Analysis of Ultrasonic Emulsification Surgery and Small Incision Cataract Extracapsular Extraction Surgery for Cataract Clinical Treatment Level Improvement

Objective:To analyze the efficacy of ultrasonic emulsification and small incision cataract extracapsular extraction in cataract patients.Methods:96 cataract patients admitted from May 2021 to May 2023 were selected and randomly grouped into group A(ultrasonic emulsification)and group B(small-incision extracapsular cataract extraction),with 48 cases each.Results:At 1 week,1-month,and 3 months post-operation,the visual acuity of group A was higher and the astigmatism value was lower than that of group B(P<0.05);at 12h,24h,and 48h post-operation,the intraocular pressure of group A was higher than that of group B(P<0.05);the thickness of macular area of group A was lower than that of group B at 1 week and 1-month post-operation(P<0.05).Conclusion:Ultrasonic emulsification in cataract patients was slightly better than small incision cataract extracapsular extraction in correcting astigmatism,improving visual acuity,and regulating macular thickness.However,due to the high energy of ultrasonic emulsification,the risk of complications such as high postoperative intraocular pressure was higher.Small-incision extracapsular cataract extraction has better application value in economically disadvantaged areas.

Effectiveness and safety of early lens extraction during par plana vitrectomy for proliferative diabetes retinopathy with mild cataract:a randomized clinical trial

●AIM:To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR)compared to those of PPV with subsequent cataract surgery.●METHODS:This multicenter randomized controlled trial was conducted in three Chinese hospitals on patients with PDR,aged>45y,with mild cataracts.The participants were randomly assigned to the combined(PPV combined with simultaneously cataract surgery,i.e.,phacovitrectomy)or subsequent(PPV with subsequent cataract surgery 6mo later)group and followed up for 12mo.The primary outcome was the change in best-corrected visual acuity(BCVA)from baseline to 6mo,and the secondary outcomes included complication rates and medical expenses.●RESULTS:In total,129 patients with PDR were recruited and equally randomized(66 and 63 in the combined and subsequent groups respectively).The change in BCVA in the combined group[mean,36.90 letters;95%confidence interval(CI),30.35–43.45]was significantly better(adjusted difference,16.43;95%CI,8.77–24.08;P<0.001)than in the subsequent group(mean,22.40 letters;95%CI,15.55–29.24)6mo after the PPV,with no significant difference between the two groups at 12mo.The overall surgical risk of two sequential surgeries was significantly higher than that of the combined surgery for neovascular glaucoma(17.65%vs 3.77%,P=0.005).No significant differences were found in the photocoagulation spots,surgical time,and economic expenses between two groups.In the subsequent group,the duration of work incapacity(22.54±9.11d)was significantly longer(P<0.001)than that of the combined group(12.44±6.48d).●CONCLUSION:PDR patients aged over 45y with mild cataract can also benefit from early lens extraction during PPV with gratifying effectiveness,safety and convenience,compared to sequential surgeries.

More than 10 Years of Experience with Immediate Sequential Bilateral Cataract Extraction (ISBCE)--A Retrospective Study

Background: To evaluate the safety of immediate sequential bilateral cataract extraction (ISBCE) with respect to indications, visual outcomes, complications, benefits and disadvantages. Methods: This is a retrospective review of all ISBCEs performed at Kantonsspital Winterthur, Switzerland, between April 2000 and September 2013. The case notes of 500 eyes of 250 patients were reviewed. Of these 500 eyes, 472 (94.4%) had a straight forward phacoemulsification with posterior chamber intraocular lens implantation;21 (4.2%) had a planned extracapsular cataract extraction;4 (0.8%) had an intracapsular cataract extraction and 3 (0.6%) had a combined phacoemulsification with trabeculectomy. Results: Over 66% of eyes achieved improved visual acuity (at least 3 Snellen lines) following ISBCE. Median preoperative best corrected visual acuity (BCVA) was 0.5 LogMAR;the interquartile range was [0.4, 1] LogMAR. At one week control the median BCVA was 0.3 LogMAR, IQR [0.1, 0.5] LogMAR. At one month the median BCVA was 0.15 LogMAR, IQR [0.05, 0.3] (p < 0.01). There were no sight-threatening intraoperative or postoperative complications observed. Conclusions: ISBCE is an effective and safe option with high degree of patient satisfaction. The relative benefits of ISBCE should be balanced against the theoretically enhanced risks.

