Phacoemulsification Surgery In Patients Research Articles

Comparative assessment of the corneal endothelium following phacoemulsification surgery in patients with type II diabetes and nondiabetes

Abstract: PURPOSE: The purpose is to assess the corneal endothelial changes after phacoemulsification surgery in diabetic patients and compare with those of nondiabetic subjects. METHODS: The study compared the corneal endothelial changes in diabetics and nondiabetics after phacoemulsification surgery. The study population included 40 patients with diabetes mellitus with good glycemic control and 40 nondiabetic patients who underwent uneventful phacoemulsification surgery. Central corneal endothelial cell density (ECD), central corneal thickness (CCT), and percentage of hexagonality percentage coefficient of variation (%CV) were measured preoperatively and postoperatively (at 4 and 12 weeks) using a specular microscope. RESULTS: Mean ECD loss (%) was measured as 9.85% and 8.41% at 4 weeks and 12 weeks postoperatively in the diabetic group while ECD loss percentage was 7.09% and 5.74% in the control group at the same time intervals, respectively. Furthermore, a significant difference was noted on comparing mean ECD measurements between the two groups at the postsurgical visits (4 weeks and 12 weeks). While the CCT was found to be similar in both diabetic and nondiabetic patients, increase was observed in the values of (%CV in both the groups at postoperative 4 weeks’ and 12 weeks’ follow-up. The values of both %CV and percentage hexagonality showed statistically significant differences between the diabetic and nondiabetic group before surgery and at 4 weeks’ and 12 weeks’ postoperative examinations. CONCLUSION: The patients with diabetes suffered greater endothelial damage despite good glycemic control as compared to nondiabetic patients which indicates the necessity of far more care to protect cornea endothelium in patients with diabetes.

Comparison of Endothelial Cell Loss after Phacoemulsification Surgery between Patients with Diabetes Mellitus and Non-Diabetic Patients at Kariadi Hospital: A Prospective Study

Abstract
 Introduction & Objectives : To compare the endothelial cell loss after phacoemulsification surgery in patients with DM and non- DM patients
 Methods : This was a prospective study conducted at Kariadi Hospital, Semarang, Indonesia. A total of 20 eyes of 20 patients (10 DM and 10 non-DM) who underwent phacoemulsification surgery were included in this study. The central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX) were measured preoperatively and on day-7 postoperatively. The percentage of endothelial cell loss (%ECL) was calculated and compared between the two groups.
 Results : The mean pre-operative and post-operative CCT was similar in both groups (DM =546.6±44.26μm, non-DM=516.7±42.2μm, p=0.949 ;DM=562.8±46.1μm, non-DM=533.7±46.6μm, p=0.997). The mean percentage of endothelial cell loss was slightly higher in the DM group compared to the non- DM group but not significant (6.66±2.36% vs. 2.31±1.72%, p=0.566). There were no significant differences between the CV and HEX on pre-operative and day-7 after surgery
 Conclusion : Patients with DM have a slightly higher percentage of endothelial cell loss after phacoemulsification surgery compared to non-DM patients. The mean CCT, CV and HEX pre-operation and day-7 were quite similar in both groups. These findings suggest that patients with DM may require more careful monitoring and follow-up after phacoemulsification surgery.

Combination of Iris Vessel Area Density and Surgery Interval as the Predictor of Perceived Pain during Consecutive Second Eye Cataract Surgery.

To explore clinical indicators to predict perceived pain during second-eye phacoemulsification surgery in patients with bilateral cataracts. Shanghai General Hospital, China. A case‒control study and a prospective cohort study. Age-related cataract patients who underwent first or second eye uneventful phacoemulsification surgery were enrolled. Before surgery, ocular examination results, including vessel area density (VAD) and vessel skeleton density (VSD) obtained by OCTA examination of the iris were performed. Patients completed a visual-analog-scale pain survey three times after surgery: 1 hour, 3 hours, and 24 hours after surgery. Seventy patients were enrolled in the case‒control study, and the pain scores of the second-eye surgery group under local anesthesia were significantly greater than those of the first-eye surgery group (p=0.0005). Preoperative iris VAD in the second-eye group affected perioperative pain scores (p=0.0047). The optimal cutoff value of VAD was 0.2167 with a specificity of 76% and a sensitivity of 62%. In the prospective cohort study, 124 patients were included in the second-eye group. Preoperative iris VAD (p=0.0361) and the time interval (p=0.0221) were independent factors for second-eye surgery pain. Combined with preoperative iris VAD and surgical interval, the negative predictive value and positive predictive value were 0.95 and 0.29 for predicting moderate pain or above, the sensitivity and specificity were 0.97 and 0.23 respectively. The combination of iris VAD and the time interval between both eye surgeries can be an effective method to predict the timing of the second-eye cataract surgery and to avoid intraoperative pain.

