Incidence of Complications in Cataract Surgery according to the Availability of Partial Coherence Laser Interferometry

PURPOSE: To validate the possibility of IOLMaster measurement as a predictor of intraoperative and postoperative complications during phacoemulsification surgery. METHODS: In this study, 2,107 eyes from 1,456 patients who underwent phacoemulsification with intraocular lens (IOL) implantation were divided into two groups according to the possibility of performing optical biometry with the IOLMaster (measurable group: 1,746 eyes from 1,141 patients, unmeasurable group: 361 eyes from 315 patients). The intraoperative and postoperative complication rates were compared between the two groups. RESULTS: Three hundred sixty-one eyes (17.1%) could not be measured using optical biometry. Dense posterior subcapsular cataract (56.0%) was the main factor resulting in failed measurements with optical biometry, followed by anterior subcapsular cataract (12.5%). The rates of posterior capsule rupture and radial tear were significantly higher in the unmeasurable group than in the measurable group (p = 0.001, p < 0.001, respectively). Corneal edema was significantly higher in the unmeasurable group (16.1%) than in the measurable group (5.3%) at postoperative 1 week (p < 0.001). CONCLUSIONS: Possibility of optical biometry measurement can be used as a simple predictor of intraoperative and postoperative complications of phacoemulsification surgery. Surgeons should pay close attention to patients who cannot be measured using IOLMaster.

A Case of Cyclic Exotropia in a Pediatric Patient

PURPOSE: To report a case of cyclic exotropia in a pediatric patient. CASE SUMMARY: There was a pediatric exotropia patient with large variation of prism diopter on alternate cover test at each visits. Not large enough for going through the surgery, she was recommended for the regular check-ups. Sometimes, she was orthophoria and some other times, distinct exotropia. After a few times of follow up, she showed 25-prism diopter exotropia on alternate cover test. The surgery was scheduled and she was admitted after 2 weeks. At the preoperative evaluation, she was orthophoria. She was discharged without having the surgery. To evaluate daily eyeball deviation status, the parents were asked to write a daily note on patient's eye condition. For 3-months, daily strabismus note was thoroughly reviewed and alternate cover test was performed monthly. Patch test was performed twice, and results were 10 and 12 prism diopter exotropia, each. Analyzing the note, a cycle of being the orthophoria and exotropia was noted. With the cycle of 72-hours, she was diagnosed with cyclic exotropia and the surgery was re-scheduled. Ulnilateral lateral rectus recession was performed. Without undercorrection or recurrence, she has been stayed stable over two years of follow up period.