Phacoemulsification without hydroprocedure: A novel technique to deal with posterior polar cataracts.

PURPOSE: The purpose of the study was to describe a new phacoemulsification technique without hydroprocedures in patients of posterior polar cataract (PPC) and determine the posterior capsular rupture (PCR) and postoperative outcomes. METHODS: We conducted a retrospective study with 115 eyes of 77 patients. After capsulorhexis, we insert the phaco tip inside the eye and do shaving of the cortex and epinucleus within the capsulorhexis area. The tip of the phacoemulsification probe is buried deep into the center of the nucleus and a anterior-poserior crack is fashioned. Then, the tip is placed at 7 o'clock position to chop away a triangular piece of the nucleus. A similar maneuver is done at 4 o'clock position to take out another piece. The phacoemulsification tip and the chopper are now positioned at the cracked site of the lower fragments. Using the two instruments, the fragments are now pushed away and easily emulsified. RESULTS: The mean age of the study population was 51.87 ± 14.19 years (range: 22-87 years). Of 77 patients, 39 (50.64%) patients had unilateral PPC and 38 (49.35%) had bilateral PPC. PCR occurred in 9 eyes (7.82%), among them two patients had fragment drop and only 1 (0.87%) patient was left aphakic. Best-corrected visual acuity (BCVA) at postoperative day 30 was 20/20 or better in 102 (88.69%) eyes, 20/32-20/80 was in 11 (9.56%) eyes, and BCVA 20/80-20/200 was in 2 (1.73%) eyes. CONCLUSION: Phacoemulsification without hydroprocedure is a novel technique that can be successfully implemented in cases of PPC and can expect an excellent visual outcome.

Efficacy and safety of dropless cataract surgery.

Purpose: To evaluate the clinical outcome following intraoperative transzonular intravitreal injection of triamcinolone acetonide and moxifloxacin in patients undergoing phacoemulsification cataract extraction with intraocular lens (IOL) implantation. Methods: In this prospective, non-randomized, clinical, interventional study, a total of 200 eyes were enrolled. Patients who voluntarily gave their consent after being informed about dropless cataract surgery along with its pros and cons were included. Those who had glaucoma or were known steroid responders as well as those who were lost to follow-up were excluded. 0.1 ml each of moxifloxacin (500 mg) and triamcinolone acetonide (4 mg) were injected transzonularly following IOL implantation in phacoemulsification cataract surgery with the help of 27G curved cannula. Slit-lamp examination was done to detect cells, visual acuity was noted, and intraocular pressure was measured postoperatively on day 1, 7, 30, 60, and 90. Results: Uncorrected visual acuity (UCVA) greater than 6/9 was achieved in 96% of patients at the end of 3 months. The mean IOP was found to be normal in all the cases at every visit. Twenty patients complained of floaters on postoperative day 1 (D1), which decreased to zero after 60 days (D60). None of the patients needed any eye drop during the entire postoperative period. Conclusion: The study demonstrates that this procedure is advantageous and safe.

Pure phaco: phacoemulsification without ophthalmic viscosurgical devices.

The ophthalmic viscosurgical device (OVD) is an essential part of modern phacoemulsification surgery. Many times, OVDs are blamed for intraocular pressure spikes, toxic anterior segment syndrome, and capsular bag distension syndrome. To avoid these complications, we developed a technique in which phacoemulsification can be done without using OVDs. The irrigating cannula, on a continuous irrigation mode, was introduced through a side port, and capsulorhexis and incision construction were performed under an irrigating balanced salt solution. No hydroprocedure was performed. Phacoemulsification was done by chopping technique. At the end of the procedure, the intraocular lens was implanted by wound assistance technique under a continuous irrigation mode.

Vulnerability of Coastal Communities from Storm Surge and Flood Disasters.

Disasters in the form of coastal storms and hurricanes can be very destructive. Preparing for anticipated effects of such disasters can help reduce the public health and economic burden. Identifying vulnerable population groups can help prioritize resources for the most needed communities. This paper presents a quantitative framework for vulnerability measurement that incorporates both socioeconomic and flood inundation vulnerability. The approach is demonstrated for three coastal communities in Mississippi with census tracts being the study unit. The vulnerability results are illustrated as thematic maps for easy usage by planners and emergency responders to assist in prioritizing their actions to vulnerable populations during storm surge and flood disasters.

Chlorido{4-ethyl-1-[1-(pyrazin-2-yl)ethyl-idene]thio-semicabazidato-κS}bis-(triphenyl-phosphane-κP)silver(I).

The title compound, [Ag(C9H13N5S)Cl(C18H15P)2], crystallizes with four independent mol-ecules in the asymmetric unit, in each of which the Ag atom is in a distorted tetra-hedral coordination, defined by the chloride ligand, the S atom of the neutral ligand and two P atoms derived from the triphenyl phosphine ligands. The thio-semicarbazone acts as a monodentate ligand through its thione S atom. An intra-molecular N-H⋯Cl hydrogen bond occurs in two of the independent mol-ecules. In the crystal, the mol-ecules are assembled through N-H⋯Cl hydrogen bonds, forming chains along [101].