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PubMed1998

[Phacoemulsification in myopia and negative or low powered posterior chamber intraocular lens implantation].

OBJECTIVE: The study was designed to investigate the technique and clinical experience of phacoemulsification in myopia and negative or low powered posterior chamber intraocular lens implantation (PC-IOL). METHODS: 120 eyes of 102 cases with myopia and cataract were included (axial length >or=28 mm) and hardness of nucleus was of grade 2 in 5 eyes, grade 3 in 84 eyes, grade 4 in 16 eyes and grade 5 in 15 eyes. Tunnel incision was made and in situ nuclear fracture technique by phacoemulsification was used. Energy and time of emulsification: 50% - 60% of energy was set up and emulsification spent 40s to 2 min. 10 s (mean, 1 min. 11.3s) for nuclear sclerosis of grade 2 or 3.65% - 70% of energy was set up and emulsification spent 48s to 1 min. 22s (mean, 68.7s) for cutting the central nucleus and removing the divided nucleus (grade 4 or 5). RESULTS: There were 120 eyes in this group. Eleven to 22 months after operation (mean 14.5 months) the visual acuities of 0.5 or better with and without correction were obtained in 62.6% and 43.4% respectively. The major complications were corneal edema and rupture of posterior capsule. No retinal detachment and cystoid macular edema were found. CONCLUSION: This operation is suitable for myopia with cataract. It is worth to spread due to good visual result, proper correction of ametropia, prevention of retinal detachment, and decrease of operative complications.

Adult↗
PubMed1998

[Intraocular pressure rise early after phacoemulsification with posterior chamber lens implantation].

OBJECTIVE: To investigate intraocular pressure (IOP) changes early after phacoemulsification with posterior chamber lens implantation. METHODS: The IOP was measured in 49 patients 53 eyes before and 10 - 12, 22 - 24, 46 - 48 hours after the operation. RESULTS: The IOP increased obviously in all eyes 10 - 12 hours after the operation, and rose more significantly from the baseline to the maximum 10 - 12 hours after surgery in 20 sutured eyes than that in 33 unsutured eyes (t = 4.41 and 3.32, P = 0.0001 and 0.0020, respectively). It was higher than 3 kPa in 16 eyes, 10 (10/20, 50.0%) in the sutured group, 6 (6/33, 18.2%) in the unsutured group, respectively, and the difference was significant between the two groups (chi2=5.9820, P=0.014). The IOP decreased markedly 22 - 24 hours, and returned to the baseline level 46 - 48 hours after the operation. CONCLUSION: These results indicate that IOP increases early after phacoemulsification with posterior chamber lens implantation, especially in sutured eyes. Therefore, to apply corresponding management properly in time and obtain better therapeutic effects of the operation, IOP should be measured regularly.

Adult↗
PubMedDate not supplied

Comparison of trabeculectomy with mitomycin C with or without phacoemulsification and lens implantation.

PURPOSE: To compare the results of combined trabeculectomy with phacoemulsification and posterior chamber intraocular lens (IOL) implantation to those of trabeculectomy alone using mitomycin C (MMC) application intraoperatively in all cases. PATIENTS AND METHODS: A retrospective comparative study of consecutive patients was conducted on two groups: 102 eyes of 90 patients studied in the combined procedure group, and 33 eyes of 30 patients in the trabeculectomy alone group. RESULTS: Both groups showed a significant decrease in IOP. The combined group had a change from 21.5+/-5.8 mm HG preoperative to 14.73+/-3.44 mm HG postoperative, P=0.0001; the trabeculectomy group changed from 24.2+/-7.5 mm HG preoperative to 12.46+/-3.86 mm HG postoperative, P=0.0001. This represents a 31.5% reduction in IOP in the combined group versus a 48.5% reduction in the trabeculectomy alone group (P=0.0001). The follow-up time was longer in the trabeculectomy group (trabeculectomy group, 22.6+/-13.3 months; combined group, 14.2+/-8.0 months), P=0.0014. There were 97 eyes in the combined group (95%) and 32 eyes (97%) in the trabeculectomy group that had an IOP of less than 20 mm HG at the end of follow up. Postoperatively, the two groups showed similar significant reductions in the number of antiglaucomatous medications used (combined group, 0.82+/-1.0 compared with 2.65+/-0.84 preoperatively, P=0.0001; trabeculectomy group, 0.76+/-1.2 compared with 2.7+/-0.95 preoperatively, P=0.0001). There were no cases of bleb leakage in the combined group and two cases (6%) in the trabeculectomy group. CONCLUSION: The reduction of IOP is significantly larger after trabeculectomy alone than after the combined procedure; however, the functional and anatomical results of the combined procedure of phacoemulsification, posterior chamber IOL implantation, and trabeculectomy with MMC application were as good as those of trabeculectomy alone with MMC.

