Journal of cataract and refractive surgery最新文献

{"title":"Depth of focus as a function of spherical aberration using adaptive optics in pseudophakic subjects.","authors":"Juan Tabernero, Carles Otero, John Kidd, Laura Zahiño, Ana Noia, Jose Luis Güell, Pablo Artal, Shahina Pardhan","doi":"10.1097/j.jcrs.0000000000001608","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001608","url":null,"abstract":"<p><strong>Purpose: </strong>To measure visual acuity at three different defocus planes in pseudophakic subjects with varying levels of spherical aberration induced by an adaptive optics visual simulator. The study aimed to simulate Extended Depth of Focus (EDOF) intraocular lenses (IOLs).</p><p><strong>Setting: </strong>Private hospital (IMO, Barcelona, Spain).</p><p><strong>Design: </strong>Observational case series; modelling theory.</p><p><strong>Methods: </strong>Through-focus visual acuity was measured in 26 pseudophakic subjects (age 63 ± 10 years old) with an adaptive optics visual simulator optimized for clinical use (VAO, Voptica SL, Murcia, Spain). Measurements were made under five different conditions of induced negative spherical aberration: 0, -0.07, -0.15, -0.23 and -0.30 μm (pupil diameter: 4.5 mm). Results were also modelled using ray tracing simulations.</p><p><strong>Results: </strong>On average, depth of focus was extended when spherical aberration increased from -0.07 to -0.15 μm (4.5 mm pupil diameter). Some indivisuals (27%) experienced improved depth of focus with higher magnitudes of spherical aberration, while others (23%) exhibited no benefit from increased (negative) SA, as visual acuity dropped below acceptable levels. Depth of focus calculations based on ray tracing showed general agreement with the measurements.</p><p><strong>Conclusions: </strong>The visual conditions of EDOF IOLs were artificially recreated in a population of pseudophakic patients implanted with a monofocal IOL. The variability seen across subjects in visual acuity at different defocus planes suggests that visual simulators might be capable of screening subjects for suitability and tolerability of these advanced technology lenses.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual outcomes, contrast sensitivity and defocus profile with an aspheric monofocal intraocular lens utilizing positive spherical aberration.","authors":"Elizabeth M Law, Rajesh K Aggarwal, Phillip J Buckhurst","doi":"10.1097/j.jcrs.0000000000001612","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001612","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual outcomes following bilateral implantation of the RayOne EMV intraocular lens with targeted micro-monovision.</p><p><strong>Setting: </strong>Southend Private Hospital, UK.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Methods: </strong>50 subjects (100 eyes) assessed at 12 to 18 months post-operatively. Emmetropia was targeted in the dominant eye and myopia of -0.50 to -1.00D in the non-dominant eye. Uncorrected and distance corrected visual acuity was assessed monocularly and binocularly at distance (6m), intermediate (70cm) and near (40cm). Defocus was assessed from +1.50D to -4.00D monocularly and binocularly. Contrast sensitivity was assessed using a computerised Pelli-Robson chart.</p><p><strong>Results: </strong>Mean Spherical Equivalent (MSE) was -0.05±0.34D and -0.91±0.60D in the dominant and non-dominant eyes respectively. Uncorrected distance visual acuity (UDVA) was significantly different in the dominant (0.08±0.10LogMAR) and non-dominant eye (0.29±0.17LogMAR). (p<0.01). Corrected distance visual acuity (CDVA), distance corrected intermediate visual acuity (DCIVA) and distance corrected near visual acuity (DCNVA) were similar between eyes. However, significant differences were found between binocular uncorrected intermediate visual acuity (UIVA) (0.16±0.11LogMAR) and DCIVA (0.31±0.11LogMAR) (p <0.01) also, binocular uncorrected near visual acuity (UNVA)(0.30±0.17LogMAR) and DCNVA (0.50±0.19 LogMAR) (p<0.01). The non-dominant eye shows superior acuity eye in both UIVA (p<0.01) and UNVA(p<0.01). Contrast sensitivity showed no significant difference between eyes (p = 0.06). Significant improvement binocularly compared to monocularly was seen through imposed defocus -0.50 to -2.50D.</p><p><strong>Conclusion: </strong>The RayOne EMV with micro-monovision is a reliable method for improving intermediate and near visual acuity, by increasing the range of focus without compromise of distance acuity or contrast sensitivity.