Systemic immune-inflammation index could be associated with pseudophakic cystoid macular edema after an uneventful phacoemulsification surgery in patients without risk factors

BackgroundTo evaluate the association between serum biomarkers and pseudophakic cystoid macular edema (PCME) in eyes without risk factors after uneventful phacoemulsification cataract surgery.MethodsThis is a case–control study. Patients without risk factors and who developed clinically significant PCME after uncomplicated phacoemulsification surgery were enrolled in the study. The age- and sex-matched control group that had normal fundus examination findings and 10/10 visual acuity in the first week, first month and following postoperative control visits was randomly recruited from the same study cohort. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were obtained from the preoperative complete blood count (CBC) test and compared between the two groups. Linear regression analysis was used to assess the relationship between central macular thickness (CMT) and biomarkers. A binary logistic regression model was generated to evaluate the significance of the biomarkers in predicting PCME. The receiver operating characteristic (ROC) curves of the significant parameters in the logistic regression model were presented to detect the area under the curve (AUC), the cut-off point, the sensitivity and the specificity.ResultsThe study cohort included 5352 patients. Of these patients, 52 (0.97%) met the inclusion criteria, and 60 age- and sex-matched patients were recruited as the control group. PLR, NLR, and SII were significantly different between the two groups (p = 0.006, p = 0.002, p < 0.001, respectively). According to the linear regression analysis, SII was found to have a significant relationship with CMT (p < 0.001). Only SII was assessed as significant in the logistic regression model (p = 0.046). In the ROC curve, the AUC of SII was 0.709. The sensitivity and specificity of SII for PCME prediction were 65.38% and 75%, respectively, and the cut-off point was 433.70.ConclusionSII is associated with the occurrence of PCME in eyes without risk factors after uneventful phacoemulsification surgery. SII could be a useful tool to predict PCME in eyes without risk factors.

The Incidence of Post Phacoemulsification Surgery Induced Dry Eye Disease in Upper Egypt.

BackgroundDry eye is described as a multifactorial disorder of the tear film that occurs due to excessive tear evaporation or tears insufficiency, and so leads to ocular discomfort sensation and ocular tissue damage with time.ObjectiveTo assess the incidence of dry eye disease after uncomplicated phacoemulsification surgery in patients with no pre-existed dry eye.Patients and MethodsThis hospital-based cross-sectional study was conducted to assess the incidence of dry eye at 100 eyes of 100 patients who underwent uncomplicated phacoemulsification surgery, with age more than 45 years old. It is measured by dry eye tests Schirmer 1 and tear break up time.ResultsThis study showed that 22% of the patients who underwent uncomplicated phacoemulsification surgery suffered from dry eye with significant results at 1st week post-operative that improved over time.ConclusionThere was a statistically significant drop in the results of the Schirmer test 1 and TBUT post phacoemulsification surgery, but with no clinical significance as they still at the normal range. The tear film assessment results at the 1st week post-operative were out of the normal range with TBUT and were borderline with ST1 in 22% of the patients. These results improved over time to return to the normal values within 12 weeks postoperatively.

Intracameral endoilluminator-assisted phacoemulsification surgery in patients with severe corneal opacity.

