Management Of Cataract Research Articles

Femtosecond laser assisted cataract surgery in a cataract patient with low vaulted ICL following LASIK: a case report

BackgroundApart from the conventional utilization of ICL implantation for the correction of refractive errors, its recent applications extend to correcting refractive errors post laser refractive surgery. Notably, the development of cataracts stands out as a prevalent postoperative complication, often associated with low vault. Previous cases have demonstrated successful management of cataracts with ICL through the combination of FLACS and ICL removal coupled with IOL implantation, resulting in favorable postoperative visual outcomes. Herein, we present a case of cataract with low vault ICL following LASIK and its subsequent management.Case presentationA 46-year-old male presented with vision loss in the right eye for 9 months, and he had undergone LASIK 22 years prior and had ICL implantation in both eyes 2 years ago to correct refractive error. One day after ICL implantation, both eyes exhibited the UDVA of 1.2 and 1.0, well-positioned ICLs, and approximate vault of 150 μm and 200 μm. Six months ago, the patient became aware of blurred vision in the right eye for a duration of 3 months. Examination revealed cloudy lens cortex in the right eye. During the current review, the UDVA of the right eye was 0.6, where nasal wedge-shaped clouding was evident and worsened, while the left eye lens remained transparent. AS-OCT demonstrated the vault of 54 μm in the right eye and 83 μm in the left eye. Considering the patient’s history of LASIK and the presence of right eye cataract, a monovision approach was adopted. The patient underwent FLACS combined with ICL extraction and monofocal IOL lens implantation in the right eye. At 10 days postoperatively, the patient exhibited the UDVA of 1.0.ConclusionsOur report confirms the feasibility of FLACS in managing cataracts in patients with low vault ICL following LASIK. This procedure does not pose significantly greater challenges than in typical cataract cases, although meticulous care remains essential throughout every step of the surgery, particularly during laser scanning and positioning. With adequate preoperative preparation and precise calculation of the IOL power, surgical outcomes can meet expectations fully.

Intraocular aphakia correction in patients with prior keratorefractive surgery: literature review. Part 1

Introduction. An increasing number of patients with a history of keratorefractive surgeries are presenting to ophthalmologists with complaints of vision loss due to cataracts. Treating this group poses surgeons with a range of unique challenges: high demands for vision quality, complexities in selecting the appropriate intraocular lens (IOL) power calculation formula and IOL model, target refraction, as well as the need to modify cataract extraction techniques and address specific postoperative considerations. Despite advancements in the development of new IOL designs and calculation formulas, clinical and functional outcomes in this group remain inferior to those in patients without prior keratorefractive procedures. A paradigm shift is emerging, advocating for a personalized approach in the diagnosis and management of cataracts in these patients. However, discussing all aspects within a single review proved impractical, leading us to divide it into two parts. The objective of the first part of this study is to assess the specific considerations for aphakia correction in patients who have undergone keratorefractive procedures, based on literature data, while taking into account the long-term complications of refractive surgery. Additionally, this part will address the fundamental principles of the design and functionality of pseudoaccommodating intraocular lenses (IOLs). Materials and methods. A selection of over 200 peer-reviewed publications from resources such as PubMed, eLibrary, CyberLeninka, Science Direct, and Google Scholar over the past 30 years was conducted. The first part of the review includes 49 publications. This work represents an analysis of contemporary literature, reflecting the impact of keratorefractive surgeries on the successful performance of phacoemulsification with IOL implantation. Results. The findings from the first part of the analysis indicate that a detailed medical history of previously performed keratorefractive corrections – specifically their type and potential long-term complications – play a significant role in determining the surgical treatment strategy. Standard examination methods do not always fully reflect the optical characteristics of the cornea in these patients. Extended preoperative assessments, including specialized techniques such as keratotopography and keratotomography, are crucial for identifying corneal irregularities and for the subsequent selection of the type of intraocular lens (IOL) for aphakia correction in patients who have undergone keratorefractive surgeries. Studies show high effectiveness not only in using monofocal lenses but also in the potential application of pseudoaccommodating IOLs, including those with extended depth of focus and multifocal lenses. The selection of optimal formulas for IOL calculation, as well as the clinical aspects influencing refraction in the postoperative period, will be addressed in the second part of the literature review. Conclusion. The increase in the number of refractive surgeries has led to a growing population of patients with cataracts following ametropia correction. This has spurred the development of new IOL variants with extended depth of focus. However, literature data on their effectiveness in patients who have undergone keratorefractive procedures remain limited. Multicenter prospective studies are needed to evaluate new IOL models and to determine the optimal surgical strategies for this category of patients.