A Clinical Analysis of 120 Cases with Traumatic Cataract Treated by Extracapsular Cataract Extraction and Posterior Chamber Intraocular Lens Implantation

Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.

Self-management of cataract extraction among diabetes patients

Background:Diabetes-related cataract extraction is a minor surgery required to regain full vision.One of the recognized factors that can delay or prevent full-vision recovery is poor management,and most of this management is being carried out by patients themselves.Objective:This study aimed to assess the knowledge of diabetes patients on self-management after cataract extraction in two tertiary hospitals in Osun State.Methods:A cross-sectional descriptive design was conducted among 97 diabetes patients who underwent cataract extraction and were attending clinics and follow-up visits in Osun State.A self-structured questionnaire was used for data collection.Results:Moderate knowledge was found among the participants on an appropriate diet(56.7%),prevention of injury risk(57.5%),prevention of infection risk(50.9%),and low knowledge on the technique of administration of eye drop(60.8%)after cataract extraction,whereas 74.7%of the total respondents were knowledgeable on the indication for follow-up visit after cataract extraction,these results were found to be below the expected knowledge level.Conclusion:An intensive and comprehensive educational initiative by nurses should be tailored to meet the specific needs of diabetes patients with cataract surgery.Nurses also need to implement the use of checklist which will enhance learning and improve patient understanding of self-management after cataract extraction.

Efficacy of combined cataract extraction and endoscopic cyclophotocoagulation for the reduction of intraocular pressure and medication burden

AIM： To report on the efficacy of combined endoscopic cyclophotocoagulation（ECP） and phacoemulsification cataract extraction（PCE） with intraocular lens placement for reduction of intraocular pressure（IOP） and medication burden in glaucoma.·METHODS： A retrospective case review of 91 eyes（73patients） with glaucoma and cataract that underwent combined PCE/ECP surgery was performed. Baseline demographic and ocular characteristics were recorded,as well as intraocular pressure, number of glaucoma medications, and visual acuity postoperatively with 12-month follow-up. Treatment failure was defined as less than 20% reduction in IOP from baseline on two consecutive visits（at 1, 3, 6, or 12 mo postoperatively）,IOP ≥21 mm Hg or ≤5 mm Hg on two consecutive visits, or additional glaucoma surgery performed within12 mo after PCE/ECP.·RESULTS： Overall, mean medicated IOP was reduced from 16.65 mm Hg at baseline to 13.38 mm Hg at 12mo（P 0.0001）. Mean number of glaucoma medications was reduced from 1.88 medications at baseline to 1.48 medications at 12mo（P =0.0003）. At 3mo postoperatively,the success rate was 73.6%（95%CI： 63.3, 81.5）, 57.1% at6mo（95% CI： 46.3, 66.6）, and 49.7% at 12mo（95% CI：38.9, 59.6）. Patient demographic characteristics were not associated with treatment success. The only ocular characteristic associated with treatment success was a higher baseline IOP.· CONCLUSION： Combined PCE/ECP surgery is an effective surgical option for the reduction of IOP and medication burden in glaucoma patients. Patients withhigher baseline IOP levels are most likely to benefit from this procedure.

Inhibitory Effect of Short-Term Palpebral Margin Cleaning with Antibiotic Eye Drops on Ocular Surface Flora before Cataract Extraction:A New Preoperative Antibacterial Method

