Senile Cataract Surgery Research Articles

Распространенность нарушений углеводного обмена у пациентов, планирующихся на хирургию возрастной катаракты

Распространенность нарушений углеводного обмена у пациентов, планирующихся на хирургию возрастной катаракты

A Preliminary Comparative Study of Visual Performance Between Two NewlyCommercially Available Monofocal Intraocular Lenses Implanted During Cataract Surgery.

PurposeTo compare visual outcomes of two newly developed monofocal intraocular lenses (IOLs) (I-Stream H and CT Lucia 211P) implanted in patients undergoing surgery for senile cataract.MethodsThis prospective, comparative, single-center, randomized study included 94 eyes of 94 patients undergoing cataract surgery. Patients were randomized to receive the implantation of I-Stream H IOL (Group 1) or CT Lucia 211P IOL (Group 2). Each patient underwent a complete ocular examination before (V0), 1 month (V1), 3 months (V2) and 6 months (V3) after surgery, including visual acuity testing, objective refraction, slit-lamp biomicroscopy, contrast sensitivity testing and visual function index questionnaire (VF-14).ResultsAfter surgery, a significant increase of best-corrected visual acuity (BCVA), CS and VF-14 and a significant decrease of SE were detected in both groups at each time point compared to baseline (always p<0.01). No significant differences in the postoperative increase of BCVA (p=0.12), CS (p=0.21) and VF-14 (p=0.31) and decrease of SE (p=0.08) were detected comparing patients from Group 1 and Group 2 at V3. Mean and median prediction error, as well as absolute prediction error values, did not significantly differ between the two groups (p>0.05). Eyes with an actual refraction within 0.25, 0.50 and 1 D were 53.1%, 85.1% and 100% for Group 1 and 55.3%, 87.2% and 100% for Group 2 (p>0.05).ConclusionI-Stream H and CT Lucia 211P allowed a satisfied recovery of visual function after senile cataract surgery; both IOLs were shown to have similar outcomes of visual performance.

Frequency of Corneal Astigmatism in Patients Presenting for Senile Cataract Surgery at a Teaching Hospital in Indian Rural Population.

The aim of this study was to assess prevalence of corneal astigmatism before cataract surgery in old age in Indian rural population. Prospective, cross-sectional, and observational study. Keratometric values were measured with an auto refractokeratometer in patients presenting for cataract surgery between January 2017 and May 2018. The demographic profiles of patients were recorded. Axial length and intraocular lens power were measured. Data were analyzed in SPSS software. This study included 1000 eyes of 880 patients with a mean age of 65.1 ± 10.12 years. The mean astigmatism was 0.89 ± 0.63 D. A total of 179 eyes (17.9%) had astigmatism between 1.00 and 1.49 D; 34 eyes (3.4%) had astigmatism between 2.00 and 2.5 D; and 20 eyes (2%) had astigmatism >3 D. Overall, 325 eyes (32.5%) had astigmatism >1.00 D. Against the rule astigmatism was seen in 44.6% cases, oblique astigmatism was seen in 32% cases, and with the rule astigmatism was seen in 20.7% cases. Against the rule astigmatism increased with age and reached a maximum between 60 and 69 years. Male eyes had flatter corneal curvature than female eyes. The mean axial length was 25.59 mm, and the mean intraocular lens power was 21.05 ± 1.0D. We found that 32.5% patients had corneal astigmatism >1 D and may benefit from toric intraocular lenses implantation. The results of this analysis provide normative data for the hospital to plan for correction of corneal astigmatism in patients undergoing cataract surgery.

