Moderator
Jason R. Mayer, MD
Panelists
Grayson W Armstrong, MD, MPH
Yvonne Wang, 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
Rajendra Prasad, MD, MBBS
Purpose
To evaluate a new efficient simple swift and safe cracking and breaking technique of solid hard mature cataract with terminator the wedge tool enabling a full thickness nuclear segmentation with least fracture force, least manipulation and stress, much lower than compressive stress, causing minimal trauma and highly satisfactory results.
Methods
A one year, non-randomized prospective series of 1008 eyes of 679 subjects who underwent elective phacoemulsification for cataract of nuclear opalescence of grade II or more (LOCS III).The technique is consonant to drag picks in rock excavation system, in which a specially designed tool terminator is used to initiate a full thickness nuclear crack at the equator which automatically traverses through the centre of the nucleus, over to the equator on the other side, breaking the entire nucleus into two complete pieces thus requiring least fracture force, least manipulation and stress, much lower than compressive stress. Full thickness free segments are then drawn and emulsified.
Results
The terminal chop technique was successfully performed in all 1000 eyes of 679 patients who underwent elective phacoemulsification and IOL implantation, during a period of 1 year at the centre. The average age was 68.3 � 6 years. The cataract was graded according to the Lens Opacities Classification System III (LOCS III) and eyes with nuclear opalescence (NO) grade II, III, IV, V and VI were included. The terminal chop technique was successful in achieving a full thickness nuclear segmentation in all 1000 eyes operated. Preoperative VA log mar 1.56 improved to VA log mar 0.16 that is 89.75%. Corneal endothelial cell count reduction was only 4.36% much less than any technique reported.
Conclusion
Terminal Chop technique is an efficient, safe, simple and swift procedure for full thickness nuclear segmentation, giving consistent results, especially in hard mature cataracts. Principle of mechanical rock excavation with drag pick wedge tool system could be safely used to crack and break these solid mature hard cataracts with minimal stress.
Presenting Author
Rajendra Prasad, MD, MBBS
Purpose
To describe a new surgical technique T Soft, the equatorial split of the soft cataract with some brittleness utilising a specially designed device �Soft Splitter� the wedge tool with a unique surgical mechanics, to split and break the soft nuclei into two complete segments with much ease and minimal manipulation for safe and swift emulsification.
Methods
In this technique a low to mod vacuum with very low or no phaco power is used to impale and hold the soft nucleus just within the equator. Full thickness nuclear split is then initiated at the open edge equator, with the help of a specially designed soft splitter, the angled wedge tool which does not cut through the soft nucleus easily. Angled wedge tool when pushed or driven through the soft nuclear substance help to completely split the entire soft nucleus into two complete halves. Each half of the nucleus, then very simply flipped out of the bag and emulsified with high vacuum and low phaco power settings.
Results
T- Soft represent a simple, safe and easy strategy for controlled nuclear division, mobilization and emulsification, within the capsular bag in cases of soft cataract, especially for beginning surgeons. T Soft technique can be used successfully for removal of adult soft cataract with good reproducibility. T Soft ensures a complete nuclear segmentation including the posterior plate from equator to equator through the centre in first attempt, in 100% 0f attempted cases. Wide angled wedge tool when driven through the soft nucleus induces transversal splitting force without making cheese wire effect resulting into complete division of nucleus.200 cases underwent prospective study results TBD.
Conclusion
With cataract surgery slowly but surely moving towards refractive lens surgery, ophthalmologists are going to see more and more soft lenses slated for removal in the next few years. Effective planning and choice of the proper surgical technique help the surgeon to avoid any unnecessary intra operative complications when faced with a soft cataract.
Presenting Author
Neeraj Khunger, MD
Purpose
To evaluate the efficacy of intracameral Lignocaine 1% in reducing the incidence of LIDRS during phacoemulsification under Topical anesthesia in high myopic patients.
Methods
Prospective, randomized, 14-month-long study including two groups of 40 eyes with cataract and no previous ocular surgery having an axial length of 26-27 mm. Phacoemulsification was performed in both groups by a single surgeon. One group was operated under topical anesthesia (Proparacaine 0.5%) only, and the other group was operated under a combination of topical anesthesia (Proparacaine 0.5%) and intracameral Lignocaine 1%. The incidence of LIDRS during surgery was the primary outcome measure.