Objective To explore the clinical significance of the combined application of palpebral margin cleaning and antibiotic eye drops in inhibiting bacterial growth in the palpebral margin and conjunctival sacs before cataract extraction.Methods In this study,61 patients(97 eyes)with age-related cataract who underwent phacoemulsification and intraocular lens implantation were selected,and randomly grouped.In the experimental group,the combined application of palpebral margin cleaning with cotton pads and levofloxacin eye drops was given for three days before the surgery.In the control group,levofloxacin eye drops alone were applied for three consecutive days.Bacteria samples from the conjunctival sac and eyelid margins were cultivated and identified before and three days after taking antimicrobial measures,respectively.Results In the experimental group,the positive rates of the two bacteria samples were 100%(50/50)and 40%(20/50)before and 10%(5/50)and 0%(0/50)after the treatment.In the control group,the positive rates of the two bacteria samples were 97.9%(46/47)and 29.8%(14/47)before and 40.4%(19/47)and 10.6%(5/47)after the treatment.The positive rates between the two groups were not significantly different before taking antimicrobial measures(P=0.485 and 0.395),while they were significantly different after taking antimicrobial measures(P=0.001 and 0.024).Conclusion Combined application of eyelid and palpebral margin cleaning with cotton pads and antibiotic eye drops before cataract extraction imparted excellent antibacterial effects.

Liquefaction for cataract extraction

A systematic review of the recent literature regarding the implementation of the liquefaction in cataract surgery and its short-term and long-term outcomes in various parameters that affect the quality of patients＂ life, including visual rehabilitation and possible complications was performed based on the PubMed, Medline, Nature and the American Academy of Ophthalmology databases in November 2013 and data from 14 comparative studies were included in this narrative review. Liquefaction is an innovative technology for cataract extraction that uses micropulses of balanced salt solution to liquefy the lens nucleus. Most studies reported that liquefaction is a reliable technology for mild to moderate cataracts, while fragmentation difficulties may be encountered with harder nuclei.

Graft survival and visual outcome after simultaneous penetrating keratoplasty and cataract extraction

AIM: To evaluate the indications, complications, and visual and graft survival outcomes in eyes that had undergone simultaneous cataract extraction and penetrating keratoplasty (PKP). ·METHODS: We described a retrospective study of 101 patients who had undergone simultaneous cataract extraction and PKP at King Khaled Eye Specialist Hospital between January 1, 2001, and December 31, 2002. All patients were followed up postoperatively with maximum follow-up 68 months. ·RESULTS: The mean age of patients was 61 years. The mean overall follow -up was 27 months. The most common indications for surgery were corneal scarring (45.5% ), previous failed graft (15.8% ), corneal ulcer (12.9% ), Fuchs endothelial dystrophy (8.9% ), stromal dystrophy (2.9% ), and other conditions (14.5% ). Overall, 69 grafts (68.3% ) remained clear at final follow -up. Previous glaucoma or postoperative glaucoma had no statistically significant effects on graft outcome (P 】0.05). The graft rejection rate (17.8% ) was a significant risk factor for failure (P =0.00). Age, gender, indications for surgery, corneal graft diameter, and intraoperative vitreous loss had no statistically significant effects on the PKP outcome (P 】0.05). Postoperative visual acuity was significantly associated with preoperative visual acuity (P 【0.01). ·CONCLUSION: The present study provides evidence that performing a combined procedure results in more rapid visual rehabilitation and good graft clarity.

Factors associated with strabismus after cataract extraction and primary intraocular lens implantation in congenital cataracts

AIM:To evaluate factors associated with the development of strabismus after cataract extraction and primary intraocular lens implantation.METHODS:The medical records of 122 patients,aged1.5mo to 9y,who had undergone cataract extraction with primary intraocular lens implantation between January1993 and August 2011 were reviewed.Fourteen patients(17 eyes)with strabismus before cataract surgery were excluded.Patients were divided into those with congenital bilateral cataracts(64 patients,128 eyes)and those with unilateral cataracts(44 patients,44 eyes).The associations between the development of strabismus and age at cataract surgery,pre-and post-cataract extraction corrected distance visual acuity(CDVA),interocular CDVA difference,nystagmus,surgical method,and secondary cataract were evaluated.RESULTS:Factors significantly associated with the development of strabismus included age at cataract surgery(≤1y),preoperative mean CDVA≤20/100,presence of nystagmus in the bilateral cataract group and postoperative interocular CDVA difference】20/70 in the unilateral group.Postoperative CDVA≤20/100 and preservation of posterior capsule,and presence of secondary cataract were significant factors in both groups.CONCLUSION:Children with congenital cataracts should be monitored carefully after cataract surgery for the development of strabismus,especially when they underwent surgery at age≤1y,and they have nystagmus,large postoperative interocular CDVA difference,poor preoperative and postoperative CDVA,preservation of the posterior capsule,or secondary cataract.