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meibomian Gland Structure and Function in Patients with Demodex Blepharitis.","authors":"Elizabeth Yeu, Cecelia Koetting","doi":"10.1097/j.jcrs.0000000000001619","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001619","url":null,"abstract":"<p><strong>Purpose: </strong>To compare structural and functional measures of meibomian gland dysfunction (MGD) in eyes with moderate to severe Demodex blepharitis (collarette grade 2-4) compared to those with collarette grade 0 (0-2 collarettes).</p><p><strong>Setting: </strong>Private clinical practice.</p><p><strong>Design: </strong>Retrospective, single-center, non-interventional, observational study.</p><p><strong>Methods: </strong>In this study, case records of patients aged ≥18 years with data available for collarettes and MGD signs (telangiectasia, meibum expressibility, meibum quality, and meibography) were included. Outcome measures were the comparison of the mean telangiectasia score, meibum expressibility score, meibum quality score, and meibomian gland atrophy score between eyes with moderate to severe Demodex blepharitis (collarette grade 2 to 4, or >10 collarettes) and those with collarette grade 0 (0-2 collarettes). Right and left eyes were analyzed separately.</p><p><strong>Results: </strong>The mean telangiectasia, meibum quality, and meibomian gland atrophy scores were statistically significantly worse in the collarette grade 2-4 group than in those in the collarette grade 0 group for both right and left eyes (even adjusting for age). There was a positive correlation between collarette grade and telangiectasia, meibum quality and meibomian gland atrophy scores.</p><p><strong>Conclusion: </strong>Structural and functional measures of MGD were significantly worse in eyes with collarette grade 2-4 than in those with collarette grade 0. Clinicians should routinely examine their patients for Demodex infestation and signs of MGD and treat both conditions as needed, especially in the perioperative setting.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Intraocular Lens Power Calculation Based on Distance from Haptic to Principal Object Plane.","authors":"Youngsub Eom, Seul Ki Yang, Minji Woo, Jae-Ik Kim, Kwang Eon Choi, Dong Hyun Kim, Hwa Lee, Young-Woo Suh, Jong Suk Song, David L Cooke","doi":"10.1097/j.jcrs.0000000000001611","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001611","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of the distance from the most-anterior surface of the optic to the principal object plane (POP) and from the foremost haptic to the principal object plane (H-POP) on the intraocular lens (IOL) power calculation.</p><p><strong>Setting: </strong>A tertiary hospital.</p><p><strong>Design: </strong>Optical simulation and retrospective cross-sectional study.</p><p><strong>Methods: </strong>The optical simulation study plotted changes in the POP and H-POP as a function of IOL power using ICB00 IOL configuration data. The clinical study included 102 eyes of 102 patients implanted with ICB00 IOL to examine the correlation between changes in both the POP and the H-POP, and the prediction error calculated using the Barrett Universal II formula with varying IOL power.</p><p><strong>Results: </strong>The ICB00 IOL showed minor fluctuations in the POP (0.21 mm to 0.30 mm) with changing IOL power. The H-POP increased stepwise from 5.0 D, peaking at 0.60 mm at 16.0 D, then decreased to a minimum of 0.14 mm at 34.0 D. The prediction error graph primarily mirrored the pattern of changes in the H-POP rather than the POP with varying IOL power. Linear regression showed a significant myopic shift in prediction error as IOL power increased beyond 16.0 D (Y = -0.069X+1.420, R2=0.178, p<0.001).</p><p><strong>Conclusion: </strong>For the ICB00 IOL, the H-POP has more impact on IOL power calculation than the POP itself. For more accurate IOL power calculations, it is essential for all IOL manufacturers to provide comprehensive information on both optic and haptic geometries, which will enable the precise calculation of H-POP.