Cataract surgery in ocular surface diseases

Sangwan, Veena; Gupta, Swati; Das, Shilpa

doi:10.1097/icu.0000000000000441

Cited by 28 publications

(30 citation statements)

References 46 publications

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“…Cataract surgery is the most frequently performed surgical procedure in developed countries 1,2 , providing significant long-term and cost-effective improvements in the quality of life of patients 3 . In the last decades, advances in cataract surgery techniques and new technological developments have led to improved patient safety and satisfaction, resulting in high expectation regarding the refractive outcomes 4 .…”

Section: Introductionmentioning

confidence: 99%

Swept-Source Optical Coherence Tomography Biometer as Screening Strategy for Macular Disease in Patients Scheduled for Cataract Surgery

Tognetto

Pastore

Giacinto

et al. 2019

Sci Rep

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The aim of this study was to assess the central macular imaging captured with an optical biometer based on full-eye-length Swept-Source OCT (SS-OCT) scan as a screening strategy for identifying macular diseases in patients scheduled for cataract surgery. 1,114 eyes of 749 consecutive patients underwent a biometrical examination with IOLMaster 700 SS-OCT technology (Carl Zeiss) and conventional Spectral-Domain OCT (SD-OCT) (Spectralis OCT, Heidelberg) device analysis on the same day. Seven examiners graded the scans individually in a full-masked mode. Twenty-five eyes were excluded for media opacities. Among the 1,089 included eyes, statistical analysis revealed a mean Kendall’s Coefficient of 0.83 (range 0.76–0.89). A logistic regression model demonstrated a highly significant correlation (p < 0.001) between the coefficient of concordance and SD-OCT imaging. Intraobserver reproducibility was 0.89 (range 0.86–0.91). Optical biometer SS-OCT scans showed a mean sensitivity of 0.81 and a mean specificity of 0.84. The positive and negative predictive value detected was 0.78 and 0.86, respectively. In order to predict the risk of reduced visual recovery, especially in cases of retinal pathology, optical biometer with SS-OCT scan has proven to be a useful modality for detecting macular structural abnormalities in patients undergoing cataract surgery. Conventional SD-OCT remains mandatory to confirm the presumed diagnosis.

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Section: Introductionmentioning

confidence: 99%

Swept-Source Optical Coherence Tomography Biometer as Screening Strategy for Macular Disease in Patients Scheduled for Cataract Surgery

Tognetto

Pastore

Giacinto

et al. 2019

Sci Rep

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“…In an animal study, EK and other ocular surface diseases were found to result from the abnormal tear function after cataract surgery [ 13 ]. As Sangwan et al [ 14 ] reported, surgeries for cataract combined with ocular surface diseases needed careful preoperative, intraoperative, and postoperative planning to prevent postoperative epitheliopathy. In this study, 60.67% of all patients with EK after cataract surgery were more than 70 years old, with an average age of 69.85 ± 9.61 years.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features, Risk Factors, and Therapy of Epithelial Keratitis after Cataract Surgery

