Efficacy Of Cataract Surgery Research Articles

Safety and efficacy of poly(methyl methacrylate), hydrophobic acrylic and hydrophilic acrylic intraocular lenses: A comparative clinical investigation

Objectives: Cataract surgery is a prevalent procedure for restoring vision in patients with cataracts. Intraocular lens (IOL) material selection significantly impacts outcomes. This study aimed to assess the safety and efficacy of poly(methyl methacrylate) (PMMA), hydrophilic, and hydrophobic IOLs in cataract surgery. The primary objective was to assess intraoperative safety and IOL performance. The secondary objective was to determine lens-related adverse events and visual acuity. Materials and Methods: This prospective clinical study included adult cataract patients undergoing IOL implantation at a single centre in India. Exclusion criteria included patients unwilling to participate, with previous intraocular or corneal surgery, traumatic cataract, pregnancy or lactation, concurrent participation in other drug or device investigations, unstable keratometry or biometry measurements, or irregular astigmatism. Patients with glaucoma and retinal disorders were also excluded. The study duration was one year with five follow-up visits. For the PMMA, hydrophilic, or hydrophobic IOLs 331, 340 and 330 eyes from 331, 340 and 330 patients were included respectively for the study. Intraoperative safety and performance were assessed through documented adverse events. Visual outcomes were evaluated at each visit using visual acuity measurements, slit-lamp examination, and intraocular pressure measurement. Results: No significant intraoperative complications or safety concerns were reported. There were no observed cases of IOL decentration, tilt, dislocation, discoloration, or opacity. Both distance uncorrected and distance best-corrected visual acuity (BCVA) showed significant improvement from baseline to the final visit in all groups. Conclusion: PMMA, hydrophilic, and hydrophobic IOLs demonstrated good safety and efficacy in cataract surgery, with significant improvement in visual acuity and no lens-related adverse events reported in this study.

Long-term visual outcomes and histopathologic findings after cataract surgery in Ebola virus disease survivors in the Ebola virus RNA persistence in ocular tissues and fluids (EVICT) study.

Ebola virus disease (EVD) survivors develop post-acute ophthalmic sequelae, including a high prevalence of uveitis that may be complicated by vision-threatening cataract. After the non-detection of Ebola virus (EBOV) RNA in sampled ocular fluid, vision impairment due to cataract can be treated safely and effectively via manual small incision cataract surgery (MSICS). However, the long-term ocular visual outcomes and assessment of ocular tissues, including for genomic RNA, have been infrequently or not reported in Western African survivors. A cohort of EVD survivors with visually significant cataract, in whom EBOV RNA was not detected by RT-PCR testing of ocular fluid sampled prior to MSICS, were followed for a year after intraocular lens replacement. Ophthalmic outcomes, including visual acuity (VA), adverse events, and follow-up examinations, were recorded. Ocular tissue specimens obtained at MSICS underwent histopathologic examination and in-situ hybridization (ISH) targeting EBOV genomic RNA. Thirty-four EVD survivors underwent MSICS and were included for analysis. The median age of EVD survivors who underwent surgery at enrollment was 22.5 years (Interquartile range, IQR: 16.5-33) and the cohort was comprised of 20 females (58.8%). Median logMAR VA at preoperative baseline was 3 (IQR: 1-3) which improved to 0.4 (IQR: 0-0.6; n = 10; p = 0.002) and 0.6 (IQR: 0.18-0.78; n = 18; p < 0.0001) at 6- and 12-months following surgery, respectively. EBOV RNA was not detected in 7 cataract and capsular tissue specimens obtained at the time of MSICS. After MSICS, meaningful improvement in vision was maintained in EVD survivors at long-term follow-up. EBOV RNA was not detected in cataract and lens capsule specimens, providing additional reassurance of the low risk of EBOV RNA exposure during cataract surgery. Further study is needed to understand long-term ocular outcomes, including adverse events, in this population. Ebola virus disease (EVD) survivors may develop several ophthalmic sequelae including uveitis and cataract that may lead to severe vision loss if left untreated. Manual small incision cataract surgery (MSICS) has been utilized to treat cataract in EVD survivors with encouraging short-term outcomes, but the long-term visual acuity outcomes and the potential for Ebola virus RNA to reside in cataract material is unknown. In this study, we reported long-term visual acuity outcomes following MSICS in a cohort of EVD survivors along with histopathology findings from materials collected during surgery. Visual acuity improved over 12-month follow-up with encouraging safety measures. Ebola virus RNA was not detected in cataract and lens capsular tissue analyzed from EVD survivors. This study provides additional assurance regarding the safety and efficacy of cataract surgery, with potential for improved vision for EVD survivors.

