Moderator
Lilian Nguyen, MD
Panelists
Seth M. Pantanelli, MD, MS, ABO
Robin R. Vann, MD, ABO
Viewing Papers
Expand a paper title to the right to view the paper abstract and authors. Use the video link to jump to that poster in the session.
Presenting Author
Boris E. Malyugin, MD, PhD
Co-Authors
Olga Fomina MD, Alexander Shpak PhD, MD
Purpose
To compare the capsular and axial stability of two monofocal hydrophobic IOL platforms (Alcon Clareon and Hoya iSert 251) during 6 months of follow-up after cataract surgery in patients with axial length exceeding 26 mm. This was IIT #68009797 supported by a grant from Alcon.
Methods
Eighty-six highly myopes (86 eyes), underwent phacoemulsification and IOL implantation. Patients were randomly selected to receive implantation of the two IOLs only in one eye. 40 eyes implanted with Clareon, and 46 eyes implanted with iSert 251. All patients were examined in 1st day, 1 week, 1, 3 and 6 months after the surgical procedure. UCVA and BCVA were assessed monocularly using a CV- 5000 phoropter with an ACP-8 chart projector. Anterior segment OCT was performed (CASIA2) to assess the axial position of the IOL. IOL rotation was measured using the �Axis Assistant� smartphone application. IOL axis was determined as the line connecting the centres of the two haptical elements.
Results
No statistically significant differences were found between groups for IOL tilt and decentration.The mean IOL tilt at 6 m after surgery was 4.49��1.52 in Clareon group, and 4.57��1.83 in iSert group.The mean IOL decentration 6 months after surgery was 0.27�0.16mm in Clareon group, and 0.31�0.20 mm in iSert group. Maximal values and numbers of patients with tilt over 5� were higher in iSert group.There were no eyes with clinically significant IOL decentration in both groups. ?n absolute value of axial displacement was relatively small (median 0.1 mm in both groups, p>0.05). The IOL axis position after 1 and 6 months in Clareon and iSert groups were: -2.7�15.1� and -2.9�24.7� (p>0.05).
Conclusion
This study supports the long-term stability of both IOL platforms in patients with an axial length exceeding 26 mm. Clareon injection system provided better corneal wound safety with less corneal oedema and local endothelial damage on the 1st day after surgery.
Presenting Author
Yang Zhao, MD, PhD
Purpose
This study aimed to evaluate visual, refractive and safety outcomes of monofocal IOL after cataract surgery in patients with mild to moderate primary open-angle glaucoma.
Methods
In this prospective, non-randomized, observational single-arm study, patients with mild to moderate POAG undergoing cataract surgery received implantation of Clareon monofocal IOL (SN60WF). The primary outcome was monocular BCDVA at 3-month postoperatively, The secondary outcomes were monocular uncorrected distance (UDVA) and manifest refraction spherical equivalent (MRSE) at 1-month and 3-month postoperatively. Thirty eyes from 30 patients were included in the study. Majority of subjects were moderate POAG (23/30, 77%) and were ?60 years old (25/30 60%), with a mean age of 67.1 years. More than half of subjects were female (17/30, 56.7%).
Results
More than 94% of subjects achieved monocular UDVA of 0.3logMAR or better. Monocular UDVA ?0.05logMAR was achieved by 80.0% and 93.3% of subjects at 1 and 3 m, respectively. More than 94% of subjects achieved monocular UDVA of 0.3logMAR or better. Monocular UDVA ?0.3logMAR was achieved by 100.0% and 100% of subjects at 1 and 3 m respectively. Monocular UDVA ?0.05logMAR was achieved by 80.0% and 93.3% of subjects at 1 and 3 m. Mean MRSE was ?1.20D, and median MRSE was -1.5D in pre-op. Median MRSE was 0.0 D at all visits post-op. The average IOP was 18.42mmHg pre-op. It was controlled at mean 13.0 and 12.6 mmHg at post-op 1m and 3m.
Conclusion
Clareon monofocal IOLs successfully restored the distance vision of people with mild or moderate glaucoma after cataract surgery.