While phacoemulsification cataract surgery is a routine and safe procedure, clear visualization of the anterior segment is challenging in patients with corneal opacity. Illumination from the operating microscope can cause scattering and light reflection in a patient with corneal opacity. A frequent approach for these cases is cataract surgery with sequential or simultaneous corneal transplantation. This method has serious preoperative, intraoperative, and postoperative drawbacks, such as a long wait for a donor cornea, choroidal hemorrhage, and delayed visual rehabilitation. In this case series, the technique of intracameral endoilluminator-assisted phacoemulsification surgery in patients with severe corneal opacity was shown to provide better visualization and reduced scattering and reflection in patients with corneal opacity.

A comparative study of intraoperative complications of pseudoexfoliation in manual small incision cataract surgery and phacoemulsification

Background: Pseudoexfoliation Syndrome is an age related generalized disorder involving abnormal production or turnover of extra-cellular matrix in ocular tissues, orbital tissues, skin and visceral organs. Cataract is clouding of the lens in the eye commonly occurring due to increasing age, removed by surgery. Objectives 1. To compare the frequency and types of complications of small incision cataract surgery (SICS) and phacoemulsification surgery in patients with cataract with associated Pseudoexfoliation. 2. To determine the clinical outcome of the procedures. Materials and Methods: Study includes a sample of 100 patients diagnosed to have cataract with pseudoexfoliation, 50 of each undergoing either MSICS or Phacoemulsification, during the period of November 2017 to April 2019. Each case was examined clinically and an elaborative study of history based on chief complaints, significant risk factors, investigations, time and type of surgery performed and intraoperative and postoperative events were recorded. Following which management of these cases, based on facility available here was done. Results were analyzed by using SPSS 22.0 Version Software. Results: Difficult capsular rhexis was encountered in 19 cases that underwent SICS and 10 cases that underwent Phacoemulsification. Difficult nucleus delivery was encountered in 11 cases that underwent SICS and 4 cases that underwent Phacoemulsification. Zonular dialysis was encountered in 4 cases that underwent SICS and 11 cases that underwent Phacoemulsification. Difficult cortical aspiration was encountered in 19 cases that underwent SICS and 10 cases that underwent Phacoemulsification. Conclusion: Patients with pseudoexfoliation syndrome undergoing Manual Small Incision Cataract Surgery are at a higher risk for the development of intraoperative complications as compared to Phacoemulsification surgery. With appropriate preparation and use of specialized adjunctive devices, phacoemulsification is the preferred method of cataract extraction in eyes with pseudoexfoliation syndrome. The postoperative visual outcome was comparatively better in the patients that underwent Phacoemulsification than the patients that underwent Manual Small Incision Cataract Surgery.

A comparative study of intraoperative complications of pseudoexfoliation in manual small incision cataract surgery and phacoemulsification

Background: Pseudoexfoliation Syndrome is an age related generalized disorder involving abnormal production or turnover of extra-cellular matrix in ocular tissues, orbital tissues, skin and visceral organs. Cataract is clouding of the lens in the eye commonly occurring due to increasing age, removed by surgery. Objectives 1. To compare the frequency and types of complications of small incision cataract surgery (SICS) and phacoemulsification surgery in patients with cataract with associated Pseudoexfoliation. 2. To determine the clinical outcome of the procedures. Materials and Methods: Study includes a sample of 100 patients diagnosed to have cataract with pseudoexfoliation, 50 of each undergoing either MSICS or Phacoemulsification, during the period of November 2017 to April 2019. Each case was examined clinically and an elaborative study of history based on chief complaints, significant risk factors, investigations, time and type of surgery performed and intraoperative and postoperative events were recorded. Following which management of these cases, based on facility available here was done. Results were analyzed by using SPSS 22.0 Version Software. Results: Difficult capsular rhexis was encountered in 19 cases that underwent SICS and 10 cases that underwent Phacoemulsification. Difficult nucleus delivery was encountered in 11 cases that underwent SICS and 4 cases that underwent Phacoemulsification. Zonular dialysis was encountered in 4 cases that underwent SICS and 11 cases that underwent Phacoemulsification. Difficult cortical aspiration was encountered in 19 cases that underwent SICS and 10 cases that underwent Phacoemulsification. Conclusion: Patients with pseudoexfoliation syndrome undergoing Manual Small Incision Cataract Surgery are at a higher risk for the development of intraoperative complications as compared to Phacoemulsification surgery. With appropriate preparation and use of specialized adjunctive devices, phacoemulsification is the preferred method of cataract extraction in eyes with pseudoexfoliation syndrome. The postoperative visual outcome was comparatively better in the patients that underwent Phacoemulsification than the patients that underwent Manual Small Incision Cataract Surgery.

