Cataract Surgery In Eyes Research Articles

Prevalence of Cystoid Macular Edema After Cataract Surgery in Eyes with Previous Macular Surgery.

ObjectiveTo determine the prevalence and risk factors for cystoid macular edema (CME) after cataract surgery in eyes that have previously undergone macular surgery.Study Design and MethodsRetrospective consecutive interventional case series. Patient medical records and Spectral Domain Optical Coherence Tomography (SD-OCT) were reviewed for eyes that underwent vitrectomy for full thickness macular hole (FTMH), lamellar macular hole (LMH) or epiretinal membrane (ERM) and subsequent cataract surgery at a large private retina practice between 2016 and 2018.ResultsAround 9.1% of eyes (22/243) developed CME post cataract surgery. The mean time from macular surgery to cataract surgery was 273 days (range: 87–797) in eyes with CME and 289 days (range: 22–897) in eyes without CME (p = 0.67). There was no difference in final visual acuity between eyes with CME (20/40, logMAR 0.312) and without CME (20/30, logMAR 0.206) (p = 0.101). Compared with patients with FTMH or LMH, patients with epiretinal membrane were more likely to develop post cataract CME (OR = 2.97, p = 0.031, Chi square test).ConclusionIn eyes with history of macular surgery, the prevalence of post cataract surgery CME was around 9.1%. The development of CME is not dependent on timing of cataract surgery but is more common in eyes with history of epiretinal membrane.

Peri and Postoperative Management of Cataract Surgery in Eyes with Ocular Inflammation

Peri and Postoperative Management of Cataract Surgery in Eyes with Ocular Inflammation

Anterior segment parameters after uveitic cataract surgery: A prospective study with 1-year results

PurposeTo determine the changes in anterior segment parameters in uveitic patients undergoing uncomplicated cataract surgery. MethodsThe best corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness (CCT), anterior chamber angle (ACA), anterior chamber depth (ACD), and axial length (AXL) of the 38 eyes of 28 well-controlled uveitic patients who underwent cataract surgery were monitored for 12 months. ResultsMean BCVA improved significantly at the postoperative visits when compared to the baseline (all P<0.001). Mean CCT increased on the first day compared to the preoperative value (627.62±71.16 vs. 572.18±53.52 µm, P=0.015) and then returned to the preoperative value at 3 months (572.27±49.93 µm). ACA showed a significant increase postoperatively in the first month (54.65±5.52 vs. 43.50±9.13°) and then decreased at 3 months (51.85±5.52°), remaining stable afterwards (51.73±6.59° at 12 months). ACD as measured by Sirius topography and IOLMaster 500 was higher at the follow-up times compared to the preoperative value (P<0.001). AXL at 1. month was significantly lower than the preoperative level (23.14±0.74 vs. 23.54±0.68 mm, P=0.003). ConclusionFollowing successful cataract surgery in well-controlled uveitic eyes, the CCT showed a rapid increase on the first day and then decreased to the preoperative level at the third month. ACA increased in the postoperative first month and then decreased, but it was higher than the baseline at all postoperative visits. ACD increased in the postoperative first week.

To determine functional visual improvement after cataract surgery in eyes with age related macular degeneration

To determine whether patients with Age related macular degeneration (ARMD) benefit from cataract surgery in terms of best corrected visual acuity (BCVA) and to assess impact of surgery on progression of ARMD.: A prospective study was carried out of patients with and without ARMD undergoing cataract surgery at our department. Patients were divided into two groups- Group A (cases) with ARMD and Group B (controls) without ARMD and other retinal pathology. BCVA of cases was recorded on day 1, day 14, 1 month and 1/month and compared to that of controls.: BCVA significantly improved but markedly less than that experienced by control eyes. No increased incidence in progression to wet form of ARMD. Cataract surgery is safe in ARMD patients with no evidence of increased complications or rates of disease advancement.

