Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Phacoemulsification”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed2000

Phacoemulsification and intraocular lens placement in eyes with cataract and congenital coloboma: visual acuity and complications.

PURPOSE: To evaluate the safety and complications of phacoemulsification in a series of patients with congenital coloboma and cataract. SETTING: University-based hospital practice. METHODS: A retrospective review was conducted of consecutive patients who had coloboma and cataract and had phacoemulsification between January 1987 through December 1998. Complications and visual acuity 2 months postoperatively were assessed. RESULTS: Mean age of 7 cases at the time of surgery was 41.6 years +/- 11.1 (SD). Visual acuity improved in 6 of 7 eyes; 1 eye had no change. Six eyes had no serious complications. In 1 eye, a retinal detachment was observed postoperatively, but there was no loss in visual acuity. Another patient developed postoperative monocular diplopia from exposure of the intraocular lens (IOL) edge within the inferonasally located corectopia associated with the coloboma. Nonsurgical treatment was unsuccessful, but this symptom resolved after surgical pupilloplasty. CONCLUSIONS: The results of this small case series affirm that clinically significant cataract develops at a younger age in eyes with congenital coloboma than in eyes with typical age-related nuclear sclerotic cataract. Monocular diplopia, a potential complication after cataract surgery in these eyes, can be managed by pupilloplasty. The improved vision in this study indicates that phacoemulsification and IOL placement are safe and beneficial in patients with typical congenital coloboma and cataract.

Adolescent↗
PubMed2000

Corneal thickness and visual acuity after phacoemulsification with 3 viscoelastic materials.

PURPOSE: To determine whether differences exist in visual acuity and corneal thickness after phacoemulsification using various viscoelastic substances. SETTING: Phillips Eye Institute, Minneapolis, Minnesota, USA. METHODS: Fifty patients having routine phacoemulsification cataract extraction and intraocular lens implantation by a single surgeon using the same technique were randomly assigned to receive intraoperative administration of 1 of 3 viscoelastic substances: Amvisc Plus(R) (sodium hyaluronate 1.6%), OcuCoat(R) (hydroxypropyl methylcellulose 2%), or Viscoat(R) (chondroitin sulfate 4%-sodium hyaluronate 3%). Visual acuity and corneal thickness on the first postoperative day were compared between groups. RESULTS: Patients with a best corrected visual acuity (BCVA) of 20/40 or better 1 day postoperatively had significantly thinner corneas (596 microm) than those with a BCVA worse than 20/40 (639 microm). There were no differences in postoperative BCVA or percentage increase in central corneal pachymetry among the 3 viscoelastic groups. CONCLUSION: Viscoat, Amvisc Plus, and OcuCoat were comparable in their ability to produce clear corneas and good vision after routine phacoemulsification.

Chondroitin↗
PubMed2000

Phaco-chop versus stop-and-chop nucleotomy for phacoemulsification.

PURPOSE: To perform a comparative evaluation of phaco-chop versus stop-and-chop nucleotomy techniques of phacoemulsification. SETTING: Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi, India. METHODS: Forty eyes of 40 patients with immature senile cataract were included in the study. Twenty eyes each were randomly assigned to have phaco-chop (Group 1) or stop-and-chop (Group 2) nucleotomy during phacoemulsification. The main parameters were corneal endothelial count, effective phaco time, volume of infusion fluid used, central corneal pachymetry, best corrected visual acuity (BCVA), and intraoperative complications during nucleotomy. Follow-up visits were scheduled at 1, 4, and 12 weeks. RESULTS: The mean effective phaco time was 27 seconds +/- 18 (SD) in Group 1 and 28 +/- 16 seconds in Group 2. The mean corneal endothelial cell loss was 6.89% and 7.17%, respectively, at the end of 12 weeks. The difference between groups was not significant. An anterior capsule tear occurred in 3 eyes in Group 1 and 1 eye in Group 2. All eyes achieved a BCVA of 20/20 at the end of 4 weeks. There were no significant between-group differences in any intraoperative or postoperative parameter. CONCLUSIONS: The phaco-chop and the stop-and-chop nucleotomy techniques were equally efficacious for nuclear management during phacoemulsification.

