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PubMed2001

Phakonit: phacoemulsification through a 0.9 mm corneal incision.

Advances in technique and equipment have led to a significant increase in the popularity of phacoemulsification and have increased its safety and efficiency. We describe a technique, phakonit, in which the lens is emulsified through a 0.9 mm clear corneal temporal incision. A cortical wash with bimanual irrigation/aspiration is followed by enlarging the incision to 2.0 mm and inserting a Staar sub-2.0 mm foldable intraocular lens. Phakonit is a safe, precise method of phacoemulsification with minimal intraoperative or postoperative complications.

Aged↗
PubMed2001

Capsular tension ring implantation after capsulorhexis in phacoemulsification of cataracts associated with pseudoexfoliation syndrome. Intraoperative complications and early postoperative findings.

PURPOSE: To evaluate the effect of an endocapsular tension ring in preventing zonular complications during phacoemulsification of cataracts associated with pseudoexfoliation syndrome. SETTING: Eye Clinic of Beyoğlu Education and Research Hospital, Istanbul, Turkey. METHODS: A prospective randomized study comprised 78 eyes with cataract and pseudoexfoliation syndrome that were randomly divided into 2 groups. The age, sex, cataract density, iridodonesis, axial length, anterior chamber depth, best corrected visual acuity (BCVA), and intraocular pressure (IOP) were matched between groups. In 39 eyes, a capsular tension ring (CTR) was implanted after capsulorhexis and hydrodissection but before nucleus emulsification. Thirty-nine eyes that did not have a CTR implanted served as a control. The main outcome measures were the rates of intraoperative zonular separation and capsular fixation of a foldable intraocular lens (IOL). Posterior capsule rupture without zonular dialysis, vitreous loss, corneal edema, fibrin in the anterior chamber, BCVA, and IOP in the immediate postoperative period were also compared between the 2 groups. RESULTS: Five eyes (12.8%) in the control group and no eye in the CTR group had intraoperative zonular separation (P =.02). Posterior capsule rupture without zonular separation occurred in 3 eyes (7.7%) in the control group and 2 (5.2%) in the CTR group. Capsular IOL fixation was achieved in 37 eyes (94.9%) in the CTR group and 31 eyes (74.3%) in the control group (P =.012). The difference in BCVA was not statistically significant between the 2 groups (P =.44); however, uncorrected visual acuity (UCVA) was significantly better in the CTR group (P =.026). CONCLUSION: In cases of cataract associated with pseudoexfoliation syndrome, implanting a CTR before phacoemulsification of the nucleus reduced intraoperative zonular separation, increased the rate of capsular IOL fixation, and improved UCVA.

Aged↗
PubMed2002

Naproxen ophthalmic solution to manage inflammation after phacoemulsification.

PURPOSE: To explore the efficacy and safety of 2 concentrations (0.1% and 0.2%) of sodium naproxen ophthalmic solution in controlling ocular inflammation in patients having phacoemulsification and intraocular lens implantation. SETTING: Service d'Ophtalmologie La Pitie' and Centre Ophtalmologique, Paris, and Clinique Sourdille, Nantes, France; Department of Ophthalmology, University of Lausanne, Switzerland. METHODS: One hundred one patients were randomly treated with naproxen 0.1%, naproxen 0.2%, or diclofenac 0.1% 3 times a day for 30 days starting the day before surgery. Postsurgical ocular inflammation was measured after 1, 10, and 30 days using the Kowa FC-1000 laser flare-cell meter and a conventional slitlamp biomicroscope. Safety parameters were evaluated at the same visits. RESULTS: Naproxen 0.2% ophthalmic solution and diclofenac 0.01% were comparable in controlling postsurgical inflammation. The naproxen was well tolerated. No serious adverse events occurred during the study. CONCLUSIONS: These preliminary results suggest that naproxen ophthalmic solution may be effectively and safely used to control inflammation after uneventful phacoemulsification. Because of the limited number of patients, larger studies are needed to confirm these results.

