Intraocular lens implantation without the use of ophthalmic viscosurgical device

Ünsal, Uğur; Baser, Gonen; Söyler, Mehmet

doi:10.1007/s10792-016-0211-x

Cited by 13 publications

(9 citation statements)

References 20 publications

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“…The cortical material was removed using an irrigation/aspiration probe. Following cortex removal, the hydroimplantation technique 11 was used to place the hydrophobic acrylic intraocular lens in the capsular bag using an injector system. Finally, the main and side-port incisions were closed, and endophthalmitis prophylaxis was performed.…”

Section: Surgical Techniquementioning

confidence: 99%

The efficacy and safety profile of cataract procedures performed with a sensor-embedded handpiece and a new hybrid phaco tip

Sabur

Ünsal

2022

European Journal of Ophthalmology

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Objective To evaluate the efficacy and safety of the new Intrepid Hybrid tip and Active Sentry handpiece in comparison to the Intrepid Balanced tip and Centurion Ozil handpiece. Methods One hundred sixty-eight eyes were included in the study and randomized into Group 1 (Active Sentry handpiece + Intrepid Hybrid tip, n = 86) and Group 2 (Centurion Ozil handpiece + Intrepid Balanced tip, n = 82). Data were collected from the phaco device, including total U/S time, cumulative dissipated energy (CDE), the total number of active surge mitigation actuations (ASM actuations), torsional amplitude, torsional amplitude on time, estimated fluid of aspirated, and aspiration time. Endothelial cell count (ECC) and central corneal thickness (CCT) were assessed. A correlation analysis was performed between ASM actuations, phaco metrics, and patient characteristics in Group 1. Results The CDE, torsional amplitude measured in Group 1 (8.8 ± 3.9, 51.2 ± 13.3, respectively) were significantly lower than those of Group 2 (10.4 ± 4.2, 65.2 ± 9.3, respectively). While no complications were observed in group 1, there were posterior capsule rupture in 2 eyes and iris damage in 1 eye in group 2. The mean ECC and CCT were similar at 1 month. The ASM actuations were more engaged in the eyes with pseudoexfoliation and small pupils. Conclusion The combination of the new Intrepid Hybrid tip and Active Sentry handpiece enables safer cataract procedures without compromising efficacy due to its surge prevention mechanisms and special tip design. It could be a good option for residents in training.

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Section: Surgical Techniquementioning

confidence: 99%

The efficacy and safety profile of cataract procedures performed with a sensor-embedded handpiece and a new hybrid phaco tip

Sabur

Ünsal

2022

European Journal of Ophthalmology

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“…In high-risk patients, early postoperative IOP increase above 28 mmHg was reported in up to 46.4% of high-risk patients [9]. The risk factors for IOP spikes following PCS include residual viscoelastic material [13][14][15], resident-performed surgery [16][17][18], glaucoma [19,20], exfoliation syndrome [21], axial length of more than 25 mm [22], tamsulosin intake [23], and topical steroid application in steroid responders [24]. Postoperative anterior chamber inflammation might also result in an early IOP increase [25].…”

Section: Iop Spikesmentioning

confidence: 99%

Do we need day-1 postoperative follow-up after cataract surgery?

Grzybowski

Kanclerz²

2018

Graefes Arch Clin Exp Ophthalmol

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The aim of our study was to evaluate the current nature and frequency of complications present on the first postoperative day (POD1) and to verify whether the completion of a follow-up visit at this time is justified after standard phacoemulsification cataract surgery (PCS). Methods We used the PubMed literature database to identify relevant studies using the following keywords: postoperative, follow-up visit, complications, outcome, intraocular pressure, IOP, intraocular pressure spikes, IOP spikes, wound leakage, wound dehiscence, intraocular lens, IOL, dislocation, exchange, phacoemulsification, cataract surgery, and cataract extraction. Results We collected and analyzed 45 articles published between 1994 and 2017. The most common complications after PCS include corneal edema, postoperative uveitis, intraocular pressure (IOP) elevation, cystoid macular edema, and posterior capsule opacification. The IOP typically peaks at 3 to 7 h after surgery; however, none of the assessed treatment regimens were sufficient to protect glaucomatous eyes from IOP spikes. The majority of postoperative complications do not require early surgical intervention. Alternatives to POD1 follow-up after PCS include a nurse-administered telephone questionnaire, shared care with non-ophthalmologists, and seeing the patients at a low threshold in cases of complaints. Conclusions The current literature does not support the concept of a POD1 follow-up after uneventful PCS in patients without posterior synechiae or chronic/recurrent uveitis and operated on by experienced surgeons. When eliminating the POD1, visit individuals should receive topically a potent steroid (preferably prednisolone or dexamethasone). Applying a combination of topical dorzolamide/timolol and brinzolamide postoperatively in patients with glaucoma would be recommended, particularly in eyes with preexisting optic nerve damage. Eliminating the routine POD1 follow-up could result in significant health care savings without an increased risk to the patient.