Presenting Author
Nicholas R. Stange, BSc
Co-Authors
Matthew Rauen MD
Purpose
CMS requires ASCs to report rates of hospital transfers, a metric that can affect payment, however, no studies have assessed the circumstances related to transfer. This study describes the causes, timing, and contributing factors of each direct hospital transfer from an ophthalmology-specific ASC and identifies actions to prevent future transfers.
Methods
A retrospective chart review was performed on 15,277 patients undergoing a total of 29,390 procedures at Wolfe Surgery Center from March 2022 through July 2024 to identify patients that required a hospital transfer. Relevant variables recorded include demographics, comorbidities, type of surgery and anesthesia, the type and timing of each complication, reasons for transfer, emergent/non-emergent transfers, prior surgeries/surgical complications, and the results of pre-operative physicals. Each transfer was assessed for its necessity, possible prevention, and outcome.
Results
A total of 22 patients required transfer during the study period for a rate of 0.75 per 1000 admissions. Only 5 (23%) transfers were related to anesthesia or surgery. The other 17 (77%) cases had concerns first noted prior to the induction of anesthesia. Only 9 (41%) of the surgeries were completed, 1 (5%) partially completed, and the remaining 12 (55%) surgeries were cancelled. The reasons for transfer were largely cardiac or blood pressure related in 18 of 22 (82%) cases. The only ocular complication prompting transfer was an intraoperative suprachoroidal hemorrhage. Nearly a third of the transfers (7 of the 22) were considered preventable.
Conclusion
Hospital transfers from ASCs are rare and all-cause hospital transfer rates may overestimate the true risk of ocular surgery. Most patients requiring hospital transfers are identified in the pre-operative area. Additionally, paying closer attention to preoperative physical reports could prevent future hospital transfers.
Presenting Author
Seth M Pantanelli, MD, MS, ABO
Co-Authors
Jeremy Kudrna MD, Zach Landis MD, Tara O'Rourke OD, Erik Lehman MS, Amy Longenecker RN, BSN
Purpose
To compare the binocular distance (4m), intermediate (66 cm), and near (40 cm) visual acuity (VA) of the Johnson & Johnson Eyhance (DIB00) and Bausch & Lomb enVista (MX60E) intraocular lenses (IOL) in photopic and mesopic conditions.
Methods
This multi-center, prospective, patient-and-assessor-masked, randomized controlled trial includes adult patients with ? 1.0 D of against-the-rule or ? 1.5 D of with-the-rule/oblique corneal astigmatism. We anticipate 80 bilaterally implanted patients (40 per group). Each subject is randomized to receive the same lens (either DIB00 or MX60E) in both eyes. The primary endpoints are best-distance corrected intermediate (DCIVA) and near (DCNVA) vision under photopic and mesopic conditions at 1-month.
Results
To date, 52 subjects have enrolled, and 28 have completed final follow-up. There was no difference in the binocular mean best-corrected visual acuity (BCDVA; p=0.857). In photopic conditions, Eyhance (0.16 � 0.12) trended toward improved binocular DCIVA than enVista (0.21 � 0.10; p=0.258). In mesopic conditions, there was no difference in the DCIVA (p=0.964), and enVista trended toward improved DCNVA (DIB00: 0.39 � 0.16 vs. MX60E: 0.34 � 0.08; p=0.31). Similar trends were observed for monocular photopic DCIVA (DIB00: 0.25 � 0.13 vs. MX60E: 0.29 � 0.12; p = 0.449) and mesopic DCNVA (DIB00: 0.478 � 0.12 vs. MX60E: 0.415 � 0.10; p = 0.104).
Conclusion
Interim results suggest that Eyhance may deliver improved intermediate vision in bright light conditions, but enVista might deliver improved near vision in low-light conditions. Ongoing enrollment will help to further elucidate the observed trends.