Confocal microscopic evaluation of cornea after AquaLase liquefaction cataract extraction

AIM: The most recent and innovative AquaLase liquefaction technology has offered an alternative to lens extraction. Many studies have investigated its functions and advantages. This article focuses on evaluating the vivo microscopic cornea changes after AquaLase liquefaction by using a laser confocal microscope. METHODS: In this perspective, randomized case study, 37 eyes of 35 patients submitted to cataract surgery were chosen to undergo AquaLase liquefaction cataract extraction. Each patient was assessed before the operation, on the 1(st), 7(th), and 30(th) postoperative days, and 6 months after the cataract extraction. The morphologies and quantitative comparisons of corneal cells and corneal nerves layer by layer were evaluated in vivo with the Heidelberg Retina Tomograph III-Rostock Cornea Module (HRT-III RCM) confocal microscope. ANOVA and Post-Hoc Bonferroni test were carried out to compare the results pre- and post-operation. RESULTS: ANOVA results indicated no post-operation changes for epithelium and anterior stroma cells. Irregular segments of sub-basal nerve fiber were most pronounced seven days post-operation. In the mid and posterior stroma, keratocytes were obvious compared with the preoperative condition. Corneal endothelium cells became obviously swollen in cytoplasm and nucleus. The mid and posterior stroma cell density decreased from the 1(st) to 7(th) postoperative days (P < 0.05). The corneal endothelium cell density decreased (P < 0.05) and did not revert to the preoperative level after six months (P < 0.05). CONCLUSION: Slight microstructural abnormalities were identified in the corneal recovery process after AquaLase liquefaction. AquaLase liquefaction cataract extraction is safe for cornea.

Vitreoretinal surgeons'experience and time interval from pars-plana vitrectomy to cataract extraction

AIM:To identify the association of the vitreoretinal surgeons'experience with the time interval between parsplana vitrectomy(PPV)and cataract extraction(CE).METHODS:Eyes with prior PPV and following CE were included in this retrospective cohort study.The years of practice and the annual case volume were used to describe the surgeons'experience.Multivariable linear regression analysis was used to investigate the relationship between surgeons'experience and the time interval adjusted for the patients age,gender,intraocular tamponade,and case complexity.RESULTS:Of 132430 eyes,1445 eyes were included in this study.In multivariable linear regression analysis,cases performed by surgeons with>20 practice years had longer time intervals compared with surgeons with<10 practice years after adjusted for other variables(β=0.329,95%CI:0.113 to 0.549,P=0.003).No difference in time interval was detected for comparing the lowest with the highest volume groups(β=0.089,95%CI:-0.164 to 0.343,P=0.343).The surgeons'practice years were not directly with the volume.For complicated surgery,the higherpractice-year surgeons had longer time interval than lowerpractice-year surgeons.CONCLUSION:The time intervals from PPV to CE is longer in higher-practice-year surgeons.The surgeons'practice years may have a greater effect on the time interval than annual case volume in high-complexity cases.Matching the complexity of vitreoretinal diseases with the surgeons'practice year should be considered.

Spontaneous resolution of traumatic cataract after removal of a ferrous intravitreal foreign body using external magnetic extraction through a pars plana incision

Dear Editor,I am Dr.Zhi-Tao Su,from the Eye Center,Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.I write to present a case of spontaneous resolution of a traumatic cataract resulted in good visual rehabilitation after removal of a ferrous intravitreal foreign body(IVFB).

PENETRATING KERATOPLASTY COMBINED WITH CATARACT EXTRACTION

The authors report the results of penetrating keratoplasty combined with cataract extraction in 50 cases. The rate of transparent grafts was 62％ after an average follow-up of 19 months. 60％ of the patients restored their vision to 0.1 and better. The rate of transparent grafts and visual improvement did not correlate with the mode of cataract extraction; however, the extracapsular procedure had less vitreous during operation than the intracapsular modality did. The authors recommend that the combined operation be adopted for patients with corneal opacity and cataract, and preferably using the extracapsular mode.