Efficacy of Cataract Surgery in Lowering IOP in Small Eyes with Shallow Anterior Chamber

Efficacy of Cataract Surgery in Lowering IOP in Small Eyes with Shallow Anterior Chamber

Safety and Efficacy of Cataract Surgery Under a Local Infection Control Protocol Before and During a COVID-19 Wave in Thailand for Healthcare Workers and Patients: A Prospective Cohort from a Secondary Center

PurposeTo assess the effectiveness of a local infection control protocol for cataract surgery (CS) during the coronavirus disease (COVID-19) pandemic and determine the trend of CSs and visual outcomes during this period, as compared to the pre-COVID-19 pandemic period.MethodsThis study was conducted at Suddhavej Hospital, Mahasarakham University, Mahasarakham, Thailand, between July 1, 2020, and March 31, 2021. In this two-phase study, we used only a COVID-19-screening questionnaire during the first phase and preoperative nasopharyngeal swab severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing for real-time reverse transcriptase-polymerase chain reaction in the second phase, during Thailand’s second COVID-19 wave. Nasopharyngeal swab SARS-CoV-2 nucleic acid testing, SARS-CoV-2 IgG/IgM, or anti-SARS-CoV-2 spike antibody seroconversion was used to detect COVID-19 infection among healthcare workers. We also compared cataract surgical volume and postoperative visual acuity of CS patients between the pre-COVID-19 period and during the COVID-19 pandemic period.ResultsA total of 947 patients underwent CS. Thirty-two healthcare workers and 275 patients tested negative for SARS-CoV-2 in the second study phase. CSs increased on average by 50.09% month-to-month when the surgery was resumed. The mean postoperative logMAR best-corrected visual acuity was significantly better in the COVID-19 pandemic period than in the pre-pandemic period (difference, 0.1 [95% CI: 0.00–0.12], p < 0.0001).ConclusionCS could be safely performed under an infection control protocol during the COVID-19 pandemic. The cataract surgical volume, with favorable visual outcomes, has an increasing trend after resuming elective surgeries.

Predictive Factors for Long-Term Outcomes of Cataract Surgery in Patients Receiving Active Treatment for Neovascular Age-Related Macular Degeneration.

Background: the safety and efficacy of cataract surgery in eyes with exudative neovascular age-related macular degeneration (nAMD), receiving active treatment, remain unclear. We evaluated the long-term outcomes and associated predictive factors of cataract surgery in eyes with exudative nAMD. Methods: this retrospective cohort study included 65 eyes (61 patients) treated with anti-vascular endothelial growth factor (VEGF) injections within six months preoperatively. Changes in best-corrected visual acuity (BCVA) and anti-VEGF treatment patterns from before to up to four years after surgery were assessed. Predictive factors were identified in association with one-year surgical outcomes. Results: the BCVA improved at six months (p < 0.001) and was maintained for three years postoperatively. The interval between anti-VEGF injections increased 3.4 times postoperatively (p = 0.001). Risk factors for poor BCVA were low preoperative BCVA (p < 0.001) and prolonged nAMD duration (p = 0.003). Prolonged nAMD duration and short exudation-free period were associated with more frequent postoperative anti-VEGF treatments (p = 0.028 and p = 0.003, respectively). AMD subtypes were not associated with both vision and injection pattern outcomes. Conclusions: patients with cataracts receiving nAMD treatment can safely undergo surgery with favorable long-term visual benefits. The preoperative BCVA, nAMD duration, and exudation-free period are potential predictors of surgery outcomes.

Efficacy and Safety Outcomes of Cataract Surgery in Survivors of Ebola Virus Disease: 12-Month Results From the PREVAIL VII Study.