Importance of Multifocal Intraocular Lenses in The Elderly Population

Background: Vision rehabilitation in elderly populations. Objective: We aimed to evaluate potential factors affecting the visual quality and other parameters in the selection of appropriate intraocular lenses in cataract surgery for patients with senile cataract. In addition, we evaluated the type of intraocular lenses optimal for cataract surgeries in elderly patients and attempted to analyze the significance of visual rehabilitation without glasses to improve the quality-of-life of elderly patients who are unable to use glasses. Method: We retrospectively investigated the records of 49 eyes from 49 patients who underwent cataract surgery for senile cataract during 2014–2015. Preoperative and postoperative pupil sizes were measured using The Oasis brand of pupillometer, and changes in the pupil size were statistically analyzed. Distribution of variables was analyzed using the Kolmogorov–Smirnov test. The Wilcoxon test was used for repeated measurements. Study data was analyzed using the SPSS 22.0 program. Results: Of all patients, 32 were males and 17 were females (age, 48–81 years). A significant decrease in the pupil size was postoperatively noted (p < 0.05). The mean preoperative pupil size decreased to 4.1 ± 0.9 mm from 4.9 ± 1.0 mm during the first postoperative month. Conclusion: Cataract is usually related to aging. Multifocal intraocular lenses (MIOLs) are not or only slightly affected by the pupil size and enable the elderly to meet their daily needs without depending on glasses and, thus, improve their quality-of-life after cataract surgery. Thus, we recommend MIOLs that function independent of pupil size as appropriate for cataract surgeries in elderly patients.

Application of integrated medical care in elderly patients undergoing phacoemulsification cataract surgery

Objective To explore the effect of integrated medical care in the treatment of senile patients undergoing phacoemulsification cataract surgery. Methods From March 2017 to March 2018, 826 patients who underwent phacoemulsification surgery in this hospital were randomly divided into control group and observation group, 413 cases of each group.The control group was treated with routine care, while the observation group adopted integrated nursing care.The length of hospital stay, hospitalization costs, the patients' psychological status, complications rate and satisfaction to the care service were compared between the two groups. Results The length of hospital stay and hospitalization expenses in the observation group were lower than those in the control group, and the differences were statistically significant (P 0.05). After operation, the scores of SAS and SDS in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). The incidence of complications in the observation group was 5.57%(23/413), lower than that in the control group, which was 12.11%(50/413), with statistically significant difference (P<0.05). The satisfaction rate in the observation group was 97.58%(403/413), higher than the 92.98%(384/413) in the control group, and the difference was statistically significant (P<0.05). Conclusions The application of integrated nursing intervention in elderly patients undergoing phacoemulsification cataract surgery can effectively reduce their negative emotions and postoperative complications, improve patients' satisfaction with nursing to a certain extent, and shorten the clinical treatment time, so as to promote the improvement of the disease. Key words: Cataract; Phacoemulsification; Medical and care integration; Psychological state; Satisfaction to nursing

The effect of intraocular lens material and postoperative therapy on the posterior capsule opacification development after the senile cataract surgery

Introduction/Objective. The most frequent postoperative complication of a successfully performed phacoemulsification cataract surgery is the development of posterior capsule opacification (PCO). It is caused by the proliferation and migration of the remaining residual epithelial cells. The objective of this study was to investigate the influence of two different intraocular lenses and two different anti-inflammatory drugs on the development of PCO in one-year follow-up period. Methods. Investigation included 120 patients (120 eyes), equally divided into four groups. The first two groups included patients who used non-steroid anti-inflammatory drug (NSAID) postoperatively, while the other groups had corticosteroid therapy. The first and third group got hydrophilic intraocular lenses (IOL), the second and fourth group had hydrophobic IOL. Software program EPCO 2000 was used for the analysis of PCO. Student?s t-test, Wilcoxon test, and ANOVA were used for data analysis and p &lt; 0.05 value was accepted as statistically significant. Results. After the first three postoperative months, patients from NSAID groups had mean PCO score 0.25 ?} 0.03, which was statistically significant higher (p = 0.042) comparing to corticosteroid groups. At the end of the investigation, the best result in PCO preventing was seen in the group of patients with hydrophobic IOL and corticosteroid therapy, with the mean PCO score of 0.47 ?} 0.08. Conclusion. This study has revealed that IOL made of acrylic hydrophobic material seemed to be the right choice when choosing intraocular lens to prevent PCO development. On the other hand, NSAID and corticosteroid therapy have showed similar results in preventing postoperative intraocular inflammation. This fact can be very useful in situations when corticosteroids must be used with great caution.

