RESUMO
Background: Posterior polar cataracts are challenging even for skilled cataract surgeons due to the high risk of posterior capsule rupture and vitreous loss during cataract surgery; hence, it is important to know how to manage such cases. Purpose: In this video, we describe the necessary precautions and steps to be taken to prevent and manage complications in phacoemulsification cataract surgery for posterior polar cataracts. Synopsis: The video contains ten tips to follow to avoid complications while performing phacoemulsification cataract surgery in patients with posterior polar cataracts and includes preoperative identification on slit?lamp examination, size of capsulorhexis, avoidance of hydrodissection, technique of nucleus management, viscoelastic injection to keep the anterior chamber formed, epinucleus and cortical matter removal, posterior capsular rupture management, anterior vitrectomy, and intraocular lens (IOL) implantation in eyes with posterior capsular rupture. Highlights: The video highlights ten different steps to be followed in the surgical management of patients with posterior polar cataract which, if followed meticulously, can give excellent outcomes in these patients. Conclusion: Posterior polar cataracts can be managed with phacoemulsification,with good visual outcomes if these precautions are followed.
RESUMO
Background: Contact lenses continue to play an important role in the effective management of keratoconus. To report visual and functional outcomes of various types of contact lenses in keratoconus patients at a tertiary referral centre. Methods: Study design: Prospective Cohort Study. 100 eyes of 51 patients with keratoconus were fitted with contact lenses with follow up at one and six months and evaluated. Statistical analysis: Paired t test, Chi Square test. Results: Best contact lens corrected visual acuity was better than best spectacle corrected visual acuity (p= 0.000).78 % patients were fitted with RGP, 12% with Rose K, 6 % Soft, 2% Piggy Back and 2% with Kerasoft IC lenses. Soft lens were preferred in mild keratoconus, RGP for moderate and Rose K, Piggy Back and Kerasoft IC lenses for severe keratoconus. The mean daily wear among the lenses was 7.59 hours per day with Rose K lenses having maximum wearing time of 8.33 hours. Comfort and tolerance level was maximum in Rose K, Piggy Back, Kerasoft IC and RGP lens users whereas it was less in the soft lens group. No significant complications were noted with contact lens use. Conclusion: Contact lenses continue to play an important role in the effective management of keratoconus. With the advent of newer designs of contact lenses for keratoconus it is possible to customize the lenses to optimize patient’s requirement visually and functionally.