Mélanose conjonctivale ethnique bilatérale et cataracte congénitale

We report the case of a female child aged eight years presenting with total congenital cataract in the right eye. The patient had a history of left eye cataract surgery with implantation into the capsular bag. Examination found maximum bilateral conjunctival pigmentation at the level of the limbus, invading the bulbar conjunctiva. Examination of the left eye showed Soemmering ring. The main differential diagnoses included congenital melanosis and acquired melanosis. No specific management was undertaken for conjunctival melanosis and simple monitoring was recommended. Ethnic or racial melanosis is common in patients with brown pigmentation and is characterized by a proliferation of benign melanocytes along the basal membrane of the epithelium. The risk of malignant transformation is very rare, therefore regular monitoring is recommended.

The outcome of cataract surgery in eyes with end–stage glaucoma

Purpose: To evaluate the outcome of phacoemulsification and intraocular lens implantation (PHACO IOL) in eyes with end–stage glaucoma.&#x0D; Methods: Eighteen eyes of 18 patients with end–stage glaucoma in which PHACO IOL was performed were included in this prospective clinical study. Intraocular pressure (IOP) was measured before and 1 week, and 1, 3, 6, and 12 months after PHACO IOL. The best corrected visual acuity (BCVA), the number of antiglaucoma medications and the visual field (VF) test results before PHACO IOL and at the end of follow–up were evaluated.&#x0D; Results: The follow–up period after PHACO IOL was 12 months for all eyes. The mean IOP before surgery was 13.5 mmHg (SD 2.6). There were no differences between the mean IOP measurements before and after surgery during the entire follow– up period (P&gt;0.05). The mean preoperative BCVA was 0.65 (SD 0.3) logMAR, improving to a mean of 0.19 (SD 0.1) logMAR postoperatively (P&lt;0.0001). The mean number of antiglaucoma medications before surgery was 1.8 (SD 1.4), and it was 2.0 (SD 1.3) postoperatively (P=0.104). The mean value of the mean deviation in 7 eyes on automated perimetry was –23.57 dB (SD 3.9) preoperatively and –22.87 dB (SD 4.1) postoperatively (P=0.105). The mean VF island in 11 eyes on Goldmann perimetry was 17.0° (SD 7.2) preoperatively, improving to 20.4° (SD 9.0) postoperatively (P=0.033).&#x0D; Conclusion: PHACO IOL in eyes with end–stage glaucoma resulted in a stable IOP and a significantly improved BCVA without worsening of the VF.

Management of late in-the-bag IOL dislocation with exchange and scleral fixation of IOL with the transfixion technique

Introduction: Late in-the-bag intraocular lens (IOL) dislocation is a serious complication of cataract surgery. Patient and clinical findings: A 70-year-old woman with a history of left eye cataract surgery presented with progressively decreasing vision that had worsened over the past 6 months. In the left eye, the uncorrected distance visual acuity (UDVA) was counting fingers at 5 m, the corrected distance visual acuity (CDVA) was 20/25 (+12.25 −1.25 × 180), and the intraocular pressure was normal. An anterior segment examination revealed severe inferior dislocation of the IOL-capsular bag complex. Diagnosis, intervention, and outcomes: The patient was diagnosed with late in-the-bag IOL dislocation and underwent IOL–capsular bag complex explantation with sulcus-sutured IOL implantation using a new scleral fixation technique that included transfixion of a foldable acrylic IOL with polytetrafluoroethylene suture. The postoperative outcome was good; the UDVA was 20/70, and the CDVA was 20/25, and there were no postoperative complications such as infection, suture erosion, iritis, uveitis, vitreous hemorrhage, or retinal detachment. Conclusions: Late in-the-bag IOL dislocation was safely managed with IOL–capsular bag complex explantation and scleral fixation of a foldable posterior chamber IOL. This transfixion technique can be used for scleral fixation in patients with late in-the-bag IOL dislocation.

Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results

BackgroundThe short- and medium-term outcomes of iStent have been extensively studied; however, only few studies have investigated its long-term outcomes. Here, we assessed the long-term efficacy and safety of two iStents with concomitant cataract surgery in glaucomatous eyes while also evaluating measures of disease stability using visual field and optical coherence tomography (OCT) of the optic nerve and the macula throughout 8 years of follow-up.MethodsThis longitudinal, single-center consecutive case series included glaucomatous eyes that underwent implantation of two first-generation trabecular micro-bypass stents (iStent) with concomitant cataract surgery. Eight-year efficacy outcomes included mean intraocular pressure (IOP) and medications, as well as surgical success. Eight-year safety outcomes included best-corrected visual acuity (BCVA), visual field mean deviation (VF-MD), cup-to-disc ratio (CDR), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, and adverse events.ResultsA total of 62 eyes with primary open-angle glaucoma (POAG) were included. At 8 years postoperative, IOP reduced by 26% from 19.2 ± 3.9 mmHg preoperatively to 14.2 ± 2.4 mmHg (P < 0.001), 91.1% of eyes achieved IOP ≤ 18 mmHg (vs. 51.6% preoperatively), 69.6% of eyes achieved IOP ≤ 15 mmHg (vs. 14.5% preoperatively), and 25% of eyes achieved IOP ≤ 12 mmHg (vs. 1.6% preoperatively). Medication use decreased by 17.9% from 2.8 ± 1.1 preoperatively to 2.3 ± 1.2 (P = 0.018). Surgical success was 90%, as six eyes underwent subsequent glaucoma surgeries. Safety measures of BCVA, CDR, RNFL thickness and GC-IPL thickness remained stable through 8 years postoperative. VF-MD remained stable until postoperative year 5 and subsequently progressed according to the natural history of glaucomatous disease.ConclusionsImplantation of two iStents with concomitant cataract surgery is an effective and safe treatment option for surgery-naïve POAG eyes, evidenced by significant IOP and medication reductions, reasonable surgical success, and favorable safety outcomes, throughout the 8-year follow-up. Our data additionally supports the efficacy of this combined procedure in stabilizing or slowing disease progression.

Neutrophil lymphocyte ratio as a predictor of perioperative complications in patients with PEX Syndrome during cataract surgery.

Pseudoexfoliation syndrome (PES) is an age-related process associated with glaucoma and cataracts. It increases the risk of complications during cataract surgery.Blood neutrophil-to-lymphocyte ratio (NLR) is shown to be an effective biomarker of inflammation in PES. We aimed to investigate association of NLR and pseudoexfoliation (PEX) related cataract surgery complications. A total of 210 eyes who underwent cataract surgery between January 2016 and January 2020 in our department were analyzed retrospectively. Patients were grouped with respect to developing complications and the two groups were compared. Medical records were reached to obtain neutrophil and lymphocyte values to calculate NLR. Data obtained were analyzed using chi-square test. Receiver operating characteristics curve analysis was performed to determine cutoff, sensitivity and specificity values. p value of ≤ 0.05 was considered statistically significant. The mean age was 68.1 ± 7.2years and mean NLR was 2.11 ± 0.81. Complications were observed in 32 (15.2%) of the patients (group 1). Neutrophil counts (5.19 ± 0.64 vs. 4.43 ± 0.86, p < 0.001) and the NLR (2.68 ± 0.73 vs. 2.01 ± 0.81, p < 0.001) of group 1 were significantly higher than group 2. The ROC analysis revealed a cutoff value of 2.33 for NLR to predict cataract surgery complications with sensitivity of 87.5% and specificity of 78.1%. There is an association between NLR and increased risk of complications during cataract surgery in PES patients. NLR can be used as an easy method to help ophthalmologists in predicting the risks associated with cataract surgery in PEX eyes.

Cataract Surgery in Short Eyes, Including Nanophthalmos: Visual Outcomes, Complications and Refractive Results.