The Analysis Study of Prevalence, Diagnosis, and Management of Cataract in Adult Eye: A Comprehensive Systematic Review

Background: Cataract remains a major cause of visual impairment worldwide. However, in many countries cataract surgery is easily available. Cataract surgery is a kind of effective way to deal with cataract, but it is acompanied with many surgical complications and expensive costs that present enormous social and economic problems to a society, especially in the remote and poor areas of developing countries. The aim: The aim of this study to show about prevalence, diagnosis, and management of cataract in adult eye. Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. Result: Eight publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: Cataracts to increase in the near future due to an increase in the aging population and pre-senile cataracts. The current study also provides clinical determinants for cataract and cataract surgery. Since cataract has emerged as a public concern and the cost burden for cataract surgery has increased with an aging population, it is expected that the present study will form a cornerstone for further investigations and the establishment of a public health plan.

A case series on small incision cataract surgery + PMMA IOL with primary posterior capsulorrhexis: A safe and cheaper alternative in management of pediatric cataracts

Pediatric cataracts, a significant cause of childhood blindness, present pronounced challenges in low-income countries where conventional phacoemulsification with hydrophobic foldable IOLs may be economically unfeasible. In resource-limited settings, the conventional method of employing phacoemulsification with hydrophobic foldable IOLs is often impractical. This case series explores an economically pragmatic alternative, centering on Small-incision cataract surgery (SICS) paired with rigid polymethyl methacrylate (PMMA) intraocular lenses (IOLs). This study delves into the visual outcomes of SICS with in-the-bag PMMA IOLs, Primary Posterior Capsulorrhexis (PPC), and anterior vitrectomy to mitigate Posterior Capsule Opacification (PCO) formation in the Visual Axis (VA). The evaluation, conducted at specific postoperative intervals spanning from Post-op Day 01 to the 6th month, provides a comprehensive understanding of the efficacy and safety of this approach. Findings underscore PMMA IOLs as both durable and cost-effective substitutes, with an emphasis on SICS with PPC as a reliable technique for cataract removal. This research delivers a practical solution to enhance visual outcomes, tackling the distinct challenges confronted in resource-limited settings and contributing to the broader global endeavor to alleviate preventable childhood blindness.

Cataract and Diabetes: a review of the literature.

Cataracts can cause visual impairment in diabetic patients. Diabetes mellitus (DM) affects different parts of the eye and causes many complications and problems before, during and after intraocular surgeries. In this review, we will discuss the effects of diabetes on different aspects of cataract surgery and review the current management of diabetic cataracts. Careful preoperative examination of the patient's ocular surface, cornea, iris and posterior segment, as well as the use of advanced phacoemulsification techniques, new intraocular lenses (IOLs) and the appropriate use of auxiliary medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and anti-vascular endothelial growth factors (VEGFs) have improved the outcomes of cataract surgery in diabetic patients.

Management of Bilateral Congenital and Juvenile Cataracts in a Low-Income Country: Patient Identification, Treatment Outcomes, and Follow Up.

