Dataset Information

Changes in symmetry of anterior chamber following routine cataract surgery in non-glaucomatous eyes.

ABSTRACT: Background:To assess minimum and maximum changes in anterior chamber dimensions following routine cataract surgery in non-glaucomatous eyes. Methods:Forty-two eyes (42 participants) underwent routine cataract surgery with same surgeon and were assessed preoperatively, 1, 3, 6 and 12?months postoperatively. Primary outcome measure: Angle-to-angle diameter (AAD) (at 0-180o, 45-225o, 90-270o, 135-315o), Anterior-chamber-angle (ACA) (at 0o, 45o, 90o, 135o, 180o, 225o, 270o and 315o) and central anterior chamber depth (ACD) at all visits. Secondary outcome measures: relationship to axial length (AL). Results:The mean AAD and ACA increased post-operatively in all meridians at all visits postoperatively. At 12?months, there was a maximum change in AAD in horizontal meridian (506.55 ± 468.71??m) and least in vertical meridian (256.31 ± 1082.3??m). The mean percentage increase in ACA postoperatively was least at 90o (5% increase compared to 29-35% elsewhere). Central ACD deepened at all postoperative visits and this did not change over 12?months. There was no correlation between AAD, ACA and ACD with AL at any visit. Conclusion:The AAD, ACA and ACD increases following cataract surgery in non-glaucomatous eyes, but at 12?months increase in AAD is least in vertical compared to horizontal meridian. Also, ACA was narrower (only 5% increase) superiorly compared to elsewhere (29-35% increase in ACA). This may have implications with regards to surgeries performed in the anterior chamber and corneal endothelial cell loss.

SUBMITTER: Lee H

PROVIDER: S-EPMC6607582 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Changes in symmetry of anterior chamber following routine cataract surgery in non-glaucomatous eyes.

Lee Hanbin H Zukaite Ieva I Juniat Valerie V Dimitry Maria E ME Lewis Amanda A Nanavaty Mayank A MA

Eye and vision (London, England) 20190703

<h4>Background</h4>To assess minimum and maximum changes in anterior chamber dimensions following routine cataract surgery in non-glaucomatous eyes.<h4>Methods</h4>Forty-two eyes (42 participants) underwent routine cataract surgery with same surgeon and were assessed preoperatively, 1, 3, 6 and 12 months postoperatively. Primary outcome measure: Angle-to-angle diameter (AAD) (at 0-180<sup>o</sup>, 45-225<sup>o</sup>, 90-270<sup>o</sup>, 135-315<sup>o</sup>), Anterior-chamber-angle (ACA) (at 0<su ...[more]

PMID: 31309126

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Project description:PURPOSE:To evaluate the efficacy of bromfenac ophthalmic solution 0.07% dosed once daily in achieving zero-to-trace (0-5 cells) anterior chamber cells, following cataract surgery with posterior chamber intraocular lens implantation. METHODS:The study designed employed two Phase III, double-masked, placebo-controlled, multicenter clinical trials of 440 subjects, randomized to either bromfenac ophthalmic solution 0.07% (n=222) or placebo (n=218). Subjects self-dosed once daily, beginning 1 day before undergoing cataract surgery with intraocular lens implantation (day -1) and again on the day of surgery (day 0) and for 14 days postoperatively. Follow-up was on days 1, 3, 8, and 15. The outcome measures included the percentage of subjects with zero-to-trace anterior chamber cells at each visit, as determined by the percentage of subjects with ?5 anterior chamber cells, overall anterior chamber cell grades, and summed ocular inflammation score (SOIS) (combined anterior chamber cell and flare scores). RESULTS:The proportion of subjects with zero-to-trace anterior chamber cells was significantly higher in the bromfenac 0.07% group compared with the placebo group as early as day 3 (P=0.0007), continued at day 8 (P<0.0001), and through day 15 (P<0.0001). At day 15, 80.2% of subjects in the bromfenac 0.07% group achieved zero-to-trace anterior chamber cells compared with 47.2% of subjects who did so in the placebo group. The overall anterior chamber cell scores were significantly lower in the bromfenac 0.07% group compared with the placebo group at days 3, 8, and 15 (P<0.0001 at each visit). The SOIS were also significantly lower in the bromfenac group compared with the placebo group at days 3, 8, and 15 (P<0.0001 at each visit). CONCLUSION:Bromfenac ophthalmic solution 0.07%, dosed once daily was clinically effective in achieving zero-to-trace anterior chamber cell severity after cataract surgery and was superior to placebo in all anterior chamber cell severity and inflammation outcome measures.