Comparative Evaluation of Extra Capsular Extraction (ECE) with Suture and Small Incision Cataract Surgery (SICS) Manual without Suture in the University Hospital of Bouake (Ivory Coast)

Objective: Cataract is a partial or total opacification of the lens responsible for blindness. The treatment is surgical. The purpose of our study was to evaluate the results of the newly introduced manual small incision cataract surgery (SICS) and compare them with those of the conventional extra-capsular extraction method. Patients and Method: Analytical cross-sectional study was carried out at the ophthalmology department of the University Hospital of Bouaké for a period of 1 year. Results: The two surgical techniques were compared at equal proportions. The average duration of interventions was longer during the sutured Extra Capsular Extraction (ECE) compared to the SICS. Rupture of the posterior capsule with vitreous exit, which was the most observed intraoperative complication, was predominant with ECE with suture (16%) against 8% for SICS. Corneal edema observed in the early postoperative period, was predominant with sutured ECE (30%), against 20% for SICS. Corneal edema, which was more observed with EEC compared to SICS, dominated secondary and late postoperative complications. Post-operative astigmatism induced by ECE with suture was between ?2 and ?4 dioptre in 51.5% of patients and between ?0.5 and ?2 dioptre in 73.91% of SICS. Visual acuity without correction in the early days was better with SICS. Conclusion: In this comparative study of cataract surgery, we noted superimposable results for both techniques. However, the prevalence of pre- and post-operative complications was more frequent with sutured ECE. The technique without suture allows visual recovery and a quick return to normal life.

Pattern of Refractive Correction and Timing of Stage Ⅱ IOL Implantation after Congenital Cataract Extraction

Congenital cataract occurs during infancy when the axial length and corneal and visual function are in the sensitive stages of rapid development..Inappropriate surgical intervention not only fails to restore visual function,.but also causes irreversible serious influences upon eyeball development in children diagnosed with congenital cataract. At present, the uncertainty of selection of intraocular lens(IOL) degrees during the eyeball development period is averted by using a main treatment of congenital cataract that includes two-stage surgery:.stage I cataract extraction and stage II IOL implantation. However, the accurate selection of a refractive correction method and the timing of IOL implantation during stage II surgery for aphakic eyes remains controversial following stage I cataract extraction..This review retrospectively summarizes the current progress and existing problems indicated by related recent studies focusing on refractive correction pattern and IOL implantation timing.

Astigmatism following Small Incision Cataract Extraction through Superotemporal Incision

Purpose:.To investigate the occurrence of corneal incision-induced astigmatism following small incision extracapsular cataract extraction through a superotemporal incision combined with intraocular lens (IOL) implantation. Methods:.A total of 255 cases (301 eyes) who received small incision extracapsular cataract extraction through a superotemporal incision with IOL implantation in the Department of Ophthalmology, Yuyan District Hospital of Guiyang were enrolled in this clinical trial..Postoperative best-corrected visual acuity and astigmatism were measured. The patients underwent 24-week follow-up. Results: In total, 166 patients (65.1%, 166 eyes) completed follow-up..Astigmatism gradually declined between 1 and 12-week postoperatively, and stabilized after 12 weeks. Among 166 patients,.125(75.3%).had astigmatism > 0.5 D at 24 weeks post-operatively,.showing mostly with-the-rule astigmatism. Visual acuity steadily improved up to 12 weeks, and tended to stabilize subsequently..Over the period of 24-week postoperatively,.visual acuity was negatively correlated with astigmatism (r=-0.691,P<0.05). Conclusion:Superotemporal small incision extracapsular extraction combined with IOL implantation is associated with modest astigmatism which declines over the post-operative period.