Phacoemulsification with Posterior Sub-Tenon Triamcinolone Acetonide Injection for Prevention of Progression of Diabetic Macular Edema after Cataract Surgery

Background: diabetic macular edema (DME) is the most common cause of visual loss in diabetic patients. The pathogenesis of DME is multifactorial. It results from multiple biochemical and cellular changes that eventually cause leakage and exudation. A number of patient characteristics such as increasing age, females, duration of DM, poor glycemic control and moderate to severe retinopathy have been found associated with poor prognosis after cataract surgery in diabetic patients. Objective: the aim of this study was to evaluate the efficacy of phacoemulsification with posterior sub-Tenon’s triamcinolone acetonide injection for prevention of progression of diabetic macular edema following uneventful cataract surgery by phacoemulsification. Patients and Methodology: this interventional study included 20 eyes of 20 diabetic patients with visually significant cataract and coexisting DME during the period from December 2017 to October 2018. Preoperative and postoperative best corrected visual acuity (BCVA) using LogMAR and intraocular pressure (IOP) were recorded. Results: statistically significant improvement in BCVA was detected when comparing postoperative values at one week, one month and three months to corresponding preoperative values. In addition, values at one month and three months were significantly improved when compared to values at one week post-operative. On other hand, values at three months revealed non-significant difference when compared to values at one month. Conclusion: this study suggests that posterior sub-Tenon’s triamcinolone acetonide injection can be given safely and easily at the time of phacoemulsification surgery in patients with visually significant cataract and DME.

Use of the chop hook to stabilize the capsular bag in patients with crystalline lens dislocations and cataracts.

ObjectiveTo observe the treatment effects of chop hook-assisted phacoemulsification surgery in patients with crystalline lens dislocation.MethodsThirty-seven eyes with cataracts and crystalline lens dislocations underwent cataract surgery. An L-shaped chop hook was introduced into the anterior chamber, and the tip was pushed or pulled to the centre of the anterior capsular edge of the zonular dialysis during the cataract operation. Postoperative follow-up was conducted for ≥ 1 month.ResultsAll patients’ postoperative visual abilities improved except one patient with glaucoma. One patient who underwent −5D intraocular lens implantation exhibited vision of 1/50. Visual acuity was less than 6/20 in 6 eyes, 6/20 to 10/20 in 7 eyes, and greater than 10/20 in 22 eyes.Conclusions L-shaped chop hooks can be used to push or pull the anterior capsular edge of the zonular dialysis for protection and avoidance of further zonular damage. This strategy provides satisfactory effects and reduces use of additional instruments.

Changes in Anterior Chamber Depth after Phacoemulsification in Pseudoexfoliative Eyes and their Effect on Accuracy of Intraocular Lens Power Calculation.

Objectives: To compare anterior chamber depth (ACD) changes after phacoemulsification surgery in patients with pseudoexfoliation syndrome (PEX) and normal patients using an anterior segment imaging method. Another aim of this study was to evaluate the effect of these changes on the accuracy of intraocular lens (IOL) power calculation and postoperative refraction.Materials and Methods: Twenty-two eyes of 22 patients with PEX and 30 eyes of 30 normal patients who underwent uneventful phacoemulsification surgery and IOL implantation were included in the study. The ACD of all patients was evaluated preoperatively and at 3 months postoperatively with the ALLEGRO Oculyzer (WaveLight® Oculyzer™ II, Alcon, Novartis)-Scheimpflug imaging system.Results: The postoperative mean ACD values were significantly larger than the preoperative ACD values in both groups (p<0.001 for both groups). The pre- to postoperative change in ACD was 0.46±0.3 mm in the PEX group, which was a larger change than seen in the normal patients (0.12±0.1 mm) (p=0.04). The mean absolute errors (MAE) calculated with different IOL formulas (SRK/T, Haigis, Hoffer and Holladay 1 formulas) were comparable and no statistically significant difference was observed between the two groups (p=0.21).Conclusion: Phacoemulsification induces more significant ACD changes in patients with PEX compared to normal patients. However, the MAE did not differ significantly between the groups.