Cell Count↗
PubMed2001

Topical anesthesia for phacoemulsification and painless subconjunctival antibiotic injection.

Endophthalmitis is a serious postoperative complication of phacoemulsification surgery. Administration of a subconjunctival antibiotic is a common method of prophylaxis in the United Kingdom and other countries. Injection of subconjunctival cefuroxime can be very painful, especially after phacoemulsification under topical anesthesia. Our experience is that this could be the only painful step in the entire operation. We evaluated a technique in which buffered lignocaine is injected into the subconjunctival space before the antibiotic injection. The technique was used in 46 eyes (46 patients) that had phacoemulsification under topical anesthesia. Eighty-seven percent of patients found the injection painless, 6.5% reported that the pain was very negligible, and 6.5% reported a moderate degree of pain.

Aged↗
PubMed2001

Clinical results of phacoemulsification with the use of Healon5 or Viscoat.

PURPOSE: To compare the ophthalmic viscosurgical devices Healon5 (viscoadaptive) and Viscoat (dispersive) regarding their overall clinical performance during phacoemulsification and posterior chamber intraocular lens (IOL) implantation as well as their influence on intraocular pressure (IOP). SETTING: Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany. METHODS: In this prospective randomized patient- and observer-masked clinical study, the performance of Healon5 (sodium hyaluronate 2.3%) and Viscoat (sodium hyaluronate 3.0%-chondroitin sulfate 4.0%) was assessed by 3 surgeons during cataract surgery in 90 patients. Surgeons used a 5-point scale for the subjective assessment of the ease of injection, maintenance capacity during continuous curvilinear capsulorhexis, remaining capacity during phacoemulsification, facilitation of IOL implantation, removal from the eye, transparency, and overall performance throughout surgery. Intraocular pressure was measured preoperatively and 24 hours and 7 days postoperatively. Best corrected visual acuity was assessed preoperatively and 7 days postoperatively. RESULTS: Overall intraoperative product performance was assessed as good or very good in 34 of 44 patients (77%) in the Healon5 group and in 16 of 46 patients (35%) in the Viscoat group (P <.001). Retention in the anterior chamber was graded good or very good in 36 patients (82%) in the Healon5 group and in 23 (50%) in the Viscoat group (P =.001). There were no statistically significant between-group differences in mean IOP preoperatively and 24 hours postoperatively. CONCLUSIONS: Surgeons graded Healon5 better than Viscoat in overall surgical performance and retention in the anterior chamber during phacoemulsification. These data support that Healon5 adapts to each step during surgery.

Aged↗
PubMed2001

Intraocular pressure after phacoemulsification and intraocular lens implantation in nonglaucomatous eyes with and without exfoliation.

PURPOSE: To evaluate intraocular pressure (IOP) after phacoemulsification and intraocular lens (IOL) implantation in nonglaucomatous eyes with and without exfoliation. SETTING: Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland. METHODS: One hundred ninety-six eyes that had phacoemulsification with IOL implantation were examined. Eyes with a history of intraocular disease or surgery that could affect IOP were excluded. The study comprised the remaining 160 eyes: 23 with exfoliation (EXF group) and 137 without exfoliation (non-EXF group). Follow-up data were available for 136 eyes. The same surgeon performed all surgeries. Patients were examined on the first postoperative day and after 1 week, 4 months, and 1.0 to 2.7 years. RESULTS: One day postoperatively, IOP rose in the EXF group from a mean preoperative level of 16.3 mm Hg +/- 2.7 (SD) to 21.0 +/- 8.5 mm Hg, a 28.4% increase (P =.0061). In the non-EXF group, mean IOP rose from 16.2 +/- 3.4 mm Hg to 20.5 +/- 5.7 mm Hg, a 29.9% increase (P =.001). In 4 eyes (17.4%) in the EXF group and 8 eyes (5.8%) in the non-EXF group, IOP increased to 30 mm Hg or higher at 1 day. After this, significant IOP decreases occurred in both the EXF and non-EXF group, respectively, as follows: 14.2 +/- 3.0 mm Hg (12.0% decrease from preoperative value; P =.001) and 15.0 +/- 2.9 mm Hg (5.9%; P =.001) 1 week postoperatively; 12.8 +/- 2.7 mm Hg (20.2%; P =.0002) and 13.8 +/- 2.7 mm Hg (13.2%; P =.001) after 4 months; and 12.3 +/- 2.6 mm Hg (23.2%; P =.0001) and 12.7 +/- 2.7 mm Hg (21.2%; P =.001) after 1.0 to 2.7 years. There was no significant difference between the 2 groups. CONCLUSION: After phacoemulsification with IOL implantation, IOP decreased significantly and remained lower than preoperatively in eyes with and without exfoliation. One day postoperatively, transient pressure peaks were more common in eyes with exfoliation. One eye without exfoliation developed glaucoma.

