Intraocular Lens Research Articles

Vault of the phakic intraocular lens during vertical and horizontal fixation within patient comparison

Vault of the phakic intraocular lens during vertical and horizontal fixation within patient comparison

The influence of peripheral vision on driving performance in patients implanted with an inverted meniscus intraocular lens

The purpose was to analyze and compare the influence of peripheral vision on driving while performing secondary visual-manual tasks in patients implanted with two types of intraocular lenses (IOLs): a standard monofocal IOL and a new inverted meniscus intraocular lens (ArtIOL). This study included 17 participants implanted binocularly with a standard monofocal IOL (control group) and 15 participants implanted binocularly with the ArtIOL. Visual acuity and contrast sensitivity were tested at 40 deg of eccentricity. Driving performance was assessed using a driving simulator. At some points of the route, participants were asked to perform a secondary task while driving. Among other driving variables, self-regulation of driving speed and was analyzed, and the overall driving performance score (ODPS) was calculated. The ArtIOL’s group had better peripheral contrast sensitivity (p = 0.003); however, no differences were observed in peripheral visual acuity. Regarding driving performance, no significant differences were observed in the ODPS between the two groups. In the general route, participants implanted with ArtIOLs drove faster, particularly in the mountain road (p = 0.002). The ArtIOL’s group self-regulated more for speed, particularly when the characteristics of the road were less complex (p = 0.037). An association was found between better contrast sensitivity and more positive values of the speed adaptation (rho = 0.342; p = 0.006). Thus, participants implanted with the ArtIOLs did not show a significant improvement in driving performance, but had a better contrast in the periphery that contributed to an increased self-confidence while driving.

Capsular Tension Ring Implantation for Intraocular Lens Power Calculation in Highly Myopic Eyes

Capsular tension ring (CTR) implantation has been shown to reduce intraocular lens (IOL) decentration and tilt in high myopia. However, the effect of CTR implantation in highly myopic eyes on IOL power calculation remains unclear, particularly in new-generation formulas. To evaluate the influence of CTR implantation on IOL power calculation in highly myopic eyes. This is a prespecified secondary analysis of outcomes of a randomized clinical trial conducted between November 2021 and September 2023 at the Zhongshan Ophthalmic Center in Guangzhou, China. Cataract patients with an axial length (AL) of 26 mm or longer were enrolled and stratified into 3 strata based on AL (stratum 1: AL 26-<28 mm; stratum 2: AL 28-<30 mm; stratum 3: AL ≥30 mm). Participants were stratified based on AL and randomized to the CTR group (a C-loop IOL combined with a CTR) or the control group (only a C-loop IOL) within each stratum. Predictive outcomes of 6 new-generation formulas and 4 traditional formulas were evaluated. The arithmetic and absolute prediction error (PE) and the percentages of eyes within ±0.25 diopter (D), ±0.50 D, ±0.75 D, and ±1.00 D of PE were analyzed. A total of 186 eyes of 186 participants were randomized into the CTR group (93 eyes [50%]) or control group (93 eyes [50%]). Excluding a withdrawal case and 24 eyes with best-corrected visual acuity less than 20/40, 80 eyes in the CTR group (86.0%) and 81 eyes in the control group (87.1%) were analyzed. Of 161 participants analyzed, overall mean (SD) participant age was 56.7 (10.5) years, and 100 participants (62.1%) were female. No differences were observed in arithmetic PE between the CTR and control groups in any strata. The CTR group showed smaller absolute PE in all new-generation formulas and higher percentage of PE within ±0.50 D in the Emmetropia Verifying Optical 2.0, Hoffer QST, LISA, and Pearl-DGS formulas only for eyes with an AL of 30 mm or longer compared with the control group. In traditional formulas, no differences were observed between the 2 groups in any strata. In this secondary analysis, CTR implantation in highly myopic eyes did not affect the target refraction and can improve the prediction accuracy of new-generation IOL calculation formulas in eyes with AL of 30 mm or longer. These findings support use of CTR implantation in eyes with an AL of 30 mm or longer. ClinicalTrials.gov Identifier: NCT05161520.