Presenting Author
Rachel Schneider, MD
Purpose
To quantify the percentage of patients who have prolonged anterior chamber cell following cataract surgery. To determine the number of extra office visits, frequency of steroid related complications, and the total duration of the inflammatory response. To identify any commonalities between these patients that may contribute to their risk.
Methods
Retrospective chart review of consecutive cataract surgeries performed by a single surgeon. Patients who had no prior history of inflammatory eye conditions and who had documented anterior chamber cell at their one month post operative visit or later were included. The total duration of the inflammatory response, number of additional visits, treatments, and steroid related complications were collected. Age, gender, ethnicity, history of autoimmune condition, history of diabetes, surgical complications, combined surgical interventions, FLACS vs standard surgery, pupil expansion device, combination vs standard post-op drops were examined to identify potential risk factors for this condition.
Results
Out of 217 eyes of 119 patients, 16 eyes of 11 patients (7.37%) had AC reaction present at the post op month 1 visit. 62.5% of patients with inflammation had an autoimmune condition compared to 11% overall. Amongst the patients with inflammation, 43.8% had sarcoidosis, 12.5% had RA, and 6.3% had ankylosing spondylitis, and none had a prior history of uveitis. 68.8% of the patients with inflammation were African American compared to 29% of the general population. 43% of patient with inflammation were diabetic compared to 29% overall. 12.5% of the inflammation patients had a concurrent MIGS procedure compared to 4.6% of the general population. No pupil expansion devices were used.
Conclusion
Patients with inflammation were more likely than the general population to have an autoimmune condition, most commonly sarcoidosis. Patients with prolonged inflammation were more likely to be African American and diabetic compared to the overall population. The impact of combined MIGS procedures is difficult to determine due to small sample size.
Presenting Author
Matthew J. Miller, MD
Co-Authors
Shawn Lin MD, MBA, David Xu MD, Ronald Smith MD, Ken Kitayama PhD, MD
Purpose
Minimizing the rate of surgical complications is critical for patient safety and is a challenge for surgeons in training. This study seeks to answer whether the rate of complications after cataract surgeries performed by residents at a teaching hospital declined by academic year quarter to reflect residents� surgical education and experience.
Methods
This was a retrospective study of all cataract surgeries performed by post-graduate year (PGY) 3 and PGY4 ophthalmology residents and supervised by 5 attending surgeons at a single VA hospital from 2014 to 2023. Complications were reported using a standardized form and were aggregated over quarter (Jul-Sep, Oct-Dec, Jan-Mar, Apr-Jun) across all years. Cumulative incidence by quarter and by year were calculated. Negative binomial regression was used to compare incidence rates of complications by quarter (reference: quarter 1), adjusting for year to account for cohort effects. A separate negative binomial model was used to compare incidence of complications by year (reference year: 2014).
Results
Summing quarters across all years, the cumulative incidence of complications was 6.0% (79/1,309) in quarter 1, 5.9% (67/1,143) in quarter 2, 5.4% (70/1,306) in quarter 3, and 4.1% (58/1,429) in quarter 4. Compared to quarter 1, there was a 4% reduction in incidence of complications in quarter 2 (incidence rate ratio [IRR]: 0.96, 95% confidence interval [CI] 0.69-1.33, p=0.80), a 14% reduction in quarter 3 (IRR: 0.86, 95% CI: 0.69-1.19, p=0.35), and a statistically significant 33% reduction in quarter 4 (IRR: 0.66, 95% CI: 0.47-0.92, p=0.02), all years equal. There was no significant difference in incidence of cataract complications across years (p>0.05).
Conclusion
The rate of cataract surgery complications declined over the course of the academic year. This suggests that residents� accumulation of surgical knowledge and experience can reduce complication rates within a relatively short time span. Minimizing complications through multi-modal surgical training should remain a priority of training programs.
