ABSTRACT
Background:Corneal endothelial cells are susceptible to mechanical trauma from ultrasound energy during phacoemulsification. Several studies have reported various results of phacoemulsification effect on corneal endothelial cells between diabetic and non-diabetic patients due to stressful events. Present study was aimed to evaluate corneal endothelial density, hexagonality and Central Corneal Thickness (CCT) changes between diabetic and non-diabetic patients at early postoperative period and 1 month after phacoemulsification.Material And Methods:Specular microscopy examinations prior to phacoemulsification and at early postoperative period and 1 months after phacoemulsification were performed on diabetic and non-diabetic groups in grade 2 and grade 3 nuclear sclerosis. Laterthe changes in endothelial density, the percentage of hexagonality, and Central corneal thickness were evaluated.Result:Mean age of 120 study sample was 58.45 years (standard deviation –8.498 years), with the highest 74 years and lowest 43 years. Therewere 53 (44%) females and 67 (56%) males in the study. 42 (35%) samples were from 51-60 years age group followed by 37 (30.83%) subjects in 61-70 years age group. Mean corneal endothelial cell density decreases after cataract surgery in comparison with pre-operative density among study samples. Mean pre-operative corneal endothelial cell density was lower in diabetics in comparison with non-diabetics, and the difference was statistically significant. Cell density count decreases after cataract surgery inboth groups with significant difference between two groups. Mean corneal endothelial cell morphology (hexagonal cell percentage) decreases after cataract surgery in comparison with pre-operative density among study sample s. Central corneal thickness increases in early postoperative period followed by normalisation at day 30.Conclusion:Diabetic group showed greater hexagonality decrease compared to non-diabetic group at 1 month after phacoemulsification. It is suggested that diabetic corneal endothelium requires additional care and protective measures during cataract surgery to minimize surgical trauma. There were no statistically significant differences in the endothelial loss and Central corneal thickness changes between the diabetic and non-diabetic group at 1 month follow up after phacoemulsification.
ABSTRACT
Background:Phacoemulsification requires a smaller incision, few or no stitches are needed and the patient's recovery time is usually shorter when using a foldable IOL.Limbal Relaxing Incisions, or LRIs, are partial thickness corneal incisions strategically placed to reduce or eliminate pre-existing astigmatism duringcataractsurgeryorrefractivelensexchangesurgery. Present study was aimed to evaluate the visual and refractive outcome in patients undergoing limbal relaxing incision during clear corneal phacoemulsification surgery with foldable intra ocular lens.Material And Methods:Present study was single-center, prospective, observational study, conducted in patients of age more than 18-75 years, with clear cornea and regular astigmatism on keratometry, with preoperative astigmatism more than or equal to 0.5D on keratometry, fit for phacoemulsification cataract surgery with foldable IOL.Result:A total of 44 eyes of 44 patients who for cataract phacoemulsification surgery, mean age of the patient was 56.98 ± 05.98 years. Refractive acceptance preoperatively was 0.50 D to 2.0 D.Onslit lamp examination showed most common Cataract Nucleus grade is NS 3 with PSC preoperatively. We observed improved diopteric difference by automated keratometry on postoperative 90th day as compared to preoperative values. Majority of patients had Preop Keratometric Difference (K1-K2) of 1.5 D, all required LRI Incisions length of 4 clock hours (60°).The difference between the visual acuity preoperatively and post operatively was found to be statistically significant with a p<0.01 by employing the statistical test Analysis of Variance (ANOVA). Visual outcome a change after limb relaxing incisions statistically significant. Keratometry changes preop and postop is statistically significant with p value <0.001.Conclusion:Visual and refractive outcome changes as improved best corrected visual acuity (BCVA), decrease in Corneal Astigmatism was noted in patients undergoing limbal relaxing incision during clear corneal phacoemulsification surgery with foldable intra ocular lens
ABSTRACT
Background:Surgically induced astigmatism (SIA) is astigmatism that is created by incisions in cataract surgery; change in both the power and to a lesser degree, orientation of the principal meridians following a corneal incision. Prese nt study was aimed to study change in vision and astigmatic refractive error postoperativelyin patientsundergoing clear corneal phacoemulsificationsurgerywithfoldableintraocularlens.Material And Methods:Present study was hospital based, prospective, observational study, conducted in patients posted for phacoemulsification cataract surgery with foldable IOL with clear cornea and regular astigmatism on keratometry, with preoperative astigmatism more than or equal to 0.5D on keratometry, willing to participate in study.Result:In present study,44 eyes of 44 patients were considered for study. Mean age of the patient is 56.98 ± 5.98 years. There were 29 males and 15 females. Right eye surgery was done in 18 eyes and left eye surgery was done in 26 eyes. Refractive acceptance preoperatively was 0.50 D to 2.0 D. Mean IOL power was 22.7 ± 0.801. Preoperatively mainly eyes had best visual activity between 6/24 to 6/18 while visual activity range from 6/60 to 6/12. Improved vision postoperatively day 90th where vision was 6/6 unaided in 24 eyes out of44 eyes and 6/9 in 14 eyes respectively. Majority of patients had Preop Keratometric Difference (K1-K2) of 1.5 D, all required LRI Incisions length of 4 cloc k hours (60°). On postoperative 90th day, improved dioptric difference by automated keratometry ascompared to preoperative values. LRI was slightly more effective in patients above 50 years as compared to in patients below 50 years.Conclusion:In patientsundergoing clearcornealphacoemulsification surgery with foldable intra-ocular lens, postoperatively improved vision and reduced astigmatic refractive error is noted.