Adult↗
PubMed2002

[Phacoemulsification of complicated traumatic cataracts].

Results of surgical treatment 142 eyes of patients with traumatic cataracts complicated with accompanied pathology (corneal scars, anterior and posterior synechia, lens subluxation, anterior and posterior capsule defects and others) are analyzed. In 107 cases phacoemulsification was done, in other cases--lensectomy, intracapsular extraction or phacoaspiration of traumatic cataract. Indications and contraindications for traumatic cataract phacoemulsification are formulated.

Adult↗
PubMed2002

[Case report of a severe corneoscleral burn caused by the phacoemulsification probe].

We report a case in which a severe corneoscleral burn occurred during the first seconds of a phacoemulsification procedure. The procedure, a superior temporal corneal limbus incision on the right eye, was carried out on a 79-year-old woman presenting a cataract with an average lens density, who had no other risk factors for complications. In spite of a mild nucleus density and routine phacoemulsification equipment (PULSAR - OPTIKON 2000) with resterilizable parts, a severe corneal injury occurred with tissue shrinkage around the surgical wound. It led to an immediate severe astigmatism which only partially decreased in the following 7 months. We discuss the mechanism which may bring about this type of injury and the likely cause in this case. We also describe the primary sign ("lens milk") indicating that the procedure should immediately be stopped, and finally we suggest methods to reduce the incidence of such so-called "phacoburns".

Aged↗
PubMed2002

[Visual outcome and complications after posterior capsule rupture during phacoemulsification].

OBJECTIVE: To determine the visual outcome and incidence of complications after posterior capsule rupture during phacoemulsification. METHODS: Sixty-six eyes of 66 patients which sustained posterior capsule rupture were retrospectively studied. RESULT: Fifty-two out of 66 eyes had best corrected visual acuity of 20/40 or better. The complications included corneal edema (42 eyes), iris injury (1 eye), pupil decentration (5 eyes), intraocular hypertension (4 eyes), intraocular lens dislocation (1 eye), cystoid macular edema (3 eyes), remain of lens material (2 eyes) and retinal detachment (2 eyes). CONCLUSIONS: Phacoemulsification, even if complicated by posterior capsule rupture, is compatible with good visual outcome. Immediate proper management of complications is important.

Adolescent↗
PubMedDate not supplied

[Phacoemulsification of traumatic cataracts].

A careful consideration was given to the results of surgical treatment of patients with traumatic cataracts complicated with concomitant pathology (corneal scars, anterior and posterior synechia, lens subdislocation, anterior and posterior crystalline capsule defects, etc.). In 107 cases phacoemulsification was done with other cases having lensectomy, intracapsular extraction or phacoaspiration of traumatic cataract. Indications and contraindications are specified for traumatic cataract phacoemulsification.

Adult↗
PubMed2001

The clinical study of Healon 5 in phacoemulsification and IOL implantation.

