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PubMed2006

Phacoemulsification and acryl foldable intraocular lens implantation in dogs: 32 cases.

This study evaluated the surgical outcome and complications of phacoemulsification and the implantation of an acryl foldable intraocular lens (IOL) with a squared edge in dogs with cataracts. Thirty-two eyes from 26 dogs were examined. The mean follow up period was 75.9 days ranging from 23 to 226 days. The complications after phacoemulsification were posterior capsular opacity (PCO) around the IOL (n = 11), ocular hypertension (n = 4), focal posterior synechia (n = 4), hyphema (n = 3) and corneal ulcer (n = 2). The complications associated with the IOL were decenteration of the optic (n = 2) and ventral haptic displacement (n = 1). Most cases of PCO were found only around the margin of the IOL, and all eyes had vision during the observation period. In conclusion, the implantation of an acryl-foldable lens with a squared edge at the time of phacoemulsification is an effective method for preserving the central visual field of dogs with cataract.

Animals↗
PubMed2004

[Phacoemulsification without mydriasis before surgery: benefits to the patient].

PURPOSE: The aim of our study was to evaluate the frequency of side effects (ataxia, dizziness and dry mouth) due to systemic absorption of parasympatholytic eye-drops, before phacoemulsification. METHODS: This single surgeon, prospective, randomized and controlled study included 303 consecutive patients selected to undergo phacoemulsification with topical and intracameral anesthesia. Patients were distributed in two groups; those receiving no mydriatics before surgery (n=151) as control group and those dilated with cyclopentolate 1% and tropicamide 1% eye-drops (n=152) as the study group. Ataxia, dizziness and dry mouth were recorded in both groups by the same observer. Surgery time and changes in systolic and diastolic blood pressures were noted. Note was also taken of the cases where pupil widening maneuvers and a second intracameral instillation of lidocaine 1% plus epinephrine 1/200,000 were needed. RESULTS: Fifteen patients (9.9%) suffered ataxia in the study group vs. three patients (2%) in the control group. Twenty-three patients (15.1%) suffered dizziness in the study group vs. two patients (1.3%) in the control group. Thirty patients (19.7%) experienced dry mouth in the study group vs. ten patients (6.6%) in the control group. No significant changes in blood pressures, surgery time and pupil dilating maneuvers were noted between groups. The odds ratio for a second intracameral instillation was 2.0 in the control group vs. the study group. CONCLUSIONS: Lidocaine 1% plus epinephrine 1/200,000 as an adjunct to topical anesthesia during phacoemulsification showed to be an effective and safe alternative to abolish side effects caused by systemic absorption of mydriatics eye-drops before surgery.

Aged↗
PubMed2006

[Short- and medium-term intraocular pressure lowering effects of combined phacoemulsification and non-penetrating deep sclerectomy without scleral implant or antifibrotics].

PURPOSE: To examine the short- and medium-term intraocular pressure (IOP) lowering effects of combined phacoemulsification and non-penetrating deep sclerectomy without the use of scleral implant or antifibrotics in open-angle glaucoma (primary and pseudoexfoliative) and coexisting cataract in eyes with no known risk factors for bleb failure. METHODS: Retrospective study of 15 eyes of 12 patients with medically uncontrolled open-angle glaucoma or open-angle glaucoma treated with two or more drugs and coexisting cataract with no known risk factors for glaucoma surgery failure. All patients received combined phacoemulsification and non-penetrating deep sclerectomy without scleral implant or antifibrotics performed by the same surgeon. Nd-YAG perforation of the trabeculodescemetic membrane and/or needling with mitomycin-C was performed postoperatively for IOP control. Main outcome measures were postoperative IOP, percentage of eyes with IOP < 17 mmHg, complications and final visual acuity (VA). Median follow-up was 12.0 months (SD: 0.6) and ranged from 1 to 30 months. RESULTS: Mean preoperative IOP with medical treatment was 21.80 mmHg (SD: 5.14) and decreased to 14.42 mmHg (SD: 2.15) at 12-month visit. Mean antiglaucoma medication preoperative was 1.93 (SD: 0.70) and was reduced to 0.13 (DE: 0.35) postoperative. At 12-month visit, 80% had an IOP lower than 17 mmHg with a mean VA gain of 2.50 Snellen lines. Conjuntival wound leakage was the most frequent complication (20%; 3/15). CONCLUSIONS: Primary combined phacoemulsification and non-penetrating deep sclerectomy without collagen implant or antifibrotics in primary open-angle glaucoma with coexisting cataract, significantly lowers IOP in the short- and medium term in low-risk cases for glaucoma surgery failure, allowing for rapid visual improvement with a low complication rate.

