BACKGROUND Complicated cataract surgery is challenging,especially in cases of hard nuclear cataract with severe anterior capsule organization.It is important to avoid the risk of surgery and improve the surgical skill...BACKGROUND Complicated cataract surgery is challenging,especially in cases of hard nuclear cataract with severe anterior capsule organization.It is important to avoid the risk of surgery and improve the surgical skills of surgeons.CASE SUMMARY A 60-year-old man presented with severe cataract and visual impairment.The anterior capsule of the lens was irregularly organized and pulled to the surrounding capsule,and white porcelain organized cord and brown-black lens nucleus were clearly visible.In phacoemulsification,maintaining the anterior capsule round and intact plays a key role in a successful surgery.In this case,if the conventional capsule treatment method was used,the anterior capsule would be torn.Therefore,we adopted a segmented anterior capsule treatment method,and a blasting method to release energy when dealing with the lens nucleus,and achieved good surgical results.CONCLUSION Complicated cataract surgery is challenging and requires precise skills.Operation plans should be made reasonably to predict the risk of surgery,and improve the visual quality of the patients.展开更多
【正】INTRODUCTION Femtosecond laser technology,introduced clinically for ophthalmic surgery as a technique for creating lamellar flaps in laser in situ keratomileusis(LASIK),has recently been developed into a tool fo...【正】INTRODUCTION Femtosecond laser technology,introduced clinically for ophthalmic surgery as a technique for creating lamellar flaps in laser in situ keratomileusis(LASIK),has recently been developed into a tool for cataract surgery.Preliminary experience for femtosecond laser-assisted cataract surgery show appropriate safety and efficacy,and possible advantage over conventional cataract surgery[1-4].The ability of the femtosecond laser to fragment the lens results in the need for less ultrasound energy to be expended inside the eye.Several studies indicate that less effective phacoemulsification time is needed to emulsify the lens展开更多
Dear Editor,Iam Dr.Ping-Hong Lai,from the Jiangxi Eye Center,Jiangxi Provincial People＇s Hospital,Nanchang,Jiangxi Province,China.I would like to present the technique of subconjunctival M-shaped limbus incision for ...Dear Editor,Iam Dr.Ping-Hong Lai,from the Jiangxi Eye Center,Jiangxi Provincial People＇s Hospital,Nanchang,Jiangxi Province,China.I would like to present the technique of subconjunctival M-shaped limbus incision for a series of cases with hard cataracts.展开更多
Many organisms have evolved an approximately 24-hour circadian rhythm that allows them to achieve internal physiological homeostasis with external environment.Suprachiasmatic nucleus（SCN） is the central pacemaker of...Many organisms have evolved an approximately 24-hour circadian rhythm that allows them to achieve internal physiological homeostasis with external environment.Suprachiasmatic nucleus（SCN） is the central pacemaker of circadian rhythm,and its activity is entrained to the external light-dark cycle.The SCN controls circadian rhythm through regulating the synthesis of melatonin by pineal gland via a multisynaptic pathway.Light,especially shortwavelength blue light,is the most potent environmental time cue in circadian photoentrainment.Recently,the discovery of a novel type of retinal photoreceptors,intrinsically photosensitive retinal ganglion cells,sheds light on the mechanism of circadian photoentrainment and raises concerns about the effect of ocular diseases on circadian system.With age,light transmittance is significantly decreased due to the aging of crystalline lens,thus possibly resulting in progressive loss of circadian photoreception.In the current review,we summarize the circadian physiology,highlight the important role of light in circadian rhythm regulation,discuss about the correlation between age-related cataract and sleep disorders,and compare the effect of blue light-filtering intraocular lenses（lOLs） and ultraviolet only filtering lOLs on circadian rhythm.展开更多
Although cataract surgery in posterior polar cataract is associated with posterior capsular rent and nucleus drop, by taking precautions the rate of complication can be decreased. The aim of this article is to review ...Although cataract surgery in posterior polar cataract is associated with posterior capsular rent and nucleus drop, by taking precautions the rate of complication can be decreased. The aim of this article is to review the etiology, pathogenesis, clinical features, and management of posterior polar cataract.展开更多
Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual...Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual outcomes. Cataract surgeries complicated by PCR and vitreous loss are managed with anterior vitrectomy at the time of surgery. However, the situation can be further complicated by dropping lens particles into the vitreous cavity necessitating a secondary pars plana vitrectomy (PPV). Purpose: To compare the visual outcomes and risk of rhegmatogenous retinal detachment (RRD) between eyes that required anterior vitrectomy (AV) alone for the management of vitreous loss and eyes that required AV and subsequent PPV for the management of dropped nuclear lens fragments (DNLF) following cataract surgery complicated by PCR in a tertiary care teaching hospital in Saudi Arabia. Methods: Medical records of patients in whom PCR occurred during phacoemulsification cataract surgery requiring AV or subsequent PPV for DNLF were retrospectively reviewed over a 6-year period from January 2016 to December 2021. Results: PCR occurred in 183 (2.3%) of 7757 consecutive eyes that underwent phacoemulsification cataract surgery during the study period. Seven eyes were excluded from analysis for missing data or short follow-up. Of the 176 eyes, 147 eyes (83.5%) were managed with AV alone, and the remaining 29 eyes (16.5%) underwent a secondary PPV for DNLF. After excluding eyes with pre-existing ocular pathology, final best-corrected visual acuity (BCVA) was similar in both groups with a mean of 0.32 logMAR (P = 0.99). Two of 147 eyes (1.4%) in the AV group developed RRD with poor final BCVA whereas none of the eyes in DNLF group developed RRD. Conclusion: The risk of RRD is lower in eyes that required PPV for DNLF than in eyes that were managed with AV alone following PCR during cataract surgery. The poor visual outcomes in eyes that suffered RRD underscore the importance of postoperative retinal examination and early detection of retinal breaks.展开更多
Background Phacoemulsification yields successful outcomes in eyes with standard cataract. Though techniques have been improved, it is still challenging to perform phacoemulsification in cases of hard cataracts for dif...Background Phacoemulsification yields successful outcomes in eyes with standard cataract. Though techniques have been improved, it is still challenging to perform phacoemulsification in cases of hard cataracts for difficulty in nuclear management and much more complications. This study aimed at describing and evaluating the efficacy and safety of a peripheral radial chop technique to remove hard cataracts. Methods In this prospective study conducted between January 2003 and January 2004, 107 consecutive eyes with hard cataract underwent modified phacoemulsification surgery with peripheral radial chop technique by the Bausch ＆ Lomb Millennium phacoemulsifler with preset parameters of power less than 30%; vaccum, 150 mmHg; and bottle height, 85 cm when a DP8145 phaco tip was used, and vaccum, 380 mmHg; bottle height, 95 cm when a DP8245 phaco tip was used. Results The mean ultrasonic power was 14.7% （range 9% to 19%）, ultrasonic time was 1.98 minutes （range 1.55 to 3.18 minutes）. At 1, 7 and 30 days postoperatively, the eyes with uncorrected visual acuity 0.5 or better accounted for 76.42%, 87.16% and 90.67% respectively. At 1 month, the endothelial cell loss rate was 9.74% （range 8% to 17%）. There were 6 cases of posterior capsule rupture in an early period of study. No serious intraoperaUve or postoperative complications were noted. Conclusions The peripheral radial chop technique was effective without serious complications in hands of an experienced surgeon.展开更多
文摘BACKGROUND Complicated cataract surgery is challenging,especially in cases of hard nuclear cataract with severe anterior capsule organization.It is important to avoid the risk of surgery and improve the surgical skills of surgeons.CASE SUMMARY A 60-year-old man presented with severe cataract and visual impairment.The anterior capsule of the lens was irregularly organized and pulled to the surrounding capsule,and white porcelain organized cord and brown-black lens nucleus were clearly visible.In phacoemulsification,maintaining the anterior capsule round and intact plays a key role in a successful surgery.In this case,if the conventional capsule treatment method was used,the anterior capsule would be torn.Therefore,we adopted a segmented anterior capsule treatment method,and a blasting method to release energy when dealing with the lens nucleus,and achieved good surgical results.CONCLUSION Complicated cataract surgery is challenging and requires precise skills.Operation plans should be made reasonably to predict the risk of surgery,and improve the visual quality of the patients.
文摘【正】INTRODUCTION Femtosecond laser technology,introduced clinically for ophthalmic surgery as a technique for creating lamellar flaps in laser in situ keratomileusis(LASIK),has recently been developed into a tool for cataract surgery.Preliminary experience for femtosecond laser-assisted cataract surgery show appropriate safety and efficacy,and possible advantage over conventional cataract surgery[1-4].The ability of the femtosecond laser to fragment the lens results in the need for less ultrasound energy to be expended inside the eye.Several studies indicate that less effective phacoemulsification time is needed to emulsify the lens
文摘Dear Editor,Iam Dr.Ping-Hong Lai,from the Jiangxi Eye Center,Jiangxi Provincial People＇s Hospital,Nanchang,Jiangxi Province,China.I would like to present the technique of subconjunctival M-shaped limbus incision for a series of cases with hard cataracts.
