An evaluation of the efficacy of a supplemental computer-based tutorial to enhance the informed consent process for cataract surgery: an exploratory randomized clinical study.

Background: To assess whether informing patients with a computer-based tutorial in addition to standard informed consent influences the patient's attitude towards surgery and increases patient's knowledge.

Methods: In this prospective, exploratory, randomized clinical study, patients scheduled for their first eye cataract surgery were randomly allocated to two groups, receiving standard face-to-face informed consent (control group) or additionally using an interactive computer-based tool (CatInfo) containing an audiovisual presentation about cataract and its treatment (study group). Cataract-related knowledge and decisional confidence (decisional conflict scale (DCS)) were assessed as well as one-month postoperatively decisional regret (decision regret scale (DRS)) and willingness to exchange face-to-face discussion time for the use of such a tool.

A Randomized Study of the Impact of a Corneal Pre-Cut During Cataract Surgery on Wound Architecture and Corneal Astigmatism.

Introduction: The aim of the current study was to assess the effect of a 600-µm corneal pre-cut on wound architecture and its impact on surgically induced astigmatism. The images were acquired intraoperatively and postoperatively with high-resolution spectral-domain optical coherence tomography (SD-OCT).

Methods: This study included patients scheduled for cataract surgery.

Effect of Air Tamponade on Postoperative Visual Acuity and Intraretinal Cystoid Changes after Peeling of Idiopathic Epiretinal Membranes in Pseudophakic Patients.

Purpose: Epiretinal membrane is a macular disorder leading to metamorphopsia and decreased visual acuity. The aim of the present study was to assess the possible effects of air tamponade, balanced salt solution (BSS), and combined phacoemulsification on functional and anatomical outcomes.

Procedures: This prospective exploratory analysis included 72 eyes with idiopathic epiretinal membranes, scheduled to undergo 23-G pars plana vitrectomy with membrane peeling.

Evaluation of an intraoperative toric intraocular lens alignment system using an image-guided system.

Purpose: To evaluate an intraoperative toric intraocular lens (IOL) alignment system using a dedicated operating microscope with an image-guided system without preoperative corneal marking.

Setting: Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria.

Design: Prospective case series.

Attaining the optimal flange for intrascleral intraocular lens fixation.

We describe a technique for making an optimal flange in intraocular lenses (IOLs) used for flanged intrascleral IOL fixation. The flange shape varies in poly(methyl methacrylate) (PMMA) haptics of different IOLs of different manufacturers. We identified the distance between the forceps grip of the haptic and the end of the haptic during heating with a cauter as a critical factor for the optimal flange shape in 5 PMMA haptics but not in 2 polyvinylidene fluoride haptics.

Enhanced Penetration for Axial Length Measurement of Eyes with Dense Cataracts Using Swept Source Optical Coherence Tomography: A Consecutive Observational Study.

Introduction: The aim of this study was to find cases in which the axial eye length could not be measured with partial coherence interferometry (PCI) technology and to assess if it could be measured using swept source optical coherence tomography (ss-OCT) technology.

Methods: All patients were measured at their pre-assessment visit 1 week prior to cataract surgery using conventional optical biometry (PCI technology, IOLMaster 500, Carl Zeiss Meditec AG, Jena, Germany). Patients in whom one or both eyes could not be measured using PCI technology were invited to participate in the study and to be measured with the ss-OCT (IOL Master 700, Carl Zeiss Meditec AG, Jena, Germany) device.

Risk factors for postoperative intraretinal cystoid changes after peeling of idiopathic epiretinal membranes among patients randomized for balanced salt solution and air-tamponade.

Purpose: Epiretinal membranes (ERM) are macular disorders leading to loss of vision and metamorphopsia. Vitrectomy with membrane peeling displays the gold standard of care. Aim of this study was to assess risk factors for postoperative intraretinal cystoid changes in a study population randomized for balanced salt solution and air-tamponade at the end of surgery.

Diagnostic precision of a microscope-integrated intraoperative OCT device in patients with epiretinal membranes.

Purpose: Preoperative and postoperative optical coherence tomography (OCT) of macular pathologies can be regarded as the gold standard diagnostic technique, providing detailed information on the microstructures of the macula for planning the surgical procedure and comparing improvements after surgery in the follow-up period. Intraoperative use of OCT is a novel application to support surgeons during macular surgery. The aim of this study was to examine the diagnostic precision of a microscope-integrated intraoperative spectral-domain OCT (i-OCT) device and compare imaging results to a stand-alone spectral-domain OCT (SD-OCT) device.

Internal limiting membrane flap transposition for surgical repair of macular holes in primary surgery and in persistent macular holes.

Purpose: Classical or temporal internal limiting membrane (ILM) flap transposition with air or gas tamponade are current trends with the potential to improve surgical results, especially in cases with large macular holes.

Methods: A prospective case series included patients with idiopathic macular holes or persistent macular holes after 23-G pars plana vitrectomy (PPV) and ILM peeling with gas tamponade. In all patients, 23-G PPV and ILM peeling with ILM flap transposition with gas tamponade and postoperative face-down position was performed.

Does perfluoro-n-octane use in 23G vitrectomy for retinal detachment surgery affect the integrity of the ellipsoid zone?

Purpose: To examine the integrity of the ellipsoid zone after perfluoro-n-octane use for reattachment of the central retina in macula-off retinal detachment cases.

Methods: Intraoperative video documentation with microscope-integrated intraoperative spectral-domain optical coherence tomography (OCT) of 10 consecutive patients with macula-off retinal detachment, scheduled for primary vitrectomy for retinal detachment repair, was retrospectively examined for defects in the integrity of the ellipsoid zone due to perfluoro-n-octane use.

Results: Successful intraoperative visualization was possible in all cases, retinal detachment was reattached in all cases, but residual islands of subretinal fluid persisted directly after perfluoro-n-octane use in 80% of cases.

Effect of a multimedia-assisted informed consent procedure on the information gain, satisfaction, and anxiety of cataract surgery patients.

Purpose: To assess whether a multimedia-assisted preoperative informed consent procedure has an effect on patients' knowledge concerning cataract surgery, satisfaction with the informed consent process, and reduction in anxiety levels.

Setting: Hietzing Hospital, Vienna, Austria.

Design: Prospective randomized controlled clinical trial.