Biomaterials in Relative Devices for Traumatic Cataract: Recent Advances and Future Perspectives.

Ocular trauma deprives one of the vision for high-quality life. Management of a traumatic cataract requires extensive surgical experience with a range of biomaterials and biomedical devices including intraocular lenses (IOLs), capsular tension rings (CTRs), prosthetic iris (PSI) implants, bandage contact lenses (BCLs), artificial corneas (ACs), and surgical sutures. Numerous demands, involving biocompatibility, cell toxicity, processability, mechanical strength, toughness/flexibility, transparency/opacity, hydrophilicity/hydrophobicity, and stability/biodegradability, are widely considered for fabricating these biomaterials and devices. Furthermore, a multifunction including drug-release and photothermal therapy is also endearing to those biomaterials in IOLs, CTRs, BCLs, and surgical sutures for anti-inflammational and antibacterial characteristics during traumatic cataract treatments. More recently, 3D printing has been demonstrated to effectively fabricate PSI and ACs with complex shapes to meet the personal requirements of patients. We summarize the main principles and the recent achievements of these advances. We also suggest the potential directions for their future development and discuss the remaining challenges.

Impact of lens capsule status on pupillary capture following intrascleral intraocular lens fixation: a retrospective study

BackgroundPupillary capture can cause complications after intrascleral intraocular lens (IOL) fixation; however, no method has been established to definitively prevent pupillary capture. Therefore, we aimed to examine the differences in the incidence of pupillary capture in patients who underwent intrascleral IOL fixation and had intraoperative lens capsule preservation or lens capsule loss.MethodsThis single-center, retrospective study, conducted at a University Hospital, included 83 eyes from 83 patients. The eyes were allocated to the capsule and no-capsule groups based on the presence or absence of capsule, respectively. Patient demographics, causative diseases, incidence of pupillary capture at 1 year postoperatively, anterior chamber depths (ACDs), IOL tilts, and decentrations of the two groups were analyzed and compared.ResultsThe capsule and no-capsule groups comprised 26 and 57 eyes, respectively. The indications for intrascleral IOL fixation were: IOL dislocation in 6 (23.1%) and 41 (71.9%), artificial aphakia in 4 (15.4%) and 2 (3.5%), conversion during cataract surgery due to complications (zonular dialysis or posterior capsule rupture) in 14 (53.9%) and 3 (5.3%), lens dislocation in 0 and 11 (19.3%), and IOL opacification in 2 (7.7%) and 0 eyes in the capsule and no-capsule groups, respectively (P < 0.05). The postoperative outcomes including ACD, magnitude of tilt, or decentration of the fixed IOL did not differ between the two groups (P > 0.05). Pupillary capture was observed in eight eyes, all in the no-capsule group (P < 0.05).ConclusionsWhen performing intrascleral fixation in cases where the lens capsule remains, preserving the capsule and fixing the IOL under the capsule may prevent postoperative pupillary capture.

Invivo and in vitro analyses of surface whitening in hydrophobic trifocal intraocular lenses

IntroductionTransparency loss due to the whitening of trifocal hydrophobic intraocular lenses (IOLs) is a rare but poorly understood phenomenon. This study investigates its characteristics, underlying mechanisms, and clinical impact to determine its relevance for patient care.MethodsA clinical and laboratory analysis was conducted on affected IOLs. Two patients with bilateral trifocal IOL implantation, where one eye exhibited whitening, underwent visual performance testing, light distortion assessment, optical coherence tomography, Scheimpflug imaging, and patient-reported outcome evaluations. An explanted IOL was examined using microscopic and optical bench methods, and attempts were made to replicate the whitening process in vitro using unused control lenses.ResultsClinical findings showed that IOL whitening had minimal impact on visual acuity and light distortion, with no significant impairment reported in patient-reported outcomes. Imaging and laboratory analysis suggested that whitening is caused by subsurface nanoglistening (SSNG), a previously unreported phenomenon in this IOL material. The modulation transfer function of the affected IOLs remained comparable to control lenses, and in vitro attempts to induce whitening were unsuccessful.DiscussionThis study provides the first evidence of SSNG in this hydrophobic IOL material, demonstrating that while whitening can occur, its clinical significance is generally low. Given the predominantly subjective nature of symptoms, management should be individualized, with explantation decisions made in close consultation with the patient. These findings contribute to a better understanding of IOL material stability and patient counseling in cases of transparency loss.