PURPOSE: To compare a new ophthalmic viscoelastic device (OVD) Healon 5 with two other kinds of OVDs commonly used in China during phacoemulsification and intraocular lens (IOL) implantation in terms of removal time, intraocular pressure, corneal and anterior chamber response. METHODS: This prospective randomized study, in which patients and observers are masked, comprises niety eyes. They were randomly divided into 3 groups with different OVDs. Healon 5 (sodium hyaluronate 5,000 2.3%) was compared with Healon GV (sodium hyaluronate 7,000 1.4%) and Iviz (sodium hyaluronate 1.0%). The surgeries were performed with temporal corneal incision, phacoemulsification in situ and foldable lens intracapsular implantation. The characteristic and the removal time of the viscoelastic material as well as the postoperative IOP, corneal reaction and anterior chamber reactions of the eyes were observed preoperatively and 24 hrs postoperatively. Exclusion criteria were glaucoma, a preoperative dilated pupil diameter smaller than 5.0 mm, proliferative diabetic retinopathy, significant corneal pathology or a history of uveitis. RESULTS: The removal time was 47.42 +/- 13.09 seconds in Healon 5, 16.50 +/- 5.45 in Healon GV and 15.83 +/- 7.40 in Iviz. The removal time of Healon 5 group was significantly longer than that of the other groups (P = 0.000). There is no significant IOP change 24 hours postoperatively and the difference of intraocular pressure among three groups was not significant (P > 0.05). Healon 5 group had the slightest corneal and anterior chamber response, followed by Healon GV and Iviz. CONCLUSION: Although takes longer time to remove, Healon 5 is an ideal viscoelastic material for its superior space maintenance capacity and high dispersity which provides superior protection of endothelial cells compared to Healon GV and Iviz.

Anterior Chamber↗
PubMed1998

[Observation of complications at the operative and early postoperative stages of phacoemulsification].

PURPOSE: The study was designed to investigate the reason and management of the complications at the initial stage of studying the technique of phacoemulsification. METHODS: Observing the complications at the operative and early postoperative stages of phacoemulsification used in situ nuclear fracture technique or in iridial plain fracture technique on 233 eyes of 212 patients with cataract. RESULTS: During the operations the rate of vitreous loss was 8.6% (20 eyes); iridial damage was 5.6% (13 eyes); hemorrhage in the anterior chamber was 0.4% (1 eye). After the operations the rate of continued corneal edema was 1.3% (3 eyes); posterior capsular opacity was 3.0% (7 eyes); inflammation was 0.9% (2 eyes); discentral location of intraocular lens was 0.4% (1 eye); leakage of wound was 0.9% (2 eyes); hemorrhage in the anterior chamber was 0.4% (1 eye). CONCLUSION: Vitreous loss and iridial damage were the frequent complications at the initial stage of studying the technique of phacoemusification. The rate of the complications was lower in situ nuclear fracture technique than in iridial plain fracture technique.

Adult↗
PubMedDate not supplied

Surgical peculiarities in type II diabetic cataracts during phacoemulsification.

BACKGROUND AND OBJECTIVE: To record the surgical peculiarities during phacoemulsification in patients with type II diabetes. PATIENTS AND METHODS: A retrospective, noncomparative analysis. Data from 58 eyes of 43 patients having significant cataract with type II diabetes of more than 5 years' duration who underwent phacoemulsification were considered. Intraoperative difficulties and complications were noted and analyzed. RESULTS: In 24.13% (n = 14) of the cases, the nucleus could not be divided after initial trenching. The management of the nucleus and the cortex required modifications in the surgical technique. CONCLUSIONS: Type II diabetic cataracts were sticky and leathery in approximately one-quarter of the cases.

Acrylic Resins↗
PubMed2002

[Phacoemulsification and diabetic eye].

THE PURPOSE OF THIS STUDY: Is to display the influence of diabetes on the course of the operation, postoperative complications and functionals results in operated primary cataract. MATERIAL AND METHODS: We performed a study on 134 eyes with cataract and diabetes operated in the Universitary Eye Hospital and Optilens Eye Clinic from Cluj-Napoca. RESULTS: The majority of patients (83.58%) had noninsulinodependent diabetes. Background diabetic retinopathy was present in 27 cases, associated with the diabetic maculopathy in 8 eyes. In 3 cases was present preproliferative diabetic retinopathy and in one eye it was discovered proliferative retinopathy. EEC + PC-IOL was performed in 81 eyes, mini-nuc in 37 cases and in 16 eyes phacoemulsification with PC-IOL. Postoperative the complications were less in the cases operated with mini-nuc and phacoemulsification. Visual acuity was better in eyes without diabetic retinopathy. CONCLUSIONS: 1. The modern surgical techniques of cataract surgery reduce significant the frequency of postoperative complications. 2. Functional results depends on the presence of diabetic retinopathy.