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toxic Anterior Segment Syndrome: A 2012-2022 Update on the Most Common Causes.","authors":"Melissa Yao, Shwetha Mudalegundi, Kevin Eid, Nour Bundogji, Neil Kelkar, Liliana Werner, Nick Mamalis","doi":"10.1097/j.jcrs.0000000000001610","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001610","url":null,"abstract":"<p><strong>Purpose: </strong>To identify trends in the reporting of toxic anterior segment syndrome (TASS) to the American Society of Cataract and Refractive Surgery (ASCRS) TASS Force from 2012-2022.</p><p><strong>Setting: </strong>John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>TASS questionnaires on instrument cleaning and sterilization, and extraocular and intraocular products used during cataract surgery were available on the American Society of Cataract and Refractive Surgery website. A retrospective analysis of questionnaires submitted by surgical centers reporting cases of TASS was performed between January 1, 2012, and December 31, 2022, to identify commonly held practices that could cause TASS.</p><p><strong>Results: </strong>Data from 77 questionnaires were analyzed. The reporting centers performed 56,319 cataract surgeries and reported 539 cases of TASS from January 1, 2012, to December 31, 2022. Common practices associated with the TASS outbreaks in the surveys included re-use of single-use cannulas, phacoemulsification, and irrigation/aspiration tips (69%), use of enzymatic cleaners (40%), inadequate flushing of phacoemulsification and irrigation/aspiration handpieces (27%), reuse of phacoemulsification tubing (22%), use of preservative-containing intracameral anesthetic (18%), and addition of antibiotics to balanced salt solution (17%).</p><p><strong>Conclusions: </strong>The surveys identified commonly held practices associated with TASS while showcasing trends over the past 10 years. Understanding these findings and the safe alternatives will allow surgical center personnel to change their practices as needed to prevent this complication.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital vs manual axis marking for toric phakic intraocular lens alignment: prospective randomized intraindividual trial.","authors":"Wolfgang List, Martin Dirisamer, Wolfgang Johann Mayer, Mehdi Shajari, Wilfried Glatz, Jakob Gran, Andreas Wedrich, Gernot Steinwender","doi":"10.1097/j.jcrs.0000000000001553","DOIUrl":"10.1097/j.jcrs.0000000000001553","url":null,"abstract":"<p><strong>Purpose: </strong>To compare visual and refractive outcomes and postoperative axis alignment for toric implantable collamer lens (ICL) implantation in astigmatic myopia using manual vs digital marking techniques.</p><p><strong>Setting: </strong>Department of Ophthalmology, Medical University of Graz, Graz, Austria.</p><p><strong>Design: </strong>Prospective randomized single-centered intraindividual comparison.</p><p><strong>Methods: </strong>Patients undergoing bilateral toric ICL implantation for myopia with astigmatism ≥0.5 diopters (D) were enrolled. Patients received both marking techniques, and randomization was performed. Postoperative retroillumination photography assessed axis alignment, and visual and refractive parameters were evaluated. Duration of the surgeries was recorded.</p><p><strong>Results: </strong>The study included 20 patients and 40 eyes. Preoperative visual and refractive parameters showed no significant differences. Postoperatively, residual astigmatism ( P = .824) and spherical equivalent ( P = .309) were comparable. No notable differences between right and left eyes in preoperative ( P = .371) and postoperative ( P = .824) astigmatism were observed. Although slight, corrected distance visual acuity (CDVA) increased in both groups postoperatively ( P = .381). Gain in CDVA was comparable between marking techniques ( P = .637). Safety and efficacy indices were comparable ( P = .991 and P = .189, respectively). Postoperative axial misalignment was 2.8 ± 3.1 degrees in the digital- and 4.4 ± 5.1 degrees in the manual group ( P = .260). Vector analysis showed no significant differences between manual and digital marking. Duration remained uninfluenced by the marking technique ( P = .970) and side of surgery ( P = .682).</p><p><strong>Conclusions: </strong>Digital and manual marking techniques provided comparable results in axis alignment, surgical duration, and visual and refractive outcomes. Both methods were viable for precise axis alignment, with digital marking offering a potential advantage in efficacy.