Aged↗
PubMed1999

Retinopathy progression and visual outcomes after phacoemulsification in patients with diabetes mellitus.

PURPOSE: To determine the rate of progression of diabetic retinopathy following phacoemulsification surgery and to determine if surgeon experience and/or surgical duration adversely affect visual outcome. METHODS: A retrospective review of 150 eyes of 119 diabetic patients who underwent phacoemulsification surgery over a 5-year period was performed. Data collected included patient age, sex, type and duration of diabetes, diabetic control, associated systemic health factors, preoperative visual acuity and retinopathy grade, duration of surgery, intraoperative complications, and postoperative course. The effect of these factors on visual outcome and rate of retinopathy progression was studied. Resident and private cases were compared. RESULTS: The visual acuity improved by two or more lines in 117 eyes (78%). Ninety-three eyes (62%) had a final visual acuity greater than or equal to 20/40. Retinopathy progression was seen in 37 eyes (25%) followed up for 6 to 10 months. Preoperative nonproliferative diabetic retinopathy, prolonged surgical duration, and limited surgical experience were statistically associated with retinopathy progression. CONCLUSIONS: The visual results and rate of retinopathy progression after phacoemulsification surgery in our series do not appear to differ significantly from those reported using other techniques. Nonproliferative diabetic retinopathy, longer surgical duration, and surgical inexperience resulted in an increased rate of retinopathy progression.

Aged↗
PubMed2000

Retinopathy progression and visual outcomes after phacoemulsification in patients with diabetes mellitus.

OBJECTIVES: To determine the rate of progression of diabetic retinopathy after phacoemulsification surgery, and whether surgeon experience and/or surgical duration adversely affect visual outcome. METHODS: A retrospective review of 150 eyes of 119 diabetic patients who underwent phacoemulsification surgery during a 5-year period was performed. Data collected included patient age, sex, type and duration of diabetes, diabetic control, associated systemic health factors, preoperative visual acuity and retinopathy grade, duration of surgery, intraoperative complications, and postoperative course. The effect of these factors on visual outcome and rate of retinopathy progression was studied by means of univariate and stepwise multivariate logistic regression analyses. Resident and private cases were compared. RESULTS: Visual acuity improved by 2 or more lines in 117 eyes (78%); 93 eyes (62%) had a final visual acuity of at least 20/40. Retinopathy progression was seen in 37 eyes (25%) with 6 to 10 months of follow-up. Preoperative nonproliferative diabetic retinopathy, proliferative diabetic retinopathy, and limited surgical experience were statistically associated with retinopathy progression and poor visual outcome. CONCLUSIONS: The visual results and rate of retinopathy progression after phacoemulsification surgery in our series did not differ significantly from those reported that used other techniques. Nonproliferative and proliferative diabetic retinopathy and surgical inexperience resulted in an increased rate of retinopathy progression. Arch Ophthalmol. 2000;118:912-917

Cataract↗
PubMed2000

[Factors influencing early post surgical ocular hypertension after phacoemulsification].

PURPOSE: To evaluate factors influencing early post surgical ocular hypertension after phacoemulsification. METHODS: Records were collected for patients who had uncomplicated phacoemulsification with IOL implantation in the bag. Aspiration of the viscoelastic was performed at the conclusion of surgery. Patients with previous ocular surgery, high myopia, or glaucoma were excluded. Intraocular pressures were measured at six hours (+/-2) postoperatively. Following factors were analysed RESULTS: 26% of the patients had an ocular pressure equal or higher than 21 mmHg. Among the factors we analysed, pilocarpine injection was the only one to produce significant decrease in postoperative ocular pressure. COMMENTS: The acute postoperative IOP increase following phacoemulsification is presumably the result of trabecular obstruction by viscoelastic material. However it can occur despite meticulous evacuation of viscoelastic, which could be dependent upon the material's viscosity, and IOL material and design. Postoperative ocular hypertension is not related to ultrasonic duration. Intracameral injection of pilocarpine significantly reduces the incidence of postoperative intraocular pressure increase. CONCLUSION: Early postoperative ocular hypertension can be observed with different kinds of viscoelastics and IOL. Meticulous evacuation of viscoelastic from anterior chamber, although necessary does not always prevent this early complication. Intracameral injection of pilocarpine can reduce its incidence.

Humans↗
PubMedDate not supplied

Iris neovascularization after vitrectomy combined with phacoemulsification and intraocular lens implantation for proliferative diabetic retinopathy.