Childhood blindness remains a neglected issue in eye care within low-income countries, with congenital and juvenile cataracts being the most common treatable causes. This study aims to investigate the factors influencing the management of congenital and juvenile bilateral cataracts, provide data on general outcomes and postoperative findings, and discuss treatment in a low-income country context. In this prospective study, data from clinical care were continuously entered into a database, and one follow-up examination of a cohort of 91 patients with congenital and juvenile bilateral cataracts in Kinshasa, Democratic Republic of the Congo, was conducted. Multiple factors that affect the first clinical presentation, the clinical management, and outcome were investigated. Most patients (88.5%) who received medical treatment were identified by cataract finders. A patient's presentation time was independent of the parent's education, social status, income, and sex of the child. The median age at first presentation was 5.8 years (ranging from 0 days to 17.3 years). The best visual acuity outcomes were achieved by patients who underwent surgery during early childhood. According to WHO grades and on an eye level basis, 51.1% (93 out of 182 eyes) showed improvement, while 34.6% (63 eyes) had unchanged results post-surgery. Among the cases without improvement, 76.2% were blind prior to surgery. Postoperative findings were observed in 56% of the patients, with secondary cataracts being the most common, affecting 26.37% of the operated eyes. Optimal management of childhood cataracts involves early identification, efficient hospital infrastructure, high-quality medical care, and long-term follow up. In sub-Saharan Africa, this approach must be adapted to the context of available resources, which differs significantly from those in high- and middle-income countries.

Case Finding and Management of Childhood Cataracts: The Role of a Child Eye Health Programme in Kaduna State, Nigeria

Abstract Objective: To evaluate the output of a child eye health programme in terms of identification, referral, and volume of paediatric cataract surgeries in Kaduna State, Nigeria. Materials and Methods: This was a retrospective review of the North-West Nigeria Child Eye Health Initiative programme referral registers at primary, secondary and tertiary hospitals in Kaduna State. Theatre registers of children 0–16 years who had cataract surgery at National Eye Centre Kaduna between 2016 and 2019 were also reviewed. Information on numbers of children, age, sex, laterality of cataract and programme status were summarised as frequencies, percentages and mean ± standard deviation. The initial 2 years of the programme (2018–2019) were compared with the 2 years (2016–2017) preceding them. Results: Between January 2018 and December 2019; primary health workers screened 41,552 children and referred 2,316 (5.6%). Of those referred 1772 (76.5%) presented at one of three zonal secondary hospitals where nurses identified 492 (27.8%) with leukocoria using torchlights and referred them to the tertiary hospital. At the tertiary hospital, 364 (74.0% of 492) attended and 262 (72.0% of 364) were confirmed to have operable cataracts after dilated slit lamp examination by ophthalmologists. Between 2016 and 2017 (pre-programme years), 201 children had cataract surgery compared to 352 in 2018 and 2019 (programme years) of whom 239 (67.9% of 352) were beneficiaries of the programme. The proportion of girls who had cataract surgery declined from 39.8% to 35.0%, while mean age increased from 5.7 ± 4.2 years to 7.5 ± 4.1 over 4 years. More children with unilateral cataracts (214 [60.8%]) presented during the programme years (Fishers exact test, P = 0.004), whereas unilateral cataract (207 [60.2%]) was significantly more common in males than females (Fisher’s exact P = 0.017). Conclusion: The programme has resulted in improved case detection of childhood leukocoria at primary eye care level. additionally, the eye health referral system in Kaduna State has been strengthened with increasing numbers of children accessing services: majority boys, older children, and unilateral cataracts.

Childhood cataract in Indian subcontinent: Challenges and strategies

Abstract Cataracts in children are one of the leading causes of visual impairment and if not treated timely have an impact on the neurobiological development of the child, leading to amblyopia. Cataracts in children are either congenital, developmental, or traumatic. A comprehensive ocular, systemic examination, age of onset, morphology, and laterality of cataracts are essential factors to be considered during management. Innovations, technology, and expert surgical techniques have made surgery uneventful with good visual outcomes. In this article, we summarize the current situation, barriers, challenges, and recommendations for the management of congenital cataracts in India. Strategies for managing congenital cataracts must be adapted and developed according to regional conditions. A basic framework for acceptable outcomes must focus on developing systems to address the critical components of education, access, quality care, and good follow-up.

Machine Learning and Vision: Advancing the Frontiers of Diabetic Cataract Management.