Effects of Topical Bromfenac Solution on Macular Thickness in Cataract Patients Undergoing Phacoemulsification Surgery

Background Although modern phacoemulsification is considered a highly safe surgery, cystoid macular edema (CME) is the common factor contributing to poor visual results following successful surgery. Bromfenac drops may be effective in treating both acute and chronic pseudophakic CME. Objectives Evaluate the effects of the non–steroidal anti-inflammatory drug bromfenac 0.09% ophthalmic solution on macular thickness after phacoemulsification surgery and report any side effects. Method This is a prospective study done in an ophthalmic center in Iraq involving adult patients with senile or iatrogenic cataracts prepared for cataract surgery by phacoemulsification with intraocular lens (IOL) implantation and were divided into two groups: • Group one: who received 0.09% bromfenac ophthalmic solution twice daily in addition to Moxifloxacin 0.5% ophthalmic drops every 6hrs and Dexamethasone phosphate 0.1% ophthalmic drops every 4-6hrs post-operatively. • Group two: who received only Moxifloxacin 0.5% every 6 hours and Dexamethasone phosphate 0.1% ophthalmic drop every 4-6 hours without administering bromfenac 0.09% ophthalmic drops post-operatively. Results Eighty-seven eyes of 87 patients were enrolled in the study. The preoperative mean of central retinal thickness in groups one and two was 248.53±35.6μm and 262.40±20.7μm, respectively, with a p-value of 0.029. The postoperative mean of central retinal thickness in groups one and two was 255.78±36.6 μm and 278.18±29.06 μm, respectively, with a p-value of 0.004, which is clinically significant. The only side effect reported was punctate epithelial corneal erosion in five patients in group one. Conclusion This study demonstrated that bromfenac has shown significant efficacy in preventing cystoid macular edema (CME) following cataract surgery as compared to corticosteroids alone but might cause punctate epithelium corneal erosion in some patients. Clinical trial Trial number: NCT06785090 registration date: 2025-01-15 registration URL: https://clinicaltrials.gov/study/NCT06785090?cond=Cataract&amp;rank=8 The registration was completed after the study commenced due to administrative and institutional requirements. As this trial was conducted as part of a master’s thesis, priority was given to obtaining ethical approval and ensuring compliance with institutional protocols, which led to an unintentional delay in registration. Once the importance of early registration for transparency and compliance was recognized, the process was promptly completed.

Effect of pharmacological pupil changes on intraocular lens power calculation: a systematic review and Meta-analysis.

To investigate the effect of pharmacological pupil alterations on intraocular lens (IOL) power calculations. A systematic review and Meta-analysis of studies published before December 2023 in the PubMed, Embase, and Cochrane library databases on the accuracy of pharmacological pupil changes on IOL power calculation was performed. The primary outcome was the results of IOL power calculations before and after the use of medications. Subgroup analyses were performed based on participants' basic characteristics, such as age, axial length (AL), and whether miosis or mydriasis were used as classification criteria for further analyses. Each eligible study was evaluated for potential risk of bias by the AHRQ assessment scale. The study was registered on PROSPERO (CRD 42024497535). A total of 3062 eyes from 21 studies were eligible. There was no significant difference in the IOL power calculation before and after pharmacological pupil changes using any of the Hoffer Q (WMD=0.055, 95%CI=-0.046-0.156; P=0.29), SRK/T (WMD=0.003, 95%CI=-0.073-0.080; P=0.93), Haigis (WMD=-0.030, 95%CI=-0.176-0.116; P=0.69), Holladay 2 (WMD=-0.042, 95%CI=-0.366-0.282; P=0.80), and Barrett Universal II (WMD=0.033, 95%CI=-0.061-0.127; P=0.49) formulas. On the measurement of parameters related to IOL power calculation, for either miosis or mydriasis AL (P=0.98 and 0.29, respectively), lens thickness (P=0.96 and 0.13, respectively), and mean keratometry (P=0.90 and 0.86, respectively) did not present significant differences, while anterior chamber depth (P=0.07 and <0.01, respectively) and white-to-white distance (P=0.01 and 0.04, respectively) changed significantly between the two measurements prior and posterior. At the same time, despite there being some participants with the difference between the before and after calculations greater than 0.5 diopter, there was no significant difference in the incidence rate between these formulas. There is no significant effect of pharmacological pupil changes on the IOL power calculation. It will considerably reduce the visit time burden for patients who require cataract surgery.

