Phacoemulsification Cataract Surgery Research Articles

Intraoperative partial thickness compression suturing for descemet’s membrane detachment: A Novel technique

: To evaluate the efficacy of partial thickness transcorneal compression suturing with air desmetopexy in descemet’s membrane detachment (DMD) during cataract surgery: This is a retrospective review of records of patients who were managed for non-planar DMDs during phacoemulsification or small incision cataract surgery with partial thickness suturing with air descemetopexy in virgin eyes. : A total of fifteen cases were identified including 11 females and 4 males with average age of 67 years. All patients involved in the study underwent uneventful cataract surgery. All 15 cases involved in the study with DMD during cataract surgery were caused by intra-operative trauma during different instrumentations. Five cases had peripheral DMDs and ten cases had central DMDs. The average size of non-planar DMD was 4 mm. Ten cases had DMDs with scrolled margins. Eight patients achieved the best corrected visual acuity (BCVA) of 6/6 at the end of one month with clear corneas. Descemet’s membrane (DM) got completely attached at two weeks follow-up. The suture removal was done approximately after one month of follow-up. : Partial thickness transcorneal compression suturing with air desmetopexy in non-planar DMD is very helpful in recovering traumatic corneal edema during cataract surgery.

Femtosecond laser-assisted cataract surgery for complex cataracts - A review.

Since its inception in 2009, femtosecond laser-assisted cataract surgery (FLACS) has become an alternative to conventional phacoemulsification cataract surgery (CPCS). Clinical studies were unable to demonstrate superior visual outcomes, but revealed reduced endothelial cell loss. More recently, the cost-effectiveness of FLACS over CPCS in routine cataract surgeries has been challenged. However, the unique abilities of FLACS to customize anterior capsulotomies precisely, soften and fragment the nucleus without capsular bag stress, and create corneal incisions may have special utility in complex cataract and less-common scenarios. In this article, we review the unique role of FLACS in complex cataract surgeries and how it could play a role to improve the safety and predictability of nonroutine cataract surgery.

Corneal endothelial changes seven years after phacoemulsification cataract surgery

PurposeTo evaluate long-term postoperative corneal changes after phacoemulsification cataract surgery.MethodsTwenty patients who participated in a previous study regarding corneal endothelial changes after phacoemulsification cataract surgery were examined after 7 years. The patients were divided in three groups based on their initial increase in central corneal thickness day one after the surgery: < 5% increase, 6–20% increase and ≥ 20% increase. The primary outcome measures were corneal endothelial cell loss (ECL), endothelial cell count (ECC) and endothelial morphology.ResultsAfter 7 years, a difference in cell loss between the groups was observed, except for groups 1 and 2. Endothelial cell count (ECC) differed significantly between groups 1 and 3 at 3 months. At 7 years, there was no difference in ECC between the three groups. Cell loss was found exclusively in group 1 between 3 months and 7 years. Endothelial cell morphology showed a converging pattern between 3 months and 7 years.ConclusionAfter phacoemulsification cataract surgery, long-term ECC and morphology appear to converge towards a comparable steady state regardless of initial corneal swelling and endothelial cell loss.

Incidence and analysis of intraoperative complications in femtosecond laser-assisted cataract surgery: a large-scale cohort study to establish the learning curve

AimsTo assess the safety of femtosecond laser-assisted cataract surgery (FLACS) based on surgical parameters and intraoperative complications analysis and to determine the length of the learning curve for FLACS.MethodsA prospective...

Swiss Multicenter Ab Interno XEN45 Gel Stent Study: 2-Year Real-World Data.