Project description:Importance:Primary epiretinal membrane (ERM) is a common retinal disorder with a prevalence of 4% to 18.5%. Although ERM and cataracts commonly occur together, to our knowledge, no studies have investigated the outcome of cataract surgery alone in this setting. Objective:To analyze the visual outcome and cystoid macular edema risk with cataract surgery in eyes with primary ERM. Design, Setting, and Participants:In this retrospective clinical database study, data were collected from July 2003 to March 2015 from 8 locations in the United Kingdom. Cataract surgery data of 217?557 eyes were extracted from the electronic medical record of the UK National Health Service. After exclusion of 57?561 eyes with combined surgery, prior vitrectomy, copathology, and complications, 812 eyes with primary ERM and 159?184 reference eyes were analyzed. Main Outcomes and Measures:We report on visual acuity (VA), the incidence of cystoid macular edema, and the need for ERM surgery. Results:The mean (SD) age of patients in the ERM group was 73.7 (9.23) years, and 395 of 812 were men (46.8%). The mean (SD) age of patients in the reference group was 74.4 (12.19) years, and 65?265 of 159?184 were men (41%). Epiretinal membrane eyes assessed at 4 to 12 weeks postoperatively gained 0.27 (0.32) logMAR (approximately?3 Snellen lines), with 200 of 448 (44.6%) improving by 0.30 logMAR or more (?3 Snellen lines) and 32 of 448 (7.1%) worsening by 0.30 logMAR or more. Reference eyes gained a mean (SD) of 0.44 (0.26) logMAR (approximately?4 Snellen lines), with 48?583 of 77?408 (62.8%) improving by 0.30 logMAR or more and 2125 of 77?408 (2.7%) worsening by 0.30 logMAR or more. Although all eyes with preoperative VA of 20/40 or less improved, only reference eyes with preoperative VA of more than 20/40 showed improvement. Cystoid macular edema developed in 57 of 663 ERM eyes (8.6%) (95% CI, 6.69-10.98) and 1731 of 125?435 reference eyes (1.38%) (95% CI, 1.32-1.45) (P?<?.001). Epiretinal membrane surgery was performed in 43 of 663 (6.5%) ERM eyes. Conclusions and Relevance:On average, VA improved 0.27 logMAR (approximately 3 Snellen lines) in eyes with ERM. Eyes with ERM and VA of 20/40 or less showed more benefit after cataract surgery than those with better preoperative vision. However, compared with eyes without ERM, higher rates of cystoid macular edema and a lower postoperative VA gain were noted.

Project description:PurposeTo investigate the relationship between early post-operative anterior chamber inflammation (aqueous flare) and central corneal thickness (CCT) after cataract surgery and to evaluate the effect of anti-inflammatory prophylaxis on CCT.SettingDepartment of Ophthalmology, Rigshospitalet-Glostrup, University Hospital Copenhagen, Denmark.DesignPost-hoc analysis of a prospective randomized controlled trial.Patients and methodsA total of 470 participants who underwent standard cataract surgery were randomly allocated to prophylactic treatment with nonsteroidal anti-inflammatory drug (NSAID, groups C and D) or a combination of NSAID and steroid eye drops (groups A and B), commenced either pre-operatively (A and C) or post-operatively on the day of surgery (B and D), or "drop-less surgery" (peri-operative subtenon depot of dexamethasone, group E). Aqueous flare was measured before and three days after surgery. CCT was measured before surgery, three days, three weeks, and three months after surgery. Data were analyzed according to the intention-to-treat method.ResultsDoubling of aqueous flare increased mean CCT by 15.6 microns (95% CI 9.8; 21.3, P<0.001) three days after surgery. Mean CCT increased from 549 microns (95% CI 545; 552) at baseline to 594 microns (95% CI 585; 602) three days after surgery and returned to 551 microns (95% CI 545; 557) three months after surgery. Mean CCT was thinner in group C compared to group A three days after surgery. No difference was found for any other groups or time points.ConclusionIncreased anterior chamber inflammation was associated with significant corneal thickening three days after cataract surgery. Choice of anti-inflammatory regimen seemed to be of no or minimal importance on CCT when the effect of inflammation was accounted for. Corneal thickening is possibly mediated by underlying deterioration of the blood-aqueous barrier and corneal endothelium pump function caused by a post-operative inflammatory response.

Project description:PurposeTo investigate the structural and clinical characteristics of peripapillary retinoschisis observed in glaucomatous eyes using spectral-domain optical coherence tomography (SD-OCT).MethodsCircumpapillary retinal nerve fiber layer (cpRNFL) and macular cross-hair SD-OCT scans and infrared fundus images of the glaucoma patients from the Investigating Glaucoma Progression Study (IGPS) and healthy volunteers were reviewed. Optic disc images obtained using enhanced depth imaging (EDI) SD-OCT were also evaluated. The structural characteristics and clinical course of the retinoschisis associated with glaucoma were investigated.ResultsTwenty-five retinoschisis areas were found in 22 of the 372 patients (5.9%) included in the IGPS, and in 1 area in 1 of 187 healthy control subjects (0.5%). In the 22 glaucomatous eyes with retinoschisis, the schisis was attached to the optic disc and overlapped with the retinal nerve fiber layer (RNFL) defect. The RNFL was the layer most commonly affected by the retinoschisis, either alone or together with other deeper layers. Acquired optic disc pit was identified in 8 eyes on disc photography and/or B-scan images obtained by EDI SD-OCT. Spontaneous resolution of this condition was observed in nine eyes. No retinal detachment or macular involvement of the retinoschisis was observed in any of the eyes. Multivariate analysis showed a significant influence of a higher intraocular pressure at SD-OCT scanning on the presence of retinoschisis (Odds ratio ?= 1.418, P = 0.001).ConclusionsThe present study investigated 22 cases of peripapillary retinoschisis in glaucomatous eyes. The retinoschisis was attached to the optic nerve and topographically correlated with RNFL defect. It often resolved spontaneously without causing severe visual disturbance. Care should be taken not to overestimate the RNFL thickness in eyes with retinoschisis, and also not to misinterpret the resolution of retinoschisis as a rapid glaucomatous RNFL deterioration.

Dataset Information

Changes in symmetry of anterior chamber following routine cataract surgery in non-glaucomatous eyes.

Publications

Changes in symmetry of anterior chamber following routine cataract surgery in non-glaucomatous eyes.

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