The evolution of intraocular lenses and their methods of fixation: A historical and modern perspective

The evolution of intraocular lenses and their methods of fixation: A historical and modern perspective

Modern manufacture of domestic serial and individual intraocular lenses

Modern manufacture of domestic serial and individual intraocular lenses

Age-Related Cataract Extraction Is Associated With Decreased Falls, Fractures, and Intracranial Hemorrhages in Older Adults.

Cataract extraction with intraocular lens insertion (CEIOL) is among the most frequently performed surgeries in the United States and is indicated for individuals with age-related cataracts causing visual impairment. The association between CEIOL and falls and hip fractures has been described, but there is a paucity of literature describing the association between CEIOL and various other common morbidity and mortality-increasing age-related traumatic injuries. This retrospective cohort study utilized TriNetX, a health database, to access de-identified electronic medical records. Cohorts of patients aged 60 years and older were identified using diagnostic and procedural codes. Cohort 1 was defined as patients with age-related cataracts who underwent CEIOL within 10 years of documented diagnosis of cataracts. Cohort 2 was defined as patients with age-related cataracts who did not undergo CEIOL within 10 years of documented diagnosis of cataracts. Propensity score matching for demographics and other relevant comorbidities was completed. Chi-square analysis was performed, and data were reported as odds ratios with 95% confidence intervals. Outcomes analyzed included proximal humerus fracture, distal radius fracture, hip fracture, ankle fracture, fall, subdural hemorrhage, and epidural hemorrhage. Patients who underwent CEIOL demonstrated significantly lower odds of falls (p < 0.0001), proximal humerus fracture (p = 0.016), distal radius fracture (p = 0.0004), hip fracture (p < 0.0001), ankle fracture (p = 0.0002), subdural hemorrhage (p < 0.0001), and epidural hemorrhage (p = 0.006) as compared to patients with a documented diagnosis of age-related cataract without CEIOL. CEIOL was significantly associated with decreased falls and reductions in major fall-related injuries among patients with age-related cataracts. These findings strongly support improved screening protocols to detect vision loss secondary to age-related cataracts, as this may decrease the incidence of common major fall-related injuries among patients with age-related cataracts.

Long-term changes in classified higher-order aberrations after implanting an EVO intraocular collamer lens

PurposeTo evaluate changes in intraocular, corneal, and whole-eye higher-order aberrations (HOAs) after EVO intraocular collamer lens (ICL) implantation.MethodsIn this retrospective study, we enrolled 53 eyes of 53 patients and measured their refractive parameters and intraocular, corneal, and whole-eye HOAs using OPD scanning preoperatively and 1 month, and 3 years postoperatively. All statistical analyses were performed using SPSS software.ResultsThe safety index was 1.31 ± 0.15, and the efficacy index was 1.02 ± 0.24 3 years postoperatively. The best linear fit curve of the attempted versus achieved correction was y = 0.96x + 0.08 at 3 years postoperatively. The mean spherical equivalent decreased from − 8.53 ± 2.49 D preoperatively to -0.09 ± 0.25 D and − 0.34 ± 0.41 D at 1 month and 3 years postoperatively, respectively (P < 0.05). The whole-eye trefoil and total HOAs, intraocular trefoil, corneal trefoil increased significantly at 1 month (P < 0.05) but did not change significantly at 3 years (P > 0.05) postoperatively compared to the preoperative value. The intraocular spherical aberration and total HOAs increased significantly at 1 month and 3 years postoperatively (P < 0.05). The whole-eye coma or spherical aberration, intraocular coma, corneal coma or spherical aberration or total HOAs did not differ from those observed at 1 month and 3 years postoperatively (P > 0.05).ConclusionsLong-term EVO-ICL implantation is safe, effective, predictable, and stable. The intraocular and corneal trefoils increased significantly in the early postoperative period but can be recovered to the preoperative level in the long term. The intraocular spherical aberration increases slightly in the long term postoperatively, but the whole-eye spherical aberration does not change significantly.