Anterior Chamber↗
PubMed2002

Accuracy of IRAS GT interferometer and potential acuity meter prediction of visual acuity after phacoemulsification: prospective comparative study.

PURPOSE: To assess and compare the accuracy of 2 methods of predicting visual acuity after phacoemulsification. SETTING: Department of Ophthalmology, Montpellier, France. METHODS: This prospective study evaluated 47 eyes of 47 patients having uneventful phacoemulsification over a 1-month period. All the patients had mild to moderate cataract. Visual acuity recovery was predicted using the white-light IRAS GT interferometer on the 3- and 8-degree wide test area and the Guyton-Minkowski potential acuity meter (PAM). Best corrected visual acuity was evaluated 1 day before and 1 month after surgery. RESULTS: Both the interferometer and PAM underestimated the retinal visual capacity. Three-degree white-light interferometry gave significantly better mean predicted results than 8-degree interferometry and the PAM. There was no statistically significant disparity between predicted and postoperative results with 3-degree interferometry (1.04 +/- 0.57 logMAR; -0.09 +/- 0.27 decimal) (P =.0647) and a statistically significant disparity with 8-degree interferometry (0.89 +/- 0.59 logMAR; -0.13 +/- 0.27 decimal) and the PAM (0.66 +/- 0.62 logMAR; -0.22 +/- 0.24 decimal) (P =.0001). The predicted values were widely dispersed; the correlation indices were 0.38 with the PAM (P =.091), 0.39 with 3-degree interferometry (P =.001), and 0.49 with 8-degree interferometry (P =.0005). CONCLUSIONS: Three-degree white-light interferometry gave more accurate results than 8-degree interferometry and the PAM. The wide dispersion of results and unsatisfactory correlation indices show the tests are poor predictors of individual acuity. They should be used semiquantitatively and the results interpreted in relation to the clinical data. Qualitative methods may be useful in confirming or refuting visual recovery capacity ascertained by quantitative systems.

Adult↗
PubMed2002

Phacoemulsification and intraocular lens implantation in nanophthalmic eyes: report of a medium-size series.

PURPOSE: To evaluate the outcomes in nanophthalmic eyes that had phacoemulsification and intraocular lens (IOL) implantation. SETTING: Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. METHODS: Six nanophthalmic eyes of 4 patients had uneventful phacoemulsification and posterior chamber IOL implantation with a retrobulbar or peribulbar block. All operations were performed by 1 surgeon. Patients ranged in age from 41 to 70 years. RESULTS: The visual acuity remained stable or improved in all 6 eyes. Glaucoma control was maintained or improved in 5 eyes. CONCLUSION: The results indicate that small-incision cataract surgery, although challenging, is safe and diminishes the need for prophylactic sclerotomies in these high-risk eyes.

Adult↗
PubMed2002

Prediction of macular edema exacerbation after phacoemulsification in patients with nonproliferative diabetic retinopathy.

PURPOSE: To ascertain whether the aqueous humor levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), and protein can predict the postoperative exacerbation of macular edema in patients with nonproliferative diabetic retinopathy (NPDR) after phacoemulsification surgery for cataract. SETTING: Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan. METHODS: This prospective study included 104 consecutive patients (104 eyes) with NPDR who had cataract surgery. The concentrations of VEGF and IL-6 in aqueous humor specimens obtained during cataract surgery were measured by enzyme-linked immunosorbent assay. Patients were followed for 6 months to assess the postoperative exacerbation of macular edema. RESULTS: Ninety patients (87%) achieved a visual acuity of 20/40 or better. Exacerbation of macular edema was seen in 30 eyes (29%) after 6 months. Hypertension and the aqueous levels of VEGF, IL-6, and protein were significantly correlated with the exacerbation of macular edema (odds ratio 1.16, 1.33, 1.27, and 1.28, respectively). In contrast, there was no correlation between the exacerbation of macular edema and other systemic factors. Multivariate logistic regression analysis showed that the aqueous VEGF level increase of 100 pg/mL increased the macular edema after phacoemulsification surgery (odds ratio 1.53). CONCLUSIONS: A high VEGF level in the aqueous humor predicted a significant risk for the postoperative exacerbation of macular edema. A model was developed to predict the risk exacerbation.