Results
LIDRS occurred in 26 eyes in the first group and 12 eyes in the second group. The difference was statistically significant (p< />
Conclusion
The use of intracameral Lignocaine significantly reduces the incidence of LIDRS during phacoemulsification in high myopic patients. This may be attributable to the direct anesthesia and cycloplegic effect on ciliary muscles, preventing their contraction and, in turn, reducing the stretching of already loose ciliary zonules in high myopic eyes.
Presenting Author
Matthew S Porter, MD, ABO
Co-Authors
Brandon Wood MD, Mark Gallardo MD, Addie Flowers MD
Purpose
To evaluate the effectiveness of canaloplasty via an ab-interno technique using the iTrack (Nova Eye Medical, Fremont, USA.) combined with microtrabecular bypass stent surgery with the Hydrus microstent (Ivantis, Inc, Irvine, CA) following cataract extraction.
Methods
Retrospective, two-center, case series including patients with primary open-angle glaucoma (POAG). 51 POAG eyes undergoing canaloplasty combined with microtrabecular bypass stent surgery and cataract extraction. A second group of patients with POAG, intraocular pressure (IOP) >18 mmHg, and/or on 3+ medications was included (uncontrolled group). Eyes were also categorized by glaucoma severity: mild (-6dB or better), moderate (-6dB to -12dB), or severe (-12dB or worse). Primary outcome measures include mean IOP and mean number of medications at 12, 24 and 36 months.
Results
Baseline IOP (mmHg) and medications (no.) were 19.1�4.0 and 2.25�1.15 and reduced to 13.9�2.57 (-27%; p<0.001) and="" 1.15�1.4="" (-50%;=""><0.001) at="" 12="" months,="" 13.7�2.0=""><0.001) and="" 1.5�1.5="" (p="0.008)" at="" 24="" months="" (n="31)" and="" 14.4�3.22=""><0.001) and="" 2.05�1.47="" (p="0.469)" at="" 36="" months.="" in="" the="" uncontrolled="" group="" (n="27)" baseline="" iop="" and="" meds="" were="" 21.9�3.1="" and="" 1.89�1.3="" and="" reduced="" to="" 14.6�4.2="" (-33%;="" p="0.006)" and="" 1.7�1.6="" (p="0.821)" at="" 36="" months.="" baseline="" iop="" and="" meds="" of="" severe="" patients="" (n="12)" were="" 19.0�4.8="" and="" 1.9�1.1.="" iop="" reduced="" to="" 12.8�2.4="" (-32%;="" p="0.005)" at="" 12="" months="" while="" medications="" did="" not="" show="" any="" statistically="" significant="" change:="" 1.91�1.64="" (p="0.388)." no="" eyes="" underwent="" additional="" glaucoma="">
Conclusion
Canaloplasty combined with microtrabecular bypass stent surgery and cataract extraction demonstrated efficacy in reducing IOP and medication burden up to 24 months postoperatively. IOP reduction was also sustained up to 36 months postoperatively. The combined MIGS procedure is also effective in eyes with uncontrolled glaucoma.
Presenting Author
Naren Shetty, MS, PhD
Co-Authors
Arkasubhra Ghosh PhD, Swaminathan Sethu PhD, Lubna Zameer DNB
Purpose
Emerging evidence has implicated the relevance of immuno-inflammatory elements in cataractogenesis. Therefore, we investigated the status of intraocular inflammatory factors and immune cell diversity across different type of cataracts.
Methods
Subjects undergoing cataract surgery (n=78) were recruited following ethics committee approval and informed consent. Study includes subjects with nuclear sclerotic cataract (NS 1-5, n=38), posterior subcapsular cataract (PSC, n=34), mature cataract (n=4) and cortical cataract (CC, n=2). Aqueous humor (AH) collected by anterior chamber paracentesis were used to measure the levels over 25 inflammatory factors and 8 immune cell types by flow cytometry.