Hasil tajam pengelihatan pasca operasi katarak senilis di RSUP Sanglah Denpasar periode Oktober 2016 - Juni 2017

Introduction: Cataract is a type of eye disease that occurs in the lens of the eye. Cataract occurs not only due to the age factor, but also can occur in children born with these conditions or congenital factors. This study aimed to find out visual acuity outcome after senile cataract surgery at RSUP Sanglah Denpasar on October 2016 - June 2017 period.Method: The type of this research was descriptive cross-sectional conducted at RSUP of Sanglah Denpasar using the medical records of the period of October 2016 - June 2017. The sampling technique used the total sampling, with the number of samples of 32 subjects. The result of this research was processed by using a computer software.Result: The postoperative patients with poor outcome tended to be experienced by the senile cataract of mature group compared to the immature that was around 9.1%, borderline outcome tended to be experienced by group with immature senile cataract of 23.8% while the dominant senile cataract outcome was 81.8%. Patients undergoing SICS procedures tended to have a poor outcome compared to those undergoing a phacoemulsification procedure of 16.7%. Borderline outcome tended to the group undergoing phacoemulsification procedures, and 83.3% of the good outcome tended to be experienced by the group undergoing SICS procedures.Conclusion: This research concludes that good outcome come from cataract senile mature group (81.8%) and the group that doing SICS procedure (83.3%)

Co-morbidities among cataract surgery patients in a tertiary hospital of south India

Aim: To assess the frequency of systemic and ocular co-morbidities among the patients seeking cataract surgery in a tertiary hospital, Puducherry, south India. Materials and Methods: This was a retrospective cross sectional study. All patients with senile cataract seeking cataract surgery in our hospital and research institute from July 2015 to June 2016 were included. Results: Out of 448 patient’s case records reviewed, there were 218(48.66%) males and 230(51.34%) females. 147 (32.81%) patients had systemic co-morbidity and 66 (14.73%) had concurrent ocular disease. Among the systemic co-morbidities, commonest was diabetes mellitus in 61(13.62%), followed by hypertension in 42(9.38%) and renal disease in 16(3.57%) patients. Among the ocular co-morbidities age related macular degeneration was the commonest seen in 19 (4.24%) cases, followed by diabetic retinopathy in 15 (3.35%) patients. Conclusion: Systemic and ocular co-morbidities are prevalent among the cataract surgery seeking population, which needs to be identified by the ophthalmic surgeons and systemic illness needs to be adequately controlled before surgery while ocular problems need prompt intervention with a close follow-up for a better quality of life. Keywords: Ocular problem, Senile cataract, Systemic illness.

Prevalence of diabetes and diabetic macular edema in patients undergoing senile cataract surgery in Italy: The DIabetes and CATaract study.

Background:The purpose of this study is to determine the prevalence of diabetes and diabetic macular edema in patients undergoing senile cataract surgery in Italy.Methods:It is a prospective, multicenter, cross-sectional study. Thirteen ophthalmic units equally distributed across the Italian territory have been involved in the study. For a period of 3 months, all subjects undergoing phacoemulsification received an Optical Coherence Tompgraphy (OCT) scan and were screened for the anamnestic presence of diabetes. In addition, five selected units collected blood samples from all their patients to measure glycated hemoglobin (HbA1c) levels and detect the presence of occult diabetes (HbA1c > 6.5%). In diabetic patients, levels of retinopathy were measured and diabetic macular edema was considered significant (clinically significant macular edema) when foveal thickness was above 30% of normal levels.Results:A total number of 3657 subjects have been screened. Among them, 20.4% were diabetics. Prevalence of diabetes was significantly higher in males (24.7%) than in females (17%). Levels of HbA1c were tested in a representative sample of 1216 consecutive subjects, and occult diabetes was diagnosed in 4.8% of cases. No significant differences were observed between age groups or different geographic areas. Among diabetic patients, diabetic macular edema of any kind was present in 27.5% (clinically significant macular edema (6.6%)). No significant differences were seen in the prevalence of diabetic macular edema between males and females or between age groups. Among the 745 diabetic patients, no signs of retinopathy were seen in 537 subjects (76.3%), while 101 patients (14.3%) had nonproliferative retinopathy, 13 (1.7%) had nontreated proliferative diabetic retinopathy, and 53 (7.5%) had laser-treated retinopathy. In the entire sample of 3657 subjects, a normal macula was present in 90.9% of cases, diabetic macular edema of any kind in 5.4%, and other maculopathies in 3.4%.Conclusion:In this large cohort study on patients undergoing cataract surgery, more than one-fourth were diabetics and more than one-fourth of these had diabetic macular edema. These high prevalences suggest the opportunity to plan an adequate preoperative assessment in all patients in order to reduce the risk of postoperative development or worsening of a sight-threatening complication such as chronic diabetic macular edema.

