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Aims: The study aimed to assess the post-operative presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) from six weeks and above post-surgery, of patients operated for age-related cataract with biometry-calculated IOL power and available IOL power implantation, in two hospitals in Jos, Nigeria.Study Design: Retrospective cross-sectional survey.Place and Duration of Study: Eye units of two mission Hospitals in Jos namely; Bingham University Teaching Hospital and the Faith Alive foundation Hospital, between June and August 2021.Methodology: Patients aged 40 years and above, who had undergone surgery for age-related cataract in the preceding 18 months in two hospitals in Jos and were six weeks or more post-surgery were consecutively enrolled into the study, after obtaining informed consent. Socio-demographic data and surgical history were obtained from patients and their surgical records. The PVA and BCVA were assessed and categorized based on World Health Organization guidelines. Results: A total of 87 patients were examined within the study period. Post-operative PVA was good (?6/18) in 32 (36.8%), borderline (<6/18-6/60) in 41 (47.1%) and poor (<6/60) in 14 (16.1%) participants. After refraction, the proportion of good outcomes increased to 78.2% with only 8.1% of outcomes remaining poor. Biometry-calculated IOL power and available IOL power use did not significantly influence visual outcome (P=.645 and P=.146 for PVA and BCVA respectively).Conclusion: Majority of participants had post-operative PVA in the borderline category with residual uncorrected refractive error as the principal cause. Regardless of the IOL power implanted, surgery for age-related cataract enhanced patients’ vision. This study has shown that the presence of biometry is a guarantee of refractive success. Hence, refractive outcome audits are essential.
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Purpose: To evaluate the outcomes of surgical intervention in cases of ectopia lentis. Methods: This retrospective study included all cases of ectopia lentis that presented between June 2015 and March 2019 in a tertiary care center. They were reviewed retrospectively. The corrected distance visual acuity (CDVA), severity of lens subluxation, type of surgery, intra?operative and post?operative complication, and specular count were recorded. Results: Seventy?eight eyes of 57 cases with a mean age at surgery of 14.73 years were analyzed. Intra?lenticular lens aspiration was the most common (n?62/78; 79.5%) surgical procedure followed by lens aspiration, intra?capsular cataract extraction, phaco?aspiration, and pars?plana lensectomy. Simultaneous intra?ocular lens (IOL) implantation was performed in 46.2% (n?32/78) of the eyes. The mean CDVA improved from 0.85 ± 0.55 logMAR to 0.44 ± 0.29 logMAR at 6 weeks follow?up. The post?operative CDVA was significantly better in the pseudo?phakic group compared to the aphakic group (p?0.02). The patient’s age at the time of surgery and the degree of subluxation did not impact the final visual outcome. Intra?operative complication included vitreous hemorrhage (n?1) and lens matter drop (n?1). Post?operative complications were noted in 26.9% of the eyes (n?21/78) with a higher complication rate in the pseudo?phakic group (p?0.00). A second intervention was required in 7.7% of the eyes (n?6/78). Conclusion: Age and degree of subluxation at the time of surgery do not influence the final visual outcome in cases of ectopia lentis undergoing lens extraction surgery. IOL implantation results in better visual outcomes but is associated with a high complication rate.
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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
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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.
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The lens of the eye has been recognized as one of the most radiosensitive tissues. It has been known that a radiation dose of 0.5 Gy or higher can induce radiation cataract. Studies have also demonstrated that long-term exposure to low-dose radiation can increase the risk of lens opacity. However, the specific biologic mechanism of lens opacity induced by low-dose ionizing radiation is still unclear. Many mechanism chains may induce opacity independently or jointly, such as genomic damage in lens epithelial cells, oxidative stress, defects in intercellular communication, and inflammatory reaction, and genetic and epigenetic factors may also play a role. This paper briefly reviews the mechanisms of low-dose ionizing radiation inducing lens opacity as well as the role of genetic susceptibility in its development and progression, in order to provide a scientific reference for the prevention and control of this disease.