PURPOSE: To analyze the incidence of iris neovascularization after vitrectomy combined with phacoemulsification and intraocular lens (IOL) implantation using a small incision in the treatment of proliferative diabetic retinopathy (PDR). PATIENTS AND METHODS: We studied a consecutive series of 46 eyes in which vitrectomy combined with phacoemulsification and IOL implantation had been performed, and compared the surgical results with a prior series of 40 eyes in which vitrectomy alone had been performed. RESULTS: Postoperative iris and angle neovascularization was found in 6 eyes (15%) treated by vitrectomy alone, but in only 1 eye (2%) treated by combined vitrectomy (P<0.05). Final visual acuity improved by two or more lines in 23 eyes (57%) in the vitrectomy alone group, and in 35 eyes (76%) in the combined vitrectomy group. CONCLUSIONS: The incidence of postoperative rubeosis iridis was significantly lower, and the visual results were satisfactory with vitrectomy combined with phacoemulsification and IOL implantation for PDR. These findings suggest that combined vitrectomy for PDR is a useful surgical procedure.

Adult↗
PubMed2001

[Phacoemulsification and intraocular lens implantation in patients with chronic renal failure and cataract].

OBJECTIVE: To report the experience in treatment of phacoemulsification and intraocular lens implantation and to evaluate its efficacy in patients with chronic renal failure and cataract. METHODS: Twelve patients with chronic renal failure, maintenance dialysis and cataract were treated with phacoemulsification and intraocular lens implantation in 1998-1999. The original disease of renal failure was non-diabetic. The average age was 51 years, and the average time course on dialysis was 6-12 months. All the patients were stable on maintenance dialysis, and the blood pressure was controlled in or near normal range. Before the operation, the administration of heparin was stopped, and the hemostatic drug was applied. RESULTS: All the procedures were performed on 23 eyes these patients without any complications. The naked visual acuity after operation improved significantly in comparison with that before the operation. At the postoperative one month of follow-up, the visual acuity of 52% of the surgical eyes was above 1.0. CONCLUSION: Phacoemulsification and intraocular lens implantation is effective and safe in chronic renal failure patients with cataract.

Adult↗
PubMed2001

[Clear lens extraction with phacoemulsification and posterior chamber intraocular lens implantation for treatment of high myopia].

OBJECTIVE: To probe into the effectiveness and safety of clear lens extraction with phacoemulsification and implantation of posterior chamber intraocular lens (PC-IOL) to correct high myopia. METHODS: Phacoemulsification and implantation of PC-IOL through scleral tunnel incision was performed on 36 eyes of 26 high myopic patients with clear crystalline lens. The average age of patients was 53.9 years (36-67 years) old. The preoperative corrected visual acuity was 0.2-1.0. The mean preoperative spherical equivalent and astigmatism was (-13.11 +/- 4.33) D and (0.72 +/- 0.91) D respectively. The mean axial length was (28.02 +/- 2.14) mm. The mean diopter of IOL was (+8.62 +/- 4.76) D. RESULTS: The uncorrected visual acuity improved in all cases postoperatively, with 25 eyes (69.4%) achieving > or = 0.5. After surgery, the corrected visual acuity improved in 27 eyes (75.0%), and was > or = 0.5 in 35 eyes (97.2%). The mean postoperative spherical equivalent and astigmatism was (-1.51 +/- 0.60) D and (0.64 +/- 0.80) D respectively. The average follow-up was 23.5 months (7-35 months). The postoperative complication was posterior capsular opacification (5.6%). No retinal hole or detachment and cystoid macular edema were observed in this series. CONCLUSIONS: Clear lens phacoemulsification and PC-IOL implantation to correct high myopia is a safe, effective procedure serving as a refractive surgery. It is worth to spread due to good outcome of visual acuity, low incidence of complications, high predictability and stability.

Adult↗
PubMed2001

[Preliminary clinical study on the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens implantation].

OBJECTIVE: To investigate the clinical results of phacoemulsification with foldable posterior chamber intraocular lens (PC-IOL) implantation in the management of angle-closure glaucoma with cataract. METHODS: Phacoemulsification with PC-IOL implantation performed on 47 eyes (42 cases) with angle-closure glaucoma and cataract was retrospectively studied, including 26 eyes with primary acute angle-closure glaucoma, 12 eyes with primary chronic angle-closure glaucoma, 5 eyes with secondary acute angle-closure glaucoma and 4 eyes with secondary chronic angle-closure glaucoma. RESULTS: After a mean postoperative follow-up of (18.40 +/- 9.51) months, the intraocular pressure was reduced from a preoperative mean of (25.47 +/- 18.43) mm Hg to a postoperative mean of (11.99 +/- 4.48) mm Hg (t = 4.918, P < 0.001). The mean anterior chamber depth was (1.69 +/- 0.46) mm preoperatively and (2.28 +/- 0.36) mm postoperatively (t = 7.738, P < 0.001). The best-corrected visual acuity was improved in 41 of 47 eyes (87.2%). CONCLUSION: Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma with cataract.