Caveolák szerepe a szürke hályog képződésében: humán szemlencse epithelsejtjeinek vizsgálata

The aim of the study was to examine and compare the morphology of caveolae and the immunohistochemical difference of caveolin-1 in control (myopic and hyperopic) lens epithelial cells and human lens epithelial cells affected by cataract. Authors investigated whether caveolae might have a role in cataractogenesis. Anterior lens capsules were obtained by capsulorhexis during surgery of senile cataract and refractive surgery of the clear lens. Ultra-fine sections have been studied by transmission electron microscopy, and semi-fine samples were labelled for immunohistochemistry with polyclonal caveolin-1 and cavin-1 antibodies. By immunohistochemistry, in the control group, significant caveolin-1 label with low cavin-1 signal were measured in the lens epithelial cells. In the cataract group high cavin-1 and caveolin-1 expression was detected. In the control group, caveolae were not observed, but in the lens epithelial cells with cataract, increased number of caveolae have been detected by electron microscopy. For the development and maintenance of the specific caveolae shape, caveolin-1 is needed to be accompanied by cavin-1. Therefore, it is presumable that the increased expression of cavin-1 could explain the higher number of caveolae in the cataract group. These results might suggest that caveolae might play a role in cataractogenesis. Orv Hetil. 2019; 160(8): 300-308.

Incidence and associated factors of posterior capsule opacification formation in pseudophakic patients at Cipto Mangunkusumo Hospital : January - December 2010

&#x0D; &#x0D; &#x0D; Objective: Posterior capsule opacification (PCO) is the most common postoperative consequence of cataract surgery which may cause visual acuity reduction. The incidence of PCO in Indonesia has not been reported yet. The objectives of this study were to evaluate three years cumulative incidence of PCO and factors associated with PCO formation at Cipto Mangunkusumo (CM) Hospital. &#x0D; Methods: This was a retrospective descriptive study to patients with uneventful senile cataract surgery in year of 2010. All related data were retrieved from those medical records in year of 2013, which included patient demographics, type of surgery, time of PCO stated, IOL characteristics (material, optic edge design and diametere. Best corrected visual acuity (BCVA) pre operatively, when PCO was determined and Nd:YAG laser (Neodymium- doped yttrium aluminium garnet) was performed in decimal. &#x0D; Result: A total of 578 eyes (485 patients) was involved in this study. Three years cumulative incidence of the PCO was 8.82% (51 eyes). Phacoemulsification surgery was conducted in 496 (85.8%) eyes. The median time to PCO was being determined was 21 months (range 1 to 34 months) with the mean of BCVA was 0.50±0.26. Age, gender, and type of surgery had no related factors to PCO, but higher evidence in using of hydrophilic acrylic IOL (10.7%) was found. After laser Nd:YAG laser was performed, BCVA was improved. &#x0D; Conclusion: Three years cumulative incidence of PCO was 8.82% and there was no defined related factor to PCO reformation, but eye had been using hydrophilic acrylic IOL seem to be higher percentage &#x0D; &#x0D; &#x0D;

Active-fluidics-based torsional phacoemulsification in diabetic eyes: A prospective interventional study.

