Different-sized incisions for phacoemulsification in age-related cataract.
Ontology highlight
ABSTRACT:
SUBMITTER: Jin C
PROVIDER: S-EPMC5665700 | biostudies-literature | 2017 Sep
REPOSITORIES: biostudies-literature
Publications
Different-sized incisions for phacoemulsification in age-related cataract.
Jin Chongfei C Chen Xinyi X Law Andrew A Kang Yunhee Y Wang Xue X Xu Wen W Yao Ke K
The Cochrane database of systematic reviews 20170920
<h4>Background</h4>Age-related cataract is the principal cause of blindness and visual impairment in the world. Phacoemulsification is the main surgical procedure used to treat cataract. The comparative effectiveness and safety of different-sized incisions for phacoemulsification has not been determined.<h4>Objectives</h4>The aim of this systematic review was to assess the effectiveness and safety of smaller versus larger incisions for phacoemulsification in age-related cataract. The primary out ...[more]
Similar Datasets
Project description:Purpose:To evaluate and compare single and multiquadrant hydrodissection in age related cataract. Design:Prospective, observational case series. Methods:In this study, 220 patients were consecutively assigned to either single (n?=?110) or multiquadrant (n?=?110) hydrodissection during phacoemulsification. Patients having operable cataract in the nuclear grade of 1-3 of Lens Opacities Classification System III were included in the study. After hydrodissection of the nucleus nuclei were not rotated. Parameters assessed were amount of balanced salt solution (BSS) required to accomplish the hydrodissection, nucleus emulsification time (NET), and cortical aspiration time (CAT). Ease in nucleus rotation during chopping of the nucleus, cortical aspiration (easy, difficult, or very difficult) and intraoperative surgical complications were qualitatively assessed. Results:Average amount of BSS required in multiquadrant hydrodissection was 1.7?ml (±0.9), which was more than double the single quadrant group 0.71(±0.17), p?=?0.001. No statistically significant differences were observed between the two studied groups with respect to the following parameters: mean NET (single quadrant 277 sec?±?95.5, multiquadrant 267 sec?±?98.8, p?=?0.379), CAT (single quadrant 75.7 sec?±?31.2, multiquadrant 73.4sec?±?33.9p?=?0.301), and total fluid required (single quadrant 154?ml?±?64.9, multiquadrant 157?ml?±?66.4p?=?0.708).Almost equal number of patients in both the groups had easy rotation of the nucleus (single quadrant: n?=?105, 95.45% and multiquadrant n?=?103, 93.64%) and cortical aspiration (n?=?102, 92.72% both the groups). Three patients in multiquadrant group had posterior capsular rupture during hydrodissection. Conclusions:A single quadrant hydrodissection is sufficient for the efficient removal of nucleus and cortex.
| S-EPMC6950964 | biostudies-literature
Project description:BackgroundTo figure out the efficacy, effects, safety and patient's subjective perceptions of phacoemulsification with the active-fluidics system (AFS).Patients and methodsThis was a prospective, randomized, double-masked, controlled clinical study. Age-related cataract patients were recruited and randomly assigned to the AFS group and gravity-fluidics system (GFS) group in a ratio of 1:1 to have phacoemulsification. Participants were followed up at one day, one week, one month and three months postoperatively (Chinese Clinical Trial Registry, ChiCTR2100044409).ResultsThe overall included participants were 107 finally. The total aspiration time of the AFS group was significantly less than that of the GFS group (p = .020), while no significant difference existed in cumulative dissipated energy and estimated fluid usage between the two groups. The best corrected visual acuity was significantly better in the AFS group at one day and one week postoperatively (p = .002, p = .038 respectively). The recovery of central corneal thickening and macular superficial vasculature increase was earlier in the AFS group. The central retinal thickness was significantly higher in the GFS group at one month and three months postoperatively (p = .029, p = .016 respectively). The incidence of corneal adverse events was higher in GFS group (p = .035). No serious adverse events occurred in either group. Pain scores and the scores of Cat-PROM5 questionnaire of the AFS group were significantly lower than that of the GFS group (p = .011, p = .002 respectively).ConclusionAFS improves the efficiency, effects, safety and patients' subjective perceptions of phacoemulsification compared with GFS. It is worthwhile to promote its application in cataract surgery.KEY MESSAGESThe active-fluidics system automatically detects and maintains stable intraocular pressure at the set value.The active-fluidics system improves the efficiency, effects, safety and patients' subjective perceptions in phacoemulsification.
