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Clear Corneal Incision (clear + corneal_incision)

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Medical Sciences	100%

Selected Abstracts

Early changes in clear cornea incision after phacoemulsification: an anterior segment optical coherence tomography study

ACTA OPHTHALMOLOGICA, Issue 7 2009
Yuanling Xia
Abstract. Purpose:, We aimed to investigate the ultrastructures of clear corneal incisions 24 hours after phacoemulsification using anterior segment optical coherence tomography (AS-OCT). Methods:, Sixty eyes of 60 patients scheduled for cataract surgery were randomly selected. All eyes underwent the same phacoemulsification procedure carried out by one experienced surgeon. Two-plane temporal clear corneal tunnel incisions were performed. The same types of intraocular lens and implant system were used in all patients. Images of the ultrastructures of the corneal incisions were taken using AS-OCT before and 1 day after surgery. Results:, Corneal thickness increased at the incision site after surgery in all eyes (p < 0.001). Epithelial bulla in the incision region was seen in two eyes (3%). Gaping at the internal aspect of the corneal wound was seen in 42 eyes (70%). Eyes with gaping had thicker localized cornea (p = 0.002). Descemet's membrane detachment was seen in 49 eyes (82%); this seemed to be associated with lower preoperative intraocular pressure (p = 0.01). Conclusions:, Anterior segment OCT provides sensitive and detailed measurements of the ultrastructures in clear corneal incision. [source]

Anterior chamber parameters measured by the Pentacam CES after uneventful phacoemulsification in normotensive eyes

ACTA OPHTHALMOLOGICA, Issue 5 2009
Özlenen Ö. Uçakhan
Abstract. Purpose:, We set out to quantify changes in the anterior chamber volume (ACV), anterior chamber depth (ACD) and anterior chamber angle (ACA) measurements obtained by the Pentacam rotating Scheimpflug camera following uneventful phacoemulsification surgery in normotensive eyes with open iridocorneal angles. Methods:, We enrolled 44 eyes of 44 consecutive patients undergoing cataract extraction in this prospective study. Patients with a history of glaucoma, angle-closure glaucoma or any other concurrent ocular disease were excluded. A detailed eye examination including intraocular pressure (IOP) measurement was performed and ACV, ACD and inferior, superior, temporal and nasal ACA measurements were obtained in each patient eye using the Pentacam Comprehensive Eye Scanner (Pentacam CES) before and 3 months after phacoemulsification and intraocular lens (IOL) implantation with temporal clear corneal incision. Data were compared using paired t -test and one-way anova. Results:, Mean preoperative ACV, ACD, ACA and IOP measurements were 164.7 ± 49.8 mm3, 3.0 ± 0.8 mm, 35.7 ± 10.2 ° and 15.8 ± 3.7 mmHg, respectively. Three months postoperatively, mean ACV, ACD, ACA and IOP measurements were 200.9 ± 33.3 mm3, 3.9 ± 0.9 mm, 41.5 ± 6.5 ° and 13.2 ± 3.9 mmHg, respectively. Postoperative mean ACV, ACD and ACA values in all four quadrants were significantly increased (p < 0.0001, p < 0.0001, p < 0.0001, respectively), whereas IOP was significantly reduced (p < 0.0001). Conclusions:, The Pentacam CES allowed very easy, fast, automatic and non-contact quantification of the anterior chamber parameters pre- and postoperatively in all patient eyes. Measurements obtained confirm that in normotensive eyes with open iridocorneal angles, the ACV and ACD increase and the ACA widens in all quadrants 3 months after uneventful phacoemulsification and IOL implantation. These changes are accompanied by a significant fall in IOP in the short term. [source]

Phacoemulsification in vitrectomized eyes: results using a ,phaco chop' technique

ACTA OPHTHALMOLOGICA, Issue 4 2009
Nishant Sachdev
Abstract. Purpose:, To evaluate the intraoperative and early postoperative complications of phacoemulsification using a ,phaco chop' technique in previously vitrectomized eyes. Methods:, A prospective interventional case series. Seventy-five previously vitrectomized eyes of 73 consecutive patients underwent phacoemulsification using a ,phaco chop' technique via clear corneal incision. Patients were observed for any intraoperative or early postoperative complications. Results:, Fifty-four eyes (72%) had predominant nuclear sclerosis or posterior subcapsular cataract. The intraoperative findings included intraoperative miosis [seen in 21 eyes (28%)] and posterior capsule plaques [in 15 eyes (20%)]. No other significant intraoperative complication (posterior capsule rupture, zonular lysis or dropped nuclei) was observed. In the early postoperative period, one patient had massive serous choroidal detachment, which resolved with conservative treatment. Mean preoperative visual acuity (LogMar scale) was 0.74, which improved to 0.36 postoperatively (p < 0.001). Conclusion:, Phacoemulsification using a ,phaco chop' technique is a safe procedure in vitrectomized eyes. [source]