Purpose:To compare the outcomes of active-fluidics based torsional phacoemulsification in diabetics and nondiabetics using a balanced tip.Methods:Two hundred and forty-eight patients undergoing senile cataract surgery using torsional phacoemulsification on an active-fluidics-based platform from December 2016 to August 2017 were included in this prospective, nonrandomized, interventional cohort study; of the 248 patients, 54 were controlled diabetics and 194 were nondiabetics. Intraoperative parameters such as cumulative dissipated energy (CDE), total ultrasound time, torsion usage time, torsion amplitude, aspiration time, and fluid usage were documented and compared. Endothelial cell loss (ECL) and central corneal thickness (CCT) were evaluated at 1 month postoperatively.Results:Diabetics and nondiabetics did not differ in CDE, total ultrasound time, torsion amplitude, aspiration time, fluid usage, endothelial cell count, and CCT. ECL on Day 1 (10.2 ± 8.0%) and Day 30 (11.05 ± 8.3%) were significantly higher in diabetics (P = 0.025 and P = 0.045, respectively). There was an increase in CCT on Day 1 (P = 0.018), which settled by Day 30. Grade 4 cataracts in diabetics had significantly higher CCT at Day 1 (P = 0.032) and Day 30 (P = 0.007). In the diabetic subgroup, Grades 3 and 4 cataracts required lower CDE (P < 0.001) and Grade 4 cataracts showed higher ECL than others till 1 month of follow-up (P < 0.05).Conclusion:Intraoperative and postoperative parameters after torsional phacoemulsification are comparable in diabetics and nondiabetics. Endothelial changes and pachymetry may be related to the grade of cataract in diabetics.

Incorporating Optical Coherence Tomography in the Cataract Preoperative Armamentarium: Additional Need or Additional Burden?

To determine the usefulness of preoperative optical coherence tomography (OCT) examination to detect asymptomatic macular abnormalities in patients scheduled for cataract surgery. Design: Prospective, interventional case series. Iladevi Cataract and Visakha Eye Center, Ahmedabad, India. Patients undergoing cataract surgery and intraocular lens (IOL) implantation for senile cataracts. Preoperatively no retinal/macular pathology was identified on clinical evaluation. All eyes underwent macular 5-line raster evaluation using spectral-domain OCT before and after cataract surgery (monthly for 3months). Central subfield thickness (CST) analysis was done. The primary outcome measure was determining the incidence of asymptomatic retinal lesions on OCT examination in clinically "normal" maculas. Secondary outcome measures included documenting change in corrected distance visual acuity and OCT thickness postoperatively. A total of 1444 eyes were evaluated. OCT revealed asymptomatic lesions in 133 (9.21%) patients. At 3months, all eyes showed significant median visual improvement (from 0.45 ± 0.13 logMAR to 0.06 ± 0.08 logMAR; P= .015) and insignificant median CST change (from 223.34 ± 21.1μm to 249.12 ± 19.24μm; P= .19). One eye showed increased vitreomacular traction (3months). Patients with asymptomatic lesions did not have significantly worse postoperative visual outcomes at 3months (from 0.52 ± 0.16 logMAR to 0.14 ± 0.1 logMAR; P= .12). A total of 9.21% patients with clinically normal maculas had subtle pathology detected on OCT, but this subset of patients did not have worse postoperative visual outcomes compared to eyes with normal OCT scans. Thus, a careful pre-cataract surgery fundus examination remains an essential part of the presurgical patient evaluation.

Does the addition of hyaluronidase improve the quality of peribulbar anesthesia in cataract surgery? – A randomized double blinded study