Presenting Author
Kamran M. Riaz, MD, ABO
Purpose
To evaluate the real-world safety, refractive outcomes, and visual acuities in cataract surgery patients implanted with an enhanced monofocal IOL (enVista Aspire, Bausch and Lomb) optimized for intermediate vision
Methods
Retrospective, single-site study of 400 eyes that underwent implantation of an enhanced monofocal plus IOL between October 2023 to October 2024. Outcome measures included uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), manifest refraction spherical equivalent (MRSE), and postoperative complications. Current data of 94 postoperative eyes included 77 eyes targeted for emmetropia and 17 eyes with a myopic offset of >-0.75 D (near-targeted eyes).
Results
In emmetropia-targeted eyes, mean postoperative UDVA, CDVA, UIVA, and UNVA were 0.15�0.12, 0.03�0.08, 0.17�0.09, and 0.32�0.12 logMAR respectively. With a mean MRSE of 0.38�0.38 D, UDVA, and UIVA of 20/30 or better were achieved in 77.9% and 79.2% of eyes, respectively, and UNVA of 20/40 or better in 50.6% of eyes. In near-targeted eyes, the mean postoperative UDVA, CDVA, UIVA, and UNVA were 0.46�0.25, 0.07�0.07, 0.02�0.08, 0.14�0.15 logMAR respectively. With a mean MRSE of -1.47�1.01 D, UDVA and UNVA of 20/40 or better were achieved in 41.2% and 88.2% of eyes respectively, and UIVA of 20/30 or better in 100% of eyes. The overall incidence of YAG capsulotomy was 4.3%.
Conclusion
The intermediate-optimized monofocal plus IOL yielded good visual and refractive outcomes with acceptable safety profile. Patients targeted for emmetropia achieved commendable distance, usable intermediate, and functional near vision. With a myopic offset, the intermediate and near vision outcomes improved further.
Presenting Author
Klemens P. Kaiser, MD
Co-Authors
Tyll Jandewerth MD, Petra Davidova MD, Thomas Kohnen MD, PhD
Purpose
To determine characteristics and differences in intraocular lens (IOL) exchange between eyes with an open (OPC) and closed posterior capsule (CPC).
Methods
This is a retrospective case series and review of literature conducted at the Department of Ophthalmology, Goethe-University, Frankfurt, Germany. Charts of all cases of IOL exchange between January 2010 and May 2024 were retrospectively reviewed. Primary outcome measures were indications for surgery, IOL implantation technique, and intraoperative complications. Secondary outcome measures were best-corrected visual acuity pre- and postoperatively, interval between IOL implantation and IOL exchange, and postoperative complications. MEDLINE database and Google scholar were used to identify relevant past publications.
Results
We included 37 eyes of 30 patients with a mean age of 62.1 � 10.2 years, with 16 eyes (43.2%) with OPC undergoing IOL exchange. Mean interval between IOL implantation and IOL exchange was 61.50 � 62.00 months in the OPC group and 15.81 � 15.03 months in the CPC group. The most common indication was optical phenomena in 18 cases (48%). In the OPC group, intraoperative anterior vitrectomy was necessary twice as often (OPC nine cases (56%) vs. CPC five cases (24%)). Bag-to-bag IOL exchange was performed in all eyes with CPC, and in 10/16 (62%) with OPC (p=0.009). Postoperative complications were seen in a total of 7/16 eyes (43.7%) with OPC and 3/21 (14.3%) with CPC (p=0.012).
Conclusion
IOL exchange in eyes with OPC is associated with markedly more intraoperative complications and bag-to-bag exchange is much less feasible compared to eyes with a CPC. Capsulotomy should only be performed if the necessity of an IOL exchange is unlikely.
Presenting Author
Biana Dubinsky-Pertzov, MD, MPH
Co-Authors
Adi Einan-Lifshitz MD, Asaf Shemer MD, Oron Mahler MD, Avner Belkin MD, Eran Pras MD, Michael Ostrovsky MD
Purpose
To report the long-term clinical outcomes and complication rate of the four-flanged scleral fixation technique.
Methods
Retrospective cohort analysis of patients who underwent scleral fixation using the four-flanged technique using a 7-0 polypropylene between 2019 to 2022 in one tertiary medical center. Patients with at least 18 months of follow-up were included. Primary outcome was the postoperative complication rate and secondary outcomes included postoperative uncorrected and best-corrected visual acuity and refractive results.