Adult↗
PubMed2001

Effect of intracameral acetylcholine on latanoprost in preventing ocular hypertension after phacoemulsification and intraocular lens implantation.

PURPOSE: To evaluate the effect of intracameral acetylcholine on latanoprost in preventing ocular hypertension in the early period after phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation. SETTING: Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Shatin, Hong Kong, China. METHODS: Patients with uncomplicated cataract having phacoemulsification with PC IOL implantation were included in this prospective randomized double-masked clinical trial. The eyes were randomly assigned to 1 of 4 groups based on postoperative application of latanoprost 0.005% alone (Group 1), latanoprost 0.005% with intracameral acetylcholine (Group 2), intracameral acetylcholine alone (Group 3), and no medication (controls (Group 4). Intraocular pressure (IOP) was measured 3 and 24 hours postoperatively. The anterior chamber was examined for the level of cells and flare using slitlamp biomicroscopy. RESULTS: Three and 24 hours after surgery, the decrease in mean IOP in eyes receiving latanoprost alone was not statistically significantly different from that in control eyes (P >.05). Eyes receiving intracameral acetylcholine alone had a significant decrease in the mean IOP at 3 hours (P <.05) but not at 24 hours compared to control eyes (P >.05). There were no significant differences in the mean postoperative IOP decrease between eyes receiving latanoprost with intracameral acetylcholine and those receiving intracameral acetylcholine alone (P >.05). CONCLUSIONS: A single application of latanoprost did not significantly lower IOP in the first 24 hours after phacoemulsification with PC IOL implantation. Eyes receiving intracameral acetylcholine alone had a significantly greater decrease in IOP than control eyes at 3 hours but not at 24 hours. The addition of intracameral acetylcholine to latanoprost did not enhance or reduce latanoprost's IOP-lowering effect.

Acetylcholine↗
PubMed2001

Intraocular pressure decrease after phacoemulsification in patients with pseudoexfoliation syndrome.

PURPOSE: To determine the intraocular pressure (IOP) response to phacoemulsification cataract extraction with posterior chamber intraocular lens (PC IOL) implantation in patients with pseudoexfoliation syndrome. SETTING: Eye clinics at the University of Ottawa Eye Institute, Ottawa, Ontario, Canada. METHODS: A retrospective cohort study design assigned patients to 1 of 3 subgroups: pseudoexfoliation syndrome (PEX) (n = 21), primary open-angle glaucoma (POAG) control (n = 23), and cataract control (n = 23). Inclusion criteria consisted of age older than 50 years, open angle by gonioscopy, and a cataract requiring phacoemulsification. The IOP response was determined at intervals up to 18 months. RESULTS: Postoperative IOP changes from baseline in the PEX group were -1.81, -4.52, and -2.31 mm Hg at 3, 6, and 12 months, respectively. The changes in the POAG control group were -2.22, -2.32, and -1.88 mm Hg, respectively, and in the cataract control group, -2.49, +0.45, and +0.28 mm Hg. Patients in the PEX group had a reduction in IOP from baseline at all postoperative measurements. That reduction was significantly greater than in the POAG and cataract control groups at 6 months (P =.012 and P =.002, respectively) and 12 months (P =.001 and P =.050, respectively). CONCLUSIONS: Patients with pseudoexfoliation syndrome had a postoperative IOP reduction from baseline at all measurements and a significantly greater reduction than patients in the POAG and cataract control groups at 6 and 12 months. Phacoemulsification cataract surgery with PC IOL implantation may be effective in managing patients with pseudoexfoliation syndrome who have elevated IOP and visually significant cataract but no advanced optic nerve damage.