Incidence of endophthalmitis after cataract surgery in Japan

ACTA OPHTHALMOLOGICA, Issue 8 2007
Tetsuro Oshika
Abstract. Purpose:, To estimate the incidence rate of endophthalmitis after cataract surgery performed by Japanese surgeons. Methods:, A sample of 20% of members of the Japanese Society of Ophthalmic Surgeons was randomly selected. Each member was sent a postal survey asking for information on the number of cataract surgeries performed in 2003 and the number of postsurgery cases of endophthalmitis. Results:, Replies were received from 78.7% (513/652) of survey recipients. The total number of cataract surgeries was 100 539, among which 52 cases of endophthalmitis occurred, resulting in an overall incidence rate of 0.052%. Incidence rates were 0.049% (38/78 170) for scleral incision phacoemulsification and 0.043% (9/20 894) for clear corneal incision phacoemulsification, with no significant difference between groups. The average annual volumes of surgery were 210 and 280 cases for surgeons who preferred scleral incision and clear corneal incision, respectively. There was a significant difference between volumes (Student's t -test, p < 0.01). The incidence of endophthalmitis was significantly lower with high-volume (> 300 cases/year) surgeons than with low-volume (, 300 cases/year) surgeons (0.040% versus 0.066%, chi-square test, p < 0.05). Conclusions:, The incidence of endophthalmitis after cataract surgery in Japan as estimated by a postal survey was low (0.052%) and consistent with rates reported previously. Surgeons who preferred clear corneal incision performed significantly more surgeries annually, but the incidence of endophthalmitis was similar between scleral and clear corneal incision phacoemulsification surgery. [source]

Experimental model for analyzing cutting resistance by various knives for cataract surgery

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2010
Takeshi Ide MD PhD
Abstract Background:, The trend in current cataract surgery towards clear corneal incision and sutureless procedures makes us realize the importance of wound construction. For optimal surgical outcomes, we need good surgical instruments. In this study, we employed a resistance recording system to analyze the characteristics of seven commercially available disposable cataract knives and to find clues for the future development of ,good' cataract knives. Methods:, The cutting resistance was recorded during perpendicular penetrations of porcine scleral tissues by cataract knives. This data was processed and analysed mathematically with MATLAB software (The MathWorks, Inc, Natick, MA, USA) to see the resistance wave shapes and their derivatives to show the products' differing characteristics. Results:, The wave shapes demonstrated product-dependent characteristics. The average maximum penetration resistance varied from 86.4 to 233 mN. The first order time derivatives also showed distinctive wave shapes. Conclusion:, We used an experimental model to analyze one aspect of a knife's character. This model can help give clues for future developments, although this is the initial step. [source]

Endophthalmitis in the western Sydney region: a case-control study

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2001
Somsak Lertsumitkul FRACO
ABSTRACT Background: A retrospective case-control study was conducted to investigate risk factors for endophthalmitis following routine intraocular surgery. Methods: A review was performed of consecutive cases of endophthalmitis from three teaching hospitals in the western Sydney region and matched controls from the same institutions between 1996 and 1998. Results: There were 31 cases and 66 controls. Eighty procedures were phacoemulsification, 15 conventional extracapsular cataract extraction, and two were penetrating keratoplasties. Of the 80 patients who had phacoemulsification surgery, 50 had a clear corneal incision, and 26 had a scleral incision (four were unknown). Logistic regression showed an increased risk of endophthalmitis with surgical complications (P = 0.002) and clear cornea temporal incisions (P = 0.007). Risk of endophthalmitis was reduced with use of subconjunctival injections (P = 0.008). The yield for the Gram stain was 47% and for culture was 67%. Anterior chamber tap in addition to vitreous biopsy alone did not increase the yield for microorganism (P = 0.78). Mean visual acuity on presentation was hand movement with 13 patients (50%) showing visual improvement following intravitreal injections of antibiotics (P = 0.003). Visual prognosis did not correlate with presenting visual acuity but appeared to be better in those who grew Staphylococcus epidermidis or were culture negative. Conclusions: Although this study is unable to draw definite conclusions regarding risk of endophthalmitis in clear corneal temporal cataract surgery, sufficient data suggest the importance of incision type and location. Surgical complication is an important risk factor for endophthalmitis. Use of subconjunctival antibiotic injections at the conclusion of the procedure is recommended. [source]