PurposeIn survivors of Ebola virus disease (EVD), intraocular viral persistence raises questions about the timing and safety of cataract surgery. To the best of our knowledge, this is the first controlled study evaluating Ebola virus persistence and cataract surgery safety and outcomes in EVD survivors.MethodsSeropositive EVD survivors and seronegative controls with vision worse than 20/40 from cataract and without active intraocular inflammation were enrolled. Aqueous humor from survivors was tested with reverse transcription–polymerase chain reaction for Ebola viral RNA. Participants underwent manual small-incision cataract surgery and 1 year of follow-up examinations.ResultsTwenty-two eyes of 22 survivors and 12 eyes of eight controls underwent cataract surgery. All of the aqueous samples tested negative for Ebola viral RNA. Median visual acuity improved from 20/200 at baseline to 20/25 at 1 year in survivors and from count fingers to 20/50 in controls (overall, P < 0.001; between groups, P = 0.07). After a 1-month course of topical corticosteroids, 55% of survivors and 67% of controls demonstrated at least 1+ anterior chamber cell. Twelve months after surgery, optical coherence tomography revealed a median increase in macular central subfield thickness of 42 µm compared with baseline (overall, P = 0.029; between groups, P = 0.995).ConclusionsEVD survivors and controls demonstrated significant visual improvement from cataract surgery. The persistence of intraocular inflammation highlights the importance of follow-up. The absence of detectable intraocular Ebola viral RNA provides guidance regarding the safety of eye surgery in Ebola survivors.Translational RelevanceThese findings demonstrate the safety and efficacy of cataract surgery in Ebola survivors and will inform ocular surgery guidelines in this population.

Cataract surgery in patients with left ventricular assist devices.

To determine the safety and efficacy of cataract surgery in patients with left ventricular assist devices (LVADs). Duke Eye Center, Durham, North Carolina, USA. Retrospective case series. Electronic medical records were used to collect patient demographics, preoperative planning, intraoperative details, and postoperative outcomes of patients with LVADs who underwent cataract surgery between March 2012 and August 2019. A total of 53 cataract surgeries were identified involving 31 patients. Most patients were men (n = 27) and white (n = 25) with a mean age of 69.5 years. Preoperative biometry was unchanged from standard protocol. Femtosecond laser, intraoperative aberrometry, and/or a premium IOL was used in 25 cases (47.2%) . Patients were on warfarin, warfarin plus aspirin, and warfarin plus clopidogrel in 51.6% (n = 16), 45.2% (n = 14), and 3.2% (n = 1) of cases, respectively. Patients underwent topical anesthesia with monitored anesthesia care from an experienced LVAD team as planned with no episodes of hemodynamic instability, respiratory compromise, or intraoperative adverse events related to the LVAD. All patients were discharged the same day as surgery. There were no hospitalizations or deaths within 30 days that were attributed to the cataract procedure. At 1 month postoperatively, 61.1% of eyes were ±0.5 diopter of their predicted spherical equivalent (n = 11/18), with a high proportion of patients returning to local providers for postoperative care. Cataract surgery was safe and feasible in patients with LVADs when performed with additional perioperative considerations and in conjunction of an experienced LVAD team. The presence of LVAD itself was not found to be a contraindication for cataract surgery.

Efficacy of cataract surgery in diabetic patients with high myopia

Objective To evaluate the clinical efficacy of cataract surgery for diabetic patients with high myopia. Methods The data of 34 eyes of 28 cases of diabetic patients with high myopia and cataract from May 2014 to Jun.2018 in this hospital were analyzed retrospectively. All cases were treated with phacoemulsification and intraocular lens implantation. The efficacy of treatment and complication were analysed. Results The best corrected visual acuity was< 0.3 in 19 eyes (55.9%) at 3 moths postoperatine. The retinal thickness in central macula at 1 day, 1 week and 1 month after surgery were thicker than that before surgery (P=0.000, 0.000, 0.001). There were 32 eyes (94.1%) recovered to preoperative condition at 3 months after surgery (P=1.000). The macular edema occurred in 2 eyes (5.9%) and posterior capsular opacification in 1 eye (2.9%) at 3 months postoperatively. Conclusion Phacoemulsification combined with intraocular lens implantation is effective and safe in diabetic patients with high myopia and cataract. Key words: Myopia, high; Diabetes; Cataract; Phacoemulsfication; Lens, intraocular

Observation on cataract surgery of patients with acquired immunodeficiency syndrome

Objective To observe the efficacy of cataract surgery for patients with acquired immunodeficiency syndrome (AIDS). Methods The data of 21 eyes of 20 patients with AIDS from Jan. 2018 to Dec. were analyzed retrospectively. All cases underwent cataract extraction and intraocular implantation. The efficacy and safety were observed. Results After surgery, the visity acuity was 0.6 in 7 eyes. No infection was detected. Conclusion To strictly obey the medial practice standard, cataract surgery for AIDS patients can be safe with satisfactory prognosis. Key words: Syndrome, acquired immunodeficiency; Cataract; Lens, intraocular