Effects of ultrasonic-assisted extraction on bioactive compounds,volatile flavors and antioxidant activities of vine tea water extracts

Background:Ampelopsis grossedentata,vine tea,which is the tea alternative beverages in China.In vine tea processing,a large amount of broken tea is produced,which has low commercial value.Methods:This study investigates the influence of different extraction methods(room temperature water extraction,boiling water extraction,ultrasonic-assisted room temperature water extraction,and ultrasonic-assisted boiling water extraction,referred to as room temperature water extraction(RE),boiling water extraction(BE),ultrasonic assistance at room temperature water extraction(URE),and ultrasonic assistance in boiling water extraction(UBE))on the yield,dihydromyricetin(DMY)content,free amino acid composition,volatile aroma components,and antioxidant properties of vine tea extracts.Results:A notable influence of extraction temperature on the yield of vine tea extracts(P<0.05),with BE yielding the highest at 43.13±0.26%,higher than that of RE(34.29±0.81%).Ultrasound-assisted extraction significantly increased the DMY content of the extracts(P<0.05),whereas DMY content in the RE extracts was 59.94±1.70%,that of URE reached 66.14±2.78%.Analysis revealed 17 amino acids,with L-serine and aspartic acid being the most abundant in the extracts,nevertheless ultrasound-assisted extraction reduced total free amino acid content.Gas chromatography-mass spectrometry analysis demonstrated an increase in the diversity and quantity of compounds in the vine tea water extracts obtained through ultrasonic-assisted extraction.Specifically,69 and 68 volatile compounds were found in URE and UBE extracts,which were higher than the number found in RE and BE extracts.In vitro,antioxidant activity assessments revealed varying antioxidant capacities among different extraction methods,with RE exhibiting the highest DPPH scavenging rate,URE leading in ABTS•+free radical scavenging,and BE demonstrating superior ferric ion reducing antioxidant activity.Conclusion:The findings suggest that extraction methods significantly influence the chemical composition and antioxidant properties of vine tea extracts.Ultrasonic-assisted extraction proved instrumental in elevating the DMY content in vine tea extracts,thereby enriching its flavor profile while maintaining its antioxidant properties.

The Preliminary Report of Epikeratophakia in the Treatment of Pediatric Aphakia after Traumatic Cataract Extraction

Purpose: To study the role of epikeratophakia in treating pediatric unilateral aphakia after traumatic cataract extraction.Methods: We performed epikeratophakia in 43 children to treat aphakia after traumatic cataract extraction, using the corneal lenses made by ourselves. The rehabilitation of the the postoperative vision and the prevention of amblyopia were observed with a mean follow-up period of 20 months.Results: All the lenses remained transparent. Postoperatively, 31 cases (72. 1%) achieved uncorrected visual acuities (V. A) over 0. 2, 32 cases (74. 4%) achieved corrected V. A over 0. 4. Most of the cases achieved the best preoperative corrected V. A with spectacles of less than 3 diopters. No severe complication occurred. Conclusion: Epikeratophakia is predictable with quality lens and correct surgical technique. The result suggests that the epikeratophakia is one of the best treatment for the pediatric aphakia especially for those who are not optimal for IOL implantation. Eye Science 1997 ;

Characterization of N6-methyladenosine long non-coding RNAs in sporadic congenital cataract and age-related cataract

AIM:To characterize the N6-methyladenosine(m6A)modification patterns in long non-coding RNAs(lncRNAs)in sporadic congenital cataract(CC)and age-related cataract(ARC).METHODS:Anterior capsule of the lens were collected from patients with CC and ARC.Methylated RNA immunoprecipitation with next-generation sequencing and RNA sequencing were performed to identify m6A-tagged lncRNAs and lncRNAs expression.Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses and Gene Ontology annotation were used to predict potential functions of the m6A-lncRNAs.RESULTS:Large amount of m6A peaks within lncRNA were identified for both CC and ARC,while the level was much higher in ARC(49870 peaks)than that in CC(18688 peaks),yet those difference between ARC in younger age group(ARC-1)and ARC in elder age group(ARC-2)was quite slight.A total of 1305 hypermethylated and 1178 hypomethylated lncRNAs,as well as 182 differential expressed lncRNAs were exhibited in ARC compared with CC.On the other hand,5893 hypermethylated and 5213 hypomethylated lncRNAs,as well as 155 significantly altered lncRNA were identified in ARC-2 compared with ARC-1.Altered lncRNAs in ARC were mainly associated with the organization and biogenesis of intracellular organelles,as well as nucleotide excision repair.CONCLUSION:Our results for the first time present an overview of the m6A methylomes of lncRNA in CC and ARC,providing a solid basis and uncovering a new insight to reveal the potential pathogenic mechanism of CC and ARC.