Adolescent↗
PubMed2003

[Phacoemulsification combined with trabeculectomy from personal material].

AIM: The aim of the study was to establish the efficiency of phacoemulsification combined with trabeculectomy in patients with cataract and glaucoma. MATERIAL AND METHODS: 102 patients (112 eyes) with cataract and glaucoma, who were operated between 1998 and 2001. The follow up time--from 6 month to 3 years. Intraocular pressure (IOP), drug therapy and visual acuity were analysed. RESULTS: Mean intarocular pressure after phacotrabeculectomy dropped from 21.6 mmHg to 14.9 mmHg. The average number of medications dropped from 2.6 to 1.2. Visual acuity improvement was achieved in 93.7% of the eyes. CONCLUSIONS: Phacoemulsification combined with trabeculectomy is safe and efficacious method of treatment of patients with coexisting cataract and glaucoma; shortens visual rehabilitation period and secures long-term postoperative IOP.

Adolescent↗
PubMedDate not supplied

[Experimental study of the effectiveness of a silicone protector designed for the vitreous body and retina in phacoemulsification].

A phacoemulsification technique is suggested that involves the use of a silicone protector. It was proven experimentally that a temporary implantation of a silicone plate, i.e. protector, into the retronuclear space, while performing the lens nuclear phacoemulsification, is an effective means of protecting the retina and vitreous body from a negative ultrasound impact.

Animals↗
PubMed2003

[Correction of corneal astigmatism during phacoemulsification].

OBJECTIVE: To evaluate the effectiveness of clear corneal incisions and opposite clear corneal incisions for correcting corneal astigmatism during phacoemulsification. METHODS: Twenty-nine patients (37 eyes) underwent phacoemulsification with foldable intraocular lens implantation through a 4.0 mm clear corneal tunnel. In the group 1 (28 eyes) the corneal tunnel incisions were placed on the steepest axis (pre-operative astigmatism >/ =1.5). In the group 2 (9 eyes) an additional penetrating incision (3.0 mm) was placed on the opposite side to enhance flattening effect (pre-operative astigmatism =1.5). Keratometry was done in all eyes on the day prior to surgery and on the first day, 2-3 weeks and 6 months post-operatively. RESULTS. After 6 months, the corneal astigmatism decreased from 0.96 D+/-0.03 to 0.78 D+/-0.06, p</=0.05 in the first group and from 2.23 D+/-0.21 to 1.56 D+/-0.18, p< or = p</0.05 in the second group. CONCLUSIONS: Clear corneal incision on the steepest axis has neutralizing effect on pre-operative astigmatism. Adding opposite clear corneal incisions can greatly enhance this flattening effect [corrected].

Adult↗
PubMed2004

[A quantitative study of anterior chamber angle with ultrasound biomicroscopy after cataract surgery with phacoemulsification and foldable intraocular lenses implantation].

OBJECTIVE: To study the changes in anterior chamber angle after phacoemulsification and foldable IOL implantation with ultrasound biomicroscopy. METHODS: Small-incision phacoemulsification and foldable IOL implantation were performed in 50 eyes of 46 senior patients, and the changes of anterior chamber angle were determined quantitatively by using ultrasound biomicroscopy before and one month after the surgery. RESULTS: In all patients, the angle was widened significantly one month after surgery (P < 0.01). The measurements of TIA500 (trabecular-iris angle at 500 micro m from the scleral spur), AOD250 (angle-opening distance at 250 micro m from the scleral spur) and AOD500 (angle-opening distance at 500 micro m from the scleral spur) increased significantly after the operation (P < 0.01). The mean post/pre-operative TIA500 ratio, AOD250 ratio and AOD500 ratio were 1.65 (1.12 - 4.91), 1.81 (1.06 - 2.67) and 1.65 (1.01 - 2.76), respectively. A significant negative correlation existed between preoperative and postoperative data. CONCLUSION: Small-incision cataract surgery deepens the anterior chamber and widens anterior chamber angle significantly in senior patients. The narrower the preoperative angle, the higher ratio of post/preoperative ratio found.