Adult↗
PubMed1999

[Phacoemulsification and posterior chamber intraocular lens implantation in high myopia].

OBJECTIVE: To evaluate the therapeutic effect of phacoemulsification and posterior chamber intraocular lens (IOL) implantation in high myopia. METHODS: Phacoemulsification with implantation of a foldable IOL or a PMMA rigid IOL was performed on 28 eyes of 21 patients with senile, complicated or congenital cataracts through a 3.2 mm small scleral tunnel incision or through a 5.5 mm incision respectively. The average age of the patients was 51.32 years (21 - 70 years). The mean axial length was (27.56 +/- 1.21) mm (26.00 - 33.41 mm). The mean keratometry was (43.38 +/- 1.36) D (42.00 - 46.54 D). The mean diopter of IOL was (+ 9.59 +/- 3.65) D (+ 4.00 - + 15.00 D). RESULTS: Postoperatively, the uncorrected or corrected visual acuity 0.5 or better at 1 day, 1 week, 1 month and 3 months was in 63.6%, 86.4%, 95.5% and 95.2% patients respectively; the patients having achieved the best visual acuity of 1.0 or better were accounted for 9.1%, 31.8%, 50.0% and 57.1% respectively. CONCLUSIONS: Phacoemulsification and the posterior chamber IOL implantation offers the advantages of rapid and better rehabilitation of visual acuity and more stabilization of postoperative astigmatism in patients with high myopia; whereas for eyes with the axial lengths over 30 mm, the recovery of the visual acuity was less satisfactory.

Adult↗
PubMed2000

[Cataract extraction with rotated-chipping phacoemulsification in the capsule].

OBJECTIVE: To observe the clinical effects of rotated-chipping phacoemulsification in the capsule. METHODS: The operation of continuous circular capsulectomy, nuclear hydrodissection, cataract extraction with rotated-chipping phacoemulsification in capsule and intraocular lens implantation was performed on 215 eyes. RESULTS: Rotated-chipping technique was successfully completed in 215 eyes. In the operation 2 to 4 circles were rotated with the ultrasonic energy 19.3% for 12 seconds on average. The rate of corneal endothelium loss was 7.5%. CONCLUSION: The technique of rotated-chipping phacoemulsification in capsule is safe and rapid which can be used for cataracts with nuclei of various degrees in sclerosis.

Aged↗
PubMed2001

[Clinical observation of astigmatism induced by corneal incision after phacoemulsification].

OBJECTIVE: To evaluate the changes of astigmatism induced by corneal incision after phacoemulsification. METHODS: Phacoemulsification was performed on 62 cases (78 eyes) without suture for a corneal incision. The changes of corneal astigmatism before and after operation in group A (incision at the superior nasal or superior temporal) and B (incision at the steepest corneal meridian) were compared. RESULTS: Three months after the operation, the surgical induced astigmatism was (0.83 plus minus 0.65) D and (0.72 plus minus 0.55) D in group A and B respectively. There was no significant difference, statistically (P > 0.05). The changes of corneal astigmatism were 0.11 D and 0.39 D in group A and B respectively, the difference being statistically significant (P < 0.05). CONCLUSION: Surgically induced astigmatism is very small after a corneal incision in phacoemulsification without a suture. If the incision is placed on the steepest meridian, the corneal astigmatism can be significantly reduced postoperatively.

Adolescent↗
PubMed2001

[Pediatric phacoemulsification with Acrysof intraocular lens implantation].

