Phacoemulsification in eyes with cataract and pseudoexfoliation syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

? AIM: To evaluate the visual outcomes and intraoperative and postoperative complications of phacoemulsification surgery in patients with cataract and pseudoexfoliation syndrome ( PEX ) and the usage of proper surgical techniques and appropriate devices intraoperatively.?METHODS: Sixty-seven eyes of 53 patients with PEX and cataract who had undergone phacoemulsification and intraocular lens ( IOL ) implantation surgery were evaluated retrospectively. The mean age was 71. 68 ± 9. 96 (53-89)y, and there were 24 (45%) males and 29 (55%) females. Nuclear, cortical, posterior subcapsular, and mature cataracts were all represented.? RESULTS: Nuclear cataract was significantly more common than other types ( P = 0. 00 ). The mean preoperative best corrected visual acuity ( BCVA) was 0. 99 ± 0. 30 ( SD ) ( 0. 40 - 1. 50 ) logMAR, and the mean postoperative BCVA was 0. 32±0. 31 (SD) (0. 00-1. 00) logMAR (P=0. 00). Iris retractors were used in 12 (18%) eyes. Capsular tension ring ( CTR) implantation was used in 15 ( 22%) eyes, it was planned in 8 ( 12%) and unplanned in 7 (10%). Posterior capsule rupture occurred in 4 ( 6%) eyes, and vitreous loss occurred in 2 ( 3%) eyes. Anterior vitrectomy was performed in these 2 eyes. Conversion to extracapsular cataract extraction ( ECCE ) was needed in these 2 ( 3%) eyes due to large posterior capsular rupture. Persistent corneal edema was observed in 4 (6%) eyes, and anterior chamber reaction in 5 (7%) eyes. IOL dislocation occurred in 4 ( 6%) eyes, but repositioning was only needed in 1 (1. 5%) eye. Posterior capsule opacification ( PCO ) requiring Nd: YAG laser capsulotomy developed in 13 (20%) eyes.?CONCLUSION: Postoperative visual acuities of patients with cataract and PEX are satisfactory. However, intraoperative and postoperative complications like posterior capsule rupture, vitreous loss, conversion to ECCE, persistent corneal edema, anterior chamber reaction and IOL dislocation may be observed. To avoid these complications, proper surgical techniques and the use of appropriate devices intraoperatively are essential.

The Surgical Result of Phacoemulsification Cataract Surgery according to Pupil Size

PURPOSE: To evaluate surgical results of phacoemulsification cataract surgery with respect to pupil size and iris retractors and to compare the effects of iris retractors according to the pupil size. METHODS: This retrospective study included 90 eyes that underwent phacoemulsification cataract surgery. All of the eyes had a maximally dilated pupil size of 7 mm or smaller. RESULTS: When the patients were evaluated according to pupil size, we found no difference in BCVA (best-corrected visual acuity) and phaco power x time between patients who had surgery involving iris retractors and those who did not. However, in patients with pupil sizes 3 mm or smaller, we did observe a statistically significant decrease in endothelial cell density (CD) when the iris retractor was used compared to when the retractor was not used (p<0.05). A comparison of preoperative and postoperative BCVA measurements revealed a significant BCVA increase in eyes with pupils larger than 3 mm. In contrast, in eyes with pupils smaller than 5 mm, significant decreases in CD were found when the preoperative and postoperative measurements were compared. CONCLUSIONS: In this study, we found that the iris retractor is useful for protecting corneal endothelial cells when the pupil size is smaller than 3 mm.

Phacoemulsification Using Microhook Iris Retractor for the Management of Ectopia Lentis in Marfan Syndrome

PURPOSE: We evaluated the clinical results of phacoemulsifacation using microhook iris retractor for the management of ectopia lentis in Marfan syndrome. METHODS: Seventeen eyes of 9 patients with Marfan syndrome were included. All the patients had undergone phacoemulsifacation with microhook iris retractor capsule stabilization between May 1997 and January 2000. RESULTS: Mean patient age was 11.6 +/-8.2 years old. Superior nasal(38%) and superior temporal(38%) were the most common direction of lens dislocation. Fifteen eyes demonstrated improvement in best corrected visual acuity by 2 lines or more following average follow-up period of 22.9 +/-9.2 months. As postoperative complications retinal detachment developed in 3 eyes. CONCLUSIONS: Phacoemulsifacation using microhook iris retractor for capsule stabilization appears to be a good technique for the management of ectopia lentis in Marfan syndrome.