Results
A significantly higher AH levels of IL-17F and VEGF-A were observed in subjects with PSC and NS cataract compared to those with NS without PSC cataract. The proportions of neutrophils, monocytes, NK cells, and T cells were significantly different between the types of cataracts studied. Neutrophils were higher in subjects with PSC cataract compared to those with NS and PSC cataracts. However, monocytes, NK cells and T cells were higher subjects with NS and PSC cataracts compared to those with PSC cataracts.
Conclusion
The immuno-inflammatory profile in PSC patients differs significantly from other cataract types. Our findings highlight cataract type-specific immune and molecular variations, crucial for understanding cataractogenesis. This has clinical implications for prognostication, prevention, and management of post-surgery outcomes and co-morbidities.
Presenting Author
Matthew P. Rauen, MD, ABO
Purpose
To investigate the impact of phacoemulsification at high vs physiologic (low) intraocular pressure (IOP) on the intraoperative experience for the patient.
Methods
Prospective, single-surgeon, randomized, paired-eye design recruiting 73 subjects (146 eyes). First eye randomized to high or low IOP setting, contralateral eye receives other IOP setting. Inclusion criteria include anticipated bilateral, sequential cataract surgery on equally dense cataracts in normal eyes. Patient, surgeon anesthesiologist and post-operative technicians blinded to study arm. Endpoints include VAS scores obtained at different steps during surgery (phaco, I/A, visco removal), comparison of discomfort between eyes, patient satisfaction with monitored anesthesia care using Iowa Satisfaction with Anesthesia Scale, and cost-analysis on intraoperative medications.
Results
Pain scores were significantly lower in the low IOP group compared to the high IOP group during phacoemulsification (0.51 v 1.80, p<0.001), cortex="" removal="" (0.52="" v="" 1.88,=""><0.001) and="" viscoelastic="" removal="" (1.24="" v="" 2.96,=""><0.001), and="" were="" similar="" during="" lens="" insertion="" (2.23="" v="" 2.38,="" p="0.55)." patient="" responses="" to="" �which="" eye="" was="" more="" comfortable?�="" were="" similar="" (first="" eye="31," second="" eye="24," neither="9)." of="" the="" patients="" who="" reported="" that="" the="" first="" eye="" was="" more="" comfortable,="" 18="" had="" the="" low="" iop="" settings="" first="" and="" 13="" had="" the="" high="" iop="" settings="" first="" (p="0.37.)" satisfaction="" with="" anesthesia="" care="" (5.9="" v="" 5.9,="" p="0.82)" was="" similar="" in="" the="" two="">
Conclusion
involving fluidics. Postoperative surveys revealed IOP settings and eye order did not affect the memory of the pain experience. Patient satisfaction with anesthesia was similar in the two groups.
Presenting Author
Smita Agarwal, FRANZCO, MS, MBBS
Co-Authors
Erin Thornell PhD, Dakota Williams BSc, MSc
Purpose
Purpose: To compare intraoperative efficiency, and postoperative ocular changes following phacoemulsification and IOL implantation using physiological intraocular pressure (IOP) with Active Sentry, and at elevated IOP without Active Sentry.
Methods
Methods: Phacoemulsification and IOL implantation was performed for 65 eyes using the Centurion phacoemulsification system with (Group1; n=35) or without (Group2; n=30) Active Sentry. Total aspiration time, total case time and IOP were measured intraoperatively and compared between groups. Central corneal thickness (CCT), IOP, endothelial cell density (ECD) and central foveal thickness (CFT) were measured pre- and postoperatively (1-week and 3-months). Observed changes were compared between groups
Results
Results: Average aspiration (2.11 vs 2.42 minutes; P=0.001) and total case (6.19 vs 7.18 minutes; P=0.008) times were shorter for Group2, however intraoperative IOP was higher (55mmHg vs 24.86 mmHg; P<0.00). there="" were="" no="" other="" significant="" differences="" between="" groups.="" group1="" and="" group2="" iop="" reduced="" by="" 0.03mmhg="" and="" 0.90mmhg="" at="" 1="" week,="" and="" by="" 2.90mmhg="" and="" 3.86mmhg="" at="" 3="" months="" respectively.="" group1="" and="" group2="" cct="" increased="" by="" 18.18?m="" and="" 14.28?m="" at="" 1="" week,="" and="" by="" 3.48?m="" and="" 1.79?m="" at="" 3="" months.="" group1="" and="" group2="" ecd="" reduced="" by="" 120.85="" and="" 71.03="" at="" 1="" week,="" and="" by="" 88.83="" and="" 62.74="" at="" 3="" months.="" group1="" and="" group2="" cft="" increased="" by="" 5.47?m="" and="" 0.86?m="" at="" 1="" week,="" and="" by="" 16.54?m="" and="" 21.21?m="" at="" 3="">
Conclusion
Conclusions: While there may be delayed recovery in eyes operated on with Active Sentry, this was largely resolved by 1 week, with evidence of less long-term foveal swelling.
