Cataract surgery in the setting of severe pathologic myopia with high axial length: use of pars plana lensectomy and vitrectomy

Gologorsky, Daniel; Flynn, Harry W.

doi:10.2147/opth.s104475

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…Moreover, different setting values may result in different flow rates and unstable anterior chamber pressure 17. We identified linear relationships among irrigation bottle height, vacuum and IOP, which will be clinically useful for surgeons to set a relatively stable IOP during surgery and avoid drastic post-occlusion vacuum surges, especially for complex situations such as post-vitrectomy eyes and eyes with extremely high myopia 18–20…”

Section: Discussionmentioning

confidence: 99%

“…17 We identified linear relationships among irrigation bottle height, vacuum and IOP, which will be clinically useful for surgeons to set a relatively stable IOP during surgery and avoid drastic post-occlusion vacuum surges, especially for complex situations such as post-vitrectomy eyes and eyes with extremely high myopia. [18][19][20] With the traditional torsional phaco tip, high-frequency tip movement can cause severe cavitation outside the tip, which can cause heavy mechanical damage (including local high pressure and temperature resulting from microjets, sonoluminescence and shock waves) to ocular tissue within a certain distance. 21 22 These damaging effects were also confirmed by long-term erosion of the surface using a phaco tip and other materials.…”

Section: Open Accessmentioning

confidence: 99%

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Simulation of fluid dynamics and turbulence during phacoemulsification using the new propeller turbo tip

Wang,

Wang

2023

BMJ Open Ophth

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PurposeTo investigate the fluid dynamics and turbulence in the anterior chamber during phacoemulsification with a new propeller turbo tip using computational fluid dynamics methods.MethodsA theoretical study, three-dimensional model with the corresponding mathematical equations for the propeller turbo phaco tip, anterior chamber and lens capsular bag was developed. A simulation was performed for the new propeller turbo tip with various parameter settings (vacuum, irrigation bottle height and phaco power). Fluid dynamics and turbulence in the anterior chamber, lens capsular bag and phaco tip were evaluated. The linear relationship between the different setting parameters and a stable anterior chamber pressure was assessed.ResultsThe fluid dynamic turbulence was mainly symmetrically distributed in the anterior chamber. Propeller turbo phaco tip vibration caused increased fluid velocity and asymmetrical fluid turbulence in the metal lumen but had little influence on dynamic intraocular pressure. Reasonable phaco machine parameter settings can maintain a stable intraocular pressure during phacoemulsification.ConclusionsEvaluation of phacoemulsification fluid dynamics using computational simulation methods could provide detailed information about the influence of the propeller on dynamic intraocular pressure during phacoemulsification, which is useful for a better understanding of this procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Open Accessmentioning

confidence: 99%

Simulation of fluid dynamics and turbulence during phacoemulsification using the new propeller turbo tip

Wang,

Wang

2023

BMJ Open Ophth

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“…Therefore, in cataract surgery concerning patients with severe pathologic myopia, most surgeons emphasize maintaining intraocular pressure to avoid rapid pressure fluctuations due to the lack of scleral rigidity. [ 3 ] Alternatively, some surgeons remove the lens through the pars plana and vitreous during the surgery, [ 4 ] which can stabilize intraocular pressure and allow treatment of any induced retinal tears or lattice degeneration. This second approach is more traumatic, it takes longer and recovery is less predictable.…”

Section: Discussionmentioning

confidence: 99%

Long-term effects of phacoemulsification and intraocular lens implantation in a patient with pathologic myopia and extremely long axial length

Yang

Chen²,

An³

et al. 2020

Medicine

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Rationale: To report a rare case of phacoemulsification cataract surgery and intraocular lens implantation that improved visual acuity and capsular stability in a patient with pathologic myopia and axial length >38 mm. Patient concerns: A 51-year-old Chinese man with high myopia since childhood who had lost sight in his left eye at the age of 25 due to retinal detachment. He was referred for ophthalmological assessment due to decreased vision in the right eye, in which the best-corrected visual acuity at distance was hand motion. Diagnoses: The patient was diagnosed with cataract, high myopia, subluxated lens, and loose zonules in the right eye. The left eyeball showed atrophy. Interventions: The patient underwent uneventful phacoemulsification. An intraocular lens (Sensar AR40M) and capsular tension ring were implanted within the capsular bag. After surgery, the patient was given eye drops containing tobramycin and dexamethasone eye drops for 1 month and eye drops containing 0.1% sodium diclofenac for 2 months. Outcomes: There were no postoperative complications. During 1-year follow-up, uncorrected visual acuity was 20/80 and the manifest refraction was −2.50DS/−1.00DC∗80, with corrected distance visual acuity of 20/60. Cataract surgery maintained adequate vision for daily living. Lessons: Implantation of specific lens and capsular tension ring as well as prolonged use of non-steroidal anti-inflammatory drugs may help prevent capsular contraction and posterior capsule opacification in patients with pathologic myopia and extremely long axial length.

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Potential guidelines for cataract surgery and rehabilitation in visually impaired patients: Literature analysis

Limoli,

Nebbioso

2024

Aging Medicine

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Cataracts can reduce the quality of vision in visually impaired patients who already have a visual impairment. The most common causes of low vision include age‐related macular degeneration (AMD), high myopia (HM), diabetic retinopathy (DR), glaucoma (GL), and inherited degenerative ocular diseases. The surgery aims to improve their independence, quality of life, and ability to engage in daily, social, and work activities. Phacoemulsification and intraocular lens (IOL) implantation, combined with visual rehabilitation, can improve visual acuity of visually impaired patients. Therefore, comprehensive guidelines for cataract surgery in patients with low vision would be beneficial to ensure optimal surgical outcomes by improving surgical planning, execution, and postoperative care, along with a well‐coordinated rehabilitation process. In cases of reduced metabolism, such as low vision, oxidative stress can be aggravated by light exposure and surgical interventions. Thus, maintaining redox balance is crucial for stabilizing retinal conditions. Patients with visual impairments rely on retinal regions with the greatest residual function, and cataract surgery aims to enhance focus on these areas, improving reading quality and reducing scotoma perception. Thorough informed consent is crucial, ensuring that patients are fully aware of the potential risks, benefits, and limitations of surgery. Close postoperative follow‐up in the first 6 months is crucial to detect and manage any complications promptly, such as reactivation of maculopathy. The aim of this work is to establish potential guidelines for optimal rehabilitation outcomes through careful literature analysis.

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Cataract surgery in the setting of severe pathologic myopia with high axial length: use of pars plana lensectomy and vitrectomy

Cited by 6 publications

References 10 publications

Simulation of fluid dynamics and turbulence during phacoemulsification using the new propeller turbo tip

Simulation of fluid dynamics and turbulence during phacoemulsification using the new propeller turbo tip

Long-term effects of phacoemulsification and intraocular lens implantation in a patient with pathologic myopia and extremely long axial length

Potential guidelines for cataract surgery and rehabilitation in visually impaired patients: Literature analysis

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