Results
A total of eighty nine eyes of 89 patients were included. Mean age was 77.83�9.33 years and 58% were male. In 45 eyes (50%) subluxated IOL was repositioned and fixated, in 28 eyes (31%) the IOL was exchanged and a new IOL fixated, and in 16 eyes (18%) a new IOL was fixated due to aphakia and lack of capsular or sulcus support. Mean follow-up time was 34.64 � 10.35 months. Loss of IOP control requiring hypotensive medication and/or glaucoma intervention was reported in 12 patients (13.5%), corneal decompensation was observed in three patients (3%) who later underwent posterior lamellar corneal transplantation. In two patients (2%) a second surgery was required to re-fixate the IOL.
Conclusion
The four-flanged scleral fixation technique has demonstrated a satisfying safety profile with a relatively low rate of complications and re-interventions, as well as good clinical results regarding IOL stability and visual outcomes.
Presenting Author
Amber Blood, MBBS, BA
Co-Authors
Ahmed Hassane MBBS, Mostafa Khalil MBBS
Purpose
Chronic Irvine-Gass Syndrome (cIGS) is poorly understood, and sometimes confused with other types of chronic cystoid macular oedema (cCMO). cIGS leads to significantly reduced visual acuity, but treatment is not standardised. We aim to identify risk factors and different treatment protocols for management of this condition.
Methods
We defined chronic Irvine-Gass Syndrome (cIGS) as pseudophakic cystoid macular oedema identified on spectral-domain ocular coherence tomography (SD-OCT) which persists for ?90 days. Retrospective data was collected from the Greater Glasgow and Clyde (GGC) cataract audit sheet for 2021-2023. Patients with active CMO of any aetiology prior to surgery were excluded. Patients with previously resolved CMO of any aetiology were included.
Results
44 eyes were identified: 24M;20F with median age 74. Median time to diagnosis was 40 days. Median central retinal thickness (CRT) was 420�m at diagnosis and 270�m at resolution (p<0.0000005). 36%="" were="" diabetics="" (8="" had="" retinopathy;="" 3="" previously="" resolved="" maculopathy).="" 41%="" were="" hypertensive,="" and="" 20%="" with="" epiretinal="" membrane="" (erm).="" 24="" eyes="" were="" treated="" exclusively="" with="" steroidal="" and="" antiinflammatory="" drops,="" with="" median="" resolution="" time="" of="" 163="" days,="" six="" switched="" to="" intravitreal="" aflibercept="" (iv-a),="" 11="" to="" intravitreal="" dexamethasone="" (iv-d),="" and="" 3="" to="" intravitreal="" triamcinolone="" with="" median="" resolution="" of="" 165,="" 126,="" and="" 152="" days="" respectively.="" patients="" waited="" a="" median="" of="" two="" months="" before="">
Conclusion
A large proportion of cIGS have diabetes, hypertension and ERM, and are diagnosed with fovea involving CMO with CRT around 420�m. We recommend earlier switch to intravitreal therapy (triamcinolone, ozurdex or anti-VEGF) for faster resolution in resistant cases. larger studies are needed to differentiate which treatment is more effective.
Presenting Author
Ahmed S Hassane, MBBS
Co-Authors
Mostafa Khalil MBBS, Amber Blood BA, MBBS
Purpose
pCMO is a well-known complication occurring in roughly 1-3%. There are a subset of patients that suffer from ongoing pCMO (defined longer than 3 months) but no research has been performed to identify possible risk factors between these 2 groups. This study aims to identify characteristics in-keeping with chronic vs non chronic pCMO groups.
Methods
Retrospective collection of patients were identified using the shared online audit worksheet of cataract surgery performed between 2021 and 2023. Of those, the pCMO patients were identified. Age, gender, past medical and ocular history, past drug history, and parafoveal vs foveal pCMO were collected on a secure sheet. Subsequent analysis using Python programming was used to identify differences between the 2 groups. CMO from other aetiology prior to cataract surgery were excluded.