Aged↗
PubMed2002

Role of intraocular pressure measurement on the day of phacoemulsification cataract surgery.

PURPOSE: To determine whether measurement of intraocular pressure (IOP) preoperatively or in the early postoperative period is an accurate predictor of raised IOP 24 hours after cataract surgery. SETTING: Department of Ophthalmology, Queen's Medical Centre, Nottingham, United Kingdom. METHODS: This prospective study comprised 101 eyes of 101 patients having phacoemulsification cataract surgery. The IOP was measured by Goldmann applanation tonometry preoperatively and 2 to 3 hours, 6 to 8 hours, and 22 to 24 hours postoperatively. The relationship between the same-day and next-day IOP readings was examined. RESULTS: One hundred patients completed the study. The IOP at 22 to 24 hours was significantly correlated with the IOP preoperatively (correlation coefficient [r] 0.54; 95% confidence interval [CI], 0.38-0.67) and at 6 to 8 hours (r = 0.56; 95% CI, 0.41-0.68). In contrast, the IOP measurement at 2 to 3 hours correlated relatively poorly with the next-day IOP (r = 0.33; 95% CI, 0.14-0.49). Twelve patients had an IOP of 26 mm Hg or higher at 22 to 24 hours. The risk of this outcome increased significantly with higher IOP values preoperatively and, to a lesser extent, with a raised IOP at 6 to 8 hours. Glaucoma and ocular hypertension were associated with a 2.9-fold increased risk (95% CI, 0.67-12.8) of a next-day IOP of 26 mm Hg or higher. CONCLUSIONS: Preoperative IOP or a diagnosis of glaucoma or ocular hypertension were significant risk factors for raised next-day IOP after small-incision phacoemulsification. It may be possible to select patients at greater risk of prolonged ocular hypertension before surgery for prophylactic IOP-lowering treatment. This would minimize patient morbidity and reduce the number of patients requiring next-day review, resulting in significant health economic savings.

Aged↗
PubMed2002

Corneal impact of ultrasound and bevel position in phacoemulsification.

PURPOSE: To investigate the amplitude of ultrasound waves that reach the cornea with the phacoemulsification tip at different angles. SETTING: Institute for Applied Mechanics and Control Engineering, University of Siegen, Siegen, Germany. METHODS: A model eye was constructed with an ultrasound tip (angle 45 degrees) in the typical position during the procedure and a sensor mounted in the apex of the artificial cornea. The sensor measured the incoming ultrasound waves. Thirty bursts of ultrasound energy were set at 100% power with the bevel of the tip facing up toward the cornea, and 30 bursts were set with the bevel facing down toward the lens. RESULTS: There was no statistically significant difference in the measurements with the tips bevel up and bevel down. CONCLUSIONS: There was no significant difference in the corneal load from ultrasound waves with the phacoemulsification tip in a bevel-up or bevel-down position.

Cornea↗
PubMed2002

Preventing intraocular pressure increase after phacoemulsification and the role of perioperative apraclonidine.