Efficacy of Cataract Surgery With Trabecular Microbypass Stent Implantation in Combined-Mechanism Angle Closure Glaucoma Patients

To evaluate the effectiveness of trabecular microbypass stent (iStent) implantation in combined mechanism glaucoma (CMG). Retrospective cohort study. We reviewed the medical charts of patients with the following scenarios: (1) primary open-angle glaucoma (POAG) undergoing phacoemulsification (PE), (2) POAG undergoing PE with iStent (POAG-PE/iStent), (3) CMG undergoing PE (CMG-PE), and (4) CMG undergoing PE with iStent (CMG-PE/iStent). CMG was defined as narrow-angle glaucoma patients whose angle had opened after iridotomy. Linear mixed-effects models were performed to determine the effect of iStent on postoperative 1-year success rate (intraocular pressure [IOP] ≤ 18 without medication), IOP, and number of medications. Data from 301 eyes were available. The number of eyes (subjects) was 61 (45) in the POAG-PE, 60 (50) in POAG-PE/iStent, 93 (76) in CMG-PE, and 87 (70) in CMG-PE/iStent group. Success criteria were achieved in 13.1% for POAG-PE, 33.3% for POAG-PE/iStent (POAG-PE vs POAG-PE/iStent B 3.01; P < .001), 37.6% for CMG-PE, and 43.7% for CMG-PE/iStent (CMG-PE vs CMG-PE/iStent B 2.25; P < .001). There was no difference in the IOP between POAG-PE and POAG-PE/iStent, and between CMG-PE and CMG-PE/iStent. The iStent significantly reduced number of medications in the POAG (B-0.70; P<.001) and CMG group (B-0.52; P < .001). Comparing the effect of iStent on POAG and CMG, the analysis showed similar iStent efficacy in terms of the success rate, IOP, and number of medications (P > .05). Combined PE/iStent significantly increased success rate and reduced number of medications in CMG patients compared to PE alone. The effects of iStent were comparable between POAG and CMG groups.

Cataract surgery in patients with corneal opacities

BackgroundInvestigating the efficacy and safety of phacoemulsification with intraocular lens (IOL) implantation in corneal opacities.MethodsThis retrospective study was conducted in a tertiary medical center. Twenty-three eyes of 19 patients with cataracts and corneal opacities obscuring the pupillary center having received phacoemulsification with IOL insertion without any ancillary techniques were enrolled. The primary study outcome measures were uncorrected and best corrected visual acuity (BCVA), and complications. Backscatters of corneal scar lesions were evaluated by slit lamp-based haze grading, Scheimpflug Pentacam and anterior segment optical coherence tomography (ASOCT). Visual outcomes after cataract surgeries and improvement range were used to determine the safety and efficacy of cataract surgery for our patients.ResultsAll patients underwent uneventful capsulorhexis and phacoemulsification. The mean age was 72.22 ± 10.1 years, and the mean follow-up period was 18.57 ± 15.42 months. The mean BCVA significantly improved from 1.45 ± 0.65 preoperatively to 0.94 ± 0.55 logMAR postoperatively (p < 0.001), and the number of eyes with a BCVA of 20/100 or better increased from 4 to 14. Complications included corneal edema in two eyes and reactivation of the previous corneal pathology in five eyes. Four eyes did not achieve an improvement in visual acuity after surgery, which may have been due to co-existing ocular co-morbidities. Both Pentacam corneal densitometry and ASOCT demonstrated no significant correlations with final visual outcome. However, a statistically significant relationship between the severity of corneal opacity and improvement range in BCVA (r = − 0.782, P = 0.001) was found by our OCT grading method.ConclusionsPhacoemulsification and IOL implantation in selected cases of coexisting cataracts and corneal opacities is safe that can provide suboptimal but long-term vision when penetrating keratoplasty is not possible or at high-risk of graft failure. ASOCT is a simple tool to predict visual outcomes after cataract surgery in opacified corneas.

