Cataract surgery and methods of wound closure: a review

Matossian, Cynthia; Makari, Sarah; Potvin, Richard

doi:10.2147/opth.s83552

Cited by 36 publications

(33 citation statements)

References 68 publications

(174 reference statements)

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“…While clear corneal incision offers a shorter procedure time, less astigmatism, and faster visual recovery, compared with a scleral tunnel procedure,25 wound integrity and fluid influx from self-sealing clear corneal incisions have been issues for a long time 2728. Also, whether suturing of the corneal wound in cataract surgery improves wound integrity has been debated 2930. The role of sutures in postoperative endophthalmitis is controversial.…”

Section: Discussionmentioning

confidence: 99%

Endophthalmitis after Cataract Surgery in Korea: A Nationwide Study Evaluating Incidence and Risk Factors in a Korean Population

Kim

Lee

et al. 2019

Yonsei Med J

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Purpose To assess the nationwide rate of acute postoperative endophthalmitis (APE) after cataract extraction in Korea and to evaluate potential risk factors thereof. Materials and Methods Nationwide insurance claims data from July 2014 to June 2017 were reviewed. All patients with phacoemulsification or extracapsular/intracapsular cataract extraction were included. Exclusion criteria were combined glaucoma surgery or total vitrectomy or when the patient had a history of intraocular foreign body. Results In total, 1505103 cases (982203 patients) were included. APE developed in 953 cases (938 patients) with an overall incidence of 0.063%. After adjusting for possible confounding factors, male sex [odds ratio (OR) 1.42; 95% confidence interval (CI) 1.25–1.61; p <0.001], primary clinical setting, operations performed in non-major cities, usage of sutures (OR 2.82; 95% CI 2.13–3.74; p <0.001), anterior vitrectomy (OR 8.71; 95% CI 6.71–11.32; p <0.001), aphakic cataract surgery (OR 1.52; 95% CI 1.03–2.22; p =0.033), hypertension (OR 1.40; 95% CI 1.18–1.66; p <0.001), diabetes (OR 1.59; 95% CI 1.31–1.93; p <0.001), and chronic renal failure (OR 1.28; 95% CI 1.01–1.62; p =0.039) were found to be related to APE development. Conclusion The incidence of APE after cataract extraction was consistent with reports from other studies. Additional research is needed to determine the relationship of newly found risk factors, such as hypertension, primary clinical setting, chronic renal failure, and usage of suturing, with APE development.

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Section: Discussionmentioning

confidence: 99%

Endophthalmitis after Cataract Surgery in Korea: A Nationwide Study Evaluating Incidence and Risk Factors in a Korean Population

Kim

Lee

et al. 2019

Yonsei Med J

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“…Hence, air injection is used for the reformation of the anterior chamber after phacoemulsification [ 12 ]. However, some studies reported air leakiness in 1/3 of the included cases [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Reformation of the Anterior Chamber by Air or by a Balanced Salt Solution (BSS) on Corneal Endothelium after Phacoemulsification: A Comparative Study

Alsmman

Ezz-Eldawla

Mounir

et al. 2018

Journal of Ophthalmology

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Aim To study the effect of reformation of the anterior chamber by air or by a balanced salt solution, after smooth phacoemulsification on the corneal endothelial count and morphology. Methods A prospective interventional nonrandomized comparative study included 500 eyes of 500 patients with age range between 50 and 60 years, prepared for cataract surgery and presented to the Ophthalmology department of Sohag University Hospital in the period from October 2016 to May 2017. Corneal endothelial morphology and count were examined, and the results were recorded for all cases before the surgery. Patients were divided into two groups, and both groups were diagnosed with grade 2 cataract and underwent uncomplicated phacoemulsification performed by well-trained surgeons. At the end of the surgery, group 1 was subjected to a reformation of the anterior chamber via a balanced salt solution (BSS) injection while group 2 was subjected to a reformation of the anterior chamber via air injection. Corneal endothelial morphology and count were evaluated in the first and 3rd month postoperatively. Results The study included 500 patients (250 in each group), 220 males (44%) and 280 females (56%) with no significant statistical age differences. Both preoperative and postoperative (3 months after the operation) recorded parameters of the corneal endothelium did not show any significant statistical differences. The cumulative dissipated energy was recorded, for all cases of both groups, during phacoemulsification with no significant statistical differences (P = 0.7). Conclusion There is no difference between the effect of reformation of the anterior chamber after phacoemulsification, using air or using a BSS injection, on the corneal endothelial count and morphology.

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“…However, these methods generally have significant drawbacks. For example, cyanoacrylate glue is associated with low biocompatibility, poor transparency, rough surface, difficult handling, and poor integration with corneal tissues ( 4 , 5 ). Grafting requires donor tissues, advanced surgical skills, and specialized equipment.…”

Section: Introductionmentioning

confidence: 99%

Sutureless repair of corneal injuries using naturally derived bioadhesive hydrogels

et al. 2019

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Corneal injuries are common causes of visual impairment worldwide. Accordingly, there is an unmet need for transparent biomaterials that have high adhesion, cohesion, and regenerative properties. Herein, we engineer a highly biocompatible and transparent bioadhesive for corneal reconstruction using a visible light cross-linkable, naturally derived polymer, GelCORE (gel for corneal regeneration). The physical properties of GelCORE could be finely tuned by changing prepolymer concentration and photocrosslinking time. GelCORE revealed higher tissue adhesion compared to commercial adhesives. Furthermore, in situ photopolymerization of GelCORE facilitated easy delivery to the cornea, allowing for bioadhesive curing precisely according to the required geometry of the defect. In vivo experiments, using a rabbit stromal defect model, showed that bioadhesive could effectively seal corneal defects and induce stromal regeneration and re-epithelialization. Overall, GelCORE has many advantages including low cost and ease of production and use. This makes GelCORE a promising bioadhesive for corneal repair.

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Cataract surgery and methods of wound closure: a review

Cited by 36 publications

References 68 publications

Endophthalmitis after Cataract Surgery in Korea: A Nationwide Study Evaluating Incidence and Risk Factors in a Korean Population

Endophthalmitis after Cataract Surgery in Korea: A Nationwide Study Evaluating Incidence and Risk Factors in a Korean Population

Effect of Reformation of the Anterior Chamber by Air or by a Balanced Salt Solution (BSS) on Corneal Endothelium after Phacoemulsification: A Comparative Study

Sutureless repair of corneal injuries using naturally derived bioadhesive hydrogels

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