ABSTRACT
PURPOSE: To compare corneal endothelial cell loss after cataract surgery by phacoemulsification and by Aqualase. METHODS: This was a prospective, randomized study of 75 eyes of 75 patients undergoing cataract surgery. Patients were randomly assigned to receive either phacoemulsification or Aqualase for cataract removal. Specular microscopy was used to calculate endothelial cell counts preoperatively and 3 weeks and 6 months afterwards. Best-corrected visual acuity was also measured. The t-test was used to detect statistical significance. RESULTS: The mean endothelial cell loss was 8.1% in the phacoemulsification group and 6.8% in the Aqualase group. There was no statistically significant difference in the amount of endothelial cell loss or in visual outcome between the 2 groups. The number of Aqualase pulses tended to increase with nuclear density while the phacoemulsification time showed little variation with nuclear subtype. CONCLUSION: Endothelial cell loss after cataract surgery is similar whether phacoemulsification or Aqualase is used. Aqualase can be considered to be as safe as phacoemulsification with regard to corneal trauma and is a useful alternative especially for soft cataracts.
Subject(s)
Cataract/complications , Corneal Endothelial Cell Loss/diagnosis , Endothelium, Corneal/pathology , Phacoemulsification/methods , Aged , Cell Count , Female , Humans , Lens Implantation, Intraocular , Male , Phacoemulsification/instrumentation , Prospective Studies , Pseudophakia/physiopathology , Visual Acuity/physiologyABSTRACT
PURPOSE: To compare the effect of ultrasound (US) phacoemulsification and AquaLase liquefaction (Alcon Laboratories) cataract surgery on the macula using optical coherence tomography (OCT). SETTING: Department of Ophthalmology, Queen Mary's Hospital, London, United Kingdom. METHODS: Sixty-three patients having cataract surgery were randomized to receive US phacoemulsification or AquaLase liquefaction cataract surgery. Macular thickness and volume were evaluated by OCT preoperatively and 2 and 6 weeks postoperatively. The primary outcomes were OCT central macular thickness and best corrected visual acuity at 6 weeks. Secondary outcomes were OCT macular volume and perioperative and postoperative complications. RESULTS: Over the 6-week study, the median increase in foveal thickness in the study eye compared with that in the fellow eye was 11 microm (interquartile range [IQR] -21 to 23 microm) in the AquaLase group and 17 microm (IQR -11 to 33 microm) in the phacoemulsification group (P = .229). A subgroup analysis of diabetic patients found a median increase in foveal thickness in the study eye versus the fellow eye of 2 microm (IQR -14 to 23 microm) in the AquaLase group and 29 microm (IQR 11 to 41 microm) in the phacoemulsification group (P = .07). CONCLUSIONS: The results in this study suggest that AquaLase liquefaction cataract extraction is as safe as standard US phacoemulsification cataract extraction and may carry less risk for the development of postoperative cystoid macular edema. This may be most evident in diabetic patients.
Subject(s)
Cataract Extraction/methods , Macula Lutea/pathology , Phacoemulsification/methods , Aged , Aged, 80 and over , Cataract Extraction/adverse effects , Double-Blind Method , Female , Humans , Lens Implantation, Intraocular , Lenses, Intraocular , Macular Edema/diagnosis , Macular Edema/prevention & control , Male , Middle Aged , Phacoemulsification/adverse effects , Postoperative Complications , Prospective Studies , Tomography, Optical Coherence , Visual AcuitySubject(s)
Anterior Chamber/pathology , Lens Capsule, Crystalline/pathology , Lens Nucleus, Crystalline/pathology , Lens Subluxation/etiology , Phacoemulsification/adverse effects , Corneal Edema/etiology , Gonioscopy , Humans , Lens Nucleus, Crystalline/surgery , Lens Subluxation/pathology , Lens Subluxation/surgery , Postoperative Period , Reoperation , Treatment OutcomeABSTRACT
PURPOSE: To evaluate the effect of pupil dilation on the accuracy of the IOLMaster (Zeiss) in performing biometry and to assess test-retest variability without pupil dilation. SETTING: Ophthalmic outpatient department of a district general hospital. METHODS: This prospective study comprised consecutive patients presenting to a cataract clinic (study group) who had biometry performed with the IOLMaster before and after pupil dilation. A control group was recruited from consecutive patients attending a cataract preassessment clinic who had 2 sets of biometric measurements with the IOLMaster but without pupil dilation. The SRK/T formula was used to calculate intraocular lens (IOL) power. RESULTS: The IOLMaster showed excellent reproducibility in the control group with no significant test-retest variability between the 2 sets of readings. The study group showed a statistically significant change in K2 and average keratometry values (P <.05) but no significant change in axial length or IOL power between undilated and dilated pupil biometry readings. No systematic errors were revealed. CONCLUSIONS: Dilating the pupil did not adversely affect the clinical accuracy of the IOLMaster.