Presenting Author
Sankar R Ananthan, MS
Co-Authors
Madhu Shekhar MS, Rishwa Hariyani MS
Purpose
To evaluate the effectiveness of virtual reality simulator(VRS) training in reducing intraoperative complications in manual small incision cataract surgery(MSICS)
Methods
A retrospective cohort study was done to assess the complications by resident surgeon after a week-long VRS training program and a comparison was made with the rates of complication prior to VRS training. The training program is a one-month training wherein each resident performs 20 MSICS. Trainers utilize the Ophthalmology Surgical Competency Assessment Rubric (OSCAR) score to evaluate residents' surgical competence. Intraoperative complications within the first day after surgery and re-surgeries within 60 days after surgery were documented. The patient demographics, Uncorrected Distance Visual Acuity (UCVA) and Corrected Distance Visual Acuity (CDVA) were noted.
Results
The results showed a significant reduction in complications post-training. Prior to VRS training, 86 complications occurred out of 2372 surgeries (3.6%), while post-training, only 28 complications were reported out of 2246 surgeries (1.2%). Complications such as zonular dialysis with vitreous disturbances and posterior capsular rent (PCR) saw notable decreases. Additionally, the rate of re-surgeries dropped from 19 to 3, indicating improved surgical outcomes and reduced patient morbidity.
Conclusion
The study concludes that VRS training significantly enhances surgical proficiency in MSICS, reducing both intraoperative complications and the need for re-surgeries. Integrating VRS training into ophthalmology optimizes surgical skills, improves patient outcomes and also decreases operating room costs by shortening surgery duration.
Presenting Author
Carlos Palomino Sr., MD, PhD, FEBO
Co-Authors
ANA Diaz Hurtado MSc, OD, Ricardo Cui�a Sardi�a PhD, FEBO, MD, Mar�a Fern�ndez Nu�ez OD, MSc
Purpose
The objective was to study the visual quality after the implantation of a trifocal intraocular lens in patients undergoing myopic refractive surgery.
Methods
This retrospective study included 20 eyes of 11 patients with a prior history of LASIK (laser-assisted in situ keratomileusis) surgery who underwent trifocal Asqelio (AST) implantation. Among the main characteristics of the lens are that it is hydrophobic, diffractive, bispherical and with a spherical aberration of -0.27 microns. Both preoperatively and one month after surgery, monocular visual acuity without correction in distance (UDVA) and near (UNVA) was measured with the ETDRS optotype, visual acuity with correction in distance (CDVA) and refraction was performed. In addition, other tests were performed such as corneal topography with Pentacam and aberrometry with Itrace.
Results
One month after surgery, mean AVL was 0.14 � 0.17 LogMAR, AVC 0.11 � 0.18 LogMAR, and AVCL improved to 0.11 � 0.14 LogMAR. The mean spherical equivalent (SE) changed from -1.61 � 1.88 D preoperatively to -0.07 � 0.17 D at one month, with only 10% of eyes improving with refraction. The preoperative mean corneal RMS (Root Mean Square) obtained with the Pentacam was 2.17 � 0.94 microns, the corneal spherical aberration (AE) was 0.47 � 0.27 microns and the effective keratometric reading (EKR) was 39.71 � 2.01 D. With the Itrace, the preoperative total RMS was obtained as 1.69 � 1.74 microns and the postoperative one was reduced to 0.41 � 0.22 microns.