Aged↗
PubMed2001

Determinants of visual outcome after pars plana vitrectomy for posteriorly dislocated lens fragments in phacoemulsification.

PURPOSE: To evaluate the visual outcome of patients with posteriorly dislocated lens fragments after phacoemulsification managed with pars plana vitrectomy (PPV) and identify risk factors for poor visual outcome. SETTING: Vitreo-Retinal Service, St. Paul Eye Unit, Liverpool, United Kingdom. METHODS: The medical records of all patients who had PPV for posteriorly dislocated lens fragments after phacoemulsification between March 1993 and August 1998 were retrospectively reviewed. Demographics, preexisting eye conditions, details of the previous cataract surgery, findings at presentation, details of the vitreoretinal procedure, final visual acuity, and complications observed during the follow-up were evaluated. Univariate and multiple regression analyses were used to determine the significance of these clinical variables as determinants of poor visual outcome (visual acuity 6/12 or worse). RESULTS: Of the 106 patients identified, 89 had a full set of data and were included in the study. In 79 patients (89%), PPV was performed from 1 to 357 days (median 15 days) after cataract extraction. In 10 patients (11%), PPV was done on the same day as the cataract surgery. Sixty-two patients (69%) had a final visual acuity of 6/12 or better. Preexisting eye disease (P <.01), PPV delayed for more than 4 weeks (P <.03), occurrence of retinal detachment after vitrectomy (P <.01), and the use of ultrasound (US) fragmentation (P <.01) were statistically significantly correlated with a poor visual outcome. CONCLUSIONS: Posterior dislocated lens fragments after phacoemulsification were safely retrieved using PPV. It appears that intervening early (within 4 weeks) and avoiding the use of US fragmentation are associated with a better visual outcome and reduced rate of postoperative complications.

Aged↗
PubMed2001

Rupture of a radial keratotomy incision after 11 years during clear corneal phacoemulsification.

We report a case of rupture of a radial keratotomy (RK) incision that occurred during clear corneal phacoemulsification 11 years after the initial surgery. The RK was done in both eyes for correction of high myopia (>8.0 diopters). This was followed by 2 enhancement procedures at 6 month intervals. The patient presented with diminished vision in both eyes. The diagnosis was nuclear cataract in the right eye, and clear corneal phacoemulsification was done. The intraoperative and postoperative courses were uneventful. Nine months later, clear corneal temporal phacoemulsification was done in the left eye. During surgery, 1 of the radial incisions opened to one third its length. The wound was sutured, and the procedure was completed uneventfully. One month later, best corrected visual acuity was 20/20.

Adult↗
PubMed2001

Risk factors for and management of dropped nucleus during phacoemulsification.

