Phacoemulsification with hydrodelineation and OVD-assisted hydrodissection in posterior polar cataract

Hua, Xin; Dong, Yi; Du, Jianying; Yang, Jin; Yuan, Xiaoyong

doi:10.1186/s12886-018-0845-8

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Regular hydrodissection procedure with PPC carries the risk of PCR with nucleus drop and vitreous loss. 26 PCR affects the placement of the intraocular lens, which might necessitate a secondary posterior segment surgery. However, if diagnosed beforehand, surgeons can perform hydrodelineation instead of hydrodissection to avoid PCR.…”

Section: Discussionmentioning

confidence: 99%

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Innovative utilization of ultra-wide field fundus images and deep learning algorithms for screening high-risk posterior polar cataract

Mai,

Chen,

2024

J Cataract Refract Surg

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Purpose: Posterior capsular rupture (PCR) is a severe complication that occurs during cataract surgery. Patients with posterior polar cataract (PPC) are at a high risk of PCR. Mydriatic agents, despite notable side effects, enhance cataract posterior visibility during slit-lamp examination, aiding PPC identification. An ultra-wide-field (UWF) retinal imaging system, which does not need the aid of mydriatic agents, can visualize the projection (shadow) of a cataract onto the retina in fundus images. The relationship between PPC and the projected shadow remains unexplored. We hypothesized a cataract-shadow-projection theory and then validated it by developing a deep-learning algorithm which enables automatic and stable PPC screening using fundus images. Setting: Data were obtained from the Department of Ophthalmology at Far Eastern Memorial Hospital with permission from the hospital's Institutional Review Board. Design: Retrospective chart review data, including UWF fundus images. Methods: We developed a deep-learning algorithm to automatically detect PPC based on our cataract-shadow-projection theory. Retrospective data (n=546) with UWF fundus images were collected, and various model architectures and fields of view (FOVs) were tested for optimization. Results: The final model achieved 80% overall accuracy, with 88.2% sensitivity and 93.4% specificity in PPC screening on a clinical validation dataset (n=103). Conclusions: This study established a significant relationship between PPC and the projected shadow, enabling surgeons to identify potential PPC risks preoperatively and reduce the incidence of posterior capsular rupture during cataract surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Innovative utilization of ultra-wide field fundus images and deep learning algorithms for screening high-risk posterior polar cataract

Mai,

Chen,

2024

J Cataract Refract Surg

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“…Posterior capsular rupture is associated with cataract surgery, especially in patients with posterior opacification ( Hua et al., 2018 ). Several clinical studies have shown that the incidence of posterior capsule rupture accounts for more than 30% of posterior polar cataract surgeries ( Varadaraj et al., 1999 ; Das et al., 2008 ), which presents a big challenge for clinicians.…”

Section: Discussionmentioning

confidence: 99%

Macrophage recruitment in immune-privileged lens during capsule repair, necrotic fiber removal, and fibrosis

Quan

et al. 2021

iScience

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Summary Emerging evidence challenges the lens as an immune-privileged organ. Here, we provide a direct mechanism supporting a role of macrophages in lens capsule rupture repair. Posterior lens capsule rupture in a connexin 50 and aquaporin 0 double-knockout mouse model resulted in lens tissue extrusion into the vitreous cavity with formation of a “tail-like” tissue containing delayed regressed hyaloid vessels, fibrotic tissue and macrophages at postnatal (P) 15 days. The macrophages declined after P 30 days with M2 macrophages detected inside the lens. By P 90 days, the “tail-like” tissue completely disappeared and the posterior capsule rupture was sealed with thick fibrotic tissue. Colony-stimulating factor 1 (CSF-1) accelerated capsule repair, whereas inhibition of the CSF-1 receptor delayed the repair. Together, these results suggest that lens posterior rupture leads to the recruitment of macrophages delivered by the regression delayed hyaloid vessels. CSF-1-activated M2 macrophages mediate capsule rupture repair and development of fibrosis.

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Residual Anterior Chamber Nuclear Mass after Phacoemulsification: A Case Report

谢¹

2021

HJO

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Phacoemulsification with hydrodelineation and OVD-assisted hydrodissection in posterior polar cataract

Cited by 4 publications

References 16 publications

Innovative utilization of ultra-wide field fundus images and deep learning algorithms for screening high-risk posterior polar cataract

Innovative utilization of ultra-wide field fundus images and deep learning algorithms for screening high-risk posterior polar cataract

Macrophage recruitment in immune-privileged lens during capsule repair, necrotic fiber removal, and fibrosis

Residual Anterior Chamber Nuclear Mass after Phacoemulsification: A Case Report

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