This comprehensive review explores the integration of machine learning (ML) in managing diabetic cataracts. It discusses the potential application of ML to identify novel methodologies for early detection, diagnosis, and therapeutic interventions. The review also addresses clinical translation challenges, including pharmacokinetics properties and ethical considerations. The approach toward cataractogenesis, therefore, has to be from a holistic viewpoint, bringing oxidative stress and metabolic disturbances to the top of importance. It outlines the important requirements, including continued research, diversified datasets, and uses interdisciplinary collaborations in making improvements in ML models and thereafter bridging the gap between computational promise and clinical implication, with the aim to help in the maximization of patient care in the management of diabetic cataract. A literature search through databases like PubMed and Scopus focusing on understanding of current innovations, challenges, and future directions in employing ML in diabetic cataract management was undertaken. This review has exploredboth recent and foundational studies in order to explain the development and gaps of current research with an aim to enhance outcomes of patient care by promoting future investigation. Key findings revealed a wide application of ML in ophthalmology including treatment identification, cataract detection and grading, and improving the surgical outcomes. However, this is accompanied by some obstacles, including risk of bias, concerns regarding artificial intelligenceapplication as a diagnostic tool, and legal regulations. ML promises extraordinary developments in the treatment of diabetic cataracts through betterment in diagnosis, treatment, and patient care. With this, it is full of clinical translation and ethical challenges, yet there is recognition in general that continuous model refinement and interdisciplinary collaboration, along with the expansion of the two identified key elements in enhancing patient outcomes, are essential for this to continue.

Peribulbar Block for Cataract Surgery in Patient with Nystagmus and Chronic Kidney Disease

Background: Management of presenile cataracts with nystagmus and chronic kidney (CKD) disease is a separate problem in anesthetic procedures. The risk of anesthesia in patients with chronic kidney disease is accumulation of nephrotoxic metabolites, unstable hemodynamic during intraoperative, and fluid overload.Case: A 43-year-old man with a diagnosis of immature presenile cataract with nystagmus and comorbid CKD was planned for phacoemulsification and intraocular lens. The anesthetic technique used was regional anesthesia with peribulbar block. Site injections in the inferotemporal and medial canthus with local anesthetic drugs levobupivacaine 0.5% 5 ml and lidocaine 2% 3 ml.Discussion: Combination of peribulbar block and mild sedation provides effective analgesic and anxiolytic effects. Peribulbar blocks in nystagmus besides sensory blocks can also block motoric function so that the position of the eyeball is in center.Conclusion: The peribulbar blockade anesthetic technique can be considered as an alternative safe anesthetic technique for cataract surgery with nystagmus and CKD.

Prescription glucocorticoid medication and iridocyclitis are associated with an increased risk of senile cataract occurrence: a Mendelian randomization study.

Iridocyclitis and the use of glucocorticoid medication have been widely studied as susceptibility factors for cataracts. However, the causal relationship between them remains unclear. This study aimed to investigate the causal relationship between the development of iridocyclitis and the genetic liability of glucocorticoid medication use on the risk of senile cataracts occurrence by performing Two-sample Mendelian randomization (MR) analyses. Instrumental variables (IVs) significantly associated with exposure factors (P < 5 × 10-8) were identified using published genome-wide association data from the FinnGen database and UK Biobank. Reliability analyses were conducted using five approaches, including inverse-variance weighted (IVW), MR-Egger regression, simple median, weighted median, and weighted mode. A sensitivity analysis using the leave-one-out method was also performed. Genetic susceptibility to glucocorticoid use was associated with an increased risk of developing senile cataracts (OR, 1.10; 95% CI, 1.02-1.17; P < 0.05). Moreover, iridocyclitis was significantly associated with a higher risk of developing senile cataracts (OR, 1.03; 95% CI, 1.01-1.05; P < 0.05). Nonetheless, some heterogeneity in the IVs was observed, but the MR results remained consistent after penalizing for outliers. The estimates were consistent in multivariate analyses by adjusting for body mass index (BMI) and diabetes mellitus type 2 (T2DM). This study provides new insights into the prevention and management of senile cataracts by highlighting the increased risk associated with iridocyclitis and the use of glucocorticoids.