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"23-30"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rotational stability of plate-haptic toric intraocular lenses implantation with a capsular tension ring: prospective randomized paired-eye study.","authors":"Xuanqiao Lin, Dongmei Ma, Xiaoyan Han, Zhixiang Hua, Wenqian Shen, Xiaodi Qiu, Lei Cai, Jin Yang","doi":"10.1097/j.jcrs.0000000000001554","DOIUrl":"10.1097/j.jcrs.0000000000001554","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the rotational stability and visual outcomes of plate-haptic toric intraocular lenses (IOLs) with and without a capsular tension ring (CTR) in paired eyes.</p><p><strong>Setting: </strong>Eye and Ears, Nose, and Throat Hospital of Fudan University, Shanghai, China.</p><p><strong>Design: </strong>Prospective, randomized, paired-eye study.</p><p><strong>Methods: </strong>Patients with bilateral cataracts and coexisting regular corneal astigmatism were enrolled. The 2 eyes of each patient were randomly assigned to the CTR or non-CTR (NCTR) group. Both eyes of each patient were subjected to phacoemulsification and toric IOL implantation. CTRs were implanted into the eyes of the CTR group. All patients were followed up for 12 months; uncorrected distance visual acuity (UDVA), residual astigmatism (RAS), and rotational degree of the toric IOL were recorded.</p><p><strong>Results: </strong>186 eyes of 93 patients were eligible for analysis. At each visit, UDVA improved significantly postoperatively in all eyes ( P < .001). The mean rotational degree and RAS were significantly smaller in the CTR group at the 2-week visit ( P < .05). The toric IOLs achieved rotational stability at 1 week postoperatively in the CTR group while at 2 weeks postoperatively in the NCTR group. In the subgroup analyses, CTR coimplantation significantly reduced the 2-week IOL rotation in eyes meeting specific ocular measurements.</p><p><strong>Conclusions: </strong>CTR coimplantation could increase the rotational stability of plate-haptic toric IOLs, by reducing the amount of IOL rotation in the early postoperative period and accelerating the stabilization of IOLs in the capsular bag.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"31-39"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse punctate deposits on the surface of hydrophilic acrylic intraocular lenses early postoperatively: case series and laboratorial analyses.","authors":"Rhaíssa Menelau, Christopher Wallace-Carrete, Edson Nakahara, Liliana Werner, Camila V Ventura, Neil Kelkar, Kevin Eid, Kayo Espósito","doi":"10.1097/j.jcrs.0000000000001562","DOIUrl":"10.1097/j.jcrs.0000000000001562","url":null,"abstract":"<p><strong>Purpose: </strong>To describe cases of hydrophilic acrylic intraocular lenses (IOLs) (Eyecryl, Biotech) exhibiting surface punctate deposits early postoperatively and provide laboratorial analyses of unused lenses of the same model.</p><p><strong>Setting: </strong>Altino Ventura Foundation (FAV), Recife, Brazil, and John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.</p><p><strong>Design: </strong>Observational, descriptive, clinical study with laboratorial analysis.</p><p><strong>Methods: </strong>A thorough review of records of patients undergoing phacoemulsification with Eyecryl implantation in December 2022 at FAV was performed, with data collection. 5 Eyecryl IOLs (never implanted/unused) were removed from the original package and underwent gross examination, light microscopy, and ultrastructural analyses using scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS).</p><p><strong>Results: </strong>Details on 5 clinical cases exhibiting surface IOL deposits on the first postoperative day after uneventful surgery and followed for at least 6 months were included. The deposits disappeared by the 60th postoperative day. No inflammatory or toxic reactions were noted, visual outcomes were favorable, and IOL explantation was not necessary. 3 of the 5 unused lenses undergoing laboratorial analyses revealed diffuse, star-like deposits that could not be removed by thorough irrigation with distilled water. SEM/EDS revealed a composition of the deposits that primarily consisted of carbon and oxygen.</p><p><strong>Conclusions: </strong>Laboratorial findings suggest the etiology of the deposits might be related to the manufacturing/packaging process of lenses from specific lots. Although the deposits did not appear to be associated with inflammatory or toxic reactions in the clinical cases, further investigations are necessary to elucidate their precise origin.