Changes in aqueous humor cytokines and metabolomics in contralateral eye after unilateral cataract surgery

BackgroundFor patients with bilateral age-related cataracts, sequential phacoemulsification and intraocular lens implantation is a common treatment. However, it remains unclear whether surgery on the first eye has an impact on the second eye, as current research results are inconsistent. This study will explore whether surgery on one eye affects the non-operated eye through aqueous humor cytokines and metabolomic analyses in the second eye.MethodsA rabbit model of unilateral phacoemulsification and intraocular lens implantation was established. The experimental group consisted of 15 rabbits undergoing this procedure. Postoperatively, rabbits were divided into five subgroups (three rabbits per subgroup), and aqueous humor was collected from both the operated and non-operated eyes at 1 day, 3 days, 1 week, 2 weeks, and 3 weeks after surgery. Additionally, 5 rabbits were selected as a control group, from which aqueous humor was extracted. Levels of IL-1a, IL-1β, IL-2, IL-4, IL-6, IL-8, IFN-γ, TNF-α, MCP-1, and VEGF in the aqueous humor were compared. In the clinical study, preoperative aqueous humor samples were collected from 22 patients undergoing bilateral phacoemulsification and intraocular lens implantation. Among them, 11 patients were tested for the aforementioned 10 cytokines, while the other 11 patients underwent untargeted metabolomics research.ResultsIn the animal experiment, levels of all 10 cytokines in the operated eyes were significantly higher compared to both the control and non-operated eyes groups (P < 0.05). In the non-operated eyes, IL-1β and IL-2 levels were also elevated compared to the control (P < 0.05); however, no statistically significant differences were observed between the non-operated eyes and the control group at postoperative time points of 1 day, 3 days, 1 week, 2 weeks, and 3 weeks. In the clinical study, no significant differences were found in cytokine levels between the two eyes. In the untargeted metabolomics analysis, 354 metabolites showed differential expression, 280 were upregulated and 74 were downregulated. Notably, Adenine and 2-Aminopurine were significantly downregulated, highlighting Purine metabolism as the most impacted pathway.ConclusionsAnimal experiments showed a significant increase in IL-1β and IL-2 levels in the non-operated eyes postoperatively, reflecting systemic and local inflammatory responses. In clinical experiments, although no significant changes in cytokines were observed in the aqueous humor of both eyes, differential expression of metabolites indicated metabolic adjustments in the non-operated eye following surgery on the first eye. These findings reveal that unilateral cataract surgery may affect the stability of the intraocular environment in the contralateral eye, suggesting that in staged bilateral surgeries, potential metabolic changes in the non-operated eye and their clinical significance should be considered. This result provides important reference value for optimizing postoperative management strategies, reducing complications, and determining the timing for bilateral surgeries, warranting further investigation.

Comparison of clinical outcomes and vault between two types of posterior phakic intraocular lenses in correction of myopia and myopic astigmatism.

