Technology and Intraocular Lenses to Enhance Cataract Surgery Outcomes-Annual Review (January 2013 to January 2014).

Purpose: This article is aimed to provide a clinical update on recent developments in cataract surgical techniques, with specific focus on femtosecond laser technology. The article also focuses on recent improvements in the technology used in implanting intraocular lenses (IOLs).

Design: Literature review.

Femtodelineation to enhance safety in posterior polar cataracts.

Unlabelled: We describe the technique of femtodelineation for posterior polar cataracts. In this technique, the femtosecond laser is used with a cylindrical pattern of lens division to create multiple cylinders within the lens, which results in sharply demarcated layers. The number, size, and depth of the cylinders can be controlled by the surgeon using the live anterior segment optical coherence tomography view.

Real-time dynamic intraocular pressure fluctuations during microcoaxial phacoemulsification using different aspiration flow rates and their impact on early postoperative outcomes: a randomized clinical trial.

Purpose: To compare the impact of varying fluidic parameters on intraoperative intraocular pressure (IOP) fluctuations and postoperative outcomes.

Methods: Prospective randomized study of 80 eyes undergoing cataract surgery that were randomly assigned to low (aspiration flow rate: 20 cc/min; bottle height: 90 cm; vacuum: 400 mm Hg) and high (aspiration flow rate: 40 cc/min; bottle height: 110 cm; vacuum: 400 mm Hg) fluidic parameter groups. Real-time dynamic intraoperative IOP was measured during nuclear fragment removal.

Outcomes of pediatric cataract surgery in anterior persistent fetal vasculature.

Purpose: To report the intraoperative performance and postoperative outcomes in eyes with anterior persistent fetal vasculature (PFV).

Setting: Iladevi Cataract & IOL Research Centre, India, and Filatov Institute Odessa, Ukraine.

Design: Prospective interventional case series.

Approaches to a posterior polar cataract.

Posterior polar cataracts present special challenges to the cataract surgeon. These are often associated with weakness/dehiscence of the posterior capsule and thus have a higher rate of intraoperative posterior capsule rupture. The surgeon needs to adhere to special surgical strategies to minimize the risk of a posterior capsule rupture.

Multilevel chop technique.

It is difficult to completely divide a hard nucleus. Excessive force is required, which may inadvertently lead to capsular bag distortion and cause stress to the zonules. We describe a chop technique that enables the surgeon to consistently achieve complete division of brunescent and black cataracts.

Comparison of posterior capsule opacification with hydrophobic acrylic and hydrophilic acrylic intraocular lenses.

Purpose: To compare posterior capsule opacification (PCO) 3 years postoperatively in contralateral eyes with a single-piece hydrophobic acrylic and 1 of 2 single-piece hydrophilic acrylic intraocular lenses (IOLs) with different configurations.

Setting: Iladevi Cataract and IOL Research Institute, Ahmedabad, India.

Design: Prospective randomized clinical trial.

Retrospective ultrasound biomicroscopic analysis of single-piece sulcus-fixated acrylic intraocular lenses.

Purpose: To evaluate the anatomic location of the haptic and optic of single-piece sulcus-fixated intraocular lenses (IOLs) and their proximity to the iris and ciliary body using ultrasound biomicroscopy (UBM).

Setting: Iladevi Cataract & IOL Research Center, Ahmedabad, India.

Methods: This retrospective study comprised eyes that had primary sulcus implantation of a single-piece IOL.

Impact of high and low aspiration parameters on postoperative outcomes of phacoemulsification: randomized clinical trial.

Purpose: To compare the effects of fluidic parameters on the central corneal thickness (CCT), corneal endothelium, and anterior segment inflammation after phacoemulsification with longitudinal ultrasound.

Setting: Iladevi Cataract & IOL Research Center, Ahmedabad, India.

Methods: In this prospective randomized patient- and examiner-masked study, consecutive patients with age-related cataract were randomly assigned to Group 1 (low fluidic parameters: aspiration flow rate 25 cc/min; bottle height 70 cm and 90 cm; vacuum View Article and Find Full Text PDF

Comparison of torsional and microburst longitudinal phacoemulsification: a prospective, randomized, masked clinical trial.

Background And Objective: To compare intraoperative performance and postoperative outcome of three phacoemulsification technologies in patients undergoing microcoaxial phacoemulsification through 2.2-mm corneal incisions.

Patients And Methods: The prospective, randomized, single-masked study included 360 eyes randomly assigned to torsional (Infiniti Vision System; Alcon Laboratories, Fort Worth, TX), microburst with longitudinal (Infiniti), or microburst with longitudinal (Legacy Everest, Alcon Laboratories) ultrasound.

Prospective evaluation of posterior capsule opacification in myopic eyes 4 years after implantation of a single-piece acrylic IOL.

Purpose: To determine whether axial myopia affects posterior capsule opacification (PCO) in eyes with high myopia (axial length [AL] > or = 26.00 mm) 4 years after implantation of an AcrySof single-piece intraocular lens (IOL).

Setting: Clinical practice, Ahmedabad, India.

Comparison between Ringer's lactate and balanced salt solution on postoperative outcomes after phacoemulsfication: a randomized clinical trial.

Aim: To compare the effects of balanced salt solution (BSS) and Ringer's lactate (RL) on corneal thickness, endothelial morphology, and postoperative anterior chamber inflammation in eyes undergoing phacoemulsification.

Setting: Iladevi cataract and IOL research center, Ahmedabad, India.

Materials And Methods: This prospective randomized study comprised 90 consecutive patients with age-related cataract who were randomly assigned to either Group 1 (n = 45) with BSS or Group 2 (n = 45) with RL.