Capsular Tension Ring and Iris Hook Use in The Management of Cataract with Phacoemulsification Method in Dogs

The purpose of this study is to evaluate the surgical outcome of capsular tension ring and iris hook use during phacoemulsification in dogs with zonular weakness and miotic pupils. This study includes nineteen dogs (29 eyes) that underwent phacoemulsification (15 dogs/25 eyes) and extracapsular cataract extraction surgery (4 dogs/4 eyes) between February 2014 and February 2015. Patients with any ophthalmic problem other than cataracts were not included in the study. Some dogs did not achieve pharmacologic pupil dilation. These dogs required the use of iris hooks or the insertion of capsular tension rings. The capsular tension ring insertion was used in dogs with zonular rupture in more than half of the zonules. Capsular tension rings were inserted in cases of zonular dialysis and iris hooks were placed to widen the pupil. Fifteen dogs (25 eyes) underwent phacoemulsification, while 4 (4 eyes) received extracapsular cataract extraction (ECCE) surgery due to the difficulty of phacoemulsification in hypermature cataracts. Iris hooks were used in four dogs (8 eyes) for drug-resistant miotic pupils. Capsular tension rings were inserted to stabilize the lens capsule during phacoemulsification and to centralize the intraocular lens (IOL) in the bag. Capsular tension rings in cases of zonular dialysis and iris hooks in drug-resistant miotic pupils improved the success of cataract operations with phacoemulsification. Both are safe and useful for zonular weakness and for maintaining mydriasis during surgery.

Clinical Outcomes of Phacoemulsification with Tecnis Eyhance Intraocular Lens Implantation for Management of Cataracts Associated with Posterior Segment Eye Diseases

Clinical Outcomes of Phacoemulsification with Tecnis Eyhance Intraocular Lens Implantation for Management of Cataracts Associated with Posterior Segment Eye Diseases

Participation of Lens Proteins and miRs in Traumatic and Inheritance Cataract: A Review on Diagnostic and Therapeutic Approaches for Cataract Management.

Traumatic and inherited cataract spiking blindness is caused by accumulated deposition of mutant eye lens protein or lens microarchitecture alteration. A traumatic cataract is a clouding of the eye's natural lens that occurs as a result of physical trauma to the eye. This trauma can be caused by various incidents such as blunt force injury, penetration by a foreign object, or a significant impact on the eye area. Inheritance cataracts or hereditary cataracts are cataracts that are genetically inherited from one or both parents. Complications following cataract surgery encompass various adverse outcomes such as inflammation, infection, bleeding, swelling, drooping eyelid, glaucoma, secondary cataracts, and complete loss of vision. The main purpose of the review is to highlight common pathophysiology associated with traumatic and inherited cataracts. Also, the review discusses diagnosis and treatment strategies for such cataract types by targeting their key pathological hallmarks. γD-crystallin plays a crucial role in maintaining the optical properties of the lens during the life span of an individual. Carbamazepine, Resveratrol, and Myricetin (CRM) are effectively bound at the γD-crystallin binding site and thereby could minimize misfolding and aggregation of γD-crystallin. miR-202, miR-193b, miR-135a, miR365, and miR-376a had the highest levels of abundance in the aqueous humor of individuals diagnosed with cataracts. The validation of these miRs will provide more insights into their functional roles and may be used for diagnostic purposes. The effective CRM combination as a multidrug formulation may postpone both traumatic and inherited cataracts and protect the eye from blindness.

Exploring awareness of cataract and associated risk factors: A cross-sectional study among the adult population in Jazan, Saudi Arabia.