Results
245 eyes were identified with pCMO but 161 eyes were included for analysis following exclusions: 82 were female, median age was 75(range 42-90). An inverse relationship between age and chronic pCMO (p<0.028) was="" found.="" diabetics="" were="" significantly="" associated="" with="" chronic="" pcmo="" over="" non="" chronic="" pcmo=""><0.032). patients="" statins="" were="" less="" likely="" to="" develop="" chronic="" pcmo="" (logistic="" regression="" coefficient="" -0.83,="" p=""><0.036). odds="" ratio="" of="" statins="" was="" 0.44="" (ci="" 0.2-0.95)="" for="" chronic="" pcmo.="" foveal="" involving="" pcmo="" was="" associated="" with="" chronic="" pcmo="" than="" parafoveal="" pcmo=""><0.000005). ppis,="" ace-="" inhibitors,="" calcium="" blockers,="" and="" prostaglandin="" analogues="" were="" not="" associated="" with="" chronic="">
Conclusion
Younger patients, diabetics, and foveal CMO are linked to chronic pCMO. Statins showed a 56% reduction in the odds of developing chronic pCMO. Although this project provides a foundational step into understanding the risk factors, our goal moving forward is to expand this project across multiple centres.
Presenting Author
Carlos R. Marquez Acosta, MD
Co-Authors
Roberto Gonzalez-Salinas MD, PhD, Ximena Luna MD, Grecia Ortiz-Ramirez MD, Vidal Sober�n-Ventura MD
Purpose
To determine the spherical equivalent after the surgical procedure at 8 weeks in patients with macular pathology undergoing combined phacoemulsification and vitrectomy surgery.
Methods
The study was prospective, cross-sectional, observational and descriptive. A convenience and sequential sampling method was used to review patients with macular pathology (epiretinal membrane or macular hole) who underwent combined phacoemulsification and vitrectomy surgery performed by training surgeons. All patients were implanted with a non-toric monofocal IOL. After 8 weeks of surgical procedure, the objective refraction and visual acuity was measured. The outcomes was reported with: Refractive Prediction Error, Mean Absolute Error, Median Absolute Error, Patients who had a history of refractive procedures that could compromise the final refractive were eliminated.
Results
A total of 38 eyes underwent combined cataract phacoemulsification and pars plana posterior vitrectomy between years 2022-2024. 76.31% were women and 23.68% men. 31.57% were diagnosed with an epiretinal membrane and 68.42% with a macular hole. The average age was 68.5 years. The mean postoperative spherical equivalent was -0.41 (SD0.74) vs. -0.90 (4.03) preoperatively (p=0.2875). Mean Error was -0.10 (0.59), Absolute values showed a Mean Absolute Error of 0.46 (0.38) and a Median Absolute Error of 0.34. 63.16% had a 0.50D error, 89.47% a 1.00D error, and 97.37% a 1.50D error. The mean best-corrected postoperative visual acuity was 0.45 (0.37) LogMAR vs. 0.86 (0.42) preoperatively.
Conclusion
There are no specific formulas for intraocular lens calculation in combined cataract and vitrectomy surgery, good results can be achieved with acceptable refractive errors with conventional formulas. This study opens the door to future research on toric lenses implant for astigmatism correction, increasing glasses independence for distance vision.
Presenting Author
�mer M. Bilgi�, None
Co-Authors
Ozlem Evren Kemer MD, Emine Esra Karaca MD
Purpose
To evaluate the volume and clearance time of residual viscoelastic behind the IOL after phacoemulsification, identify risk factors affecting this, and analyze its impact on intraocular pressure (IOP) and refractive errors.
Methods
Cataract surgeries performed between May and June 2024 using standard phaco techniques and monofocal posterior chamber IOLs were included in this study. Patients underwent routine eye exams and IOP measurements before surgery. Postoperatively, the distance between the lens and posterior capsule was measured with anterior segment OCT (Anterion) on days 1, 3, 5, 7, and 10. Residual viscoelastic behind the IOL was manually quantified in a 2 mm diameter area using ImageJ software. The study analyzed residual viscoelastic volume, refractive changes, and IOP variations, and investigated correlations between the amount of residual viscoelastic on postoperative day 1 and potential risk factors.