PurposeTo compare refractive and clinical outcomes of two posterior chamber phakic intraocular lenses (pIOLs) for correction of myopia and myopic astigmatism. To evaluate the vault and its variance for the phakic lenses by anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM).SettingQuinze-Vingts National Ophthalmology Hospital, Paris, France.Designretrospective case seriesMethodsPatients received an Implantable Collamer Lens (V5 EVO + ICL, Staar surgical AG, Switzerland) or Intraocular Phakic Contact Lens (V2.0 IPCL Caregroup Sight Solution, India). AS-OCT, optical biometry and corneal topography were performed to measure biometric parameters and evaluate post-operative vault.Results12 eyes received an ICL and 14 eyes an IPCL. At 12 months postoperatively, the mean UDVAs were 0.06 ± 0.18 logMAR and 0.16 ± 0.23 logMAR in the ICL and IPCL groups, respectively (p = 0.30). No eye lost CDVA in either group. By AS-OCT, the mean vault was 335.33 ± 165.83 μm and 532.64 ± 167.25 μm in the ICL and IPCL groups, respectively (p = 0.006). By UBM, the mean vault was 355.6 ± 136.6 μm and 509.3 ± 180.79 μm in the ICL and IPCL groups, respectively (p = 0.041).ConclusionsICL and IPCL offer similar refractive and clinical outcomes. IPCL tends to display a more consistent vault with less variation from one patient to another.

Analysis of preoperative ocular optical parameters in patients with cataract

This study aims to evaluate the distribution of preoperative corneal parameters obtained using the Pentacam anterior segment analyzer in Chinese male and female patients with cataracts and to investigate the correlation between these parameters and related factors. Preoperative examination data of the eyes of 1,255 patients who underwent cataract surgery were retrospectively analyzed. The Pentacam AXL was used to extract preoperative corneal measurements, and the total corneal measurement data were analyzed. The average age of the patients was 52.9 ± 21.3 years. The mean simulated keratometry values and corneal curvature of total corneal refractive power were positively correlated with age (both P < 0.01). Spearman’s correlation analysis revealed a positive association between age and anterior corneal spherical aberration, posterior corneal spherical aberration, and total corneal spherical aberration changes. A negative correlation was found between age and with-the-rule astigmatism, and it was positively correlated with the ratios of against-the-rule and oblique astigmatism. A significant between-eye correlation was observed regarding spherical aberration (Z40), horizontal coma (Z31), vertical coma (Z3-1), and horizontal trefoil (Z33). The corneal curvature in females was significantly steeper than that in males (P < 0.01). Corneal curvature, corneal spherical aberration, and corneal astigmatism were found to change with age. Additionally, we found physiological differences between the sexes. Individual measurements could be taken preoperatively to facilitate the development of personalized surgical plans. By identifying age- and gender-related corneal variations, this study enables more personalized cataract surgery planning, potentially improving refractive outcomes and reducing postoperative complications through tailored surgical techniques and intraocular lens selection.

Evaluation of Reliability of Formulas for Intraocular Lens Power Calculation After Hyperopic Refractive Surgery

Background: We evaluate the accuracy of intraocular lens (IOL) power calculation in the following formulas—Barrett True-K No History (BTKNH), EVO 2.0 Post-Hyperopic LASIK/PRK (EVO 2.0), Haigis-L, Pearl-DGS, and Shammas (SF)—with patients who have undergone cataract surgery at the Eye Unit of University of Campania Luigi Vanvitelli, Naples, Italy, and had prior hyperopic laser refractive surgery. Methods: A monocentric, retrospective, comparative study, including the charts of patients who had undergone cataract surgery and previous hyperopic laser refractive surgery, was retrospectively reviewed. Patients with no other ocular or systemic disease which might interfere with visual acuity results and no operative complications or combined surgery were enrolled. The mean absolute prediction error (MAE) was calculated for each formula and compared. Subgroup analysis based on the axial length and mean keratometry was performed. Results: A total of 107 patients (107 eyes) were included. The MAE calculated with SF provided less accurate (p &lt; 0.05) results when compared to both BTKNH and EVO 2.0 formulas. The MAE obtained using Haigis-L, EVO 2.0, Pearl-DGS, and BTKNH showed no significant differences. Conclusions: The analysis of the accuracy of the selected formulas shows no clear advantage in using one specific formula in standard cases, but in eyes where it is mandatory to reach the target refraction, SF should be avoided.

A cost-saving, picture-assisted method for toric intraocular lens alignment versus manual self-leveling marking via RoboMarker.