BackgroundTo report the visual outcomes, complications and refractive results of phacoemulsification surgery and intraocular lens implantation in a large series of adult patients with short and nanophthalmic eyes.MethodsThe records of all patients with axial length <21.0 mm undergoing phacoemulsification with intraocular lens implantation at an adult teaching hospital were retrospectively reviewed. The main outcome measures were corrected distance visual acuity and refraction at 90 days after surgery and intra- and postoperative complications occurring during the follow-up period.ResultsA total of 71 eyes of 51 patients (median age 71 years, interquartile range 62–75.5) were included. Surgery resulted in an improvement in corrected distance visual acuity in 53 eyes (74.6%) (95% confidence interval, logMAR 0.11–0.29) and was logMAR 0.30 or better in 47 eyes (66.2%). Worsening of corrected distance visual acuity occurred in 9 eyes (12.7%). Median postoperative refractive error was −0.75 dioptres. SRK/T and Kane formula were more accurate in predicting postoperative refraction than Barrett Universal II and Hoffer Q when based on mean absolute error (P < 0.005). Complications occurred in 18 eyes (25.4%). The most frequent complications were iris prolapse, Descemet’s membrane and/or endothelial trauma, transient severe corneal edema and cystoid macular edema. There was no statistically significant difference in complication rates between senior surgeons and senior trainees (P = 0.66).ConclusionCataract surgery in short and nanophthalmic eyes is challenging with a higher complication rate than routine cataract surgery, but frequently results in good visual outcomes. Postoperative refractive outcomes are more difficult to predict in this cohort.

Single-port transconjunctival vitrectomy for malignant glaucoma.

The management of malignant glaucoma involves either anterior vitrectomy with zonulectomy and iridectomy or 3-port core pars plana vitrectomy (PPV) by retinal surgeons. The proposed modification can be performed with reasonable success rates. In this technique, synechiolysis and anterior chamber irrigation were performed through a limbal incision, and a single-port 23- or 25-gauge vitrector was introduced through PPV superotemporally to perform anterior vitrectomy and central posterior capsulotomy in pseudophakic eyes. The same procedure can be performed after cataract surgery in phakic eyes. Vitrectomy is continued until anterior chamber deepens, ensuring a conduit between anterior and posterior chambers through the posterior capsulotomy alone, bypassing the need for a posterior iridectomy/zonulectomy. In a series on 9 eyes, all achieved optimization of anterior chamber depth with intraocular pressure normalization in 8 of 9 eyes, without showing any signs of recurrence at a mean follow-up of 8.6 months.

Hoornvliesbeschadiging na cataractchirurgie: belang van het droge-ogensyndroom en topische NSAID’s en oppuntstelling van de behandeling

Dry eye disease and cataract surgery: identification of risk factors for corneal damage and optimisation of treatment Various factors in the perioperative cataract surgery period can synergistically initiate a vicious inflammatory cycle of dry eye disease (DED) and tissue damage, with dire consequences. A careful anamnesis and preoperative assessment of the ocular surface can reveal some of the risk factors and facilitate an appropriate perioperative approach. Attention should be paid to DED and associated conditions, such as Meibomian gland dysfunction, as these conditions are very common. In the postoperative period, it is wise to avoid preserved topical medication, as well as to use topical medication that may be toxic to the ocular surface, such as non-steroidal anti-inflammatory drugs (NSAIDs), with care in specific cases. The treatment of DED and its complications consists primarily of the careful use of lubricating, antibiotic and anti-inflammatory agents. In serious DED cases, autologous serum promotes tissue regeneration by promoting epithelialisation and stromal recovery, and can be a useful adjunct to the first-line treatment. In extreme and rare cases, DED can, in combination with the use of topical NSAIDs and other risk factors, lead to sight-threatening complications, such as corneal melting. A surgical treatment consisting of conjunctival flap transplantation, amniotic membrane transplantation, gluing of the cornea or tectonic keratoplasty may be necessary when perforation is imminent.