| S-EPMC9310653 | biostudies-literature
Project description:Purpose. Vitamin D insufficiency and age related cataract (ARC) are public health problems. We evaluated serum vitamin D levels in ARC patients. Method. A prospective hospital-based cross-sectional study was designed to measure the vitamin D status of patients with ARC. Patients have grouped either presence of any type of posterior subcapsular cataract (PSC) (group 1) or ARC without the PSC component (Group 2). After full ophthalmologic consideration, patients over 40 years of age with no history of ocular trauma, multivitamin supplement ingestion, chronic renal failure, thyroidectomy, parathyroidectomy, skin cancer, and cigarette smoking were included in the study. Results. Totally, 79 subjects of which 26 (32.9%) subjects in group 1 and 53 (67.1%) subjects in group 2 were included in the study. Group 1 had mean vitamin D levels of 17.31±13.30 ng/mL. Vitamin D levels in Group 2 were 13.34±7.87 ng/mL. Group 1 did not show vitamin D insufficiency (P = 0.31; one-sample t-test). However, Group 2 showed a statistically significantly lower vitamin D level compared to the insufficiency level of 20ng/mL (P= 0.00; one-sample t-test). Conclusion. Vitamin D may have an important function in lens metabolism. Vitamin D deficiency and cataract development need further extensive researches.
| S-EPMC7535882 | biostudies-literature
Project description: Not available
| S-EPMC6916141 | biostudies-literature
Project description:To characterize the N6-methyladenosine (m6A) modification patterns in long non-coding RNAs (lncRNAs) in sporadic congenital cataract (CC) and age-related cataract(ARC).
2024-11-06 | GSE221970 | GEO
Project description:PurposeTo describe a novel technique of phacoemulsification in morgagnian cataract using capsular tension ring (CTR).MethodsThis was a retrospective, non-comparative, clinical interventional study. Patients with hypermature morgagnian cataract who had undergone CTR-assisted phacoemulsification were included in the study. After capsulorhexis, CTR was inserted in a clockwise manner to stabilize the capsular bag in each case. Phacoemulsification was then performed using either horizontal chopping or vertical chopping. We have used the CTR in these cases without any obvious lens subluxation in order to perform safe emulsification of the nuclear pieces in the capsular bag. We have performed the procedure successfully in eleven eyes with hypermature morgagnian cataract.ResultsThe mean corrected distance visual acuity (CDVA) improved from 2.62 ± 0.25 Log MAR to 0.35 ± 0.28 Log MAR at 3 months postoperatively (P = 0.00008). Total nine out of 11 patients gained CDVA of 20/40 or better at 3 months postoperatively. No intraoperative complications such as posterior capsular rupture, zonular dialysis, iris trauma, vitreous loss were noted. The mean endothelial cell loss was 148.82 ± 41.52 cells/mm2 after 3 months of surgery.ConclusionThe main culprit for intraoperative complications during phacoemulsification in a morgagnian cataract is the vulnerable capsular bag. Following insertion of a CTR after capsulorhexis, the bag becomes stable and the subsequent steps of the surgery become uneventful, thereby, preventing any further complications.
| S-EPMC8374776 | biostudies-literature
Project description:In this new technique of cataract surgery in patients with iris-fixated phakic intraocular lens with cataract, phakic IOL is explanted at the end of surgery. Phakic IOL remains stable and securely enclaved to the iris during phacoemulsification which is performed through a small 2.2 mm incision. Endothelial protection is provided by viscodispersive OVD above the phakic IOL and space for surgery is created by high molecular weight viscocohesive OVD beneath the phakic IOL. This technique provides significant advantages from the previously described techniques in terms of chamber stability, endothelial protection, iris trauma and surgical ease.
