No abstract

Central PCO affects psychophysical test results with differing degrees of sensitivity. Forward light-scatter is the most sensitive, followed by contrast sensitivity and visual acuity.

A larger IOL optic diameter was associated with less PCO.

Aim: To compare the efficacy of two preoperative steroid regimens for cataract surgery in patients with uveitis. Methods: 40 uveitis patients with cataract underwent phacoemulsification and intraocular lens (IOL) implantation. Preoperatively they were randomised into two groups: group 1 (20 patients) received a single dose of intravenous methylprednisolone (15 mg/kg) half an hour before surgery, and group 2 (20 patients) received a 2 week course of oral prednisolone (0.5 mg/kg) which was tapered postoperatively. Preoperatively patients had aqueous flare and cells measured with the Kowa laser flare meter. On days 1, 7, 28, and 90 aqueous flare and cells were measured, and on days 7 and 90 fluorescein angiography was performed to determine the incidence of cystoid macular oedema (CMO). Results: At all postoperative visits the mean increase in flare was greater for group 1 (intravenous steroid). Patients with posterior synechiae had greater blood-aqueous barrier damage (BAB) postoperatively. There were no statistically significant differences in logMAR visual acuity and incidences of CMO between the two groups at 7 and 90 days. Conclusion: A 2 week course of oral prednisolone, tapered postoperatively, produced a better recovery of the BAB than a single dose of intravenous methylprednisolone and is thus the recommended preoperative regimen. C ataracts occur in up to 50% of patients with uveitis and ocular inflammation should be minimised for at least 2 months before proceeding with surgery. [1][2][3] Additionally, these patients should receive increased preoperative immunosuppressive steroid prophylaxis as this has been shown to increase the proportion of patients with a visual acuity (VA) of 20/40 or better at 3 months. 3 The aim of this prospective randomised study was to compare the effects of a single dose of intravenous methylprednisolone given half an hour before surgery with a 2 week preoperative course of oral prednisolone on VA, blood-aqueous barrier recovery (BAB), and the incidence of angiographic CMO in patients with uveitis undergoing phacoemulsification. PATIENTS AND METHODSFollowing ethics committee approval patients with uveitis requiring cataract surgery were randomised to two groups of preoperative augmented steroid treatment. Group 1 received intravenous methylprednisolone (15 mg/kg given over half an hour before surgery) and group 2 had a 2 week course of oral prednisolone (0.5 mg/kg/day) before surgery. Attempts were made to minimise ocular inflammation for at least 2 months preoperatively using either topical or oral steroid.On the day of surgery logMAR VA was measured and aqueous flare and cells were determined with the Kowa FC-1000 laser cell flare meter (LCFM). Patients underwent clear corneal incision phacoemulsification and acrylic intraocular lens implantation by a single surgeon. Posterior synechiae were present in 40% of group 1 and in 58% of group 2. The iris was stretched with Hirschmann hooks and iris sphincterotomies were performed in five and six patients in groups 1 and 2, respect...

There was no evidence of a difference in the area of PCO after cataract surgery between 1-piece and 3-piece IOLs, which were otherwise matched for material and lens geometry.

This prospective, randomized, placebo-controlled trial confirmed that MDX-RA is safe for intraocular use and is of potential value for further clinical trials of the prevention of PCO.

Aims-To determine whether topical anaesthesia in small incision self-sealing phacoemulsification cataract surgery provides comparable anaesthesia to subTenon's infiltration. Methods-Thirty five patients undergoing small incision self-sealing phacoemulsification cataract surgery were allocated randomly to receive topical anaesthesia with 0.4% oxybuprocaine or sub-Tenon's infiltration with 2% lignocaine. Pain experienced during the operation was assessed by asking the patient to score on a visual analogue graphic pain score chart. Results-The median pain score for the topical group (3) was significantly higher than that of the sub-Tenon's group (0) (p = 0.004). Conclusion-Sub-Tenon's infiltration is superior to topical anaesthesia in ensuring patient comfort during small incision scleral tunnel self-sealing phacoemulsification cataract surgery. (Br J Ophthalmol 1997;81:288-290) Over the past 2 years, small incision self-sealing phacoemulsification cataract surgery has been performed on more than 600 patients by one surgeon (JAAG), using sub-Tenon's infiltration as the preferred method of local anaesthesia. This technique avoids many of the risks of retrobulbar and peribulbar local anaesthetic injections, yet provides good anaesthesia with variable akinesia.1 Topical anaesthesia has also been advocated as a safer local anaesthetic technique compared with retrobulbar and peribulbar anaesthesia, providing eVective intraoperative anaesthesia, although no akinesia. The obvious advantages of topical anaesthesia versus sub-Tenon's infiltration are time saved in administering the local anaesthetic and shorter duration of action, which allows the patient to regain visual acuity rapidly after surgery.2 Another potential advantage of topical anaesthesia versus sub-Tenon's infiltration is less patient discomfort associated with administration of the local anaesthetic. However, from personal experience, most of the discomfort associated with sub-Tenon's infiltration is ascribed to instillation of the anaesthetic drops.In deciding whether to change from subTenon's anaesthesia to topical anaesthesia, patient comfort during the operative procedure was deemed to be the most important consideration. A study was thus undertaken to assess the pain experienced by individual patients during small incision self-sealing phacoemulsification cataract surgery performed under topical anaesthesia compared with subTenon's infiltration. Materials and methodsThirty five patients undergoing small incision self-sealing phacoemulsification cataract surgery were allocated randomly to receive topical or sub-Tenon's anaesthesia. Topical anaesthesia was provided by 0.4% oxybuprocaine hydrochloride (Benoxinate), instilled onto the cornea and conjunctiva. For the sub-Tenon's technique, Benoxinate drops were instilled as for topical anaesthesia. A small subconjunctival injection of 2% lignocaine with 1:200 000 adrenaline was then given in the inferior-nasal quadrant approximately 5 mm from the limbus, in order to raise a small bleb, and a small...

Haptic compressibility should be an important consideration in IOL design. The results suggest that to avoid posterior capsule folds, the compressibility should be less than 2.5 mN.