A study of complications during cataract surgery in patients with pseudoexfoliation syndrome

Aim: Pseudoexfoliation (PXE) is a common and clinically important systemic condition that affects elderly people, who are also likely to undergo cataract surgery. It can cause serious complications during cataract surgery due to the pupillary rigidity and zonular weakness and instability. The purpose of this study was to study the frequency and types of complications of small incision cataract surgery (SICS) and phacoemulsification surgery in patients with cataract and PXE. Materials and Methods: This cross-sectional descriptive study was carried out on 52 eyes of 52 patients with cataract and PXE who underwent SICS or phacoemulsification surgery in a tertiary care hospital. Their perioperative and post-operative complications were documented and analyzed through statistical package for social sciences version 15.0 (IBM). Results: Poor pupillary dilatation in spite of use of standard mydriatic drops and non-steroidal anti-inflammatory drugs was the most common finding. This single factor made subsequent steps of surgery very difficult due to poor peripheral visualization. Pupillotomy was done in 25% cases. Other problems encountered were accidental iridodialysis, posterior capsule rupture, vitreous loss, retained cortical matter, decentered intraocular lens and zonular dialysis. Conclusion: Presence of associated PXE in cataract patients significantly increases the risk of vision threatening complications. Use of flexible iris hooks for small pupils and for capsular stability, capsular tension rings and high viscosity viscoelastics are useful modifications of surgical technique for good visual outcome.

Corneal edema after phacoemulsification surgery in patients with type II diabetes mellitus

Corneal edema delays early visual recovery after phacoemulsification surgery in diabetes mellitus. To compare corneal edema of eyes in patients with type II diabetes mellitus and in non-diabetics after phacoemusification surgery. A hospital-based, retrospective study involving 96 eyes that underwent phacoemulsification surgery for immature cataract at the Department of Ophthalmology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal was carried out. Evaluation was performed of 33 eyes in patients with diabetes mellitus (diabetic group) and of 63 eyes in patients without diabetes mellitus (non-diabetic group). All diabetic patients had controlled blood glucose for at least one week prior to the surgery. The operated eye was examined before surgery and on one day, one week, and one month after surgery. Intraocular pressure was measured on each visit. The findings of post-operative corneal edema and visual acuity between the diabetic and non-diabetic groups were studied and compared. There was no difference clinically in any pre-operative corneal examination between the diabetic and non-diabetic groups. The corneal edema after surgery was significantly higher in the diabetic group than in the non-diabetic group (p less than 0.001). The number of patients with corneal edema one day and one week after surgery was significantly higher in the diabetic group than in the non-diabetic group (after 1 day, OR = 62.5; 95 % CI = 15.31 - 255.11, p less than 0.000) and after 1 week, OR = 6.77; 95 % CI = 1.28 - 35.76, p less than 0.006). Corneal edema following phacoemusification surgery in diabetic eyes is likely to be more frequent than in non-diabetic eyes.

Clinical research of anterior chamber inflammation after phacoemulsification surgery in patients with complicated cataract secondary to uveitis

