PurposeTo assess the relationship between postoperative endothelial cell loss and microcoaxial phaco parameters using Ozil IP (Alcon Laboratories, Inc, Fort Worth, TX) in noncomplicated cataract surgery.MethodsIn this prospective observational study, 120 consecutive cases of cataract patients with different grades of nuclear hardness underwent microcoaxial phacoemulsification through a 2.2-mm clear corneal incision. An Alcon Infinity Vision System with Ozil IP (Alcon Laboratories) was used with an Ozil torsional handpiece and a Kelman-style 45° phacoemulsification tip. Patients underwent preoperative and postoperative central endothelial cell counts.ResultsThe study included 120 cases of age-related cataract whose mean age (standard deviation [SD]) was 59.68 years (9.47). There was a highly statistically significant endothelial cell loss (P < 0.001). The endothelial cell loss ranged 11–1149 cells/mm2 with a median (interquartile range) of 386 cells/mm2 (184.5–686 cells/mm2). The percentage of postoperative ECLoss% ranged from 0.48% to 47.8% with a median (interquartile range) of 15.4% (7.2% to 26.8%). A significant positive correlation was found between the ECLoss% and different phaco parameters. The Spearman’s rank-order correlation coefficient values, rho, (ρ) were as follows: CDE (ρ = 0.425), aspiration time (ρ = 0.176), and volume (ρ = 0.278). Also, ECLoss% was significantly correlated with the grade of nuclear opalescence (Kendall’s tau τ = 0.42).ConclusionMicrocoaxial phacoemulsification was efficient in removing noncomplicated cataracts; however a statistically significant endothelial cell loss was noted, especially with increased nuclear hardness. This endothelial cell loss was mostly related to the increased cumulative dissipated energy (CDE), aspiration time, and volume of balanced salt solution used.

The single-injection technique for percutaneous peribulbar anesthesia with a short needle is a suitable alternative to the double-injection technique for cataract surgery.

Purpose:To evaluate the results of reconstruction of large defects in the upper lid using two composite contra-lateral eyelid margin grafts.Methods:This is an interventional case series in which a large full thickness defect of the upper lid was reconstructed in 7 patients using two composite eyelid margin grafts and myocutaneous advancement. The grafts were taken from both eyelids of the contra lateral eye and the final outcome was evaluated.Results:Cosmetic results were achieved in both donor and recipient eyes satisfying to all patients; no graft sloughing was seen. Transient edema, punctate epithelial erosions, lid notching, madarosis and ptosis were seen in the early postoperative period.Conclusion:Reconstruction of a large defect in the upper lid with two composite eyelid-margin grafts is an easy, safe, effective technique with minimal complications.

Purpose:The aiming was to study the long-term clinical outcome and the merit of the author's modification of the fox's procedure.Methods:Mersilene mesh brow suspension (MMBS) procedure was performed in 50 upper lids with severe blepharoptosis and poor levator function.Results:The improvement in lid height was evaluated by preoperative and postoperative vertical palpebral aperture measurements and ranged from 2 to 6 mm (average 4 mm). The functional and cosmetically accepted results were maintained in 94% of the lids during mean follow-up of 39.4 months.Conclusion:In the present non-comparative study we believe that late Mersilene knot extrusion and forehead granuloma formation can be prevented by the modification adopted by the authors.

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