Efficacy of Preoperative Music Intervention on Pain and Anxiety in Patients Undergoing Cataract Surgery

The aim of the present study was to investigate the impact of preoperative music exposure on intra- and post-operative pain during cataract surgery. This study was conducted alongside a prospective single-masked randomized controlled trial (ClinicalTrials.gov NCT02892825). Patients undergoing first eye cataract surgery were included and randomly assigned to either the intervention or control group. Patients in the intervention group had a 20-min music session through earphones before surgery, while patients in the control group wore earphones without music. Anxiety level evaluated using the visual analog scale and heart rate were collected before and after music intervention. Pain level was assessed using the Numerical Pain Rating Scale, during the surgical procedure, prior to discharge and 7 days postoperatively. A total of 243 patients were included: 119 in the intervention group and 124 in the control group. No significant differences in baseline characteristics, including age, sex and rate of treated hypertension were found between the 2 groups (all p-values > 0.05). In addition, no significantly differences were found in heart rate and anxiety level before music intervention between the 2 groups (all p-values > 0.05). Conversely, anxiety level was significantly lower in the music group after the intervention (respectively, 1.3 ± 1.1 vs 3.2 ± 2.2; p < 0.05). Patients in the music group reported a lower mean pain level during surgical procedure and before discharge compared with control group (respectively, 1.2 ± 0.5 vs 2.1 ± 1.1, p = 0.03 and 0.23 ± 0.4 vs 0.81 ± 0.7, p = 0.04). No difference was found in pain level 7 days postoperatively (0.1 ± 0.3 vs 0.2 ± 0.4, p = 0.1). A significant correlation was found between anxiety level and intraoperative pain level (R = 0.64, p = 0.02). In conclusion, music intervention was effective in reducing anxiety level and self-reported pain both during surgery and in the early postoperative period. Clinical Trial Registration: https://clinicaltrials.gov/ct2/home, identifier NCT02892825.

Intraocular lens power calculations in eyes with pseudoexfoliation syndrome

To compare refractive outcomes after cataract surgery in pseudoexfoliation syndrome (PEX) and control eyes and to investigate the accuracy of 3 intraocular lens (IOL) calculation formulas in these eyes. In this prospective comparative study 42 eyes (PEX group) and 38 eyes (control group) of 80 patients were included. The follow-up was 3 months. The refractive prediction error (RPE), mean absolute error (MAE), median absolute error (MedAE) and the percentages of eyes within ± 0.25 D, ± 0.5 D, ± 1.0 D and ± 2.0 D of prediction error were calculated. Three IOL calculation formulas (SRK/T, Barrett Universal II and Hill-RBF) were evaluated. PEX produced statistically significantly higher mean absolute errors and lower percentages of eyes within ± 0.5 D than control eyes in all investigated IOL calculation formulas. There were no statistically significant differences in the median absolute errors between the 3 formulas in either PEX or control eyes. Refractive outcomes after cataract surgery are statistically significantly worse in PEX than in control eyes. All three IOL calculation formulas produced similar results in both PEX and control eyes.Trial registration: ClinicalTrials.gov registration number NCT04783909.

Outcomes of manual small incision cataract surgery and phacoemulsification in eyes with chorioretinal coloboma.