PURPOSE: To study the risk factors and management of posteriorly dislocated crystalline lenses during phacoemulsification at a teaching institution. SETTING: L.V. Prasad Eye Institute, Hyderabad, India. METHODS: This retrospective analysis included all phacoemulsification procedures performed by experienced and inexperienced surgeons over 7 years. The incidence, risk factors for, role of surgical experience, mode of management, and the final outcome of posteriorly dislocated lens nuclei were evaluated. RESULTS: Of a total 11 343 phacoemulsification procedures performed between 1993 and 1999, the nucleus was dropped in 38 eyes (0.3%). Two patients with a dropped nucleus were referred from an outside practice. The incidence of dropped nucleus with experienced surgeons (22/8671; 0.2%) was significantly less than that with inexperienced surgeons (16/2672; 0.6%) (P =.007). Sixteen of the 22 cases of dropped nucleus (72.7%) in the experienced group and 1 of 16 (6.3%) in the inexperienced group had risk factors (P =.0005). Nucleus removal was performed using vitreoretinal procedures in 39 eyes; 1 eye with a dropped epinucleus was managed conservatively. The final best corrected visual acuity was 20/40 or better in 21 eyes (53.8%). CONCLUSIONS: The incidence of dropped nucleus was more frequent with inexperienced surgeons, even though experienced surgeons had more cases with predisposing risk factors. Modern vitreoretinal procedures reduce morbidity and improve the visual outcome.

Clinical Competence↗
PubMed2001

Flared phacoemulsification tips to decrease ultrasound time and energy in cataract surgery.

PURPOSE: To determine the effect on ultrasound (US) time and energy of using flared phacoemulsification tips in cataract surgery. SETTING: Private referral practice of Pacific Cataract & Laser Institute, Chehalis, Washington, USA. METHODS: One surgeon using the Allergan Medical Optics Diplomate phacoemulsification machine performed cataract surgery by a single divide-and-conquer technique. A prospective nonmasked consecutive study group (n = 262) was selected from patients operated on with phaco tips flared by 25%. A consecutive control group (n = 440) was selected from patients having surgery using the same technique except for the use of straight phaco tips. The study group had cataract surgery over a 5 week period and the control group, over an earlier 10 week period. Two weeks separated the groups. Cases complicated by vitreous loss were eliminated. The 2 groups were compared by age, sex, total phaco time (TPT, the total time ultrasound energy was applied), and equivalent phaco time (EPT, the product of the phaco time elapsed and the phaco energy). RESULTS: One patient in each group was eliminated for vitreous loss during surgery. There were no significant differences in age, sex, or eye between the 2 groups. The study group had a mean TPT of 29.2 seconds +/- 11.7 (SD) (range 0 to 88 seconds) and a mean EPT of 16.4 +/- 8.6 seconds (range 0 to 67 seconds). The control group had a mean TPT of 34.4 +/- 16.1 seconds (range 0 to 130 seconds) (P <.001) and a mean EPT of 20.0 +/- 12.8 seconds (range 0 to 107 seconds) (P <.001). CONCLUSION: Flared ultrasonic phacoemulsification tips significantly reduced the US time and energy used in cataract surgery.

Adult↗
PubMed2001

No-anesthesia clear corneal phacoemulsification versus topical and topical plus intracameral anesthesia. Randomized clinical trial.

PURPOSE: To compare the intraoperative pain scores during clear corneal phacoemulsification under no anesthesia, topical anesthesia, and topical plus intracameral anesthesia. SETTING: Dr. Agarwal's Eye Hospital and Eye Research Center, Chennai, India. METHODS: Seventy-five patients were randomized to have phacoemulsification under no anesthesia, topical anesthesia, or topical plus intracameral anesthesia. Uncooperative or illiterate patients and those with hard cataract, a shallow anterior chamber, or small pupils were excluded. A protocol was established for supplemental anesthesia in case of breakthrough pain during the surgery. Each patient was asked to grade the overall severity of intraoperative pain immediately after surgery on a 10-point visual analog scale. Also evaluated were the general discomfort during surgery, discomfort from the microscope lights, surgeon stress during surgery, and total surgical time. Comparison among the 3 groups was performed using an analysis of variance. RESULTS: No supplemental anesthesia was required in any group. No significant difference was noted in the mean scores of the subjective sensation of pain with or without topical anesthesia (P =.610). The mean scores of patient discomfort from the microscope lights and surgical time were also statistically insignificant. Patient discomfort and surgeon stress during surgery were significantly greater in the no-anesthesia group than in the topical and topical plus intracameral groups (P =.0235 and P = 0.0206, respectively). CONCLUSION: No-anesthesia clear corneal phacoemulsification was performed by a highly experienced, skilled surgeon without causing an unacceptable level of pain. However, this technique is not suitable for every cataract surgeon or patient.

