Phacoemulsification in adult patients with  post-uveitis complicated cataract

Macarie, S; Macarie, Daniela

doi:10.22336/rjo.2018.19

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…The technique used was the "stop and chop", the phacoemulsification device was the Legacy® 20000 and the viscoelastic used was sodium hyaluronate 3.0% -chondroitin sulfate 4.0% (Viscoat®) [40]. In addition, the positive correlation between endothelial loss and ultrasound duration, used in PE surgeries in this study, confirms the findings of other studies that point to ultrasound energy as a harmful factor to the corneal endothelium [43,[47][48][49][50][51].…”

Section: Major Findings and Discussionsupporting

confidence: 85%

Phacoemulsification associated with loss of endothelial cells in cataract surgery: a systematic review of main surgical techniques

Garcia¹,

Liedtke²

2023

MedNEXT

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Introduction: Phacoemulsification (PE) cataract surgery is the gold standard in ophthalmology, being effective in improving vision in more than 90.0% of patients. In this context, authors found that PE was associated with 16.67% of endothelial cell loss, which correlated with the degree of trauma during surgery. Endothelial changes are considered an important parameter for assessing trauma and for estimating the safety of a surgical technique. In this sense, more modern PE machines are capable of removing cataracts using optimized parameters such as high vacuum, aspiration flow, and low amount of ultrasonic energy. Objective: It was to present and discuss the main phacoemulsification techniques for optimizing the treatment of cataracts, in an attempt to reduce the loss of corneal endothelial cells. Methods: Experimental and clinical studies were included (case reports, retrospective, prospective, and randomized studies) with qualitative and/or quantitative analysis. Initially, the keywords were determined by searching the DeCS tool (Descriptors in Health Sciences, BIREME base) and later verified and validated by MeSH Terms. The search literature was carried out from January to April 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Results: A total of 122 articles involving phacoemulsification and endothelial cells were found. Initially, the existing title and duplications were excluded according to the interest described in this work. After this process, the abstracts were evaluated and a new exclusion was performed. A total of 80 articles were evaluated in full and 59 were included and discussed in this study. At the beginning of treatment with PE, without the endothelial protection of viscoelastic agents and the use of ultrasound in the anterior chamber, the endothelial loss was greater than in extracapsular cataract extraction. With the modernization of PE, the use of viscoelastic agents, the emergence of techniques for fracture of the nucleus within the capsular bag, and the use of ultrasound in the posterior chamber, the loss of endothelial cells reduced from 7 to 12% on average. Conclusion: Endothelial changes are considered an important parameter to assess trauma and estimate the safety of a surgical technique. Highlighted, the main predictors associated with the loss of corneal endothelial cells are the duration of the ultrasound used in the surgery, the turbulence of the liquid in the anterior chamber, and the mechanical trauma.

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Section: Major Findings and Discussionsupporting

confidence: 85%

Phacoemulsification associated with loss of endothelial cells in cataract surgery: a systematic review of main surgical techniques

Garcia¹,

Liedtke²

2023

MedNEXT

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“…In Group 1, synechiolysis had to be performed more often during explantation surgery than in Group 2; while no synechiolysis was required in Group 3. Intraocular adhesions requiring additional manipulation carry the risk of subsequent complications [ 28 ]. Sammouh et al observed haptic migration through the iris tissue in 23% of 35 eyes treated with angle-supported (Phakic 6) pIOLs [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Reasons for explantation of phakic intraocular lenses and associated perioperative complications: cross-sectional explant registry analysis

et al. 2021

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Background We discuss the safety, since their introduction, of phakic intraocular lenses (pIOLs) to correct refractive errors in healthy eyes. We investigated the reasons for pIOL explantation and the associated perioperative complications. Methods This retrospective, cross-sectional study included 69 pIOLs, explanted at a single tertiary center between July 2005 and March 2020: 34 angle-supported (G1), 28 iris-fixated (G2) and seven posterior chamber (G3) pIOLs. Case data including the reason for explantation was taken from the patient records. Intra- and postoperative complications were evaluated for an association with the pIOL. Results The mean duration in the eye was 10.4 (0.2–28) years. Cataractogenesis and subsequent surgery that required pIOL explantation was the reason in 42% of all cases. In 22%, cataract in combination with endothelial damage prompted explantation, with 26, 18 and 14% for G1, G2 and G3 respectively. The second most common reasons were corneal damage alone in the angle-supported group (26%), IOL subluxation in the iris-fixated group (18%), and photopic disturbance in the posterior chamber group (29%). In 68% of all explantations, the surgical course was unremarkable, while in the remaining cases perioperative complications were associated with the lens in 45.7%. Conclusion Overall, the need for cataract surgery was the most common reason for pIOL explantation. Corneal complications were more frequent in the angle-supported pIOLs and their removal was associated with higher rates of complication compared to the other groups.

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