Wang

et al. 2021

Journal of Ophthalmology

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Purpose. The study aimed to assess the clinical characteristics, risk factors, and therapy of epithelial keratitis after cataract surgery. Methods. Medical data of 89 consecutive patients who developed epithelial keratitis after cataract surgery, including 37 patients with diabetes mellitus (37 eyes) and 52 patients without diabetes mellitus (52 eyes), were retrospectively reviewed. The clinical characteristics, risk factors, and therapy in those patients were evaluated. Results. The preoperative tear film function determined by the tear breakup time, meibomian gland atrophy score, and low tear meniscus height in diabetic patients was poorer than nondiabetic patients ( P < 0.001 ). Of diabetic patients, 83.78% (31/37) had been diagnosed with meibomian gland dysfunction before cataract surgery and treated with topical nonsteroidal anti-inflammatory drugs after cataract surgery for 44.69 ± 10.51 days, compared to 42.31% (22/52) of nondiabetic patients receiving the topical nonsteroidal anti-inflammatory treatment for 33.35 ± 5.16 days (both P < 0.001 ). Epithelial lesions progressed within three to four days following cataract surgery in 59.46% (22/37) of diabetic patients, versus 30.77% (16/52) of the nondiabetic patients ( P = 0.025 ). Patients with combined meibomian gland dysfunction and epithelial defects accounted for 48.65% (18/37) in the diabetic group and 25.00% (13/52) in the nondiabetic group ( P < 0.001 ). In vivo confocal microscopy showed absence of subbasal never fibers in eyes with epithelial defects, and central corneal sensation was also significantly depressed in those eyes, but there was no significant difference between the two groups ( P = 0.227 ). Corneal ulceration and herpes simplex keratitis were found in 2.70% (1/37) and 5.41% (2/37) of diabetic patients, respectively. Amniotic membrane transplantation was required in 32.43% (12/37) of patients in the diabetic group, and the proportion was higher than 1.92% (1/52) in the nondiabetic group ( P < 0.001 ). Average healing time of the corneal epithelium in the diabetic group was 40.62 ± 20.0 days, much longer than 21.74 ± 6.94 days in the nondiabetic group ( P = 0.002 ). Conclusion. Epithelial keratitis after cataract surgery in diabetic patients has the characteristics of rapid development, severe epithelial damage, and slow repair of the corneal epithelium. Amniotic membrane transplantation is a good choice for persistent epithelial defects associated with such epithelial keratitis. Attention should be paid to the tear film function and use of topical nonsteroidal anti-inflammatory drugs in patients undergoing cataract surgery.

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“…A cataract is the first kind of blinding eye disease in China and even in the whole world. Usually, the metabolic disorder of the patient's eye lens leads to degeneration of lens protein, which leads to intraocular lens opacity (1). Cataracts mostly occur in middle-aged and elderly people over 50 years old, which can be caused by age, decreased immunity, radiation, drugs, poisoning, and other factors.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Effect of Phacoemulsification and Intraocular Lens Implantation Combined With Trabeculectomy on Cataract and Its Influence on Corneal Endothelium

Wang

Tang

2022

Front. Surg.

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ObjectiveThis study aimed to discuss the effect of phacoemulsification and intraocular lens implantation (PHACO + IOL) combined with trabeculectomy (TRAB) on cataracts and its influence on the corneal endothelium.MethodsWe selected 120 cataract patients admitted to our hospital from January 2018 to January 2021. According to different surgical methods, they were divided into the control group and the observation group. The observation group was treated with PHACO + IOL combined with TRAB, the control group only received PHACO. The clinical effect, ophthalmic-related parameters, corneal endothelium, complications, the satisfaction of the two groups were observed.ResultsThe total effective rate and total satisfaction rate of the observation group were significantly higher than the control group (P < 0.05). One month after the operation, the vision and central anterior chamber depth of the observation group were higher than those of the control group, and intraocular pressure (IOP) was lower than that of the control group (P < 0.05). One month after the operation, the corneal endothelial cell area and cell density in the observation group were not significantly different from those before operation (P > 0.05). There was no significant difference in the total incidence of complications between the two groups (P > 0.05).ConclusionThis study concluded that PHACO + IOL combined with TRAB has a good curative effect in the treatment of cataracts, which can improve the patients' vision and IOP, keep the functional integrity of corneal endothelial cells, and does not increase the occurrence of complications, the patients' satisfaction is high.

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Cataract surgery in ocular surface diseases

Abstract: Cataract surgery in ocular surface diseases needs careful preoperative, intraoperative and postoperative planning. Performed in a staged manner under favorable ocular environment, it has good visual outcomes and can improve the quality of life in such patients.

Cited by 28 publications

References 46 publications

Swept-Source Optical Coherence Tomography Biometer as Screening Strategy for Macular Disease in Patients Scheduled for Cataract Surgery

Swept-Source Optical Coherence Tomography Biometer as Screening Strategy for Macular Disease in Patients Scheduled for Cataract Surgery

Clinical Features, Risk Factors, and Therapy of Epithelial Keratitis after Cataract Surgery

Analysis of the Effect of Phacoemulsification and Intraocular Lens Implantation Combined With Trabeculectomy on Cataract and Its Influence on Corneal Endothelium

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