The aim of this study was to investigate the 2-year postoperative efficacy of the XEN45 Gel Stent by evaluating the reduction of intraocular pressure (IOP) and the need for eye pressure-lowering medications in a multicenter setting in Switzerland. Patients with various types of glaucoma who received a XEN45 Gel Stent with or without combined phacoemulsification cataract surgery at five hospitals in Switzerland were retrospectively enrolled. Pre- and postoperative IOP, the number of antiglaucoma medications, and the need of subsequent interventions to control IOP were assessed. The success rate was defined as a ≥ 20% reduction of IOP 2years postoperatively without the need for subsequent glaucoma surgery. A total of 345 eyes were included: 44.3% with primary open-angle, 42.0% pseudoexfoliation, and 13.7% with other types of glaucoma. Of these, 206 patients were followed for 2years. Preoperatively, the mean IOP was 26.3 ± 8.9mmHg and the mean number of antiglaucoma medications administered was 3.0 ± 1.3. Two years postoperatively, the success rate was 66.0% (95% confidence interval 59.3-72.1%), the IOP had dropped by 43.8% to 14.8 ± 5.7mmHg, and the number of medications was reduced by a mean of 2.0 ± 1.7 per day. Postoperative complications and the need for interventions remained low. The XEN45 Gel Stent successfully reduced IOP and the number of antiglaucoma drugs in most patients at 2years postoperatively.

Triamcinolone Acetonide Subconjunctival Injection as Stand-alone Inflammation Prophylaxis after Phacoemulsification Cataract Surgery

PurposeTo compare the effectiveness and safety of a single injection of subconjunctival triamcinolone acetonide (TA) to postoperative topical prednisolone acetate (PA) with and without nonsteroidal anti-inflammatory drug (NSAID) for cataract surgery prophylaxis DesignRetrospective comparative effectiveness cohort study ParticipantsPatients undergoing phacoemulsification cataract surgery at Kaiser Permanente Northern California from 2018 through 2021 InterventionAnti-inflammatory prophylaxis exposure groups included topical PA with or without NSAID, and subconjunctival injection of TA (Kenalog®) 10 mg/mL or 40 mg/mL in low (1.0 - 3.0 mg) or high dose (3.1 - 5.0 mg). Main Outcome MeasuresThe adjusted odds ratio (OR) and 95% confidence interval (CI) for the association of postoperative macular edema (ME) and iritis diagnoses 15 to 120 days following surgery (effectiveness measures) and a glaucoma-related event (safety measure) between 15 days to 1 year after surgery ResultsOf 69,832 eligible patient-eyes, postop ME, iritis, and a glaucoma-related event occurred, on average in 1.3%, 0.8% and 3.4% in the topical groups and 0.9%, 0.5% and 2.8% in the injection groups, respectively. In multivariate analysis, all injection groups had a trend of a lower OR of ME compared with the topical PA reference group, with the high dose TA 10 mg/mL group reaching statistical significance (OR 0.64, CI 0.43,0.97, P=0.033). The PA + NSAID group had higher odds (OR 0.88, CI 0.74,1.04, P =0.135). There was a trend of lower odds of a postop iritis diagnosis in the high strength (40 mg/mL) groups. For postop glaucoma-related events, compared with PA, the TA 10 mg/mL low dose group had lower odds (OR 0.69, CI 0.55,0.86, P=0.001), the TA 10 mg/mL high dose group had similar odds (OR 0.90, CI 0.70,1.15, P=0.40) and the TA 40 mg/mL low and high dose groups had higher odds (OR 1.46, CI 0.98,2.18, P=0.062), (OR 2.14, CI 1.36,3.37, P=0.001), respectively. ConclusionsThe TA 10 mg/mL high dose group, with an average dose of 4 mg, was associated with lower risk of postop macular edema and a similar risk of a glaucoma-related event compared with the topical groups.

Comparison of posterior capsular rupture rates during phacoemulsification using 3D heads-up visualization system and traditional microscopes.