PURPOSE: To evaluate the effectiveness of prophylactic topical apraclonidine 1% in preventing an intraocular pressure (IOP) rise in the early period after uneventful phacoemulsification with intraocular lens (IOL) implantation. SETTING: District general hospital, United Kingdom. METHODS: In this prospective masked randomized trial, 61 patients had elective, routine, corneal tunnel, sutureless phacoemulsification with in-the-bag foldable IOL implantation. A single surgeon operated on all the patients. Patients were randomized to receive topical apraclonidine 1% eyedrops (n = 31) or artificial tears (control group, n = 30) 1 hour preoperatively and at the end of the surgery. An observer masked to the perioperative drops used measured the IOP preoperatively and 3 to 6 hours and 16 to 24 hours postoperatively. The primary outcome was the change in IOP between the baseline and the 2 postoperative intervals. The IOP changes within and between the groups were analyzed using the t test and chi-square test. RESULTS: The changes between the postoperative and preoperative IOPs in the study groups were statistically significant (apraclonidine, P = 0.018 and P = 0.007, respectively; artificial tears, P = 0.028 and P = 0.023, respectively; paired t test). There was no significant difference in the postoperative IOP between the apraclonidine and control groups 3 to 6 hours and 16 to 24 hours postoperatively (P = 0.717 and P = 0.497, respectively; independent t test). The mean difference was 0.2 mm Hg (95% confidence interval [CI], -3.4 to 3.1) in the apraclonidine group and 2.2 mm Hg (95% CI, -2.5 to 7.0) in the control group. In each group, a few patients had an IOP greater than 30 mm Hg in the first 24 hours. CONCLUSION: Prophylactic topical perioperative apraclonidine 1% did not cause a significant reduction in the postoperative IOP when compared with a control group.

Administration, Topical↗
PubMed2003

Intraocular pressure changes and the implications on patient review after phacoemulsification.

PURPOSE: To determine the pattern of intraocular pressure (IOP) change postoperatively and its bearing on the timing of postoperative review. SETTING: Ophthalmology department of a district general hospital, Northamptonshire, England. METHODS: One hundred eyes of 100 consecutive patients having uneventful phacoemulsification were included in this study. The IOP was measured preoperatively and 2 hours, 1 day, and 1 week postoperatively. The IOP readings were statistically analyzed using the Fisher exact probability test. RESULTS: From 1 week before surgery, there was a mean rise in IOP of 8.14 mm Hg 2 hours after surgery followed by a mean fall of 5.18 mm Hg at 24 hours (next-day review). The mean fall in IOP at 1 week was 2.94 mm Hg. Ten percent of patients had an IOP greater than or equal to 35 mm Hg 2 hours postoperatively and required oral IOP-lowering agents. All patients had an IOP lower than 35 mm Hg at the next-day review. At 1 day, 18.6% of patients had a higher IOP than at 2 hours; however, the mean IOP was 21.39 mm Hg. CONCLUSIONS: The results show it is safe to review patients 2 hours after uneventful phacoemulsification and omit the next-day review. This enhances patient acceptance of true day-case cataract surgery as it eliminates the need for an inpatient stay and transport on the following day. It also improves utilization of hospital resources. A larger study will help confirm the conclusions of this study.

Adult↗
PubMed2003

Entry of antibiotic ointment into the anterior chamber after uneventful phacoemulsification.

A 77-year-old woman had uneventful phacoemulsification. Postoperative examination revealed that chloramphenicol ointment instilled in the conjunctival fornix had entered the anterior chamber and smeared the intraocular lens (IOL). Immediate surgical removal of the ointment with IOL exchange was performed. The eye settled in 6 weeks with a best corrected visual acuity of 6/9. This case raises concerns about the integrity of clear corneal incisions and the need for postoperative review of uneventful phacoemulsification surgery.

Aged↗
PubMed2003

Viscoanesthesia. Part II: toxicity to intraocular structures after phacoemulsification in a rabbit model.