Cataracts are a leading cause of visual impairment globally and significantly affect quality of life. In the Jazan region of Saudi Arabia, an area characterized by unique environmental and socioeconomic factors, the awareness of the cataract and its associated risk factors remain poorly understood. Therefore, assessing the knowledge about this problem in our region is the initial step to mitigate the impact of cataracts in the region. This descriptive cross-sectional study evaluated the prevalence of cataracts and the associated risk factors among adults in the Jazan region of Saudi Arabia. The study employed an online questionnaire divided into the sociodemographic characteristics and cataract knowledge sections. Data were analyzed using Statistical Package for Social Sciences for descriptive statistics. The study included 701 participants, predominantly young males (64.2%, aged 18-30 years). The participant profile included students (35.7%) and teachers (16.4%), and the majority held university degrees (69.2%). The preferred sources of information were TV and social media (23.8%), the Internet (23.3%), and academic studies (10.9%). Regarding cataract awareness, 57.6% correctly identified cataracts, 64.9% recognized blurred vision as a symptom, and 68.8% were aware of surgical treatment. Notable associations were found with sex (84.1% of females with higher education, P = .039), age (90.4% of those with >50 years of education, P = .002), and occupation (93.2% of students, P < .001). Overall, there were significant associations between the knowledge level and age (67.3%, P < .001) and occupation (77.6%, P < .001). This study revealed a moderate level of awareness of cataracts in Jazan, with significant variations based on sex, age, and occupation. These findings highlight the need for targeted educational interventions, particularly among certain demographic groups, to enhance understanding and management of cataracts in the region.

Updated Customized Clinical Practice Guidelines for Management of Adult Cataract in Iran.

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The burden, causes, and determinants of blindness and vision impairment in Asia: An analysis of the Global Burden of Disease Study.

Asia accounts for more than half of the world's population and carries a substantial proportion of the global burden of blindness and vision impairment. Characterising this burden, as well as its causes and determinants, could help with devising targeted interventions for reducing the occurrence of blindness and visual impairment. Using the Global Burden of Disease Study 2019 database, we retrieved data on the number of disability-adjusted life years (DALYs); crude and age-standardised rates; and the prevalence (with 95% uncertainty intervals (95%UIs)) of blindness and vision loss due to six causes (age-related macular degeneration, cataracts, glaucoma, near-vision impairment, refractive error, and other vision loss) for Asian countries for the period between 1990 and 2019. We defined DALYs as the sum of the years lost due to disability and years of life lost, and calculated age-standardised figures for the number of DALYs and prevalence by adjusting for population size and age structure. We then evaluated the time trend of the disease burden and conducted subgroup analyses by gender, age, geographic locations, and socio-demographic index (SDI). In 2019, the DALYs and prevalence of blindness and vision loss had risen by 90.1% and 116% compared with 1990, reaching 15.84 million DALYs (95% UI = 15.83, 15.85) and 506.71 million cases (95% UI = 506.68, 506.74). Meanwhile, the age-standardised rate of DALYs decreased from 1990 to 2019. Cataracts, refractive error, and near vision impairment were the three most common causes. South Asia had the heaviest regional disease burden (age-standardised rate of DALYs = 517 per 100 000 population; 95% UI = 512, 521). Moreover, the burden due to cataracts ranked high in most Asian populations. Being a woman; being older; and having a lower national SDI were factors associated with a greater vision loss burden. The burden due to vision loss remains high in Asian populations. Cataracts, refractive error, and near vision loss were the primary causes of blindness and vision loss. Greater investment in ocular disease prevention and care by countries with lower socioeconomic status is needed, as well as specific strategies targeting cataract management, women and the elderly.