To compare the posterior capsular rupture (PCR) rates of cataract surgery using a traditional ophthalmic surgical microscope (OSM) and a three-dimensional (3D) heads-up visualization system (HUVS). Single tertiary referral center. Retrospective study. This study included 10,101 eyes that underwent phacoemulsification cataract surgery. Surgeries were performed using either 3D HUVS (1,964 eyes, performed by two surgeons, HUVS group) or traditional OSM (8,137 eyes, performed by six surgeons, OSM group) from February 2018 to June 2022. Data were collected based on the diagnosis-related group system, and the rate of PCR requiring vitrectomy and the surgical time were evaluated. The PCR rates were not significantly different between the OSM (n = 63; 0.7%) and HUVS (n = 19; 0.9%, p = 0.392) groups. The mean surgical times was significantly longer in the HUVS group (14.7 ± 10.6 min) than in the OSM group (12.9 ± 9.9 min, p < 0.001). In the 3D HUVS group, there were no PCR cases among the initial 100 patients. In both groups, no significant difference was observed in the PCR rates over time. Although the difference was not statistically significant, the PCR rate decreased over time in the HUVS group. Our results indicate that 3D HUVS-based cataract surgery performed by experienced cataract surgeons had a PCR rate similar to that of traditional OSM-based surgery during the 4-year study period. Although the surgical time was slightly longer with 3D HUVS, cataract surgery using 3D HUVS can be performed safely by experienced surgeons.

FREQUENCY OF CYSTOID MACULAR EDEMA ON OPTICAL COHERENCE TOMOGRAPHY IN TWO DIFFERENT TYPES OF CATARACT SURGERY

Cystoid macular edema (CME), also known as Irvine-Gass syndrome, has been recognized as a non-specific manifestation of various ocular conditions, with cataract surgery being a significant contributing factor. First reported by Sir Irvine in 1953 and further discussed by Sir Norton in 1966, CME following cataract surgery remains a topic of interest and concern in ophthalmology. The precise etiology of CME in post-cataract surgery patients remains elusive; however, it is widely accepted that post-surgical inflammation plays a pivotal role. To address this issue, we conducted a comparative study to assess the frequency of CME using spectral-domain optical coherence tomography (SD-OCT) in patients undergoing extracapsular cataract extraction (ECCE) versus phacoemulsification cataract surgeries. The study was conducted at the Department of Clinical Ophthalmology, Khyber Institute of Ophthalmic Medical Sciences; Medical Teaching Institute Hayatabad Medical Complex, Peshawar, over a period of 6 months. Utilizing a randomized controlled trial design and non-probability consecutive sampling, we determined a sample size of 70 patients, with 35 patients allocated to each group (Group A: ECCE, Group B: Phacoemulsification). The age of the participants ranged from 50 to 85 years, with a median of 60 years and a mean of 65±8 years. Our findings revealed that CME was observed in 11% of patients in Group A and 6% in Group B, indicating a lower frequency in post-operative cases. However, the difference in CME incidence between ECCE and phacoemulsification cases was not statistically significant. These results suggest that the risk of CME in post-operative cases may be influenced by various factors, including surgical technique and patient-specific variables. In conclusion, our study contributes to the understanding of CME following cataract surgery and underscores the importance of continued vigilance and further research in this area. Improved surgical techniques and perioperative management may help mitigate the risk of CME and enhance patient outcomes in the postoperative period.

Needle goniotomy decreases early intraocular pressure spike compared with phacoemulsification alone

PurposeTo evaluate the effect of needle goniotomy during phacoemulsification cataract surgery on early IOP spikes in patients with glaucoma compared with phacoemulsification alone. DesignRetrospective case control series MethodsCataract surgeries with concurrent goniotomy for glaucoma (n = 46) were compared with controls (n = 115) with and without glaucoma. IOP was measured prior to surgery and monitored through six months postoperatively. Between-group differences in IOP and postoperative IOP reduction were tested with ANOVA and Welch's 2-sided t-tests. Demographic, clinical, and intraoperative variables were also analyzed for significant association with postoperative IOP using univariate analysis. The incidence of IOP spike was evaluated according to two criteria: IOP > 30 mmHg or IOP > 10 mmHg above baseline. ResultsPhaco-goniotomy significantly lowered IOP at postoperative day one and month six. Following goniotomy, IOP was reduced on average 28 % (95 % CI [21, 36]) at month six compared with baseline, a mean reduction of -6.3 mmHg (95 % CI [-8.6, -4.0]), and a significantly greater reduction than in glaucoma controls (1 %, 95 % CI [-9, 7] and -0.3 mmHg, 95 % CI [-1.7, 1.1], p < 0.05). The average month six IOP following phaco-goniotomy was 12.9 mmHg (95 % CI [11.6, 14.1]), significantly lower than for glaucoma controls (15.6 mmHg, 95 % CI [14.0, 17.3], p < 0.05). The incidence of early IOP spike was significantly higher in glaucoma controls (23.1 %) than in the phaco-goniotomy cohort (6.0 %) (OR = 4.5, p < 0.05). There were no associations between CDE, ultrasound and aspiration time, or irrigation volumes on postoperative IOP. We showed that preoperative IOP was the only significant contributor to postoperative IOP reduction after phaco-goniotomy. ConclusionIncidence of early postoperative IOP elevation after phacoemulsification alone was 4.5 times higher than after phaco-goniotomy. Needle goniotomy may be a consideration for IOP lowering in glaucomatous eyes having cataract surgery.