Conclusion
The Asqelio trifocal lens provides good visual results in patients undergoing previous myopic refractive surgery.
Presenting Author
Yen-Jui Chang, PhD
Purpose
We present a novel technique for intraocular lens (IOL) fixation. The technique can be used on almost all kinds of IOL such as single-piece acrylic IOLs and can manage the patients who are either aphakia or with a dislocated IOL. Toric IOL can acurrately aligned by this method, and minimize endothelium damages in eyes after corneal transplants.
Methods
Single sclerotomy setting: a pair of sincle sclertomies 1.5 mm posterior to limbus were made beneath the scleral flaps and the thread should be went with a needle on one end. IOL fixation and closing of sclerotomy could be done simultaneously, and the nodes of suture could be embedded into the sclerotomies. This setting is suitable for fixation of a pre-exisiting sinking IOL. Double sclerotomies setting: two sclerotomy made anteriorly and posteriorly to the point 1.5 mm posterior to the limbus. In this setting, the thread should be tighted onto the IOL before injected into the anterior chamber without any needle attached. This setting is suitable for fixation of a newly injected IOL.
Results
The technique is suitable for any type of single-piece IOLs with a notch or a hole in the optic-haptic junction, which can be used to tie the suture. To date, our technique has been successfully tested on many types of single-piece IOLs, including Alcon AcrySof IOLs, Johnson and Johnson Sensar and Tecnis platform IOLs, and Millennium Biomedical Inc. PreciSAL IOLs. Some complications could occur after this fixation technique, most of them were selflimited or could be controlled medically, including transient microscopic hyphema or increased IOP. Only one patient had a stitch erosion due to insufficient covering of the knot by the scleral flap.
Conclusion
Our technique can manage patients without a sufficient capsular support, and it also can refix a dislocated single-piece acrylic IOL. And this technique can be accomplished with readily accessible instruments. In our experience, this technique is a reliable method for scleral fixation of IOLs, with low rate of IOL tilt or complications.
Presenting Author
Zain S Hussain, MD
Co-Authors
Jawad Muayad BSc, Asad Loya MD, Muhammad Chauhan MS, MD, Ahmed Shakarchi MPH, MD, Ahmed Sallam FRCOphth, MD, PhD
Purpose
Data shows good control of glucose is associated with reduced complications after cataract surgery. However, little evidence details whether a discrete HbA1c or serum glucose level exists beyond which it would be unsafe to receive cataract surgery. We investigated the association between preoperative glycemic control and post-surgical outcomes.
Methods
We conducted a retrospective cohort study using a world federated database. Patients who underwent cataract surgery with available HbA1c (within 3 months pre-op) or blood glucose (on surgery day or up to 3 days prior) data will be included. Outcomes will be assessed within 30 days post-surgery for cataract surgery and no cataract surgery cohorts. Outcomes include post-operative mortality, hospitalization, and endophthalmitis. To mitigate confounding, propensity score matching included age, sex, socioeconomic status, smoking status, obesity, and others. We used Cox proportional hazards modeling to curate hazard ratios with 95% CI. Statistical significance was achieved at p< />
Results
Among 94,952 diabetic patients (25,456 with good, 13,678 with moderate, 9,959 with poor, and 1,703 with very poor control) matched via propensity scoring to non?diabetics, baseline variables were balanced (all p<0.05). the="" 30?day="" poe="" risk="" was="" 0.07%="" for="" both="" good="" and="" moderate="" control,="" 0.15%="" for="" poor,="" and="" 0.58%="" for="" very="" poor="" control.="" corresponding="" hrs="" were="" 0.62="" (95%="" ci,="" 0.30�1.27),="" 1.08="" (0.44�2.66),="" 1.36="" (0.43�4.28),="" and="" 2.85="" (0.29�27.44).="" similar="" trends="" were="" seen="" with="" preoperative="" blood="" glucose="">
Conclusion
Across a wide range of glycemic levels, cataract surgery was not linked to increased 30?day POE or serious systemic events in diabetic patients. These findings support individualized risk assessment and preoperative optimization over strict HbA1c thresholds in determining surgical candidacy.
