ABSTRACT
Epithelial basement membrane dystrophy(EBMD)is a common anterior corneal dystrophy with hidden and easily missed clinical manifestations. Patients usually complain of mild blurred vision or foreign body sensation, or occasional pain at night or immediately after opening the eyelid in the morning. Slit-lamp examination revealed irregular, amorphous corneal surfaces, fingerprint-like linear lesions, and punctate or bubble-like lesions. EBMD has a significant impact on preoperative biometrics and intraocular lens power calculation, which can lead to inaccurate measurement and postoperative refractive accident, and cataract surgeons must be aware of this. This article reviews recent research and conference reports on the impact of EBMD on cataract surgery, as a reference for refractive cataract surgeons, thus improving the preoperative diagnosis and detection rate, so as to provide the optimal treatment plan for patients.
ABSTRACT
With the rapidly improvement of people's living standard and diversification life style, obtaining better visual quality has become a new goal of cataract surgery. Corneal astigmatism directly affects the selection of functional intraocular lens(IOL)in cataract surgery and the recovery of postoperative visual function. The types of corneal astigmatism are no longer limited to a single astigmatism value, but subdivided into anterior corneal astigmatism, posterior corneal astigmatism, total corneal astigmatism and corneal higher order astigmatism. The corresponding examination equipment and technology are also updated. According to the characteristics and application of different equipment, clinicians can select appropriate examination equipments to evaluate the preoperative corneal astigmatism, so as to provide reference for formulating more accurate refractive cataract surgery planning. It is important for the axis and power calculation of Toric IOL and the selection of multifocal IOL. This paper reviews the recent progress of corneal astigmatism examination before cataract surgery.
ABSTRACT
@#With the continuous progress and development of modern surgical equipment, the types of intraocular lens and the continuous improvement of people's requirements for visual quality, cataract surgery has been transformed from traditional vision restoration surgery into a high-quality and high-demand refractive surgery. Piggyback intraocular lens implantation was originally a new surgical method for clinicians to implant two or more posterior chamber intraocular lenses in patients' eyes to correct hyperopia or secondary correction refractive errors after cataract surgery. With the birth and promotion of functional lenses in recent years, this surgical method has been applied to the field of refractive cataract surgery, which expanded the application of functional intraocular lens and achieved good postoperative effect. This review discusses the development and current clinical application of Piggyback intraocular lens implantation, and further expounds its development trend in the future.
ABSTRACT
Corneal astigmatism in patients with cataract is very common,but it could not be accurately corrected during previous cataract surgery,which usually affects the visual quality seriously.The accurate measurement of corneal astigmatism power and meridian before surgery is key to the effective correction of astigmatism during the cataract surgery by either the determination of astigmatic keratotomies or the selection and implantation of toric intraocular lenses (IOL).The combination of IOL Master for sphere,the Pentacam for the total corneal refractive power and VERION Digital Marker for surgical orientation can provide promising refractive examination,treatment and good postoperative outcomes.Preexsisting astigmatism can be corrected during cataract surgery by modifying incision,performing arcuate keratotomy,or implanting a toric IOL.Femtosecond laser arcuate keratotomy combined with phacoemulsification is an effective,safe and precise method for the correction of low to moderate corneal astigmatism power,and it can improve visual acuity in cataract surgery candidates.Further work is required to establish corneal biomechanics numerical simulation and nomography protocol for cataract refractive surgery so as to improve the predictability and accuracy of femtosecond laser-assisted astigmatic keratotomy during refractive cataract surgery.
ABSTRACT
We investigated pseudophakic residual astigmatism in order to minimize postoperative refractive astigmatism. We examined 110 eyes of 87 patients who had undergone phacoemulsification with small incision and posterior chamber intraocular lens (IOL) implantation. Corneal astigmatism was measured using an autokeratometer (RK-5, canon), refractive astigmatism by manifest refraction, and residual astigmatism by vector analysis. Mean pseudophakic residual astigmatism was +0.47 X 176degrees, predominantly against-the-rule. Variations of pseudophakic residual astigmatism according to sex, age and IOL type were not statistically significant. When performing cataract surgery as refractive surgery, we may consider that pseudophakic residual astigmatism is approximately 0.50D against-the-rule.