文摘Many organisms have evolved an approximately 24-hour circadian rhythm that allows them to achieve internal physiological homeostasis with external environment.Suprachiasmatic nucleus（SCN） is the central pacemaker of circadian rhythm,and its activity is entrained to the external light-dark cycle.The SCN controls circadian rhythm through regulating the synthesis of melatonin by pineal gland via a multisynaptic pathway.Light,especially shortwavelength blue light,is the most potent environmental time cue in circadian photoentrainment.Recently,the discovery of a novel type of retinal photoreceptors,intrinsically photosensitive retinal ganglion cells,sheds light on the mechanism of circadian photoentrainment and raises concerns about the effect of ocular diseases on circadian system.With age,light transmittance is significantly decreased due to the aging of crystalline lens,thus possibly resulting in progressive loss of circadian photoreception.In the current review,we summarize the circadian physiology,highlight the important role of light in circadian rhythm regulation,discuss about the correlation between age-related cataract and sleep disorders,and compare the effect of blue light-filtering intraocular lenses（lOLs） and ultraviolet only filtering lOLs on circadian rhythm.
文摘Although cataract surgery in posterior polar cataract is associated with posterior capsular rent and nucleus drop, by taking precautions the rate of complication can be decreased. The aim of this article is to review the etiology, pathogenesis, clinical features, and management of posterior polar cataract.
文摘Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual outcomes. Cataract surgeries complicated by PCR and vitreous loss are managed with anterior vitrectomy at the time of surgery. However, the situation can be further complicated by dropping lens particles into the vitreous cavity necessitating a secondary pars plana vitrectomy (PPV). Purpose: To compare the visual outcomes and risk of rhegmatogenous retinal detachment (RRD) between eyes that required anterior vitrectomy (AV) alone for the management of vitreous loss and eyes that required AV and subsequent PPV for the management of dropped nuclear lens fragments (DNLF) following cataract surgery complicated by PCR in a tertiary care teaching hospital in Saudi Arabia. Methods: Medical records of patients in whom PCR occurred during phacoemulsification cataract surgery requiring AV or subsequent PPV for DNLF were retrospectively reviewed over a 6-year period from January 2016 to December 2021. Results: PCR occurred in 183 (2.3%) of 7757 consecutive eyes that underwent phacoemulsification cataract surgery during the study period. Seven eyes were excluded from analysis for missing data or short follow-up. Of the 176 eyes, 147 eyes (83.5%) were managed with AV alone, and the remaining 29 eyes (16.5%) underwent a secondary PPV for DNLF. After excluding eyes with pre-existing ocular pathology, final best-corrected visual acuity (BCVA) was similar in both groups with a mean of 0.32 logMAR (P = 0.99). Two of 147 eyes (1.4%) in the AV group developed RRD with poor final BCVA whereas none of the eyes in DNLF group developed RRD. Conclusion: The risk of RRD is lower in eyes that required PPV for DNLF than in eyes that were managed with AV alone following PCR during cataract surgery. The poor visual outcomes in eyes that suffered RRD underscore the importance of postoperative retinal examination and early detection of retinal breaks.
文摘Background Phacoemulsification yields successful outcomes in eyes with standard cataract. Though techniques have been improved, it is still challenging to perform phacoemulsification in cases of hard cataracts for difficulty in nuclear management and much more complications. This study aimed at describing and evaluating the efficacy and safety of a peripheral radial chop technique to remove hard cataracts. Methods In this prospective study conducted between January 2003 and January 2004, 107 consecutive eyes with hard cataract underwent modified phacoemulsification surgery with peripheral radial chop technique by the Bausch ＆ Lomb Millennium phacoemulsifler with preset parameters of power less than 30%; vaccum, 150 mmHg; and bottle height, 85 cm when a DP8145 phaco tip was used, and vaccum, 380 mmHg; bottle height, 95 cm when a DP8245 phaco tip was used. Results The mean ultrasonic power was 14.7% （range 9% to 19%）, ultrasonic time was 1.98 minutes （range 1.55 to 3.18 minutes）. At 1, 7 and 30 days postoperatively, the eyes with uncorrected visual acuity 0.5 or better accounted for 76.42%, 87.16% and 90.67% respectively. At 1 month, the endothelial cell loss rate was 9.74% （range 8% to 17%）. There were 6 cases of posterior capsule rupture in an early period of study. No serious intraoperaUve or postoperative complications were noted. Conclusions The peripheral radial chop technique was effective without serious complications in hands of an experienced surgeon.