To evaluate outcomes of manual small-incision cataract surgery (MSICS) and phacoemulsification in eyes with chorioretinal coloboma. Tertiary eye center, South India. Retrospective study. Electronic medical records of 71 patients with chorioretinal coloboma undergoing cataract surgery from January 2017 to December 2019 were evaluated. Demographics, corrected distance visual acuity (CDVA), slitlamp biomicroscopy findings, grade of cataract, type of coloboma and associated posterior segment pathology, outcomes of different surgical techniques and risk factors for poor visual outcomes, and intraoperative complications were analyzed. Among the 78 eyes studied, 53.9% eyes achieved visual outcome of 20/40 or greater and 20.5% eyes achieved CDVA less than 20/200. For the MSICS group, the median preoperative CDVA was 1.78 (interquartile range [IQR] 1.08 to 2.60) logMAR), which improved to 0.60 (IQR 0.30-1.08) logMAR postoperatively. In phacoemulsification group, the CDVA improved from 0.78 (IQR 0.60-1.00) logMAR to 0.18 (IQR 0.18-0.30) logMAR. Statistically significant visual improvement was noticed in both groups (P < .001 in both). However, eyes that underwent phacoemulsification showed better visual recovery (P < .001). The mean age at presentation was 49.7 ± 10.8 years. MSICS was the most commonly performed surgery (61.54%), and 62 eyes had uneventful cataract surgery. Twelve eyes in MSICS group and 4 eyes in phacoemulsification group had intraoperative complications. Poor visual outcome was associated with male sex, microcornea, hard cataracts, and macular involvement of coloboma. MSICS is an alternative to phacoemulsification in colobomatous eyes with advanced cataract. Hard cataract and microcornea were risk factors for intraoperative complications. Significant postoperative improvement in CDVA was noticed in both macula involved and macula not involved groups.

Correlation between Hyperalgesia and Upregulation of TNF-α and IL-1β in Aqueous Humor and Blood in Second Eye Phacoemulsification: Clinical and Experimental Investigation.

The aim of this study was to explore the correlation between intraoperative hyperalgesia of the second eye and the dynamic changes of tumor necrosis factor (TNF)-α and interleukin (IL)-1β levels in aqueous humor (AH) of the second eye and whole blood after the first eye cataract surgery. A rabbit model of monocular phacoemulsification was established by administration of 0.3% levofloxacin. Whole blood and AH samples from non-surgical eyes in the experimental group (n =25) and second eye in the blank control group (n =15) were obtained and corneal sensitivity was examined after surgery (1, 3, 7, 14, and 21 days postoperatively). TNF-α and IL-1β levels in AH and TNF-α mRNA and IL-1β mRNA levels in whole blood were measured. In a clinical study, 30 patients who underwent bilateral phacoemulsification within 1 month were divided into six groups in accordance with the operation intervals (1, 3, 7, 10, 14, and 21days). TNF-α and IL-1β levels in AH were measured at the beginning of surgery and intraoperative pain was assessed immediately after surgery. Corneal sensitivity (F =244.910, P <0.05), TNF-α and IL-1β levels in AH (F =184.200, 82.900, P <0.05) of non-surgical eyes and in whole blood (F =272.800, 193.530, P <0.05) in the experimental group were significantly higher than the baseline levels after phacoemulsification. In the clinical study, NRS scores of second eye surgery were higher than those of the first eye(P =0.0025) and 19 (63.3%) patients reported more pain during the second eye surgery. TNF-α and IL-1β concentrations in AH of the second eye were significantly higher than those of the first eye (F =123.60, P <0.05; F =59.60, P <0.05). In conclusion, within 1 month after the first eye phacoemulsification, higher pain sensitivity (hyperalgesia) exists in the second eye, which may be related to dynamic changes in TNF-α, IL-1β levels in AH or whole blood.

Fall risk in patients with pseudophakic monovision

ObjectiveVision changes can precipitate falls in the elderly resulting in significant morbidity and mortality. We hypothesized that pseudophakic monovision and ensuing anisometropia and aniseikonia impact elderly fall risk. This study assessed fall risk in patients with pseudophakic monovision, pseudophakic single vision distance (classic cataract surgery), and cataracts with no surgery. DesignRetrospective single-institution cohort study ParticipantsPatients with bilateral cataracts diagnosed at 60 years of age or older who underwent bilateral cataract surgery (monovision or single vision distance) or did not undergo any cataract surgery (n = 13 385). Patients with unilateral surgery or a fall prior to cataract diagnosis were excluded. MethodsData were obtained from the Stanford Research Repository. Time-to-fall analysis was performed across all 3 groups. Primary outcome was hazard ratio (HR) for fall after second eye cataract surgery or after bilateral cataract diagnosis. ResultsOf 13 385 patients (241 pseudophakic monovision, 2809 pseudophakic single vision, 10 335 no surgery), 850 fell after cataract diagnosis. Pseudophakic monovision was not associated with fall risk after controlling for age, sex, and myopia. Pseudophakic single-vision patients had a decreased time to fall compared with no-surgery patients (log rank, p < 0.001). Older age at cataract diagnosis (HR =1.05, 95% confidence interval [CI] 1.04–1.06, p < 0.001) or at time of surgery (HR = 1.05, 95% CI 1.03–1.07, p < 0.001) increased fall risk, as did female sex (HR = 1.29, 95% CI 1.10–1.51, p = 0.002) and preexisting myopia (HR = 1.31, 95% CI 1.01–1.71, p = 0.046) among nonsurgical patients. ConclusionsPseudophakic monovision did not impact fall risk, but pseudophakic single vision may increase falls compared with patients without cataract surgery.