Ultrasound biomicroscopy and stability of intraocular lens in patients with myopia after phacoemulsification cataract surgery

Ultrasound biomicroscopy and stability of intraocular lens in patients with myopia after phacoemulsification cataract surgery

LASIK is associated with early cataract surgery in healthy patients.

To evaluate the association between LASIK and early cataract phacoemulsification surgery (PE). A matched case-control study was conducted. Cases were otherwise healthy adults with a history of LASIK. Groups were paired according to corrected-distance visual acuity (CDVA), axial length, and cataract grade. A total of 213 patients were included. 85 patients were classified as post-LASIK group and 128 as controls. The mean age at the time of LASIK was 42.32 ± 9.24years. The mean CDVA before PE was 0.29 ± 0.19 Log MAR in post-LASIK group and 0.34 ± 0.22 Log MAR in controls (p = 0.07). The mean axial length was 23.99 ± 1.78mm in post-LASIK group and 23.62 ± 0.98mm in controls (p = 0.085). The mean nuclear cataract grading was 1.36 in post-LASIK group and 1.47 in controls (p = 0.34). The mean age at the time of PE was 60.18 ± 7.46years in post-LASIK group and 67.35 ± 9.28 in controls (p < 0.0005). The difference between the mean age of LASIK and the mean age of PE was 17.85 ± 5.72years. There was a positive association between the post-LASIK group and the age of PE ≤ 55years (OR: 4.917, 95% CI: 2.21-10.90, p < 0.001). LASIK may be associated with early PE. Patients with LASIK had a 7-year earlier PE compared to a matched control group.

Visual outcomes and risk factors of uveitis cataract eyes after phacoemulsification and manual small-incision cataract surgery.

To examine the visual outcomes and risk factors of uveitis cataract eyes after phacoemulsification and manual small-incision cataract surgery (MSICS). Tertiary-care eye hospital in southern India. Retrospective interventional case series. Of the uveitis eyes operated for cataract surgery between 2017 and 2020, eyes with a minimum of 6 months postoperative follow-up were included. Eyes with ocular trauma, lens subluxation, lens-induced uveitis, or retinal detachment-induced uveitis were excluded. Demography, visual acuity, intraoperative and postoperative records, and surgical outcomes were analyzed. 191 eyes of 191 patients with a mean age of 51.7 ± 14.4 years were included. Phacoemulsification was performed in 134 eyes, and 57 eyes underwent MSICS. Synechiolysis and pupil-expanding maneuvers were required in 74 eyes (38.7%). No differences were noted in the rates of complications between phacoemulsification and MSICS eyes, except at 1 year, where higher rates of posterior capsular opacification and vitritis were noted in MSICS eyes ( P = .018). The visual outcomes of eyes that underwent MSICS and phacoemulsification were comparable ( P = .463). In 12 eyes (13.5%), improvement in vision was not significant. This study shows phacoemulsification may be a preferred technique in uveitis cataracts, given the lesser incidence of postoperative complications. Patients should be counseled for realistic expectations.

Ethnic Differences in the Rates of Posterior Capsule Rupture and Long-Term Sequelae in Phacoemulsification Cataract Surgery.