Results
Thirty eyes of patients with an average age of 70.90�6.71 years were studied. Significant positive correlations were found between intraocular pressure (IOP) changes and viscoelastic volume changes at 1-3 days (p = 0.01, r = 0.581) and 1-5 days (p = 0.017, r = 0.432). A positive correlation was also observed between refractive changes and residual viscoelastic volume behind the lens from 3-5 days (p = 0.014, r = 0.444), but not from 1-3 days. IOP and viscoelastic volume decreased significantly at each follow-up (p < 0.05). Additionally, a negative correlation was noted between lens thickness and residual viscoelastic volume on the first postoperative day.
Conclusion
Residual viscoelastic after eye surgery can cause hyperopia and raised intraocular pressure. Thorough removal during surgery is crucial. Early refraction changes usually correct within a week. Extra care is needed for patients with thinner lenses due to potentially higher viscoelastic residue.
Presenting Author
Wonseok Choi, MD
Purpose
To evaluation rotational stability of toric intraocular lens (IOL) depending on haptic design.
Methods
826 eyes of 688 patients were erolled and divided into three groups depending on haptic design. Group 1 had cataract surgery with frosted haptic (Synergy, Eyhance, Puresee; Johnson & Johnson), group 2 had surgery with AcrySof & Clareon Panoptix (Alcon) and group 3 had surgery with Lisa tri (Zeiss). Degrees of axis misalignment and residual astigmatism was measured 1 month postoperatively
Results
The mean refractive astigmatism significantly decreased from 1.73 D � 0.86 to 0.35 � 0.60 D in group 1 (p<0.01), from="" 1.53="" d="" �="" 0.97="" to="" 0.48="" �="" 0.68="" d="" in="" group="" 2=""><0.01) and="" 1.86="" d="" �="" 0.91="" to="" 0.43="" �="" 0.56="" d="" in="" group="" 3=""><0.01) at="" postop="" 1="" month.="" degree="" of="" axis="" misalignment="" of="" group="" 1="" was="" 3.1�2.5,="" that="" of="" group="" 2="" was="" 5.1�4.9="" and="" that="" of="" group="" 3="" was="" 4.8�3.5="" at="" postop="" 1="" month.="" and="" it="" showed="" no="" statistically="" difference="" of="" amount="" of="" misalignment="" degree="" (p="0.137)" but="" the="" rate="" of="" misalignment="" less="" than="" 3="" degrees="" was="" significantly="" higher="" in="" group="" 1="" compared="" to="" two="" other="" groups.="" (p="0.04" with="" group="" 2,="" p="0.03" with="" group="">
Conclusion
All toric IOLs showed good rotational stability after the cataract surgery. And IOLs with frosted haptic design showed relatively higher rotational stability than IOLs with other haptic designs.
Presenting Author
Dagny Zhu, MD, ABO
Purpose
Vitreous opacities have been shown to significantly degrade visual quality in patients post-cataract surgery. This study aimed to evaluate quantitative contrast sensitivity function (qCSF) and visual outcomes after YAG laser vitreolysis treatment in pseudophakic eyes with visually significant vitreous opacities after cataract surgery.
Methods
A prospective study evaluating pseudophakic eyes undergoing YAG laser vitreolysis for the treatment of visually significant vitreous opacities after femtosecond laser-assisted cataract or refractive lens exchange surgery will be conducted. Eyes requiring simultaneous YAG laser treatment for significant posterior capsular opacities or with other underlying pathology will be excluded. Uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BCDVA), and qCSF (adaptive sensory technology) will be evaluated at baseline, 1 week, and 4 weeks. The Vitreous Floaters Functional Questionnaire (VFFQ) will also be administered at 1 and 4 weeks.
