifocal toric IOLs. Moreover, topography guides the surgeon while performing a corneal incision in the most curved axis to reduce postoperative astigmatism and allows the assessment of changes generated by corneal incision after cataract surgery. Therefore, topography has assumed an important role in surgical planning and preventing undesirable outcomes. This study presents the various applications of corneal topography in cataract surgery.