Purpose The purpose of this study is to investigate the rates of posterior capsular rupture (PCR) and its sequelae during phacoemulsification across different ethnicities. Methods This is a retrospective cohort study of all consecutive phacoemulsification cases complicated by PCR that met the inclusion criteria over a four-year period at a single tertiary eye centre in the United Kingdom (UK). Results PCR occurred in 0.85% of cases overall (157/18,481). PCR rates were 1.8% (26/1485), 1.2% (51/4350), and 0.7% (75/10,927) in African-Caribbean, Indian subcontinent, and Caucasian patients, respectively (p < 0.001). Mean final corrected distance visual acuity improved (p < 0.05) in all ethnic groups(0.40 ± 0.57 logMAR) compared to pre-op (0.78 ± 0.61 logMAR). Post-operative cystoid macular oedema and unstable intraocular pressure rates following PCR did not statistically differ amongst ethnicities (p = 0.37 and p = 0.75, respectively). However, post-operative uveitis rates significantly differed at 11.5%, 15.7%, and 1.3% amongst the three ethnic groups, respectively (p = 0.01). Conclusion This is the first study to highlight a possible link between patient ethnicity and the risk of PCR during phacoemulsification cataract surgery. We observed significantly greater numbers of PCR cases amongst certain ethnic groups (highest in African-Caribbean eyes, then Indian subcontinental eyes, and lowest in Caucasian eyes) within the same multi-cultural urban population. Ethnicity may therefore be a contributing factor for PCR and should potentially be taken into consideration during preoperative risk stratification.

Early cataract surgery and affordable Sinskey hook goniotomy in Black and Afro-Latino glaucoma patients: a 6-month retrospective study

AimThe purpose of this study was to determine the real-world efficacy of early phacoemulsification cataract surgery and goniotomy with a Sinskey hook in patients with glaucoma.MethodsThis study was conducted at Advanced Eye Care of New York, a private practice located in Manhattan, NY. This was a single-center, retrospective study of predominantly Black and Afro-Latino patients with glaucoma. These patients underwent early phacoemulsification cataract surgery and goniotomy using an affordable and reusable straight Sinskey hook (Ambler 200-μm tip). Patients who underwent the aforementioned procedure with 6 months of follow-up were included in this study. Investigated parameters were intraocular pressure, number of medications, mean deviation on visual field test, visual acuity, adverse events, and pre/postoperative spherical refractive error.ResultsAmong all 38 eyes that were enrolled in the study and underwent surgery (goniotomy using a Sinskey hook with phacoemulsification), mean intraocular pressure was reduced from 16.45 mmHg at baseline to 13.24 mmHg at month 6, a 19.5% reduction. The mean number of topical intraocular pressure-lowering medications used was reduced from 1.81 at baseline to 0.52 at month 6, a 71% reduction in topical medications.ConclusionCombined early cataract surgery and goniotomy performed with a Sinskey hook is an affordable microinvasive surgery and an effective way to reduce intraocular pressure and the number of ocular hypertensive medications used in Black and Afro-Latino patients with primary open-angle glaucoma.

Exploring anterion capsular contraction syndrome in cataract surgery: insights into pathogenesis, clinical course, influencing factors, and intervention approaches.

Anterior capsular contraction syndrome (ACCS) is a challenging complication that can occur following phacoemulsification cataract surgery. Characterized by capsular bag wrinkling, intraocular lens (IOL) decentration and tilt, ACCS can have negative effects on visual outcomes and patient satisfaction. This review aims to investigate the pathogenesis, clinical course, influencing factors, and intervention approaches for ACCS after cataract surgery. By understanding the underlying mechanisms and identifying factors that contribute to ACCS, surgeons can enhance their ability to predict and manage this complication. Various intervention strategies are discussed, highlighting their importance in reducing complications and improving surgical outcomes. However, further research is needed to determine optimal prevention and management strategies through long-term follow-up and comparative analyses. Advancements in this field will ultimately lead to improved visual outcomes and optimized cataract surgery for patients.