Comparison of efficacy between coaxial microincision and standard-incision phacoemulsification in patients with age-related cataracts: a meta-analysis

BackgroundIncision size plays a critical role in the efficacy of cataract surgery, but the available evidence on ideal incision size is inconsistent. In this study, we conducted a meta-analysis to evaluate the efficacy of coaxial microincisional phacoemulsification surgery (MICS) compared with that of standard-incision phacoemulsification surgery (SICS) in patients with age-related cataracts.MethodsThe Cochrane Library (Wiley Online Library), PubMed, Medline, National Knowledge Infrastructure (CNKI), and VIP databases were searched to identify reports of clinical randomized controlled trials (RCTs) comparing MICS to SICS for the treatment of age-related cataracts. The outcomes of interest included surgically induced astigmatism (SIA), effective phacoemulsification time (EPT), central corneal thickness (CCT), endothelial cell count (ECC), endothelial cell count loss (ECC Loss %), and average ultrasonic energy (AVE).ResultsEleven RCT studies were included in this meta-analysis. No statistically significant differences were observed in EPT (Z = 1.29, P > 0.05), CCT (1 day: Z = 1.37, P > 0.05; 7 days: Z = 0.75, P > 0.05; 30 days: Z = 0.38, P > 0.05; 90 days: Z = 0.29, P > 0.05), ECC (7 days: Z = 1.13, P > 0.05; 30 days: Z = 1.42, P > 0.05) or ECC Loss % (7 days: Z = 0.24, P > 0.05; 30 days: Z = 0.06, P > 0.05; 90 days: Z = 0.10, P > 0.05) between MICS and SICS. However, statistically significant differences were found in AVE (Z = 4.19, P < 0.0001) and SIA (1 day: Z = 10.33, P < 0.00001; 7 days: Z = 10.71, P < 0.00001; 30 days: Z = 10.95, P < 0.00001; 90 days: Z = 2.21,- P < 0.01) between MICS and SICS.ConclusionCompared with SICS, MICS can reduce short-term and long-term SIA, but it does not differ in safety outcomes or in the time required for surgery.

Analysis on the efficacy of cataract surgery during the international aid to African "Brightness Action"

Objective To analyze the safety and efficacy of cataract surgery during the international aid to African Brightness Action . Methods The data of 280 eyes of 240 cases with cataract were collected during international aid to Cameroon Brightness Action from May 2016 to Jun. 2016. They underwent phacoemulsification or small incision cataract extraction and intraocular lens implantation. Results Followed up for 3 to 6 months, no endophthalmia, bullous keratopathy or other serious complication occurred after surgery. No cystoids macular edema, retinal detachment or secondary opacification of the posterior capsule happened. At 1-3 days postoperatively, the visual recovery rate was 98.21% and the visual acuity recovered from disability occupyed for 83.93%. The visual acuity at 1-3 days after surgery was ≥0.5 in 203 eyes (72.50%). At the end of the follow-up, the visual acuity was ≥0.5 in 266 eyes(95.00%), 0.05-0.25 in 8 eyes (2.97%). The main cause of low vision after surgery was ocular fundus disease. Conclusion The operation of large-scale cataract rescue operation during the international aid to Brightness Action is effective, the treatment is selected by phacoemulsification and small incision manual operation, the safety is reliable. Key words: Cataract; Brightness Action international aid to Africa; Phacoemulsificstion; Small incision extracapsular cataract extraction; Intraocular lens implantation

Clinical observation on cataract surgery in patients with diabetic renal failure

Objective To observe the efficacy of cataract surgery of patients with diabetic renal failure after proper treatment during perioperative period and improved surgical method. Methods A retrospective clinical study. The data of 57 eyes of 43 patients with cataract and diabetic renal failure were selected as observation group and they received phacoemulsification. All cases of observation group received non-heparin dialysis, control of blood glucose and blood pressure in perioperative period. During the operation, strong suction and low energy were applied, and anterior and posterior capsule polishing were performed. The data of 61 eyes of 45 patients with similar general conditions with the normal renal function and diabetic cataract were selected as control group. The postoperative complications and the visual acuity of 3 months after operation were compared between the two groups. Results There was no significant difference between the two groups in complication and the visual acuity 3 months after operation (P>0.05). Conclusion Under the premise that all aspects of the perioperative period can be controlled strictly and the surgical method be improved, cataract surgery is a safe and effective treatment for cataract patients with diabetic renal failure. Key words: Diabetic; Failure, renal function; Cataract surgery