To determine the accuracy of two axis-marking methods for toric intraocular lens (IOL) implantation, one picture-assisted approach based on scleral vessel vectors, and the other based on a self-leveling device for manual marking. This retrospective single-center study involved 60 eyes of 51 participants, who underwent phacoemulsification with toric IOL implantation. In all eyes, preoperative markings were made in a seated position both manually via a self-leveling corneal marker (RoboMarker), and digitally on slit-lamp photographs, defining scleral vessels as landmarks, aiding to find the correct intraoperative orientation for an angular graduation instrument. The axis of IOL alignment at the end of surgery was determined from high resolution, intraoperative footage from a microscope-integrated camera and the axis-marking error served as an outcome measurement for both marking techniques. The endpoint was the alignment of the lens at the end of surgery. The average axis-marking error was 2.5 ± 1.9 degrees for picture-assisted marking, which was significantly less than that of the self-leveling corneal marker, being 5.4 ± 4.4 degrees. Our results indicate that scleral vessel vector marking leads to highly accurate toric IOL alignments, while being an inexpensive technique, as solely a slit-lamp camera is required for preoperative preparation.

Efficacy and safety of capsule support hooks vs. iris hooks in cataract surgery for cases with zonular insufficiency.

To compare the efficacy and safety of capsule support hooks and iris hooks in stabilizing the capsular bag during cataract surgery in patients with significant zonular weakness. This retrospective comparative study included 46 eyes of 39 patients with zonular weakness exceeding 90 degrees who underwent cataract surgery at a tertiary clinic. Patients were divided into two groups due to intraoperative usage of capsule support hooks (Group 1) or iris hooks (Group 2) for capsular stabilization. Intraoperative complications such as capsular tears and vitreous loss, as well as postoperative visual outcomes and intraocular lens (IOL) centration, were evaluated. There was no significant difference in terms of postoperative visual acuity and intraocular pressures between the two groups (p = 0.370, p = 0.250 respectively). Anterior capsular tear occurred in 4 eyes in the iris hook group compared to none in the capsule support hook group (p = 0.017). Vitreous loss was observed in 4 eyes in the capsule hook group and 7 eyes in the iris hook group (p = 0.122). Cystoid macular edema developed in 1 patient in each group (p = 0.849). Capsule support hooks provide a safer and more stable option for capsular stabilization for zonular weakness during cataract surgery with a lower incidence of intraoperative complications compared to iris hooks. Despite their higher cost and limited availability, capsule support hooks should be preferred to enhance surgical outcomes and patient safety. Iris hooks, while less optimal, remain a viable alternative when capsule support hooks are not available.

Analisis Komplikasi Operasi Katarak Terhadap Pasien Katarak

Cataracts are the most common cause of blindness in the world. About 90% of cataract cases are age-related, other causes are congenital and trauma. The definitive treatment for cataracts is surgery. Several cataract surgery techniques are increasingly developing with smaller incisions, fast healing, and low complication rates. Periodic examination after cataract surgery is very important to detect complications. This literature review study aims to determine the description of cataract surgery complications. The journal in this literature review uses 3 databases including Google Scholar, PubMed, and Science Direct using the keywords complications of cataract surgery and complications of cataract surgery. The literature search was adjusted based on inclusion and exclusion criteria. The search results obtained 10 journals consisting of 5 national journals and 5 international journals. The results show the types of cataract surgery complications, namely Irregular Pupil/anisocoria, Posterior Capsule Rupture (PCR), Vitreous loss, Hyphaema, Iris Prolapse, Vitreous Prolapse, Iris Prolapse, Traumatic Iris, Descemet's Membrane Detachment (DMD), Retinal Detachment, Posterior Capsule Opacity ( PCO), Intraocular Lens Malposition (LIO), Cystoid Macular Edema (CME), Pseudophakic Bullous Keratopathy (PBK), Increased Intraocular Pressure (IOP), Iridodialysis, Surgically Induced Astigmatism (AIS), Cystoid Macular Edema (EMK), Uveitis, Dry Eye Syndrome, Corneal Edema, Anterior Segment Toxic Syndrome, Ocular Hypertension, Endophthalmitis, Zonular dehiscence.

Circular or radial capsulotomy for the treatment of capsular phimosis: Which is the better option?

Circular or radial capsulotomy for the treatment of capsular phimosis: Which is the better option?