Adult↗
PubMed2001

Clear lens phacoemulsification for correction of high myopia.

PURPOSE: To assess phacoemulsification and posterior chamber intraocular lens (IOL) implantation as an effective, safe, and predictable technique for the correction of high myopia. SETTING: University Eye Clinic of Verona, Verona, Italy. METHODS: A series of 25 eyes with myopia higher than -12.0 diopters (D) had clear lens extraction by phacoemulsification and IOL implantation in the capsular bag. The mean postoperative follow-up was 42.92 months +/- 3.76 (SD). RESULTS: No serious intraoperative complications occurred. Uncorrected visual acuity improved in all cases. The mean postoperative best corrected visual acuity improved by an average of 1 line. One case (4.0%) of postoperative retinal detachment (RD) occurred at 12 months. One case (4.0%) of biometric error (3.0 D) occurred. CONCLUSION: Clear lens extraction by phacoemulsification and IOL implantation in a series of highly myopic eyes was effective and had an acceptable predictability and a low rate of complications. Careful evaluation of the retinal periphery by indirect ophthalmoscopy is recommended to avoid postoperative RD.

Adult↗
PubMed2001

Refractive stabilization after temporal phacoemulsification with foldable acrylic intraocular lens implantation.

PURPOSE: To determine the rate of stabilization of refractive error after temporal small incision phacoemulsification with insertion of an acrylic foldable intraocular lens (IOL) (AcrySof MA30). SETTING: A university hospital anterior segment referral practice. METHODS: The records of 100 consecutive patients with good visual potential having phacoemulsification with acrylic IOL implantation who had good visual acuity on the first postoperative day were reviewed. Refractive data at 1 day, 1 week, and 1 and 4 months were compared. RESULTS: The mean spherical equivalent refraction was +0.31 diopter (D), -0.33 D, -0.51 D, and -0.35 D at 1 day, 1 week, 1 month, and 4 months, respectively. Cylinder by refraction was 1.17 D, 1.09 D, 0.96 D, and 0.99 D, respectively. From 1 week on, the cylinder power and axis did not differ significantly from that at 4 months. At 1 week, the spherical equivalent was within +/-0.50 D of the 4-month refraction in 66.1% of eyes and the cylinder was within +/-0.50 D in 72.9%. At 1 month, the corresponding values were 87.1% and 85.7%. CONCLUSION: The refractive error stabilized rapidly after temporal phacoemulsification with acrylic IOL implantation.

Acrylic Resins↗
PubMed2001

Preoperative latanoprost to prevent ocular hypertension after phacoemulsification and intraocular lens implantation.

PURPOSE: To evaluate the efficacy of latanoprost given 2 hours preoperatively to prevent ocular hypertension in the early period after phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation. SETTING: Departments of Ophthalmology, United Christian Hospital and Prince of Wales Hospital, Hong Kong, China. METHODS: Sixty-four eyes of 64 patients with uncomplicated cataract having phacoemulsification with PC IOL implantation were included in this prospective randomized double-masked clinical trial. The eyes were randomly assigned to 1 of 2 groups: application of latanoprost 0.005% 2 hours before surgery or no latanoprost (control). Intraocular pressure (IOP) was measured 3 and 24 hours postoperatively. The anterior chamber was examined for the level of cells and flare using a slitlamp biomicroscope. The level of significance was 5%. RESULTS: The decrease in the mean IOP was not statistically significantly different between eyes receiving latanoprost 2 hours preoperatively and control eyes 3 hours (P =.843) and 24 hours (P =.721) postoperatively. CONCLUSION: A single application of latanoprost given 2 hours before phacoemulsification and PC IOL implantation did not produce a statistically significant IOP-lowering effect when compared with a control group in the first 24 hours after surgery.