To investigate anterior chamber inflammation after phacoemulsification with intraocular lens (IOL) implantation in patients with Vogt-Koyanagi-Harada (VKH) syndrome or Behçet's disease (BD). Cohort study. Seventeen patients (20 eyes) with complicated cataracts and VKH syndrome or BD who underwent phacoemulsification with IOL implantation at Zhongshan Ophthalmic Center, Sun Yat-Sen University (SYSU) between January 2010 and June 2011 were included as the experimental group in this study. Cataract surgery was performed on these patients only when uveitis had been under control for more than three months. Thirty patients (40 eyes) with age-related cataracts who underwent phacoemulsification with IOL implantation in the same period were included as the control group. Quantitative measurements of anterior chamber aqueous flare and inflammatory cells were conducted preoperatively and postoperatively using a Laser Flare Cell Meter (LFCM). Independent t-test was used to compare patients' ages, and the energy and time of phacoemulsification between the two groups. The Student's t-test was used to assess the differences between paired data preoperatively and postoperatively. Independent t-test was also used to assess the quantitative data between groups. The study recruited 20 eyes in the experimental group and 40 eyes in the control group, including 11 eyes from 9 VKH patients and 9 eyes from 8 BD patients. The preoperative and postoperative flare values in the experimental group were (19.86 ± 6.47), (44.28 ± 18.47), (35.60 ± 12.65), (23.85 ± 8.41), and (13.86 ± 4.27) pc/ms, respectively, which were statistically higher than that of the control group preoperatively, and on days 1, 7, 30, and 90 after surgery (tpre = 4.643, Ppre < 0.01; t1 = 6.035, P1 < 0.01; t7 = 3.595, P7 = 0.001; t30 = 4.658, P30 < 0.01; t90 = 3.308, P90 = 0.002). Aqueous flare in Group A and Group B declined to preoperative levels on day 30 (t = 0.320, P = 0.753) and day 7 (t = 0.454, P = 0.653). For the experimental group, the inflammatory cell count on day 1 and 7 was (83.46 ± 27.08) and (27.56 ± 8.32) cells/0.5 mm(3), respectively, which was significantly higher than the preoperative level [(6.47 ± 3.56)cells/ 0.5 mm(3), t1 = 5.261, P1 < 0.01; t7 = 2.766, P7 = 0.012]. On days 30 and 90, the inflammatory cell count was (11.43 ± 4.81) and (4.82 ± 2.29) cells/0.5 mm(3), respectively, and there was no statistically significant difference in the inflammatory cell count compared with the preoperative level (t30 = 2.348, P30 = 0.042; t90 = 1.376, P90 = 0.186). For the control group, inflammatory cell count reduced to pre-operative level on day 7 (t7 = 2.464, P7 = 0.018). Anterior chamber inflammation reaches peak levels one week postoperatively in VKH and BD patients who receive phacoemulsification with IOL implantation. It takes three months for the inflammation to recede, and might take longer for complete restoration of the blood-aqueous barrier.

The Combination of Intravitreal Bevacizumab and Phacoemulsification Surgery in Patients with Cataract and Coexisting Diabetic Macular Edema

The aim of this study was to assess the efficacy of phacoemulsification combined with intravitreal (i.v.t.) bevacizumab injection in diabetics with clinically significant macular edema (CSME) and cataract. This retrospective study included diabetic patients with cataract and CSME who underwent phacoemulsification and intraocular lens implantation with a 2.5-mg bevacizumab i.v.t injection (ivBe) (15 eyes) or without ivBe (controls, 14 eyes). Best-corrected visual acuity (BCVA), central macular thickness (CMT) measured by optic coherence tomography (OCT), and adverse events were recorded. In the ivBe group, the OCT images demonstrated that CMT (mean +/- standard deviation [SD]) decreased significantly from 466 +/- 105 at baseline to 333 +/- 107, 313 +/- 138 and 333 +/- 111 microm at 4, 8, and 12 weeks, respectively, after treatment (P < 0.05). The visual acuity in logMAR (mean +/- SD) improved significantly from 1.66 +/- 0.39 at baseline to 1.30 +/- 0.50, 1.15 +/- 0.42, 0.99 +/- 0.48, and 1.03+/- 0.44 at 1, 4, 8, and 12 weeks, respectively, after treatment (P < 0.05). However, in the control group, the CMT changed insignificantly from 443 +/- 109 at baseline to 463 +/- 106, 425 +/- 128, and 421 +/- 119 microm at 4, 8 and 12 weeks, respectively after treatment (P > 0.05). The visual acuity in logMAR improved insignificantly from 1.63 +/- 0.42 at baseline to 1.43 +/- 0.53, and 1.39 +/- 0.43 at 1, and 4 weeks (P > 0.05) and significantly to 1.24 +/- 0.45 and 1.18 +/- 0.44 at 8 and 12 weeks, respectively, after treatment (P < 0.05). None of the patients in both groups experienced injection- or surgery-related complications or any obvious systemic adverse events. The short-term results suggest that phacoemulsification with i.v.t. bevacizumab safely reduces macular edema and improves visual acuity for cataract and CSME in diabetics.