Diabetes, Diabetic Retinopathy, and Intravitreal Injection as a Risk Factor of Posterior Capsular Rupture in Phacoemulsification Cataract Surgery :A Systematic Review and Meta Analysis

Abstract&#x0D; Introduction &amp; Objectives : The risk of PCR in patients with diabetes and its sequential complication including diabetic retinopathy and Intravitreal Injection (IVI) was still under debate. This study was aimed to summarize the risk of diabetes, diabetic retinopathy, and intravitreal injection towards PCR events during phacoemulsification cataract surgery.&#x0D; Methods : A systematic literature search was performed up to March 2023 from the last 10 years publications using Medline and Cochrane library databases. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes, diabetic retinopathy, and IVI with PCR events were calculated using random-effects models. The quality of included studies was appraised using the Newcastle-Ottawa Scale.&#x0D; Results : Six studies about diabetes, six studies about diabetic retinopathy and seven studies about IVI were included in this meta-analysis. The pooled odds ratios of PCR in eyes with diabetes was 1.22 (95% CI: 1.16-1.28) I2 =0.0%, with the diabetic retinopathy patients was 1.23 (95% CI: 1.13-1.33) I2 =64.3%, and with prior IVI was 1.05 (95% CI: 1.03-1.08) I2 =51%.&#x0D; Conclusion : This meta-analysis emphasize that diabetes, diabetic retinopathy, and previous IVI significantly increase the risk of PCR on future phacoemulsification surgery. Further studies are needed to elucidate the underlying mechanism.

Socio-demographic Characteristics and Visual Acuity Patients Underwent Cataract Surgery at Pandaan Eye Clinic

Introduction &amp; Objective : Cataracts are one of the leading causes of blindness affecting 94 million worldwide including 77,7% blindness of Indonesians with prevalence in people aged over 50 years reaching 1,9%. This study aimed to describe the socio-demographic characteristics and visual acuity of patients who underwent phacoemulsification cataract surgery at Pandaan Eye Clinic.&#x0D; Methods : Patients were consecutively included from January 2022 to December 2022. Data of age, gender, area of residence, occupation, comorbid systemic disease, laterality, intraocular lens (IOL) power, and best-corrected visual acuity (BCVA) after four weeks of surgery was obtained. Visual acuity (VA) is classified in the WHO category. Data were recorded in sheets and proceeded using SPSS.&#x0D; Results : There were 1583 eyes out of 1230 patients with 55,4% having done unilateral cataract surgery and the most used IOL power at the range 19.00 to 23.00D (75%). The mean age was 60,83 ? 9,05 years and 53,9% were male. Most of them live in Pasuruan Regency (77,7%), without systemic comorbidity (68,8%), and work outdoors (62,2%). Before cataract surgery, most of the patients had blindness (57,6%) (presenting VA &lt;3/60). The BCVA outcomes were 6/6 to 6/18 in 1129 eyes (71,3%).&#x0D; Conclusion : This study marked the immense incidence of cataracts as a cause of blindness, particularly in males. The increase in cataract surgery performed also determines that eye care services reach a certain area. Therefore, eye health resources must be evenly available throughout the country to reduce the impact of socio-demographic status

THE EFFECT OF LIMBAL RELAXING INCISIONS ON 1-WEEK POSTOPERATIVE IN K1 AND K2 VALUES

Introduction: Limbal Relaxing Incisions (LRI) is a surgical technique used to correct astigmatism during cataract surgery. This technique used to reduce the steepness of the corneal curvature in a particular meridian. LRI can be performed alone or in combination with phacoemulsification. Methods: This prospective study aimed to investigate the effect of Limbal Relaxing Incisions (LRI) on corneal astigmatism in patients who underwent phacoemulsification cataract surgery. Five patients were included in this study, and preoperative and 1-week postoperative keratometry values (K1=flat keratometry and K2=steep keratometry) were measured using the IOL Master. Paired t-test analysis was used to compare the changes in K1 and K2 values before and after LRI. Results: Five patients with the mean age 39.8 years (range: 22 to 76 years) and corneal astigmatism 3.12 D (range: 2.25 to 4.66 D) were underwent LRI and cataract surgery. The mean preoperative K1 and K2 values were 42.12 D and 46.44 D, respectively, while the mean 1-week postoperative K1 and K2 values were 42.60 D and 45.80 D, respectively. Paired t-test analysis showed a statistically significant decrease in K2 values (p = 0.025) but no significant change in K1 values (p = 0.329). Conclusion: This study showed there were no significant difference between pre and postoperative of K1 and showed a significant decrease in K2 on IOL Master examination. The wide age range of the included patients may have influenced the effectiveness of LRI in reducing astigmatism. Further study with more subjects are required.