Aged↗
PubMed2001

Phacoemulsification in Indian eyes with pseudoexfoliation syndrome.

PURPOSE: To evaluate the intraoperative and postoperative behavior after phacoemulsification in Indian eyes with pseudoexfoliation syndrome. SETTING: Iladevi Cataract & Intraocular Lens Research Centre, Ahmedabad, India. METHOD: Ninety eyes were prospectively evaluated. Group 1 (cohort) comprised 45 consecutive eyes with pseudoexfoliation and coexisting cataract and Group 2 (control), 45 consecutive normal eyes with senile cataract only. Phacoemulsification was performed by a single surgeon using a step-by-step, chop in situ, and lateral separation technique. An AcrySof intraocular lens was implanted in the bag in all eyes. Intraoperative observations included pupil size after maximal mydriasis, phakodonesis, zonular dehiscence, grade of cataract, and capsule tear/rupture. Postoperatively, intraocular pressure (IOP), best corrected visual acuity, aqueous flare/cell response, and the presence of posterior synechias were evaluated at 1 day and 1 month. A chi-square test was used for statistical analyses. RESULTS: The mean pupil size was significantly smaller in Group 1 (P =.0000). No eye in either group had phakodonesis. Sixty percent of eyes in Group 1 and 31% in Group 2 had a hard cataract (P =.008). Endocapsular phacoemulsification was performed in 82% of eyes in Group 1 and 84% of eyes in Group 2. Intraoperative complications such as zonular or capsular dehiscence were not seen in any eye. Postoperatively, IOP and aqueous cell response were comparable between groups (P =.11 and P = 0.81, respectively). A significantly higher flare response was observed in Group 1 (P =.000). The visual outcome at 1 month was similar between groups. CONCLUSIONS: The intraoperative performance of Indian eyes with pseudoexfoliation was comparable to that in normal eyes. A good surgical outcome is ensured by using an appropriate surgical technique. Apart from a higher flare response, the postoperative outcomes in eyes with pseudoexfoliation were within normal limits, and the outcome at 1 month was satisfactory.

Aged↗
PubMed2002

Revisiting early postoperative follow-up after phacoemulsification.

PURPOSE: To determine whether postoperative evaluation of routine phacoemulsification can be safely and effectively performed on the day of surgery and 4 days postoperatively and evaluate the incidence and management of early intraocular pressure (IOP) elevations 3 to 7 hours postoperatively in patients with or without glaucoma. SETTING: Community-based hospital. METHODS: This retrospective series comprised 465 consecutive patients who had phacoemulsification and intraocular lens implantation. All patients had postoperative follow-up on the day of surgery (3 to 7 hours postoperatively) and at 4 days. Patients were classified into 2 groups: nonglaucoma (NG), 396 patients; and glaucoma (GL), 69 patients. The main outcome measures were the incidence and management of postoperative complications including IOP spikes, wound leaks, uveitis, and endophthalmitis. RESULTS: Three to 7 hours postoperatively, 73 NG (18.4%) and 32 GL (46.4%) patients had IOP elevations greater than 28 mm Hg, a significant change from baseline (P <.0001). Fourteen NG (3.6%) and 13 GL (18.8%) patients had IOP elevations greater than 40 mm Hg (P <.0001). Significant IOP elevations were effectively managed with a paracentesis with or without short-term antiglaucoma medications on the day of surgery, with 75 NG (18.9%) and 39 GL (56.5%) patients requiring IOP intervention. There were no IOP elevations greater than 21 mm Hg on the next day or at 4 days. There were no complications that were missed at the same-day evaluation that may have been identified at the 1-day postoperative visit. CONCLUSIONS: The results indicate that after routine phacoemulsification, patients can be safely and effectively reviewed on the day of surgery and 4 days postoperatively to identify and manage early postoperative IOP spikes. A significant number of patients, particularly those with preexisting glaucoma, had potentially harmful IOP spikes 3 to 7 hours postoperatively.

Anti-Inflammatory Agents↗