Efficacy of cataract surgery in patients with uveitis

To evaluate the visual outcomes of cataract surgery in patients with uveitis, and to determine risk factors for the recurrence of uveitis and postoperative complications.Eighty patients with uveitis who underwent phacoemulsification with intraocular lens (IOL) implantation were included in this retrospective study. We analyzed the following data: patient characteristics, medications used, visual acuity, and complications of cataract surgery.The mean ± standard deviation time from cataract surgery to the last visit was 20.8 ± 10.4 months. Best-corrected visual acuity improved significantly after surgery (P < .001). The visual outcome was worse in patients with Behçet disease than in patients with other etiologies of uveitis. Gender (P = .018) and IOL type (P = .020) were significantly associated with recurrent uveitis after surgery. The incidence of recurrent inflammation was not significantly different between patients who did or did not receive systemic therapy (P = .43). Perioperative systemic therapies (P = .011) and recurrent uveitis within 3 months of surgery (P = .043) were associated with posterior capsular opacification. Perioperative systemic therapies (P = .026) and recurrent uveitis after surgery (P = .006) were also significantly associated with cystoid macular edema.Patients with uveitis could benefit from cataract surgery. Patients with Behçet disease had worse postoperative prognosis than patients with other etiologies of uveitis. A heparin-surface-modified IOL may reduce the incidence of recurrent inflammation.

Can we improve the efficacy of modern cataract surgery by using different tip designs? A comparison of balanced and tapered tip in femtosecond laser-assisted cataract surgery and manual phacoemulsification.

Different tip designs in modern cataract surgery have not been studied between the reported systems. Aim of this study is to assess the efficacy of two tip designs, Intrepid® balanced tip (BT) and Kelman tapered tip (TT), in femtosecond laser assisted cataract surgery (FLACS) and the microcoaxial torsional phacoemulsification. Prospective randomized unmasked cohort outcome study (hospital setting). Threehundert-forty-three eyes of 343 patientes underwent cataract surgery. Data of n=196 FLACS and n=147 manual phacoemulsification were analysed. Intrepid® balanced tip and Kelman tapered tip, Alcon, USA, were tested in FLACS (LenSx Alcon, USA) und manual phaco (Alcon Centurion System, USA). Four study cohorts were formed; FLACS BT (n=90, 70.2 years), FLACS TT (n=106, 68.1years), Manual BT (n=70, 71.3 years), Manual TT (n=77, 71.8 years). The nuclei were graded in Lens Opacities Classification System (LOCS) II,III and IV. Cumulative dissipated energy (CDE%s), balanced salt solution volume (BSSml), total longitudinal energy (%s) and torsional amplitude (%s). Lower CDE values were seen in FLACS compared to manual phacoemulsification (CDE %s median FLACS BT 3.28, FLACS TT 4.07, Manual BT 5.57, Manual TT 6.27). There was a significant difference between CDE FLACS BT and FLACS TT (p=0.038), and between FLACS BT and Manual TT (p=0.001). The right choice of tip designs in advanced phacoemulsification systems is a key factor in increasing efficacy in cataract surgery. The balanced tip showed a considerable energy-saving advantage in FLACS and manual phacoemulsification compared to the tapered tip.

The effects and related risk factors on cataract surgery in Shandong province

Objective: To explore the efficacy and related risk factors on cataract surgery in Shandong province. Methods: A total of 108 190 cataract surgeries which were reported from 17 cities of Shandong province during January 2013 to December were reviewed. The demographic information, preoperative examination, surgery related information (including date of surgery, surgical methods, and intraoperative complications), and postoperative situations (naked eye visual acuity, curative efficacy after three days, and postoperative complications) were reviewed. Wilcoxon signed-ranks, univariate and orderly multivariate Logistic regression analysis were used according to nature of the data. Results: There were 64 852 female patients (59.9 %) and 43 338 male patients (40.1%) in all 108 190 cases. About 36.5% patients (39 496 cases), the highest proportion, were 71 to 80 years of age, 31.26% patients (33 711 cases) were 61 to 70 years old and 13.6% patients (14 720 cases) were over 81 years old. Visual acuity increased significantly after surgery (Z=165.24, P<0.01). Simple factor Logistic regression analysis showed that preoperative corrected visual acuity less than 0.1 (OR=2.30 95%CI: 0.59 to 1.07), complications (OR=8.50,95% CI: 1.34 to 2.94), congenital cataract (OR=1.69, 95%CI: 0.22 to 0.83), extracapsular cataract extraction (OR=1.99, 95% CI:0.57 to 0.81), postoperative complications in three days (OR=7.46, 95% CI:1.77 to 2.25) were predictors of worse outcome after cataract surgery. Multivariate logistic regression analysis showed that the efficacy of cataract surgery were influenced by history of diabetes (OR=1.79, 95% CI: 0.46 to 0.71), history of hypertension (OR=3.49, 95% CI: 1.07-1.43), postoperative complications in three days (OR=3.91, 95% CI: 1.53 to 1.20) and extracapsular cataract extraction (OR=1.54, 95% CI: 0.20 to 0.66). Young male patients (OR=0.82, 95% CI:-0.28 to -0.12), normal preoperative intraocular pressure (OR=0.79, 95%CI: -0.38 to -0.10) and pupil (OR=0.42, 95% CI:-1.17 to -0.57) were predictors of better outcome. Conclusions: Visual acuity improved significantly after cataract surgery in Shandong province. The efficacy of cataract surgery was influenced by many factors. It is important to control systemic diseases and to choose modern operation method. (Chin J Ophthalmol, 2016, 52: 929-935).