PURPOSE: To investigate the toxicity of a solution that combines sodium hyaluronate 1.5% with lidocaine (0.5%, 1.0%, or 1.65%) to intraocular structures. SETTING: Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: Phacoemulsification was performed in both eyes of 29 rabbits. They were divided into 3 groups; in each group (n = 7), 1 viscoanesthetic solution was used before capsulorhexis. After irrigation/aspiration, 0.2 mL of the solution was purposely left in the capsular bag. In 1 rabbit in each group, the solution was injected into the vitreous cavity through a posterior capsulorhexis. In 8 rabbits used as controls, balanced salt solution (BSS(R)) (n = 4) or sodium hyaluronate 1.5% (n = 4) was injected into the vitreous cavity. Enucleations were performed 15, 30, and 60 days postoperatively. Histological sections were cut and stained with hematoxylin-eosin, periodic acid-Schiff, and Masson trichrome stains. RESULTS: Light microscopic evaluation of the eyes enucleated after 15, 30, and 60 days in the study and control groups showed similar findings in intraocular structures such as the ciliary body and retina. No evidence of an inflammatory reaction, cell necrosis, or cell degeneration was observed in the histological sections. CONCLUSIONS: The use of viscoanesthesia during phacoemulsification appeared to be safe, with no histologic abnormalities observed with the 3 lidocaine concentrations. The efficacy of the anesthetic effects of these solutions will be addressed in clinical trials.

Anesthetics, Local↗
PubMed2003

Reasons for secondary surgical intervention after phacoemulsification with posterior chamber lens implantation.

PURPOSE: To determine the indications for secondary surgical intervention in patients who had primary phacoemulsification with posterior chamber intraocular lens (IOL) implantation and to assess the final visual outcomes. SETTING: Department of Ophthalmology, Scarborough Hospital, Scarborough, United Kingdom. METHODS: The case notes of 17 patients (18 eyes) were reviewed to determine the reasons for secondary surgical intervention. From September 1997 to December 2000 (40 months), 4388 primary phacoemulsification procedures with posterior chamber IOL implantation were performed. RESULTS: Fifteen eyes required secondary surgical interventions for lens-related factors and 3, for surgeon-related factors. All patients had satisfactory visual outcomes after the secondary intervention. CONCLUSIONS: The indications for secondary intervention included unsatisfactory refractive outcome, posterior settlement of the IOL, unwanted imagery, inappropriate IOL power, and IOL dislocation. Secondary intervention can be performed safely and provides satisfactory final visual outcomes.

Adult↗
PubMed2003

Same-day versus first-day review of intraocular pressure after uneventful phacoemulsification.

PURPOSE: To compare the incidence and the spectrum of postoperative complications detected when the intraocular pressure (IOP) is reviewed 4 to 6 hours or the day after uneventful phacoemulsification cataract extraction and intraocular lens (IOL) implantation. SETTING: Royal Free Hospital, London, United Kingdom. METHODS: The study cohort consisted of 141 patients who had uneventful phacoemulsification and IOL implantation under regional (peribulbar/topical) or general anesthesia. Postoperative evaluation of the patients was performed by an ophthalmologist using a standard form at 4 to 6 hours or 24 hours. RESULTS: The mean IOP at 4 to 6 hours and 24 hours was 22.85 mm Hg +/- 9.56 (SD) and 19.44 +/- 7.04 mm Hg, respectively. The IOP was more likely to be greater than 30 mm Hg when measured on the same day, resulting in a significantly higher intervention rate than on the first day (P =.037). The best corrected visual acuity was significantly better at 24 hours than at the same-day review (P <.001). There was no significant difference in the extent of anterior chamber activity, patient comfort, or state of the wound between the same- or next-day follow-up. All patients attended a follow-up appointment 3 weeks after surgery, had an IOP of 21 mm Hg or less, and were subsequently discharged. CONCLUSIONS: The results indicate that moderate IOP spikes (<40 mm Hg) can be left untreated if they are not associated with corneal edema or patient discomfort as they decline spontaneously. Before they are discharged, patients with compromised optic discs or predisposed to retinal or optic nerve pathology should be carefully evaluated the day after surgery to treat IOP elevations.

Adolescent↗
PubMed2003

Combined phacoemulsification and pars plana vitrectomy: clear corneal versus scleral incisions: prospective randomized multicenter study.