OBJECTIVE: To investigate the operative effects of pediatric phacoemulsification with Acrysof intraocular lens (IOL) implantation. METHODS: Among 153 eyes of 120 children with cataract aged 3 -- 12 years old, phacoemulsification with Acrysof IOL implantation was performed on 76 eyes of 61 children, and cataract extracapsular extraction with polymethylmethacrylate (PMMA) IOL implantation was performed on 77 eyes of 59 children. The visual acuity, percentages of various complications and rate of neodymium: YAG (Nd: YAG) capsulotomy were followed up for 6 -- 18 months. RESULTS: There were significant differences in the percentages of various complications and rate of neodymium: YAG (Nd: YAG) capsulotomy between the Acrysof group and the PMMA group (P < 0.01). The Acrysof group was associated with less posterior capsular opacification (6.6%) than the PMMA group (80.5%). The YAG capsulotomy rate was 2.6% for the Acrysof group, and 64.9% for the PMMA group. After operation 100% and 90.6% patients were relieved from blindness in the Acrysof group and the PMMA group respectively, the difference being not statistically significant (P > 0.05). 72.6% patients in the Acrysof group and 51.5% in the PMMA group obtained corrected visual acuity greater-than-or-equal 0.3, and the difference was statistically significant (P < 0.05). CONCLUSIONS: Phacoemulsification with Acrysof intraocular lens implantation is effective in pediatric cataract surgery. Most of the patients obtain remarkable improvement in visual acuity with minimal complications and YAG capsulotomy rate after operation. It is necessary to perform further randomized and prospective studies to evaluate the long-term postoperative effects of Acrysof IOLs used in pediatric cataract surgery.

Cataract↗
PubMed2001

[Phacoemulsification of the subluxated lens with cataract].

OBJECTIVE: To study the efficiency of phacoemulsification in the treatment of subluxated lens with cataract. METHOD: Phacoemulsification combined with intraocular lens implantation was performed on 19 eyes of 18 patients. RESULT: The visual acuity in 18 eyes was improved to different degrees. The visual acuity in one eye was not improved due to the preoperative macular contusion. CONCLUSION: Phacoemulsification for treatment of subluxated lens with cataract may decrease many complications occurring in the past procedure.

Adult↗
PubMed1998

[Rotated-chipping phacoemulsification in front of capsule].

OBJECTIVE: The study was designed to investigate the clinical effects of rotated-chipping phacoemulsification in front of capsule. METHODS: Phacoemulsification using rotated-chipping technique in front of capsule with intraocular lens implantation was performed with medium energy and high vacuum on 50 eyes. RESULTS: Rotated-chipping technique was successfully completed in 46 of 50 eyes (92%), unsuccessful cases were related to shallow anterior chamber and incomplete hydrodissection. CONCLUSION: These results suggest that rotated-chipping phacoemulsification be used for cataracts with various sclerotic nuclei and it is valuable to be applied extensively.

Aged↗
PubMed1998

[Phacoemulsification for mature or hypermature cataracts].

OBJECTIVE: To discuss how to choose the methods of capsularhexis and phacoemulsification in cases with mature or hypermature cataract. METHODS: On fifty-nine mature or hypermature cataract patients, continuous circular capsularhexis or can-opener capsulotomy was performed. The nucleus was emulsified by the method of divide and conquer or phaco chop or rotatory carousel in the bag or at the plane of iris. RESULTS: Continuous circular capsularhexis was successful in 51 cases, failed or shifted to can-opener in 8 cases. There were posterior capsular rupture in 1 cases, partial dehiscence of the zonule in 1 cases and iris bitten by the phaco tip in 1 cases. Postoperatively, there were mild corneal edema in 6 cases and iris posterior synechia in 1 cases. CONCLUSION: Continuous circular capsularhexis is the key point to obtain a successful phacoemulsification for mature or hypermature cataract. Hydrodissection is not important before the phacoemulsification. Skillful phaco chop can reduce the surgical manipulation and the postoperative reaction.

Aged↗
PubMed1998

[Phacoemulsification and foldable lens implantation through a temporal clear corneal tunnel incision].

OBJECTIVE: To investigate the therapeutic effects, advantages and disadvantages of phacoemulsification and foldable lens implantation through a temporal clear corneal incision. METHODS: Eight hundreds and twelve patients (845 eyes) underwent phacoemulsification and foldable lens implantation through a temporal clear corneal tunnel incision which has a groove of 0.30 mm deep, a tunnel length of 1.75 mm, an internal opening of 3.20 mm and an external opening of 3.50 mm. The postoperative uncorrected visual acuity, the changes of corneal topography, astigmatism and endothelia were observed. RESULTS: The proportions of uncorrected visual acuity of 0.5 or better were 61.30% and 79.05% respectively at one day and a month after the operation. Postoperatively, topographical changes displayed temporal flattening near the incision in the early stage. The change of central corneal astigmatism was mild. Endothelial cell loss was 8.23%. The complications included burn of the incision (0.40%), tear of the posterior capsule (1.07%), subluxation of the lens (0.12%), endophthalmitis (0.12%) and cystoid macular edema (0.24%). CONCLUSION: The phacoemulsification and foldable lens implantation through a temporal clear corneal incision is convenient and effective.

Aged↗