Cataract surgery assisted by anterior endoscopy

Cataract surgery alone or combined with trabeculectomy should be considered in the treatment of angle closure glaucoma. However, in eyes with open angle glaucoma, cataract surgery alone may be of limited clinical benefit in lowering IOP. Surgical alternatives to be combined with cataract extraction may be utilized to achieve a more significant IOP reduction. The appropriate treatment should be tailored based on patient's characteristics and the target IOP to be achieved.

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“…Alternative procedures to be effected during phacoemulsification, such as endocyclophotocoagulation, also have been proposed [76,77].…”

Section: Recent Techniques To Lower Intraocular Pressure Combined Witmentioning

confidence: 99%

Cataract surgery and glaucoma

Vizzeri

Weinreb

2010

Current Opinion in Ophthalmology

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“…Furthermore, uncontrolled dye dispersion through zonules can obscure the capsular anatomy [ 9 ]. With regards to modified illumination methods, transcorneal oblique illumination and endoscope-assisted phacoemulsification have been utilized, however, they are time consuming and require skilled clinicians [ 5 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Cataract surgery in patients with corneal opacities

Sun

Chen

2018

BMC Ophthalmol

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BackgroundInvestigating the efficacy and safety of phacoemulsification with intraocular lens (IOL) implantation in corneal opacities.MethodsThis retrospective study was conducted in a tertiary medical center. Twenty-three eyes of 19 patients with cataracts and corneal opacities obscuring the pupillary center having received phacoemulsification with IOL insertion without any ancillary techniques were enrolled. The primary study outcome measures were uncorrected and best corrected visual acuity (BCVA), and complications. Backscatters of corneal scar lesions were evaluated by slit lamp-based haze grading, Scheimpflug Pentacam and anterior segment optical coherence tomography (ASOCT). Visual outcomes after cataract surgeries and improvement range were used to determine the safety and efficacy of cataract surgery for our patients.ResultsAll patients underwent uneventful capsulorhexis and phacoemulsification. The mean age was 72.22 ± 10.1 years, and the mean follow-up period was 18.57 ± 15.42 months. The mean BCVA significantly improved from 1.45 ± 0.65 preoperatively to 0.94 ± 0.55 logMAR postoperatively (p < 0.001), and the number of eyes with a BCVA of 20/100 or better increased from 4 to 14. Complications included corneal edema in two eyes and reactivation of the previous corneal pathology in five eyes. Four eyes did not achieve an improvement in visual acuity after surgery, which may have been due to co-existing ocular co-morbidities. Both Pentacam corneal densitometry and ASOCT demonstrated no significant correlations with final visual outcome. However, a statistically significant relationship between the severity of corneal opacity and improvement range in BCVA (r = − 0.782, P = 0.001) was found by our OCT grading method.ConclusionsPhacoemulsification and IOL implantation in selected cases of coexisting cataracts and corneal opacities is safe that can provide suboptimal but long-term vision when penetrating keratoplasty is not possible or at high-risk of graft failure. ASOCT is a simple tool to predict visual outcomes after cataract surgery in opacified corneas.

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“…Advantages of endoscopy in cases of media opacity are well established (endophthalmitis, trauma); [19][20][21][22][23] nonetheless, a broader number of indications for endoscopy exists when used as "endoscopy-assisted" vitrectomy. 6,18,[24][25][26][27][28][29] We propose the use of endoscopy to perform a detailed endoscopic revision during SO extraction in complex RDs. In the current era of small-gauge, high-resolution, and digitally-assisted vitrectomy, the potential advantages of endoscopy clearly outweigh the added costs, offering significant advantages, including complete SO removal, lowering of redetachment rates, and improvement of anatomical outcomes in this complex subset of patients.…”

Section: Discussionmentioning

confidence: 99%

Endoscopy-Assisted Vitrectomy Outcomes During Silicone Oil Removal After Complex Retinal Detachment Repair

Vilà

Rampakakis

Rezende

2019

Journal of VitreoRetinal Diseases

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Purpose: This retrospective study recorded intraoperative findings during silicone oil removal and postoperative anatomical outcomes comparing endoscopy-assisted pars plana vitrectomy (E-PPV) vs pars plana vitrectomy (PPV) alone after proliferative vitreoretinopathy (PVR)-related retinal detachment (RD) repair. Methods: This single-center retrospective study included patients who underwent PPV for silicone oil removal after RD with PVR from July 2009 to January 2017. Patients with diabetic tractional RD, history of trauma, uveitis, or endophthalmitis were excluded. After 2013, an endoscopic visualization system (E2 MicroProbe; Endo Optiks) was used in a nonrandomized fashion. Data collection included reattachment rate, intraoperative endoscopic findings and phthisis rate. Results: Fifty-four eyes of 54 patients were included. The mean participant age was 58.4 ± 12.9 years and 36 (65.5%) participants were male. The mean (± SD) follow-up duration after oil removal was 24.3 ± 20.1 months. E-PPV combined with wide-angle visualization system was performed in 26 (48.1%) of the patients; the surgical management was modified after endoscopic examination in 17 (65.4%) of the cases. Reattachment rate in the E-PPV group was 96.2% compared with 76.0% in the PPV-alone group ( P = .04). Conclusions: E-PPV for silicone oil removal appears to be advantageous for prevention of RD recurrence, thus achieving better reattachment rates. A thorough examination is facilitated by endoscopic visualization and contributory factors for anterior PVR can be identified and treated.

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Cataract surgery assisted by anterior endoscopy

Abstract: The ophthalmic microendoscope appears to be safe and effective in simultaneously providing illumination, video recording and a clear endoscopic view of the anterior chamber. This study demonstrates that in selected cases, anterior segment endoscopy is a useful adjuvant to cataract surgery.

Cited by 16 publications

References 20 publications

Cataract surgery and glaucoma

Cataract surgery and glaucoma

Cataract surgery in patients with corneal opacities

Endoscopy-Assisted Vitrectomy Outcomes During Silicone Oil Removal After Complex Retinal Detachment Repair

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