Cataract in the Adult Eye Preferred Practice Pattern

Efficacy and Safety of Femtosecond Laser-Assisted Cataract Surgery Compared with Manual Cataract Surgery: A Meta-Analysis of 14 567 Eyes.

Purpose To compare the outcomes between femtosecond laser–assisted cataract surgery (femtosecond group) and conventional phacoemulsification cataract surgery (conventional group) in patients with hard nuclear cataract Setting Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China Design Prospective consecutive nonrandomized comparative cohort study Methods According to the Emery-Little classification, cataract patients with a grade 4 or 5 hard nuclei were assigned to 1 of the 2 groups The endothelial cell density (ECD), central corneal thickness (CCT), and uncorrected and corrected (CDVA) distance visual acuities were evaluated preoperatively and 1 day, 1 week, 1 month, and 3 months postoperatively Results The study comprised 95 eyes (47 in the femtosecond group; 48 in the conventional group) The effective phacoemulsification time, absolute phaco time, and mean ultrasound power were lower in the femtosecond group ( P P  = 001, and P P P Conclusion Compared with conventional phacoemulsification, femtosecond laser–assisted cataract surgery for hard nuclear cataracts conserved phacoemulsification power, provided a significant reduction in corneal endothelial damage, and led to faster visual rehabilitation

Clinical outcomes of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification surgery for hard nuclear cataracts.

Purpose:This meta-analysis compares Descemet membrane endothelial keratoplasty (DMEK) with Descemet stripping automated endothelial keratoplasty (DSAEK) to evaluate their strength and weakness profilesDesign:Meta-analysisMethods:We performed a meta-analysis and searched the peer-reviewed literatur

Meta-Analysis of Postoperative Outcome Parameters Comparing Descemet Membrane Endothelial Keratoplasty Versus Descemet Stripping Automated Endothelial Keratoplasty.

Purpose of reviewPresence of a small pupil is still considered a major challenge for cataract surgeons. Appropriate mydriasis and maintaining it is of paramount importance to prevent potential serious complications. Recently, more interventions and instruments are available for the cataract surgeons

Small pupil and cataract surgery.

Purpose
To compare the complication rate of posterior capsule rupture (PCR) with vitreous loss during phacoemulsification at an ambulatory surgical center with published results as a clinical audit for quality control.

/pdf/complication-rate-of-posterior-capsule-rupture-with-vitreous-401903npn1.pdf

Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical center: a clinical audit

AIM
To compare the complication rate of femtosecond laser-assisted cataract surgery (FLACS) and traditional phacoemulsification for the first 18mo of FLACS use at a private surgical center in Hawaii.

Comparing the intraoperative complication rate of femtosecond laser-assisted cataract surgery to traditional phacoemulsification.

PURPOSE To compare cumulative dissipated energy between two phacoemulsification machines. SETTING An ambulatory surgical center, Honolulu, Hawaii, USA. DESIGN Retrospective chart review. METHODS A total of 2,077 consecutive cases of cataract extraction by phacoemulsification performed by five surgeons from November 2012 to November 2014 were included in the study; 1,021 consecutive cases were performed using the Infiniti Vision System, followed by 1,056 consecutive cases performed using the Centurion Vision System. RESULTS The Centurion phacoemulsification system required less energy to remove a cataractous lens with an adjusted average energy reduction of 38% (5.09 percent-seconds) (P<0.001) across all surgeons in comparison to the Infiniti phacoemulsification system. The reduction in cumulative dissipated energy was statistically significant for each surgeon, with a range of 29%-45% (2.25-12.54 percent-seconds) (P=0.005-<0.001). Cumulative dissipated energy for both the Infiniti and Centurion systems varied directly with patient age, increasing an average of 2.38 percent-seconds/10 years. CONCLUSION The Centurion phacoemulsification system required less energy to remove a cataractous lens in comparison to the Infiniti phacoemulsification system.

/pdf/comparison-of-cumulative-dissipated-energy-between-the-57yzby3rzp.pdf

Comparison of cumulative dissipated energy between the Infiniti and Centurion phacoemulsification systems.

Cumulative dissipated energy (CDE) was used with Infiniti((R)) Vision System (Alcon Labs) as an energy delivery guide to compare four different phaco techniques and phaco settings. The supracapsular phaco technique and burst mode is known for efficiency and surgery is faster compared with the old phaco unit. In this study, we found that supracapsular phaco with burst mode had the least CDE in both cataract and nuclear sclerosis cataract with the new Infiniti((R)) unit. We suggest that CDE can be used as one of the references to modify technique and setting to improve outcome for surgeons, especially for new surgeons.

/pdf/a-retrospective-randomized-study-to-compare-the-energy-49tv6gfi2x.pdf

A retrospective randomized study to compare the energy delivered using CDE with different techniques and OZil settings by different surgeons in phacoemulsification.

BACKGROUND This study aimed to find the strength of the correlation between ORange(®) (intraoperative wavefront aberrometer) objective refraction during pseudophakic cataract surgery (Gen 1) and 1-week objective autorefraction postcataract surgery in order to establish the clinical degree of confidence in the ORange. Gen 1 was used because Gen 2 was not available at the time of the study. However, Gen 1 can still be a good reference. METHODS Thirty-two consecutive eyes were included in this prospective nonrandomized study. ORange was used after phacoemulsification and intraocular lens implantation. There were no complications and no withdrawals from the study. The refraction data from the ORange were recorded in spherical equivalents and put into Excel. One week postoperatively, autorefraction was done and the data were again recorded in spherical equivalents and put into Excel. Both sets of data were then transferred to SPSS for a correlation study. Because ORange is an objective refractor, it is necessary to use another objective refractor, such as the Zeiss Autorefractor, for comparison. Measurement at 1 week postoperatively is for cornea clearance for autorefraction and is the closest time to intraoperative assessment for comparison. RESULTS The Pearson correlation was r = +0.56, P < 0.01, which qualifies for a moderate or good correlation (0.5-0.75). CONCLUSION Intraoperative refraction using the ORange Gen 1 after cataract surgery and intraocular lens implantation is moderate to good when correlated with objective autorefraction 1 week after cataract surgery.

/pdf/correlation-between-orange-gen-1-pseudophakic-intraoperative-1169tkgsvj.pdf

Ming Chen

Papers

Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical center: a clinical audit

Comparing the intraoperative complication rate of femtosecond laser-assisted cataract surgery to traditional phacoemulsification.

Comparison of cumulative dissipated energy between the Infiniti and Centurion phacoemulsification systems.

A retrospective randomized study to compare the energy delivered using CDE with different techniques and OZil settings by different surgeons in phacoemulsification.

Correlation between ORange ® (Gen 1, pseudophakic) intraoperative refraction and 1-week postcataract surgery autorefraction