Results
Seven eyes of 7 patients (mean age 62.3 �5.5; 4 male, 3 female) were enrolled in this preliminary study. Mean UDVA (logMAR 0.14 � 0.17) and BCDVA (logMAR 0.03 � 0.05) were unchanged pre- and post-procedure (p > 0.05). QCSF improved significantly in 4 of 7 eyes (mean 2.58 � 0.12 dB) as measured by area under log contrast sensitivity (AULCSF) at 1 week. These eyes were characterized by more diffuse vitreous opacities, while eyes with no improvement had more discrete opacities. Vitreous floater questionnaire demonstrated improvement in floater symptoms and daily function in patients with improved qCSF. No adverse events were noted.
Conclusion
YAG laser vitreolysis may be a safe and effective option for improving contrast sensitivity and visual quality in some eyes with significant vitreous opacities post-cataract surgery.
Presenting Author
Roberto Gonzalez-Salinas, MD, PhD
Co-Authors
Arantxa Carcoba Abando MD, Miguel Castro Monreal MD
Purpose
This study aims to compare the safety and efficacy of scleral IOL fixation employing the Malbran technique, the Yamane technique, and the 4-point Gore-Tex suture in patients with aphakia.
Methods
This cross-sectional study included 78 eyes of 76 patients. A review of the electronic chart of patients with a history of aphakia who underwent IOL scleral fixation surgery employing either the Malbran technique, Yamane, or the four-point fixation using Gore-Tex suture from March 2016 to January 2024 was performed. The variables included in the study were the cause of aphakia, lens power, lens type, surgical technique, safety, and efficacy measured by the postoperative spherical equivalent, MAE, MedAE, and visual capacity. The One-way ANOVA test was performed to compare outcomes among groups. Univariate and multivariate analyses were performed.
Results
A total of 76 eyes of 76 patients were evaluated. The average age was 60.95 � 18.57. No significant differences were observed in the final visual capacity measurement three months postoperatively. A statistically significant difference was found in the post-surgical spherical equivalent at 3 months between the Malbran technique and the four-point technique (<0.0001) as well as between the Malbran technique and Yamane (p 0.0037). No difference was obtained between the four-point and Yamane (p >0.9999). The Malbran technique showed a tendency towards positive residual spherical equivalent.
Conclusion
Conclusions: There was no significant change in visual capacity at 3 months after scleral fixation surgery; there was a statistically significant difference in the residual spherical equivalent between techniques, with Malbran showing a tendency towards hyperopia.
Presenting Author
Christoph F. Kranemann, MD
Purpose
To determine the stability, tilt and centration of 3-point fixation of a capsular tension ring (CTR)/intraocular lens (IOL) complex to the sclera over a 5 year period.
Methods
Consecutive patients who underwent surgery for a dislocated CTR/IOL complex were followed for 5 years. They were assessed week 1, month 1 and 3, year 1, 2, 3, 4 and 5. Apart from a full eye examination, the CTR/IOL complex was assessed for centration and tilt. A combined wavefront/topography system and anterior segment OCT as well as an ocular guidance system were utilized to obtain the centration and tilt data. During surgery 9-O Prolene sutures were used @10:30/1:30 and 6 o'clock to secure the CTR to the sclera.
Results
21 eyes completed the follow-up period. All were within 5 degrees of the visual axis and had <5 degrees="" of="" tilt="" best="" corrected="" vision="" improved="" from="" 20/60="" to="" 20/25.="" intraocular="" pressured="" reduced="" from="" 22.0="" mm="" hg="" pre-op="" to="" 16.5="" mm="" hg="" post-op.="" 2/21="" eyes="" experienced="" a="" pressure="" increase="" and="" required="" iop="" lowering="" surgeyr="" at="" 3="" and="" 4="" months="" post-operatively="" respectively.="" all="" ctr/iol="" complexes="" remained="" stable="" for="" 5="">
Conclusion
3-point fixation of the CTR/IOL complex provides stable outcomes with excellent centration potential. It should be considered as a reasonable option for these patients.
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