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“…The risk factors for IOP spikes following PEI include residual viscoelastic material [23,24] , residentperformed surgery [17,25,26] , glaucoma [14,16] , exfoliation syndrome [27] , an axial length of more than 25 mm [28] , and topical steroid application in steroid responders [29] . However, a few studies have reported the associations of IOP spike after PEI-GSL in PACG.…”

Section: Discussionmentioning

confidence: 99%

Early intraocular pressure spike after phacoemulsification with intraocular lens implantation and goniosynechialysis in primary angle-closure glaucoma

Zuo

et al. 2022

Preprint

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Purpose: To evaluate the characteristics and associated risk factors of early postoperative intraocular pressure (IOP) spike in patients undergoing phacoemulsification with intraocular lens implantation and goniosynechialysis in primary angle-closure glaucoma.Design: Retrospective case series.Patients and Methods: Patients with consecutive primary angle-closure glaucoma patients without previous incisional glaucoma surgery who had undergone phacoemulsification with intraocular lens implantation and goniosynechialysis (PEI-GSL) by the same surgeon between January 2017 and November 2019 were reviewed to obtain the demographic information, number of antiglaucoma medications, preoperative IOP, pre-operative peripheral anterior synechiae (P-PAS), axial length (AL), anterior chamber depth (ACD), lens thickness (LT), mean deviation (MD), as well as pattern standard deviation (PSD) of the visual field (VF), Optic Vertica Cup-to-Disc ratio (C/D), intraoperative PAS remain (I-PAS), and postoperative outcomes. A postoperative early IOP spike was defined as an IOP of at least 21 mmHg at 2 h post-operation. The main outcome parameters were the frequency and distribution of postoperative IOP spikes and the risk factors associated with an IOP spike after PEI-GSL.Results: Of 100 eyes (100 patients) included in the study, 32% showed an early IOP spike (IOP spike group), while 68% showed no early IOP spike (no IOP spike group). Eleven patients (34.3%) from the IOP spike group showed an IOP value of ≥30 mmHg, and all underwent 2.82 times of aqueous humor release postoperatively. In the IOP spike group, twelve patients (37.5%) showed an IOP value of ≥21 mmHg at postoperative day (POD) 1, while three (9.4%) showed an IOP value of ≥21 mmHg at POD 7. The overall success rate was 89.74%, and the qualified success rate was 95.12% at the last follow-up (mean = 19.9 months, range 6–46 months). There was no significant difference in the frequency of IOP levels of ≥ 21 mmHg between the IOP spike group and the non-IOP spike group at the last visit (Fisher exact test, P = 1.000). Diagnosis of APACG or CPACG was associated with P-PAS, ACD, and PSD of VF but not with IOP spike (F = 4.003, P = 0.045).Conclusions: A significant percentage of PACG patients undergoing PEI-GSL had IOP spike at 2 h postoperatively. Side-port release of aqueous humor and use of antiglaucoma medications can effectively reduce IOP within one week after surgery. IOP spike was observed more frequently in patients with CPACG than in patients with APACG at 2 h postoperatively. Postoperative IOP spike did not affect the long-term success rate of IOP control.

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Intraocular lens implantation without the use of ophthalmic viscosurgical device

Cited by 13 publications

References 20 publications

The efficacy and safety profile of cataract procedures performed with a sensor-embedded handpiece and a new hybrid phaco tip

The efficacy and safety profile of cataract procedures performed with a sensor-embedded handpiece and a new hybrid phaco tip

Do we need day-1 postoperative follow-up after cataract surgery?

Early intraocular pressure spike after phacoemulsification with intraocular lens implantation and goniosynechialysis in primary angle-closure glaucoma

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