Comparison of 2 moxifloxacin regimens for preoperative prophylaxis: prospective randomized triple-masked trial. Part 2: residual conjunctival flora.

Purpose: To determine whether a regimen of topical moxifloxacin hydrochloride ophthalmic solution 0.5% (Vigamox) administered on the day of cataract surgery reduces conjunctival bacterial flora.

Setting: Iladevi Cataract & IOL Research Centre, Ahmedabad, India.

Comparison of 2 moxifloxacin regimens for preoperative prophylaxis: prospective randomized triple-masked trial. Part 1: aqueous concentration of moxifloxacin.

Purpose: To evaluate the aqueous concentration of moxifloxacin following 2 dosing regimens of topically administered moxifloxacin hydrochloride ophthalmic solution 0.5% (Vigamox).

Setting: Iladevi Cataract & IOL Research Centre, Ahmedabad, India.

Comparative quantification of ingress of trypan blue into the anterior chamber after microcoaxial, standard coaxial, and bimanual phacoemulsification: randomized clinical trial.

Purpose: To compare ocular surface fluid ingress into the anterior chamber at the end of microcoaxial, standard coaxial, and bimanual phacoemulsification using trypan blue as the quantifying tracer.

Setting: Iladevi Cataract and IOL Research Centre, Ahmedabad, India.

Methods: This prospective randomized observational study comprised 180 consecutive patients who had microcoaxial, standard coaxial, or bimanual phacoemulsification.

The probable associations for corticocapsular adhesions in patients undergoing cataract surgery: a clinic-based observational study.

Background: Corticocapsular adhesions (CCA) are frequently seen between lens capsule and adjacent cortical layer. During cataract surgery, in the presence of CCA, excessive efforts to rotate the nucleus can result in zonular damage. To reduce morbidity, identification of associations with CCA can be helpful in appropriately modifying the surgical procedure.

Ingress of bacterial inoculum into the anterior chamber after bimanual and microcoaxial phacoemulsification in rabbits.

Purpose: To compare the amount of bacterial ingress from the ocular surface into the anterior chamber at the end of bimanual and microcoaxial phacoemulsification in rabbits.

Setting: Iladevi Cataract & IOL Research Centre, Raghudeep Eye Clinic, Memnagar, Ahmedabad, India.

Methods: This randomized study comprised 40 eyes of 20 rabbits.

Post-operative capsular opacification: a review.

Post-operative capsular opacification is a multifactorial physiological consequence of cataract surgery. Opacification involving the central posterior capsule has a significant impact on high and low contrast acuity and low contrast sensitivity. The assessment of Posterior Capsule Opacification (PCO) on cadaver eyes, experimental studies, culture models and in clinical studies has provided an understanding of its pathogenesis.

Intraoperative performance and postoperative outcomes of microcoaxial phacoemulsification. Observational study.

Purpose: To evaluate the intraoperative performance and postoperative outcomes after microcoaxial phacoemulsification.

Setting: Iladevi Cataract & IOL Research Centre, Ahmedabad, India.

Methods: A prospective observational case series comprised 84 eyes with age-related uncomplicated cataract having microcoaxial phacoemulsification through a 2.

Effect of stromal hydration of clear corneal incisions: quantifying ingress of trypan blue into the anterior chamber after phacoemulsification.

Purpose: To use trypan blue as a quantifiable ingress tracer to determine whether stromal hydration reduces ocular surface fluid ingress at the end of phacoemulsification.

Setting: Iladevi Cataract and IOL Research Centre, Memnagar, Ahmedabad, India.

Methods: A prospective randomized study included 80 eyes having phacoemulsification through 2.

Contrast sensitivity and glare disability after implantation of AcrySof IQ Natural aspherical intraocular lens: prospective randomized masked clinical trial.

Purpose: To evaluate contrast sensitivity and glare disability after implantation of an AcrySof IQ Natural SN60WF aspherical intraocular lens (IOL) (Alcon Laboratories).

Setting: Iladevi Cataract & IOL Research Centre, Ahmedabad, India.

Methods: One hundred twenty consecutive patients who had phacoemulsification in a prospective triple-masked trial were randomized to receive an AcrySof SA60AT IOL (40 eyes), AcrySof Natural SN60AT IOL (40 eyes), or AcrySof IQ SN60WF IOL (40 eyes).

Effect of cortical cleaving hydrodissection on posterior capsule opacification in age-related nuclear cataract.

Purpose: To evaluate the effect of multiquadrant cortical cleaving hydrodissection on the development of posterior capsule opacification (PCO) after phacoemulsification.

Setting: Iladevi Cataract and IOL Research Center, Ahmedabad, India.

Methods: A prospective randomized triple blind clinical trial was conducted in 86 eyes (86 patients) having phacoemulsification.

Analysis of patients with good uncorrected distance and near vision after monofocal intraocular lens implantation.

Purpose: To analyze factors contributing to uncorrected visual acuity of at least 6/12 for distance and at least J4 for near (pseudoaccommodation) after monofocal intraocular lens (IOL) implantation.

Setting: Iladevi Cataract and IOL Research Center, Ahmedabad, India.

Methods: In a case-controlled study of 30 eyes (30 patients) that had phacoemulsification, those with pseudoaccommodation were assigned to cases and 30 eyes (30 patients) without pseudoaccommodation were designated as controls.

Management of congenital bilateral subluxated cataract with Cionni ring.

Use of Cionni ring helped in the successful intraocular lens (IOL) implantation in a 30-year-old patient with bilateral congenital subluxated cataracts. The IOL was stable, well-centered without any iridodonesis or pseudophakodonesis.