Management and Outcomes of Traumatic Cataract During Open Globe Repair

PurposeTo compare outcomes of primary lensectomy (PL) versus no lensectomy (NL) during repair of zone I (involving cornea and limbus) and II (up to 5mm posterior to the limbus) ruptured globe injuries (RGIs) with lens involvement. DesignRetrospective clinical cohort study. Methods107 patients with RGIs involving both blunt and penetrating injury to the lens who presented to Wills Eye Hospital between April 1, 2017 and August 31, 2022 were included. Data from presenting visit was collected including demographic information, time from injury to surgery, visual acuity (VA), intraocular pressure (IOP), injury characteristics, and years since residency graduation of surgeon. VA, IOP, retinal detachment (RD) rate, and endophthalmitis incidence were compared between PL and NL groups at postoperative week 1 (POW1) and postoperative month 1 (POM1). VA, peak IOP, need for further surgeries, and types of additional surgery were compared between the two groups at the final visit. Results19 (17.8%) patients underwent PL. Age, sex, and initial VA were similar between groups (all p≥0.05). The PL group had surgery later from the time of injury (6.1±14.6 days vs. 1.3±1.9 days; p=0.010), higher IOP at presentation (12.9±11.6 mmHg vs. 7.7±11.3 mmHg; p=0.046), shorter wounds (2.3±1.4mm vs. 4.7±3.2mm; p=0.003), more frequent lens capsule violation (89.5% vs. 50%; p=0.010), increased likelihood of intraocular foreign bodies (52.6% vs. 17.0%; p=0.004), and were more likely to be operated on by surgeons with ≥ 5 years of experience post-residency (68.4% vs. 28.4%; p<0.001). At POW1, the PL group had significantly better logMAR VA (1.2±0.9 vs. 2.0±1.0; p=0.002), and this continued at POM1 (1.0±0.8 vs. 1.6±1.1; p=0.031) and the final visit (0.4±0.7 vs. 1.0±1.1; p=0.010). The PL group had lower IOP at POW1 (12.4±3.0 mmHg vs. 17.3±8.2 mmHg; p=0.005) than the NL group. There was no difference in RD or endophthalmitis rates between the two groups at POW1 or POM1 (p>0.05 for all). The NL group was more likely to require additional surgery by final follow-up (77.3% vs. 47.4%; p<0.001). In the multivariable analysis, PL had better final VA and decreased need for further surgery (both p<0.05). ConclusionsIn the appropriate circumstance, PL during lens-involving anterior RGI repair may lead to improved patient outcomes.

Visual outcome of cataract surgery in paediatric uveitis

1. To analyse the visual outcome in patients of paediatric uveitis who underwent cataract surgery; 2. To analyse the post-operative complications of cataract surgery in paediatric uveitis.Retrospective observational study was done on patients of uveitis who underwent cataract surgery. Patients who were under 18 years and co-operative for examination were included.They underwent Phacoaspiration with posterior chamber IOL implantation by a single surgeon after 3 months of activity free interval, BCVA(in Log MAR) in every follow up, anterior segment examination using slit lamp and posterior segment examination using IDO, post-operative complications and Intra ocular pressure was recorded using Noncontact tonometer.Uveitis was classified using the SUN classification of uveitis. Use of corticosteroids, biologics and immunosuppressive drug were collected at each visit. Total of 18 subjects diagnosed with cataract as a complication of uveitis &amp; undergone cataract surgery were studied (6 were females, 12 were males) 9 had anterior uveitis, 1had intermediate uveitis and 5 had pan uveitis. JRA (66.7%) was the most common cause identified. Improvement in vision from baseline was observed post-surgery at the end of first, third and 6th month which was statistically significant (P- Value &amp;#60;0.05). Average duration of disease before they underwent surgery was 18 months. Most common post op complication was posterior capsular opacification (50 %), others include secondary glaucoma (38.9), exudative retinal detachment (5.6%) and Vitritis (22.2%)Unlike adult uveitic patients, the surgical management of paediatric uveitic cataract is both challenging and controversial, and the surgery itself has been associated with poor visual outcomes. However, our study had shown that with implantation of IOL, good immunosuppressants and control of the disease can give these children a good visual outcome.

Unilateral Congenital Cataracts: Best Practices and Case Studies for Effective Management

Congenital cataract is a clouding of the eye lens in children, which contributes to blindness in 5% to 20% of children throughout the world. Cataracts can occur unilaterally or bilaterally and can vary in size, morphology, and degree of opacification. This report aims to comprehensively diagnose and treat unilateral cataracts and provide optical rehabilitation. A 3-month-old baby boy was brought by his family with complaints of a white spot on the right eye, which the family had known about since the patient was one month old. The patient was diagnosed with a congenital cataract and underwent surgery, which included aspiration irrigation, primary posterior capsulotomy, and anterior vitrectomy under general anesthesia. The use of glasses is chosen as optical rehabilitation. Collaborative management is also done with pediatric specialists, ENT, and pediatric cardiology. It was concluded that congenital cataract management aims to prevent amblyopia by clearing it as soon as possible (Clear Visual Axis) and optical rehabilitation (Clear Retinal Image) to improve the vision prognosis.