Case Report of Brown McLean Syndrome

Purpose: To report two rare cases of Brown McLean syndrome after cataract surgery in a patient with aphakia.Case summary: (Case 1) A 54-year-old woman with Marfan’s syndrome who had aphakia and peripheral corneal edema after left eye cataract surgery 4 years ago. The patient had an elevated lesion in the peripheral cornea without involving the central cornea, and had symptoms of pain, irritation and tearing. Specular microscopy showed normal endothelial cell density and morphology in the edematous cornea. The peripheral corneal edema improved after use of antibiotics, autoserum eyedrops and 5% NaCl eyedrops. (Case 2) A 61-year-old woman with aphakia in her left eye after bilateral cataract surgery 11 years ago, underwent surgery for a macular hole in both eyes. The patient developed peripheral corneal erosions and edema in the left eye 2 months after the surgery. Specular microscopy showed normal endothelial cell density and morphology. The peripheral corneal edema was static over the years while using 5% NaCl eyedrops and artificial tears, and did not progress to involve the central cornea.Conclusions: Brown McLean syndrome is a rare disease but the possibility should be considered if a patient with aphakia after cataract surgery has peripheral corneal edema for several years.

Pediatric cataract surgery following treatment for retinoblastoma

To determine the visual and refractive outcomes, ocular and systemic complications of cataract surgery in eyes treated for retinoblastoma (RB).

The effects of trypan blue use on the corneal endothelium during cataract surgery in patients with pseudoexfoliation syndrome (PEX)

Purpose In the present clinical study, it was aimed to investigate the possible effects of Trypan blue (TB) use on the corneal endothelium during cataract surgery in eyes with pseudoexfoliation syndrome (PEX) during a three-month follow-up period using the contralateral eye control design. Methods This prospective, randomised controlled, individual cohort study included 92 eyes of 46 patients with bilateral PEX and cataracts. While 1% TB was applied to one eye of the patients before capsulorhexis (study group), it was not applied to the other eye (control group). Both groups were compared preoperatively and postoperatively in terms of endothelial cell density (ECD), endothelial cell loss (%), pleomorphism, polymegathism and central corneal thickness (CCT) using specular microscopy. Results Preoperative corneal ECD was measured as 2362.56 ± 253.27 in the study group, 2380.84 ± 220.54 in the control group, and 2145.58 ± 221.71 in the study group and 2184.97 ± 200.94 cells/mm2 in the control group in the postoperative 3rd-month follow-up (p = 0.71 and = 0.37, respectively). In addition, there were no significant differences between the two groups in terms of the percentage of hexagonal cells, coefficient of variation (CV), and CCT both preoperatively and postoperatively 3 months later (p = 0.78, =0.39, =0.95 preoperatively and p = 0.31, =0.26, =0.83 postoperatively, respectively). Conclusion This study demonstrated that the injection of 1% TB into the anterior chamber for staining the anterior capsule during cataract surgery did not cause significant corneal endothelial changes at postoperative 3rd months, despite the increased fragility of corneal endothelial cells in patients with PEX.