Phacoemulsification in Previously Vitrectomized Eyes; Results of a 5-Year Period in Surgical Outcome

Purpose: To compare the incidence of complications and the outcome of phacoemulsification surgery in patients with and without previous vitrectomy. Methods: We retrospectively investigated 60 patients in a study group that received phacoemulsification with posterior chamber IOL implantation (PC-IOL) in the vitrectomized eye and 60 patients in a control group that received only phacoemulsification with PC-IOL implantation from January 2003 to December 2007. The interval from PPV to cataract extraction, sex, age, type of cataract, intraoperative and postoperative complications, pre- and postoperative refraction were reviewed. Results: The most common indication of pars plana vitrectomy was diabetic retinopathy. Nucleosclerosis was the most common type of cataract. The most common intraoperative complication was posterior capsular rupture, but there was no statistical significance when compared with the control group (p=0.116). In addition, the most common postoperative complication was posterior capsular opacity. After phacoemulsification, the rate at which a BCVA of 0.5 or better was obtained was lower in the study group than the control group. The spread between actual and expected refraction showed no statistically significant difference when compared with the control group (p=0.309). Conclusions: Experienced surgeons can safely perform phacoemulsification and PC-IOL implantation in previously vitrectomized eyes. However, the outcome of visual acuity is limited by vitreoretinal pathology that requires vitrectomy.

Intraocular Lens Tilt and Decentration&amp;nbsp;After Phacoemulsification Surgery in&amp;nbsp;Patients With and Without Primary&amp;nbsp;Open Angle Glaucoma

&lt;h4&gt;Intraocular Lens Tilt and Decentration After Phacoemulsification Surgery in Patients With and Without Primary Open Angle Glaucoma&lt;/h4&gt; &lt;p&gt;&lt;b&gt;To the Editor:&lt;/b&gt;&lt;br&gt; Phacoemulsification and intraocular lens (IOL) implantation is a common procedure that provides fast rehabilitation and excellent visual results. Intraocular lens tilt and decentration after cataract surgery are frequent complications, which cause astigmatism, glare, reflection, halo formation, and visual disability. Although phacoemulsification is the standard procedure for cataract removal, few reports exist regarding the positioning of IOLs implanted in patients with glaucoma after cataract surgery.&lt;/p&gt;

Phacoemulsification Surgery in Patients with Vogt- Koyanagi-Harada Syndrome

Phacoemulsification Surgery in Patients with Vogt- Koyanagi-Harada Syndrome

The −174G/C interleukin-6 promoter polymorphism influences the development of macular oedema following uncomplicated phacoemulsification surgery

To determine whether the functional -174 G/C interleukin-6 gene polymorphism is a risk factor for the development of cystoid macular oedema (CMO) following routine uncomplicated phacoemulsification surgery in patients with no established risk factors. A total of 40 patients who underwent routine phacoemulsification surgery as part of a randomised controlled trial comparing the use of postoperative steroid drops against a single sub-tenon injection of triamcinolone were genotyped for the IL-6 -174G/C polymorphism. All patients underwent fluorescein angiography at 30 days and anterior chamber flare measurements pre-operatively and at day 1, 7, and 30. Angiographic CMO developed in 14 patients of the 40 studied. 9 out of the 14 patients carried the GG genotype (Fisher's exact test P=0.05, Hazard ratio for GG genotype; 4.05 (1.02-16.00)). There was no difference in flare measurements between the GG and Non-GG (GC/CC) group. The two groups were otherwise well matched in terms of age, sex, phacoemulsification energy used intraoperatively, and proportion of patients receiving postoperative triamcinolone or steroid drops. The -174G/C interleukin-6 promoter gene variant appears to modulate the response to phacoemulsification surgery and to influence the development of postoperative CMO. These data suggest a genetic predisposition to this complication.

Intravitreal steroids in the management of macular oedema

The use of intravitreal corticosteroids in the management of macular oedema has recently gained widespread acceptance. New long-acting steroid preparations and methods of delivery have facilitated the use of these new modalities. This review describes the various types of macular oedema for which this therapeutic option is used and the results.