| S-EPMC6213707 | biostudies-literature
Project description:IntroductionThe active-fluidics system is a new irrigation system of phacoemulsification that automatically detects and maintains stable intraocular pressure at the set value. This trial is designed to compare the efficacy, visual outcomes, safety and patients' subjective perceptions of cataract surgery with the active-fluidics system and gravity-fluidics system.Methods and analysisThis trial will recruit 110 patients with age-related cataract at the Chinese People's Liberation Army (PLA) General Hospital (Beijing, China) and they will be randomly assigned to the active-fluidics group and gravity-fluidics group in a ratio of 1:1 to have phacoemulsification. Patients will be followed up at 1 day, 1 week, 1 month and 3 months postoperatively. The primary outcomes are the cumulative dissipated energy and best corrected visual acuity. Secondary outcomes include: estimated fluid usage, U/S time, total aspiration time, intraocular pressure, corneal endothelium parameters, retinal thickness, macular superficial vessel density, pain scores, scores of the Cataract surgery Patient-Reported Outcome Measures Questionnaire and the complication rates. The data will be independently analysed by the statistical team, who will be masked for the allocation information as participants are.Ethics and disseminationThis study was approved by the Ethics Committee of Chinese PLA General Hospital (approval no. S2021-068-01). Informed consent will be obtained from each participant. All the results will be published in peer-reviewed journals and used for scholarly communication or technical guidance. Protocol version 1.0.Trial registration numberChinese Clinical Trial Registry (ChiCTR2100044409).
| S-EPMC8783808 | biostudies-literature
Project description:BackgroundMinimally invasive glaucoma surgeries (MIGS) have attracted significant attention, as they have been reported to lower intra-ocular pressure (IOP) and have an excellent safety profile. The iStent is an example of a minimally invasive glaucoma device that has received particular attention due to its early and wide spread utilization. There is a growing body of evidence supporting its use at the time of phacoemulsification to help lower IOP. However, it is still not clear how much of the IOP lowering effect can be attributed to the iStent, the crystalline lens extraction or both when inserted concurrently at the time of phacoemulsification. This has been an important issue in understanding its potential role in the glaucoma management paradigm.PurposeTo conduct a systematic review and meta-analysis comparing the IOP lowering effect of iStent insertion at the time of phacoemulsification versus phacoemulsification alone for patients with glaucoma and cataracts.MethodsA systematic review was conducted utilizing various databases. Studies examining the IOP lowering effect of iStent insertion in combination with phacoemulsification, as well as studies examining the IOP lowering effect of phacoemulsification alone were included. Thirty-seven studies, reporting on 2495 patients, met the inclusion criteria. The percentage reduction in IOP (IOPR%) and mean reduction in topical glaucoma medications after surgery were determined. The standardized mean difference (SMD) was computed as a measure of the treatment effect for continuous outcomes taking into account heterogeneity. Fixed-effect and random-effect models were applied.ResultsA 4% IOP reduction (IOPR%) from baseline occurred following phacoemulsification as a solo procedure compared to 9% following an iStent implant with phacoemulsification, and 27% following 2 iStents implants with phacoemulsification. Compared with cataract extraction alone, iStent with phacoemulsification resulted in significant reduction in the post-operative IOP (IOPR%) (SMD = -0.46, 95% CI: [-0.87, -0.06]). A weighted mean reduction in the number of glaucoma medications per patient was 1.01 following phacoemulsification alone compared to 1.33 after one iStent implant with phacoemulsification, and 1.1 after 2 iStent implants with phacoemulsification. Compared to cataract extraction alone, iStent with cataract extraction showed a significant decrease in the number of glaucoma medications (SMD = -0.65, 95% CI: [-1.18, -0.12]). Funnel plots suggested the absence of publication bias.ConclusionBoth iStent implantation with concurrent phacoemulsification and phacoemulsification alone result in a significant decrease in IOP and topical glaucoma medications. In terms of both reductions, iStent with phacoemulsification significantly outperforms phacoemulsification alone.
| S-EPMC4492499 | biostudies-literature
Project description:As an ageing population trend, age-related cataracts (ARC) continue to be the primary cause of reversible severe vision impairment and blindness worldwide, with an increasing incidence. The primary disease mechanism of ARC formation is metabolic abnormalities and oxidative stress mainly caused by increasing age. Additionally, ultraviolet B exposure, systematic disease factors (diabetes and hypertension), and lifestyle factors (smoking, drinking, and malnutrition) are the risk factors for ARC formation. Although surgical removal of the onset lens and replacement of the intraocular lens is currently the only effective treatment method with a high success rate and a high-cost fee, cataracts have so far lacked effective therapeutic drugs leading to a heavy burden on the patient's family and society. Therefore, we performed transcriptomic analysis of human lens and ARC to investigate the possible pathogenesis of lens opacification in ageing people.
2023-02-23 | GSE213546 | GEO