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Phacoemulsification Surgery (phacoemulsification + surgery)
Selected AbstractsPeribulbar blockade with a short needle for phacoemulsification surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2009W. RIAD Background: Peribulbar blockade is still widely used for phacoemulsification surgery. The potential complications of this technique include central spread, globe perforation and retrobulbar hemorrhage. The 25 mm needle is the most common needle used to perform the block. The aim of this study was to demonstrate the efficacy of a 12.5 mm needle in performing peribulbar blockade for phacoemulsification surgery. Methods: After obtaining the hospital research and the Human Ethics Committees' approval, 200 patients undergoing the phacoemulsification procedure under local anesthesia were enrolled in this descriptive study. Peribulbar blockade was performed with a 27 G, 12.5-mm-long needle. The needle was inserted transcutaneously through the lower eyelid into the inferotemporal quadrant. Digital pressure was applied by the thumb and index fingers around the needle hub during injection. After negative aspiration, a local anesthetic solution was injected until total drop of the upper eyelid was achieved. Ocular akinesia was assessed 10 min after the block using the simple akinesia score. A score of 3 or less was accepted to provide adequate analgesia for the surgical procedure to be performed. If the block was inadequate for surgery after 10 min, supplementary anesthesia was provided using the same needle. Results: Adequate analgesia after the first injection was reported in 90.5% of the patients while 9.5% required supplementary anesthesia. There were no major sight or life-threatening complications. Conclusion: Using a 12.5-mm-long needle for peribulbar blockade produced satisfactory results. This technique is effective for phacoemulsification surgery. [source] Anterior chamber parameters measured by the Pentacam CES after uneventful phacoemulsification in normotensive eyesACTA OPHTHALMOLOGICA, Issue 5 2009Özlenen 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] Preoperative topical cyclopentolate can be omitted when using intracameral lidocaine in phacoemulsification surgeryACTA OPHTHALMOLOGICA, Issue 3 2009Björn Lundberg Abstract. Purpose:, To evaluate the mydriatic effect of topical cyclopentolate 1% when combined with topical phenylephrine 10% and intracameral lidocaine 1% in phacoemulsification cataract surgery. Methods:, We performed a prospective, double-masked, randomized trial including 20 patients with age-related cataract, who were scheduled for unilateral phacoemulsification and intraocular lens (IOL) implantation. Patients were given either two drops of phenylephrine 10% at 30 mins and 15 mins prior to surgery (group 1), or two drops each of cyclopentolate 1% and phenylephrine 10% at the same time points (group 2). All patients were also given lidocaine 1% intracamerally at the beginning of the procedure. Intraoperative pupil sizes were assessed from video-recordings. Results:, Initially, pupil sizes were significantly smaller in group 1 (4.8 ± 1.2 mm versus 6.5 ± 1.4 mm; p = 0.0098), but the lidocaine injection increased the pupil sizes in group 1 significantly, so that pupil sizes in both groups were equalized throughout the surgical procedure. Conclusions:, Preoperative topical cyclopentolate does not enhance mydriasis in phacoemulsification surgery when using intracameral lidocaine and can be omitted when intracameral lidocaine is used. [source] Increased anterior chamber penetration of topical levofloxacin 0.5% after pulsed dosing in cataract patientsACTA OPHTHALMOLOGICA, Issue 2 2009Karin Sundelin Abstract. Purpose:, This study aimed to investigate the rise in aqueous humour (AH) levels of levofloxacin after a specific perioperative pulsed topical drop regimen. Methods:, Thirty patients undergoing phacoemulsification surgery were administered two preoperative drops of levofloxacin 0.5%, 30 mins apart, and three pulsed drops postoperatively, 5 mins apart. Aqueous humour levels of levofloxacin were measured at the start of surgery and from 5 mins to 90 mins after the last postoperative drop. Samples from individual patients were collected at the time of surgery and at one additional sampling interval by aqueous tap, and analysed using a high-performance liquid chromatography assay. Results:, Aqueous humour levels of levofloxacin continued to rise gradually, reaching a mean peak level (Cmax) of 4.4 ,g/ml (± 2.5) at 60 mins after the last postoperative drop was administered. This level exceeded the minimum inhibitory concentration of common ocular pathogens at least fourfold. At 90 mins after the last drop, mean AH levels remained > 3 ,g/ml. Conclusions:, This is the first study to measure AH levels of levofloxacin after postoperative pulsed dosing in humans. Higher AH levels were found than in previously reported studies in which only preoperative drops were given and levels were measured at the time of surgery. Levels of levofloxacin continued to rise for 60 mins after administration of the last postoperative drop, demonstrating that delivery and maintenance of effective antibiotic levels may be achievable with alternative dosing schedules. [source] Incidence of endophthalmitis after cataract surgery in JapanACTA OPHTHALMOLOGICA, Issue 8 2007Tetsuro 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] Endophthalmitis in the western Sydney region: a case-control studyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2001Somsak 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] | ||||||||||