PurposeTo determine the necessity of hyaluronidase as an anesthetic adjuvant for peribulbar anesthesia during cataract surgery and to assess differences in anesthetic outcomes in the absence of hyaluronidase. MethodsIn this double blinded randomized study, 202 patients reporting for surgery for senile cataract in their first eye under regional ocular anesthesia without pre-existing extra ocular movement restriction were randomly divided into 2 groups: Group 1 – anesthesia without hyaluronidase, Group 2 – anesthesia with 50 IU/ml Hyaluronidase. Peribulbar block with 5 ml of anesthetic mixture of 2% lignocaine with 1:200000 adrenaline and 0.5% bupivacaine with or without hyaluronidase was performed with 3 ml deposited in the infero-medial quadrant and 2 ml in the supero-medial quadrant followed by ocular massage. Surgeons’ score for akinesia, patients’ score for analgesia, augmentation of block if any and extra ocular movements on first post-operative day were compared between the groups. ResultsThere was no statistically significant difference between the two groups in akinesia (p = 0.22, 0.68 and 0.98), analgesia (p = 0.44 and 0.09) or requirement of anesthetic augmentation (p = 0.3). Extraocular movement restriction was not noted in any patient. Onset of akinesia and analgesia was earlier in Group 2 (p = 0.004 and p = 0.005 respectively). ConclusionsHyaluronidase is not an essential adjuvant for peribulbar block for cataract surgeries. Appropriate deposition of a smaller volume of anesthetic agent and adequate ocular massage provide adequate and safe anesthesia.

ANGIOPOIETIN-LIKE 4 CORRELATES WITH RESPONSE TO INTRAVITREAL RANIBIZUMAB INJECTIONS IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

To investigate whether the aqueous angiopoietin-like 4 (ANGPTL4) level correlates with clinical features in neovascular age-related macular degeneration (AMD). The control and study groups consisted of all consecutive patients who received senile cataract surgery or intravitreal ranibizumab injection for treatment-naïve neovascular AMD, respectively. The AMD group received 3 monthly ranibizumab injections followed by monthly pro re nata for at least 12 months. Aqueous ANGPTL4 and vascular endothelial growth factor (VEGF) were measured at baseline and 4 weeks after the first injection. In the AMD group, best-corrected visual acuity, lesion area by fluorescein angiography, and central subfield thickness were measured at baseline and at 12 months. The AMD group (30 eyes) had higher baseline aqueous ANGPTL4 and VEGF levels than those of the control group (32 eyes) (both P < 0.001). Four weeks after the first injection, VEGF in the patients with AMD had dropped significantly (P < 0.001). Baseline ANGPTL4 correlated with the lesion area at baseline and at 12 months (P < 0.05, respectively), and also correlated with the frequency of anti-VEGF injections during 12 months (P = 0.008). Aqueous ANGPTL4 levels correlated with the lesion area and anti-VEGF treatment frequency. Angiopoietin-like 4 may be a potential diagnostic and/or therapeutic biomarker in the neovascular AMD.

Colaizzi 7-step analysis in patients with senile cataract eye surgery applications of subjective analysis

Objective Explore Colaizzi′s 7-step analysis in patients with senile cataract surgery subjective feelings and provide a basis for formulating targeted interventions. Methods It was a phenomenological study, and a total of 21 cases were recruited and conducted with semi-structural interviews. Results Five themes were found including fear, discomfort, insecurity, eager to communicate, a strong sense of family support. Conclusions Importance to subjective feelings, after entering the operating room to strengthen communication with the patient, increase opponents cognition, is an important measure to reduce the psychological burden of patients. And evidence-based, and scenario training before the increase, using a variety of forms of education, help to reduce patient anxiety and fear and promote patient safety. Key words: Senile cataracts; Operation; Subjective experience; Colaizzi′s 7-step method

Occurrence rate of retinal detachment after small gauge vitrectomy for idiopathic epiretinal membrane.

PurposeTo assess the occurrence rate of retinal detachment (RD) after small gauge vitrectomy for idiopathic epiretinal membrane (ERM).Patients and methodsRetrospective observational case series. The records of consecutive patients operated on for idiopathic ERM using small gauge pars plana vitrectomy between August 2012 and December 2014 with at least a 1-year follow-up were reviewed. All patients were contacted by phone to assess the occurrence of RD during the post-operative follow-up. The main outcome was the occurrence of RD. Patients who underwent surgery for senile cataract over the same period with at least a 1-year follow-up were also contacted by phone for comparison.ResultsTwo hundred and sixteen eyes of 212 patients who had undergone ERM surgery were included, with a mean follow-up of 892±211 days (216-1238). RD occurred in two eyes (0.92%). Over the same period, two RD occurred in the 203 eyes (0.98%) of 157 patients operated on for senile cataract in our department.ConclusionsThe occurrence of RD after 25-gauge vitrectomy for idiopathic ERM was <1%. Using small gauge sutureless vitrectomy systems has improved the safety of ERM surgery, with a RD rate similar to that observed after cataract surgery.