PURPOSE: To compare the complications and outcomes of implantation of a foldable intraocular lens (IOL) through a clear corneal incision and implantation of a poly(methyl methacrylate) (PMMA) IOL through a scleral incision in combined phacoemulsification and pars plana vitrectomy. SETTING: Departments of Ophthalmology, St. Franziskus Hospital, Muenster, Eye Hospital, Muelheim, and University of Essen, Essen, Germany. METHODS: This prospective randomized study included 62 eyes having implantation of a PMMA IOL (811B, Pharmacia) through a scleral incision and 61 eyes having implantation of a polyacrylic (AcrySof, Alcon) IOL through a clear corneal incision. The preoperative visual acuity, underlying retinal disease, and vitreoretinal surgical maneuvers did not differ between groups. The surgical methods and intraoperative complications were noted. Examinations 2 days and 3 months after surgery included visual acuity, refractive error, keratometry, slitlamp evaluation, tonometry, and ophthalmoscopy. RESULTS: Intraoperatively, both incisions were stable and no serious complications occurred. Two days after surgery, the incidence and quantity of cells and fibrin in the anterior chamber were lower in the clear corneal incision group than in the scleral incision group (P<.05). Corneal endothelial dysfunction was more common in the clear corneal group than in the scleral group (P<.05). Three months after surgery, the astigmatic changes did not differ significantly between groups and the incidence of posterior capsule opacification (PCO) was lower in the clear corneal group (P<.05). Postoperative visual acuity improved significantly in 63% of eyes and 61% of eyes in the scleral group and clear corneal group, respectively. Visual acuity was limited by macular pathology. CONCLUSIONS: Both clear corneal and scleral incisions were safe in combined phacoemulsification and vitrectomy. Eyes with smaller clear corneal incisions and foldable IOLs had less postoperative inflammation and PCO.

Aged↗
PubMed2003

Phacoemulsification of the crystalline lens and implantation of an intraocular lens for the correction of moderate and high myopia: four-year follow-up.

PURPOSE: To assess the safety of lens extraction and intraocular lens (IOL) implantation in patients with high myopia treated for initial lens opacity and/or refractive indications. SETTING: Instituto de Microcirugía Ocular de Barcelona, Barcelona, Spain. METHODS: This retrospective nonrandomized case series study comprised 44 eyes of 30 consecutive myopic patients who had surgery because of initial lens opacity and/or refractive indications during a 2-year period. In each case, phacoemulsification was performed using an ultrasonic technique and an IOL was implanted in the capsular bag. The patients were seen preoperatively to evaluate retinal pathology. They also had a complete ophthalmologic evaluation that included detailed indirect ophthalmoscopy. All patients were followed at regular intervals. The main outcome measures were preoperative and postoperative spherical equivalent (SE), the incidence of posterior capsule opacification (PCO) and the need for capsulotomy, and the incidence of retinal complications. RESULTS: In all eyes, the surgery was uneventful. The mean patient age at surgery was 42.83 years; the mean preoperative SE was -15.77 diopters (D) and the mean postoperative SE, -1.05 D. No eye required preoperative peripheral retinal photocoagulation. Twenty-five eyes (56.8%) had PCO and had a neodymium:YAG laser capsulotomy. One eye had a retinal tear 14 months after surgery and was treated with focal photocoagulation. The mean endothelial cell loss was 2.1% during the first postoperative year. Two eyes had an immediate postoperative intraocular pressure (IOP) rise, 1 with an inflammatory membrane and the other with corneal edema; both resolved with topical treatment. One eye with elevated IOP and a bad response to medical treatment had argon laser trabeculoplasty. No eye had a retinal detachment during the follow-up. CONCLUSION: With a thorough preoperative ophthalmologic evaluation and uneventful surgery, patients who have phacoemulsification and IOL implantation for the correction of myopia have a satisfactory chance of obtaining good visual results with few complications.

Adult↗
PubMed2003

Posterior capsule opacification after phacoemulsification: silicone CeeOn Edge versus acrylate AcrySof intraocular lens.