Cataract Surgery and the LenSx® Femtosecond Laser System—2015 Update

Femtosecond laser-assisted cataract surgery continues to gain popularity as clinicians adopt the technology with the desire to improve the safety and efficacy of cataract surgery. The technology continues to evolve as clinical experience points to improvements to better meet the needs of surgeons and patients. The effect of these system updates, and the increasing body of experience with femtosecond laser systems, has reduced complication rates and seen the technology applied to more challenging cases. This article provides an updated review of the LenSx® femtosecond Laser system, including recent system modifications and the most- recent published literature.

Étude de satisfaction et de sécurité d’un protocole d’anesthésie simplifié pour la chirurgie de cataracte sous anesthésie topique

The purpose of our study was to assess safety and efficacy of cataract surgery (CS) under topical anesthesia alone, i.e. without pre-anesthetic evaluation and without direct presence of an anesthesiologist. To this end we assessed the incidence of patients' preoperative anxiety, perioperative adverse events and patients' and surgeons' satisfaction. Patients undergoing CS under topical anesthesia over a one-month period were included. An anesthesiologist and nurse anesthetist were present in the area and could intervene in case of an adverse event. Patients' anxiety was scored using the Amsterdam Preoperative Anxiety & Information Scale (APAIS), and their satisfaction with the Iowa Satisfaction with Anesthesia Scale (ISAS). Surgeons' satisfaction was scored with a VAS from 0 to 10 (0: surgery not possible & 10: excellent surgical conditions). One hundred and twenty-four consecutive patients were included; mean age was 71 (±9.4) years. Mean APAIS I was 6.4/20 (±3.7). Mean APAIS II was 3.1 (±1.8). Mean ISAS score was 5.5/6 (±0.6), indicating high patient satisfaction. Surgeon satisfaction score was 8.9/10 (±1.7). Twenty-three adverse events occurred of which 16 required interventions by the anaesthesiologist or surgeon: 5 supplemental local or regional anaesthesia, 6 iv-analgesia, 5 management of hypertension. These preliminary data suggest that a simplified topical anesthesia protocol for ambulatory CS appears to be feasible and safe, as long as an anesthesia team is present in the area to intervene if needed.

Clinical observation of the treatment of cataract surgery after glaucoma filtering surgery

Objective To observe the clinical efficacy of cataract surgery after glaucoma filtration.Methods Phacoemulsification and intraocular lens implantation through clear corneal incision were performed on 43 eyes of 32 cases after glaucoma filtering surgery.Results The postoperative visual acuity was improved in all cases compared with preoperative varying degrees.The visual acuity of 0.3 ～ 0.5 was 10 eyes (23.26％),0.6 to 0.8 was 15 eyes (34.88％),≥ 1.0 was 8 eyes (18.60％).The postoperative complications were intraoperative posterior capsular rupture in 1 eye (2.32％),the cornea with above moderate edema 8 eyes (18.60％),postoperative hyphema 2eyes (4.65％),postoperative high intraocular pressure 6 eyes (13.95％),postoperative iritis 3 eyes (6.98％) and optic atrophy 6 eyes(13.95％).No serious complications occurred.Conclusion The advantages of the surgery were simple,small damage,faster visual recovery and the good effect reducing the intraocular pressure. Key words: Glaucoma; Trabeculectomy; Cataract, phacoemulsification, clear corneal incision