The effect of intravitreal Ranibizumab for refractory cystoid macular edema after cataract surgery

Objective To evaluate the effect of intravitreal Ranibizumab for refractory pseudophakic cystoid macular edema (CME) after routine senile cataract surgery. Methods From April 2013 to May 2015, 5 patients with refractory pseudophakic CME were treated with intravitreal Ranibizumab injection. Followed up for 3-6 months, visual acuity, retinal morphology and thickness of macula were compared before and after treatment to evaluate the effect. Results After once treatment of intravitreal Ranibizumab, all patients showed better visual acuity and less macular edema without recurrence or complication. Conclusion Intravitreal Ranibizumab is safe and effective for refractory pseudophakic cystoid macular edema. Key words: Ranibizumab, intravitreal; Cataract , age-related; Cystoid macular edema, refractory, pseudophakic

Vision related problems after cataract surgery

Introduction. Senile cataract is an age-related eye disease and one of the most common causes of visual impairment. It is one of the most important causes of reversible blindness in the elderly persons, with a steady increase in prevalence with advanced age. The resulting loss of visual acuity has important implications for physical functions and the overall quality of life of affected individuals. However, cataract related visual loss is completely reversible with modern cataract surgery techniques. The purpose of the study was to evaluate the visual outcomes (visual acuity and visual function) before and after cataract surgery, and to assess patient satisfaction with final surgical outcomes. Material and Methods. This prospective study included 176 consecutive patients with senile cataract who underwent phacoemulsification with a foldable intraocular lens implantation. Evaluation of vision related problems of daily living was done in all patients using a vision related quality of life questionnaire, before and 10 days after the surgery. All patients self-rated their vision-related problems into 4 categories: no problems, small problems, big problems, and very big problems. The results were presented as a vision-related quality of life index. Results. There were 176 patients included in this study, with an average age of 65.4 ? 12 years. The operated patients had significantly better visual acuity than before cataract surgery (p &lt; 0,001), with a median postoperative visual acuity of 0.8. Before cataract surgery, the average vision-related quality of life index was 53.7 (range 21.3 - 87.7). The self-rated vision related problems were present in 59.8% patients before senile cataract surgery, and only in 12.8% of patients undergoing phaco cataract surgery (p&lt;0.001). Ten days after cataract surgery vision-related quality of life index improved to 92.9 (range 57.1 - 98.7). Conclusion. Visual function, self-estimated vision related problems and patients satisfaction are significantly higher after the phaco cataract surgery. We believe that vision related quality of life index is a valid and sensitive tool for visual function and vision-related quality of life evaluation.

Accuracy of various intraocular lens power calculation formulas in steep corneas

Purpose:To compare the accuracy of four different intraocular lens (IOL) power calculation formulas for eyes with mean keratometry values greater than 46 diopters (D).Methods:Forty five eyes from 45 patients who were candidates for senile cataract surgery with mean keratometry values greater than 46 D were included. Calculation of the IOL power was performed by the Lenstar. The implanted IOL in all cases was Acrysof SA60AT. The average absolute value of the differences between the actual and predicted spherical equivalent (SE) of the postoperative refractive error (mean absolute error: MAE) was calculated using 4 formulas (Haigis, Holladay 1, Hoffer Q, and SRK/T) with optical IOL constants from the User Group for Laser Interference Biometry constants.Results:The MAE was smallest in the SRK/T formula (0.39 D ± 0.35) followed by those of the Holladay 1 (0.44 D ± 0.32), Haigis (0.45 D ± 0.35) and Hoffer Q (0.5 D ± 0.38) formulas. However, there was no statistically significant difference between the MAE among different formulas. The SRK/T formula predicted more eyes within ± 0.5 D of the SE (77.8%) compared to other formulas.Conclusion:In eyes with steep corneas, there were no statistically significant differences among the accuracies of the four common IOL power calculation formulas.