Aged↗
PubMed2004

[Analysis of phacoemulsification complications during mastering of the method].

PURPOSE: Intra-operative and postoperative complications of the first 50 phacoemulsifications were evaluated. The procedures were performed by one, skilled at ECCE surgeon. The phaco-chop technique was carried out in all cases with use of anterior chamber maintainer (ACM). MATERIAL AND METHODS: Eyes for surgery met the requirements: normal comea, presence of red reflex from the fundus and correct lens position. The patients were divided into 2 groups: I group--25 eyes had first surgery, II group--25 eyes had second surgery. On the first day after surgery complications and uncorrected acuity were evaluated. RESULTS: 50 eyes of 48 patients underwent operation. The mean age was 69.4 years 5% eyes had previous surgical record: 4--underwent trabeculectomy, 1--pars plana vitrectomy. The 12 intra-operative complications appeared in 10 eyes (20%): posterior capsule rupture without vitreous loss in 4% and 10% with vitreous loss, Descemet membrane detachment in 4%, iris dialysis in 2%, and persistent iris damage without sphincter disruption in 4%. The 16 postoperative complications concerned 10 eyes (20%): corneal oedema in 20%, transient intra-ocular pressure raise in 8%, hyphaema in 2%, and fibrin exudation in 2%. The majority of complications concerned the I group of eyes. The uncorrected visual acuity was 0.5 or better in 80% of eyes, on the first day after the operation. CONCLUSIONS: The use of ACM made the first steps in phacoemulsification rate during the learning course.

Aged↗
PubMed2004

Late recurrent uveitis after phacoemulsification.

It is now assumed that recurrent late onset uveitis after phacoemulsification with intraocular lens (IOL) is due to indolent infection. Fifteen such cases were observed after uncomplicated phacoemulsification with-in-the-bag IOL implant. These cases were considered noninfective and treated medically with good visual recovery.

Aged↗
PubMed2004

[Clinical observation of the combination of phacoemulsification and trabeculectomy].

OBJECTIVE: To evaluate the therapeutic effects of combined phacoemulsification and trabeculectomy surgery with intraocular lens implantation and compare the results of two different approaches. METHODS: In a retrospective study, forty eyes of 35 cases cataract patients with primary open-angle or chronic angle-closure glaucoma were assigned to undergo either a single incision (single incision group, 15 eyes) or two-incision (double incision group, 25 eyes). best-corrected visual acuity (BCVA), pre-and post-operation intraocular pressure (IOP), postoperative bleb formation and postoperative complications were analyzed and compared between the two procedures. All cases were followed up for over 12 months. RESULTS: The mean IOP of 35 cases (40 eyes) in 12 months postoperatively was (14.35 +/- 3.03) mm Hg (1 mm Hg = 0.133 kPa), which was distinctly lower than that of preoperative [(35.76 +/- 4.39) mm Hg (t = 25.39, P < 0.001)]. There was no significant difference between the two groups in the mean IOP preoperation and 1 week, 1 month, 3, 6, 12 months postoperation. The postoperative BCVA was between 0.2 and 1.2, BCVA < 0.3 was found in three eyes (7.5%), and > or = 0.3 in 37 eyes (92.5%), BCVA was significantly improved in 4 eyes after surgery (chi(2) = 31.03, P < 0.001). There was no obviously difference in visual acuity between the two groups at one week, 3 months postoperatively (chi(2) = 0.22, and 0.05, P > 0.05), the type I or II bleb formation was detected in 35 eyes (87.5%). Post operation, among the eyes, 13 eyes were single-incision while 22 eyes with double-incision. No severe postoperative complications were revealed in all of operated cases. CONCLUSIONS: The procedures of combined phacoemulsification with trabeculectomy is safe, effective surgery for cataract patients combined with glaucoma. There were no differences in IOP, BCVA developing, bleb formation in early stage postoperatively using either single-incision or double-incision.

Aged↗