PURPOSE: To compare the rates and morphologic features of posterior capsule opacification (PCO) after small-incision phacoemulsification and in-the-bag implantation of 2 foldable intraocular lenses (IOLs) over an 18-month follow-up. SETTING: Departments of Ophthalmology, Hospital of Conegliano, Conegliano, and Maggiore Hospital of Bologna, Bologna, Italy. METHODS: In an open clinical study, 78 cataract patients were randomly selected to have implantation of a silicone CeeOn Edge (Pharmacia) or acrylate AcrySof (Alcon) IOL after phacoemulsification cataract surgery. All the patients were operated on using a standard technique and in-the-bag IOL implantation. One eye in each patient was studied. Morphologic evaluation of PCO was performed using Evaluation of Posterior Capsule Opacification software. RESULTS: At 18 months in the CeeOn Edge group, 36 eyes (90%) had a clear posterior capsule and 4 (10%) had PCO that did not affect visual acuity. In the AcrySof group, 26 eyes (68%) had a clear posterior capsule, 11 (29%) had PCO that did not affect visual acuity, and 1 (3%) had PCO with a decrease of 2 or more lines of visual acuity that required a neodymium:YAG laser capsulotomy. No eye developed Elschnig pearls or stretched folds in the bag. The postoperative best corrected visual acuity ranged from 0.8 to 1.0 in 96% in the CeeOn Edge group and in 92% in the AcrySof group. No IOL haze or discoloration was observed in the CeeOn Edge group. Mild IOL decentration and tilting occurred in 4 AcrySof eyes; however, no glistenings were found any AcrySof IOL. CONCLUSIONS: Both the CeeOn Edge and AcrySof groups had a low incidence of PCO after an 18-month follow-up. The CeeOn Edge group had significantly less PCO than the AcrySof group. These results confirm that IOLs with square truncated edges create a barrier effect at the optic edge, reducing the overall incidence of PCO.

Acrylic Resins↗
PubMed2003

Phacoemulsification without intraocular lens implantation in patients with high myopia: long-term results.

PURPOSE: To estimate the cumulative incidence of postoperative retinal detachment (RD), rhegmatogenous retinal lesions requiring argon laser treatments, anterior (ACO) and posterior (PCO) capsule opacification, and neodymium:YAG (Nd:YAG) laser capsulotomy in patients with high myopia who had phacoemulsification without intraocular lens (IOL) implantation. SETTING: Department of Ophthalmology and Neurosurgery, University of Siena, Siena, Italy. METHODS: Seventy-three eyes of 57 patients with high myopia who had phacoemulsification without IOL implantation from 1993 to 1996 were retrospectively reviewed. The mean postoperative follow-up was 62.3 months and the mean axial length, 30.22 mm (range 29.10 to 33.70 mm). The incidence of RD and preoperative and postoperative prophylactic argon laser photocoagulation for rhegmatogenous retinal lesions were assessed. Between 1997 and 2000, ACO was evaluated subjectively and PCO was evaluated using the EPCO photographic image-analysis system. The incidence of Nd:YAG laser capsulotomy was noted. RESULTS: Argon laser photocoagulation was performed in 8 eyes (10.9%) preoperatively and 3 eyes (4.1%) postoperatively. One RD (1.3%) was observed 26 months after surgery; no preoperative or postoperative prophylactic argon laser photocoagulation or Nd:YAG laser capsulotomy was performed in this eye. At 1 year, 49 eyes (67.1%) had mild ACO and 24 (32.8%) had anterior capsule fibrosis. The data did not change during subsequent follow-up visits. At 6 years, the mean PCO grade was 1.109 (range 0.972 to 2.931); an Nd:YAG laser capsulotomy was performed in 12 eyes (16.4%). CONCLUSIONS: Compared with other studies that evaluated the outcomes of highly myopic patients who had cataract surgery with posterior chamber IOL implantation, our patients, who did not have IOL implantation, had a lower incidence of postoperative rhegmatogenous retinal lesions requiring argon laser treatments and a similar incidence of postoperative RD and visually significant PCO.

Aged↗