The Effect of Limbal Relaxing Incisions on 1-Week Postoperative K1 and K2 Values

Abstract&#x0D; Introduction &amp; Objectives : Limbal Relaxing Incisions (LRI) is a surgical technique used to correct astigmatism during cataract surgery. This technique used to reduce the steepness of the corneal curvature in a particular meridian. LRI can be performed alone or in combination with phacoemulsification.&#x0D; Methods : This prospective study aimed to investigate the effect of Limbal Relaxing Incisions (LRI) on corneal astigmatism in patients who underwent phacoemulsification cataract surgery. Five patients were included in this study, and preoperative and 1-week postoperative keratometry values (K1 and K2) were measured using the IOL Master. Paired t-test analysis was used to compare the changes in K1 and K2 values before and after LRI&#x0D; Results : Five eyes of Five patients with the mean age 39.8 years (range : 22 to 76 years) and corneal astigmatism 3.12 D (range : 2.25 to 4.66 D) were underwent LRI and cataract surgery. The mean preoperative K1 and K2 values were 42.12 D and 46.44 D, respectively, while the mean 1-week postoperative K1 and K2 values were 42.60 D and 45.80 D, respectively. Paired t-test analysis showed a statistically significant decrease in K2 values (p = 0.025) but no significant change in K1 values (p = 0.329).&#x0D; Conclusion : This study showed there were no significant difference between pre and postoperative of K1 and showed a significant decrease in K2 on IOL Master examination. The wide age range of the included patients, may have influenced the effectiveness of LRI in reducing astigmatism. Further study with more subject are required.

Changes in endothelial cell density following conventional phacoemulsification and femtosecond laser-assisted cataract surgery in eyes with dense cataracts.

To compare the safety, effectiveness and changes in endothelial cell density following standard phacoemulsification and femtosecond laser-assisted cataract surgery (FLACS) in dense cataracts (LOCS III grade 3.0 NO and above). Nethradhama Superspeciality Eye Hospital, Bangalore, India. Prospective, randomized, comparative study. 100 eyes of 100 patients were randomly assigned to either conventional phacoemulsification surgery (CPS) or FLACS (LENSAR Laser System) using pre-defined patterns of nuclear fragmentations. Measured outcomes included intra-operative phaco time, irrigation fluid volume, surgical time and complication rates. Endothelial cell density was evaluated at baseline, 2 weeks and 6 months post-operatively. The CPS group had significantly higher mean total phaco time (TPT, 11.17 ± 6.5 sec vs 8.03 ± 3.77 sec), effective phaco time (EPT, 6.14 ± 3.62 sec vs 4.42 ± 2.07 sec) and total surgical time (8.18 ± 2.36 min vs 7.11 ± 1.55 min) than the FLACS group (p<0.001). Volume of irrigation fluid was comparable between the two groups (CPS, 36.7 ± 12.18 ml, FLACS, 38.64 ± 13.73 ml, (p =0. 45). Mean corneal oedema score and CCT values on POD-1 were significantly higher for the CPS group. At 6 months, % endothelial cell density (ECD) loss was significantly higher in the CPS group (16.08%) versus the FLACS group (12.8%), p <0.001. Three eyes in the CPS group had wound burns of varying severity. FLACS with customized nuclear fragmentation patterns resulted in significantly less intra-operative phaco time, surgical time and endothelial cell loss compared to conventional phacoemulsification when treating dense cataracts.