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"66-71"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of vaults in eyes with vertical implantable collamer lens implantation.","authors":"Ryuichi Shimada, Satoshi Katagiri, Hiroshi Horiguchi, Tadashi Nakano, Yoshihiro Kitazawa","doi":"10.1097/j.jcrs.0000000000001556","DOIUrl":"10.1097/j.jcrs.0000000000001556","url":null,"abstract":"<p><strong>Purpose: </strong>To design formulas for predicting postoperative vaults in vertical implantable collamer lens (ICL) implantation and to achieve more precise predictions using machine learning models.</p><p><strong>Design: </strong>Retrospective, observational study.</p><p><strong>Setting: </strong>Eye Clinic Tokyo.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 720 eyes in 408 patients who underwent vertical ICL implantation. The data included age, sex, refractions, anterior segment biometric data, and surgical records. We designed 3 formulas (named V1 to V3 formulas) using multiple linear regression analysis and tested 4 machine learning models.</p><p><strong>Results: </strong>Predicted vaults by V1 to V3 formulas were 444.17 ± 93.83 μm, 444.08 ± 98.64 μm, and 444.27 ± 108.81 μm, with a mean absolute error of 127.97 ± 107.92 μm, 126.41 ± 105.86 μm, and 122.90 ± 103.00 μm, respectively. There were no significant differences in error among the V1 to V3 formulas, despite the fact that the V1 and V2 formulas referred to limited parameters (3 and 4, respectively) and the V3 formula referred to all 12 parameters. 2 of 4 machine learning models-Extreme Gradient Boosting and Random Forest Regressor-showed better performance in predicted vaults: 444.52 ± 120.51 μm and 446.00 ± 102.55 μm, and mean absolute error: 118.31 ± 100.55 μm and 118.63 ± 99.34 μm, respectively.</p><p><strong>Conclusions: </strong>This is the first study to design V1 to V3 formulas for vertical ICL implantation. The V1 and V2 formulas exhibited good performance despite the limited parameters. In addition, 2 of the 4 machine learning models predicted more precise results.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"45-52"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal endothelial cell loss with different techniques of nucleus delivery in Manual Small Incision Cataract Surgery- Randomized Controlled Trial.","authors":"Fincy Mol, Swathi Nagarajan, Rajalakshmi Ar, Ezhumalai Govindasamy","doi":"10.1097/j.jcrs.0000000000001605","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001605","url":null,"abstract":"<p><strong>Purpose: </strong>To compare corneal endothelial loss in manual small incision cataract surgery (MSICS) following three different techniques of nucleus delivery (Viscoexpression, Irrigating Vectis, Phacosandwich).</p><p><strong>Setting: </strong>Mahatma Gandhi Medical College and Research Institute, Puducherry, India.</p><p><strong>Design: </strong>Prospective, single blinded, randomized controlled trial.</p><p><strong>Methods: </strong>Willing patients > 40years of age with immature cataract and posted for MSICS were recruited for the study. Those with systemic or ocular comorbidities which may influence corneal endothelium, dilated pupil size of <5mm, intraoperative complications and postoperative corneal haze were excluded. They were randomly divided to one of the three groups (Group 1- Viscoexpression, Group 2- Irrigating Vectis, Group 3- Phacosandwich) for nucleus delivery. Visual acuity and corneal endothelial parameters were recorded preoperatively and postoperatively at 6-8weeks.</p><p><strong>Results: </strong>A total of 90 patients with mean age of 59.13 ± 9.42 years (range 40-82years) were studied with 30 patients in each group. Following MSICS there was a 12.12% (p=0.001) endothelial cell loss. It was 10.81% in viscoexpression group, 11.3% in irrigating vectis group and 14.28% in phacosandwich group. Post hoc analysis with Dunn Bon ferroni test showed endothelial cell loss following viscoexpression and irrigating vectis methods of nucleus delivery were comparable (p=0.096) and significantly lesser (p<0.001) than in Phacosandwich group.</p><p><strong>Conclusion: </strong>There was significant endothelial cell loss following MSICS. Nucleus delivery by viscoexpression and irrigating vectis had similar endothelial cell loss while it was greater with phacosandwich technique.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}