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Herein, we report a case of in-the-bag dislocation of a WIOL-CF® polyfocal full-optics intraocular lens (IOL), without a history of trauma. A 56-year-old man was referred to our hospital with the chief complaint of sudden-onset visual disturbance in his left eye. He had undergone uneventful phacoemulsification with WIOL-CF® IOL implantation in the left eye at the local clinic 7 years prior. In fundus examination, IOL-capsular bag complex dislocated into the posterior vitreous was observed. We believe this is the first report of in-the-bag dislocation of a WIOL-CF® IOL that has been subluxated or dislocated in a characteristic pattern, not an in-the-bag pattern.
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Objective To make a summary of radiation-induced changes in ocular lens and retinal lesions based on dynamic follow-up of a patient exposed to a radiation exposure from 192 Ir source accident,in order to provide the information and experience for the clinical diagnosis and treatment of such injury in emergency of a nuclear or radiation accident.Methods The examination methods included eye lens and visual acuity,slit-lamp examination,fundus examination,automated perimetry,optical coherence tomography (OCT) examination,fundus photography,and fundus fluorescein angiography (FFA).The patient was followed-up for 20 months.Comparative analyses were made of the follow-up results.Results One month after 192Ir radiation exposure,the visual acuities in both eyes were 1.0.Mild age-related opacities were observed in peripheral cortex,but the fundus looked normal.Twenty months later,the patient was followed-up.The visual acuities reduced to about 0.6,evident powder-and punctuate-like opacities could be observed in the cortex of the right lens,and mild turbid foci in the posterior polar and capsule.Multiple scotomata appeared in the superior temporal and inferior nasal in the right eye.The macular fovea thickness was not changed significantly in the right eye.Examination with fundus photography demonstrated mild optical nerve atrophy,drusens,and pale optic discs,while FFA examination showed punctuate or flocculent leakages in both eyes.Conclusions The lens opacity could be induced or accelerated by radiation exposure.In addition to the posterior capsule and pole cataracts,punctuate opacity within cortical layer may also occur.It also suggests that cataract and fundus injuries may occur later during long-term follow-up,even though the eyes may look normal during early examination after the patient exposed to the radiation.
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Background: The incidence of ocular injuries in India is estimated to be 20.5% affecting mainly those aged less than 40 years and males. Cataract is the commonest complication after ocular injury resulting from either penetrating injuries from sharp objects like stick or thorn or with blunt trauma by objects like stone, cricket ball etc. The present study aims to find out the visual outcome of traumatic cataract cases. Material and methods: This was a cross sectional study conducted among 40 traumatic cataract cases attending outpatient units of SVRR Government General Hospital, Tirupati during July 2014 to June 2015. A predesigned interview schedule was used to collect the necessary information. All patients had undergone Posterior Chamber Intra Ocular Lens Implantation and visual outcome was assessed after 15 days, 6 weeks, 3 months and 6 months. The results were analyzed using MS excel software and Epiinfo 7 version statistical software. Results: It was found that a large majority of the cases were aged less than 40 years (67.5%) and males (62.5%). The most common type of cataract developed was found to be ‘white soft’ type (47.5%). In 52.5% of patients, the time lag between injury and surgery was found to be 1 week to 1 month. It was found that 70% patients had regained vision (>6/18) after surgery. Conclusion: Posterior Capsular Intra Ocular Lens Implantation is highly effective in restoring vision in traumatic cataract cases. The time lag between injury and surgery should be as short as possible for complete recovery. There should be quick referral of traumatic cataract cases to the specialized ophthalmic care units depending on condition of patients.
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Aims: To study the indications, safety, efficacy, post-operative outcome and complications in patients with primary scleral fixated IOL implantation. Materials and Methods: Forty patients, who underwent primary scleral fixated IOL implantation over a period of 2-years were analyzed for demographic data, indications, post-operative outcome, and complications of the procedure. Results: The study group ranged from 16-30 years. The male:female ration was 1.86:1. Subluxated cataract was the most common indication. All (100%) of our patients showed improvement in vision postoperatively. Complications were early complications like corneal odema, hyphema, iritis, and late complications including cystoid macular edema, secondary glaucoma, and astigmatism No vision-threatening complications including retinal detachment and endophthalmitis were observed. Conclusion: SF-IOLs give good anatomical and visual outcome in patients of cataract with inadequate capsular support.