Effects of Continuous Curvilinear Capsulorhexis, Intraocular Lens Decentration and Tilt on Clinical Outcomes

PURPOSE: To evaluate the effects of continuous curvilinear capsulorhexis, intraocular lens (IOL) decentration and tilt on postoperative clinical outcomes after cataract surgery. METHODS: We reviewed 62 eyes of 52 patients who underwent cataract surgery and measured the uncorrected visual acuity, best corrected visual acuity and manifest refraction preoperatively and 3 months postoperatively. IOL decentration on anterior segment photography and IOL tilt on anterior optical coherent tomography were analyzed and correlations of postoperative uncorrected visual acuity, best corrected visual acuity, and higher order aberrations were evaluated. In addition, we inspected the relationship of size and decentration of continuous curvilinear capsulorhexis (CCC) intraoperatively with the change in IOL position postoperatively. RESULTS: The average size of CCC was 5.40 ± 0.51 mm (4.12-6.24 mm) and the average decentration of CCC was 0.30 ± 0.19 mm (0.09-1.21 mm) intraoperatively. The average decentration of IOL was 0.23 ± 0.15 mm (0.00-0.71 mm) and the average IOL tilt was 1.43 ± 0.73° (0.00-4.22°) postoperatively. Intraoperative CCC size and decentration were associated with postoperative IOL decentration (p = 0.01, p < 0.001), but not with IOL tilt (p = 0.69, p = 0.52). There were no significant correlations between IOL decentration and tilt with postoperative visual outcomes and higher order aberrations. CONCLUSIONS: The CCC size and decentration can affect the IOL decentration, but IOL decentration and tilt do not have a significant impact on clinical outcomes after cataract surgery.

Effects of Continuous Curvilinear Capsulorhexis, Intraocular Lens Decentration and Tilt on Clinical Outcomes

PURPOSE: To evaluate the effects of continuous curvilinear capsulorhexis, intraocular lens (IOL) decentration and tilt on postoperative clinical outcomes after cataract surgery. METHODS: We reviewed 62 eyes of 52 patients who underwent cataract surgery and measured the uncorrected visual acuity, best corrected visual acuity and manifest refraction preoperatively and 3 months postoperatively. IOL decentration on anterior segment photography and IOL tilt on anterior optical coherent tomography were analyzed and correlations of postoperative uncorrected visual acuity, best corrected visual acuity, and higher order aberrations were evaluated. In addition, we inspected the relationship of size and decentration of continuous curvilinear capsulorhexis (CCC) intraoperatively with the change in IOL position postoperatively. RESULTS: The average size of CCC was 5.40 ± 0.51 mm (4.12-6.24 mm) and the average decentration of CCC was 0.30 ± 0.19 mm (0.09-1.21 mm) intraoperatively. The average decentration of IOL was 0.23 ± 0.15 mm (0.00-0.71 mm) and the average IOL tilt was 1.43 ± 0.73° (0.00-4.22°) postoperatively. Intraoperative CCC size and decentration were associated with postoperative IOL decentration (p = 0.01, p < 0.001), but not with IOL tilt (p = 0.69, p = 0.52). There were no significant correlations between IOL decentration and tilt with postoperative visual outcomes and higher order aberrations. CONCLUSIONS: The CCC size and decentration can affect the IOL decentration, but IOL decentration and tilt do not have a significant impact on clinical outcomes after cataract surgery.

Meta Analysis of Clinical Studies of Pregnancy and Delivery in Elderly Gravida / 대한산부인과학회지

OBJECTIVE: Our purpose was to identify the age-related inceased risks of the elderly gravida over 35 or 40 years at delivery by clarifying the effects of age and parity, their combination, and their interaction and the relationships of other complications. METHODS: We have made meta analysis about general and clinical characteristics of elderly gravida over the aged 35 or 40 years, based on the 7 domestic theses since 1996 year at the department of Obstetrics and Gynecology. RESULTS: The results were obtained as follows; In elderly gravida over the aged 35 or 40 years at delivery, maternal and neonatal outcomes were generally good, but in study group, there were a high incidence of gestational (preterm delivery, fetal presentation, pregnancy-induced hypertension, gestational diadetes, placenta previa, premature rupture of membranes) complications, uterine myoma during pregnancy and low birth weight in neonate after delivery. CONCLUSION: The increased risks of the elderly gravida over the aged 35 or 40 years at delivery may have been overshadowed by the previous focus on the elderly nullipara. In spite of high incidence of maternal morbidity, the overall maternal and neonatal outcomes were generally good. It is important to recognize what is more important in age-related pregnant-risks of the elderly gravida over the aged 35 or 40 years at delivery to appropriate counsel and manage this group of patients. This informations may be helpful for counsel in elderly gravida over the aged 35 or 40 years who are considering pregnancy.