Presenting Author
Nir Sorkin, MD
Co-Authors
Eric Rosenberg MSE, DO, Nir Gomel MD, David Varssano MD, Eliya Levinger MD, Asaf Achiron MD, Eyal Cohen MD
Purpose
To present initial experience and outcomes of cataract surgery performed using infra-red illumination, which has been incorporated into a digital 3D head-mounted display (HMD) system.
Methods
A retrospective analysis of consecutive cataract cases performed using the infra-red 3D HMD system, including surgical outcomes and surgeons� impressions of performing cataract procedures using infra-red illumination.
Results
Fifteen eyes of 15 patients were included. All procedure were uneventful. There were no postoperative complications. Best-corrected visual acuity improved from 0.35 �0.20 logMAR to 0.09 �0.12 logMAR (p<0.001) with="" a="" mean="" improvement="" of="" 2.6="" �1.6="" etdrs="">
Conclusion
Use of infra-red illumination was safe and effective in cataract surgery.
Presenting Author
Vinita Yadav, MS, MBBS
Co-Authors
Naren Shetty MS, PhD
Purpose
The study aims to evaluate changes in anterior segment parameters and intraoperative challenges following Nd-YAG laser capsulotomy in various types of intumescent mature cataracts, as classified by anterior segment OCT features.
Methods
This prospective observational study involved 90 eyes from 90 patients diagnosed with intumescent mature cataracts, as determined by slit lamp bio microscopy. The AS-OCT scans were used to classify the cataracts into four types. Each patient underwent preoperative biometry using Immersion ultrasound, IOL Master, and Argons. A single Nd laser shot was administered 30 minutes prior to surgery. CASIA-2 scans were performed both before and after the Nd laser capsulotomy. The study analyzed lens biometry, circumferential lens rise, anterior chamber depth, and angle parameters both pre- and post-laser treatment. Additionally, intraoperative complications were documented.
Results
Nd:YAG laser is most effective for type II and type III intumescent cataracts, as classified by anterior segment OCT features. Following Nd:YAG treatment, there is a notable reduction in the anterior lens capsule�s convexity and circumferential lens rise. Additionally, the anterior chamber depth increases and angle parameters improve. No cases of Argentinian flag sign, capsulorhexis extension, posterior capsular rupture, or nucleus drop occurred during surgery.
Conclusion
Nd: YAG is highly effective in preventing Argentinian flag sign and capsulorhexis extension in intumescent cataracts. Anterior segment OCT is a valuable tool for understanding the morphological characteristics of different types of intumescent cataracts and predicting the effect of Nd: YAG capsulotomy.
Presenting Author
James F Twist, BSc
Co-Authors
Pradeep Ramulu PhD, Kamran Riaz MD, Fasika Woreta MD, Nazlee Zebardast MD, MPH
Purpose
Various strategies exist to address the increased risk that pseudoexfoliation syndrome (PXF) poses during cataract surgery. There is ample literature on surgical techniques for managing PXF; however real-world preferences remain unexamined. This study surveyed ophthalmologists about current approaches for managing PXF during cataract surgery.
Methods
We conducted a Qualtrics survey targeting practicing ophthalmologists, focusing on demographics, surgical preferences during routine cataract surgery, and surgical preferences for cataract surgery in patients with PXF. The survey questions were reviewed and approved by four ophthalmologists. Questions addressed preferences for anesthesia, iris expansion, capsulorhexis diameter, nuclear disassembly, irrigation/aspiration, IOL choice, and capsular tension ring use. The survey was distributed through the American Glaucoma Society and Cornea Society. Statistical analyses included unpaired t-tests and Fisher's exact test.
Results
A total of 90 responses were collected from glaucoma (51%) and cornea specialists (37%) with a median of 12 years in practice (IQR=18.5). The most common IOL choice for a patient with PXF and no zonular weakness was single-piece acrylic (82%), followed by 3-piece acrylic (12%). Surgeons chose to use iris expansion devices at a larger pupil size for PXF (5.1mm) compared to routine cases (4.8mm); p=0.019. Surgeons also preferred a larger capsulorhexis size for PXF (5.5mm) vs. non-PXF (5.2mm); p<0.001. finally,="" surgeons="" were="" more="" willing="" to="" consider="" placing="" a="" toric="" (92%)="" than="" a="" presbyopia-correcting="" iol="" (66%)="" in="" a="" patient="" with="" pxf;="">< />
Conclusion
This study provides insight into the range of surgical preferences that exist among cornea and glaucoma specialists for managing PXF during cataract surgery. These data provide a foundation for future research into the outcomes of patients with PXF undergoing cataract surgery.
