Cataract surgery in patients with corneal opacities

Ho, Yi-Ju; Sun, Chi-Chin; Chen, Hung-Chi

doi:10.1186/s12886-018-0765-7

Cited by 25 publications

(41 citation statements)

References 31 publications

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“…In this study, postoperative UCVA (0.30 ± 0.17) and BCVA (0.22 ± 0.16) were significantly improved compared to preoperative UCVA (1.20 ± 0.34) and BCVA (1.10 ± 0.30) (P < 0.05). Ho et al reported preoperative mean UCVA and BCVA of 20/800 and 20/630, respectively, which significantly improved to 20/200 and 20/160 (P < 0.001) after cataract surgery with monofocal IOL implantation in patients with corneal opacity [4]. In the Ho et al's study, the amount of visual acuity improvement was less than that in our study, because astigmatism was not corrected in this study [4].…”

Section: Discussioncontrasting

confidence: 66%

“…However, simultaneous penetrating keratoplasty and cataract surgery may induce more astigmatism than the preoperative condition [2,8]. Phacoemulsification and IOL implantation in selected cases of coexisting cataract and corneal opacity are safe and can provide suboptimal but long-term vision when penetrating keratoplasty is not an option or there is a high risk of graft failure [4]. Cataract surgery with toric IOL implantation could better improve visual acuity than simultaneous penetrating keratoplasty and cataract surgery when the central cornea is not totally opaque [3].…”

Section: Discussionmentioning

confidence: 99%

“…Cataract surgery with toric IOL implantation could better improve visual acuity than simultaneous penetrating keratoplasty and cataract surgery when the central cornea is not totally opaque [3]. BCVA improvements after surgery are less likely for more severe opacity indices that involve the pupil, according to the reflectivity signal [4]. In this study, postoperative UCVA (0.30 ± 0.17) and BCVA (0.22 ± 0.16) were significantly improved compared to preoperative UCVA (1.20 ± 0.34) and BCVA (1.10 ± 0.30) (P < 0.05).…”

Section: Discussionmentioning

confidence: 99%

“…Cataract surgery without PK is sometimes associated with good visual acuity when the corneal opacity partially obscures the pupillary area [3]. Even though visual outcomes after cataract surgery in eyes with corneal opacities can vary, corneal opacity severity may be one of the major prognostic factors of visual acuity [4]. When there is opacity in the patient's cornea, astigmatism usually occurs in the vertical axis (with-the-rule astigmatism), horizontal axis (against-the-rule astigmatism), oblique axis, or irregular axis.…”

Section: Introductionmentioning

confidence: 99%

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Toric intraocular lens implantation in cataract patients with corneal opacity

Hwang

Kim

et al. 2020

BMC Ophthalmol

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Background: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism.Methods: Thirty-one eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) were statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P < 0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P < 0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R = 0.91 P < 0.05 and R = 0.92 P < 0.05, respectively). Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Toric intraocular lens implantation in cataract patients with corneal opacity

Hwang

Kim

et al. 2020

BMC Ophthalmol

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“…The difference was maintained throughout the follow up, from one month (mild haze) to the end of the study (12 months, full recovery of the Group 2) and it was significant starting from three months after PRK surgery. Moreover, no patient has developed corneal opacification, according to corneal opacification grading [23], in the following months.…”

Section: Resultsmentioning

confidence: 99%

Oral l-Cysteine Supplementation Enhances the Long Term-Effect of Topical Basic Fibroblast Growth Factor (bFGF) in Reducing the Corneal Haze after Photorefractive Keratectomy in Myopic Patients

et al. 2020

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We aimed at evaluating the long-term effects of l-cysteine oral supplementation to basic fibroblast growth factor (bFGF) eye-drops on corneal re-epithelization and transparency in myopic patients subjected to photorefractive keratectomy (PRK). Forty patients subjected to bilateral PRK for myopia were enrolled and randomly divided into two groups receiving an additional therapy together with the standard postoperative treatment consisting in local tobramycin 0.3%, dexamethasone 0.1%, diclofenac 0.1%, and 0.2% hyaluronate. Group 1 included 20 patients (11 males and 9 females; 34.09 ± 8 years of age) receiving only bFGF eye-drops (10 μg/10 μL) four times a day for 7 days starting from the day of surgery; Group 2 included 20 patients (12 males and 8 females; 37.35 ± 11.5 years of age) who were postoperatively administered with topical basic fibroblast growth factor (bFGF; 10 μg/10 μL) four times a day for 7 days plus oral l-cysteine supplementation (500 mg/capsule) once a day for 15 days, starting 7 days before PRK. Patients were followed-up for 12 months. Clinical ophthalmologic parameters were recorded for all the 80 examined eyes. The corneal transparency was evaluated in vivo by slit lamp and confocal microscopy. The data showed that: (a) the corneal haze occurred in a smaller percentage of the patients who were postoperatively administered with topical bFGF plus oral l-cysteine supplementation (Group 2) compared to patients who received only bFGF (Group 1); (b) at 6 months of follow-up, the stromal mean image brightness of the patients belonging to Group 2 was significantly lower than that of the Group 1 (p < 0.03), and, interestingly, the difference was even more evident at 12 month from the treatment (p < 0.001). Moreover, the final mean of the spherical equivalent refraction was −0.06 ± 0.2 D in Group 1 and −0.08 ± 0.3 D in Group 2, whereas the final uncorrected distance visual acuity (UDVA) was equal or superior to 20/25 in 100% of eyes in both Group 1 and 2. Post refractive patients can benefit from the administration of l-cysteine before the surgery and in association with bFGF in the early postoperative period, showing a faster corneal re-epithelization able to prevent corneal haze in the long-term recovery.

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