Presenting Author
Hamidreza Hasani, MD, MSc, BA
Purpose
This study aims to compare the changes in physiologic visual indices, specifically Dysphotopsia and contrast sensitivity, in patients undergoing cataract surgery via phacoemulsification with either superior or temporal corneal incisions
Methods
This study included 148 patients aged 18 and above who underwent cataract surgery with phacoemulsification and implantation of hydrophobic acrylic foldable lenses (Rayner's Ray One Aspheric preloaded IOL). Among these, 84 surgeries were performed with superior incisions, and 64 with temporal incisions. Detailed preoperative and postoperative examination reports at 1 month, 6 months, and 12 months were meticulously reviewed. Contrast sensitivity was assessed using Pelli Robson test, and Dysphotopsia symptoms were evaluated through a questionnaire, rated on a scale of 1 to 10.
Results
The study comprised 148 patients. The incidence of Dysphotopsia was higher in the temporal incision group compared to the superior incision group, with a faster recovery observed in the superior incision group. Both incision types showed an improvement in contrast sensitivity postoperatively (P<0.05). however,="" there="" was="" no="" statistically="" significant="" difference="" between="" the="" two="" groups="">< />
Conclusion
Superior corneal incisions in phacoemulsification cataract surgery are associated with a lower incidence of Dysphotopsia and a faster recovery compared to temporal incisions. Although contrast sensitivity improved following surgery in both groups, the difference between the two incision types was not statistically significant.
Presenting Author
Zain S Hussain, MD
Co-Authors
Ahmed Sallam FRCOphth, MD, PhD, Jawad Muayad BSc, Muhammad Chauhan MS, MD
Purpose
To determine the trend and regional differences of cataract surgeries overseen collaboratively by ophthalmologists and optometrists among older Americans.
Methods
We used the Medicare Provider Utilization and Payment Data from the Centers for Medicare and Medicaid from 2013 to 2021 to assess trends in payments and joint management of cataract surgeries between ophthalmologists and optometrists in each state. Additionally, we determined the impact of the expansion of the scope of practice on joint management and payments. To assess the trends over time we used a Cochran�Armitage test. We also determined the regional/state variations in joint management.
Results
TBD
Conclusion
TBD
Presenting Author
Yong Wang, MD
Purpose
To report the outcomes of the Kontless double-flanged Polypropylene suture loop haptic fixation for the repositioning of the dislocated intraocular lens-capsule complex
Methods
A 30G needle was inserted 2.5mm posterior to the corneal limbus, passing through the IOL haptic and optics junction. A 23-gauge forceps grasped a 7-0 polypropylene suture, inserted through a side incision and threaded into the needle tube. The suture was guided out by withdrawing the needle. The needle was reinserted 1.5mm anterior to the first scleral puncture, with the tip above the haptic root. The other suture end was inserted, forming a loop at the haptic root, secured by the fibrotic capsule. The opposite haptic was fixed similarly. The suture was tightened outside the eye to center the IOL, then cut short and thermally cauterized, with the end inserted into the scleral layers.
Results
This is a Retrospective case series study. A total of 23 patients with dislocation of the C-shaped haptic intraocular lens (IOL) capsular complex were included in the study. The average uncorrected far visual acuity (UDVA) after surgery was 0.17 � 0.11 logMAR. The average postoperative equivalent spherical value was -0.68 � 0.49 D. The average surgical time was 16.46 � 7.51 minutes. The average inclination of the IOL detected by optical coherence tomography in the previous section was 4.76? � 2.31?; the average eccentricity of the IOL was 0.19 � 0.09 mm. All patients did not experience any complications that threatened their vision.
Conclusion
The Kontless double-flanged Polypropylene suture loop haptic fixation technique for repositioning the dislocated intraocular lens-capsule complex is a convenient and safe method.
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