Real-Time Dynamic Intraocular Pressure Fluctuations During Microcoaxial Phacoemulsification Using Different Aspiration Flow Rates and Their Impact on Early Postoperative Outcomes: A Randomized Clinical Trial

Vasavada, Vaishali; Raj, Shetal M.; Praveen, Mamidipudi R.; Vasavada, Abhay R.; Henderson, Bonnie An; Asnani, Priyadarshi K.

doi:10.3928/1081597x-20140711-06

Cited by 33 publications

(47 citation statements)

References 32 publications

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“…However, out of ten papers published in the cataract subspecialty, three were randomized trials and thus generated evidence of the highest order. [234]…”

Section: Resultsmentioning

confidence: 99%

“…Out of the 58 free papers published, 4 were randomized control trials,[2345] fifty were original articles, two were surgical techniques, one was a case report, and one was a review article. In addition, five out of the 58 (8.6%) publications were from international presenters including one each from China, Scotland, Canada, and two from the Middle Eastern countries.…”

Section: Resultsmentioning

confidence: 99%

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Publication rates from the All India Ophthalmic Conference 2010 compared to 2000: Are we improving?

Kumaragurupari

Sengupta

Bhandari

2016

Indian J Ophthalmol

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Purpose:To determine the publication rates of free papers and posters presented at the All India Ophthalmic Conference (AIOC) 2010 in peer-reviewed journals up to December 2015 and compare this with publication rates from AIOC2000 published previously.Methods:A thorough literature search was conducted using PubMed, Google Scholar, and the general Google search engine by two independent investigators. The title of the paper, keywords and author names were used to “match” the AIOC free-paper with the published paper. In addition, the “purpose,” “methods,” and “outcome measures” between the two were studied to determine the “match.”Results:A total of 58 out of 394 free-papers (14.7%) from AIOC2010 were published till December 2015 compared to 16.5% from AIOC2000. Out of these, 52 (90%) were published in PubMed indexed journals. Maximum publications were seen in pediatric ophthalmology (50%) followed by glaucoma (24.4%) and cornea (23.8%). Fifteen out of 272 posters (5.5%) were published; orbit/oculoplastics had the highest poster publications (13%). Excluding papers in nonindexed journals and those by authors with international affiliations, the publication rate was approximately 12%.Conclusion:The publication rate of free papers from AIOC2010 has marginally reduced compared to AIOC2000. Various causes for this such as lack of adequate training, motivation, and lack of incentives for research in the Indian scenario have been explored, and measures to improve this paradigm have been discussed. It will be prudent to repeat this exercise every decade to compare publication rates between periodic AIOC, stimulate young minds for quality research and educate policy makers toward the need for developing dedicated research departments across the country.

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“…However, out of ten papers published in the cataract subspecialty, three were randomized trials and thus generated evidence of the highest order. [234]…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Publication rates from the All India Ophthalmic Conference 2010 compared to 2000: Are we improving?

Kumaragurupari

Sengupta

Bhandari

2016

Indian J Ophthalmol

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“…In our case, the cataract surgery was the presumed trigger for the BRVO. It is known that during phacoemulsification wide fluctuations of IOP occur . Vasavada and colleagues documented that IOP reached 85 mmHg during nuclear fragment removal (60 mmHg is the perfusion pressure of the retinal artery), while Zhao and colleagues reported values of 96 mmHg during the simulated cortical clean‐up and viscoelastic removal.…”

Section: Discussionmentioning

confidence: 99%

Branch retinal vein occlusion following cataract surgery

Polizzi

Barca

Caporossi

et al. 2018

Clinical and Experimental Optometry

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Cataract surgery is one of the most frequently performed surgical procedures in the world.1 Technological progress has increased the safety and efficacy of this surgery; however, as with any surgery, it is not devoid of possible complications, some of which are related to the anatomical features of the operated eye. Herein, we report a case of branch retinal vein occlusion (BRVO) following cataract surgery. CASE REPORTA 64-year-old woman was referred to our clinic for cataract evaluation in the right eye. Her medical history was positive for well-controlled hypertension. She had surgery for a macular hole in the right eye and a prior BRVO in the left eye. On examination, her visual acuity (VA) was 6/120 in the right eye and 6/7.5 in the left. The anterior segment examination demonstrated 3+ nuclear changes in the right and 1+ nuclear sclerosis in the left eye. Intraocular pressure (IOP) was 15 mmHg in the right eye and 16 mmHg in the left. Fundus examination of the right eye revealed epiand peri-papillary local venous narrowing, tortuous blood vessels at the posterior pole, arteriovenous (A/V) crossing changes and loss of the normal foveal reflex. In the left eye, arteriovenous crossing changes, tortuous blood vessels at the posterior pole, collateral vessels and some small hard exudates inferonasal to the macula were present. Optical coherence tomography (OCT) showed notching of the foveal tissue with disruption of inner segment ellipsoid band in the right eye and mild macular oedema below the fovea in the left. After discussing the risk and benefits of cataract surgery, the patient decided to undergo phacoemulsification with intraocular lens (IOL) implantation. The surgery was performed under topical anaesthesia, without any complications.On post-operative day 1, the patient's VA was 6/18.9 in the operated eye. Slitlamp examination showed a clear cornea and 0.5+ anterior chamber cells. IOP was 16 mmHg. Fundus examination demonstrated three small flame-shaped intraretinal haemorrhages below the macula.After five days, her visual acuity was 6/18.9 -in the right eye and fundus examination showed an increase in the number and size of flame-shaped haemorrhages limited to the retinal area, which is drained by the inferotemporal retinal vein. On OCT, there were small intraretinal cysts inferonasal to the fovea. A diagnosis of inferotemporal BRVO was made in the right eye, so the patient underwent further medical tests to identify any other vasculopathic risk factors, apart from hypertension. The results of the tests were all normal except for D-dimer, fibrinogen and homocysteine, which were slightly high at 488 ng/mL (normal range less than 400), 439 mg/dL (normal range 200 to 420) and 21.0 μmol/L (normal range 5.0 to 15.0), respectively.

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“…However, the influence of intraoperative IOP fluctuations during phacoemulsification or vitrectomy is dependent on the applied aspiration pressure [17, 18]. The higher the aspiration pressure, the higher the IOP up to 85 mmHg.…”

Section: Discussion: Possible Triggering Mechanismsmentioning

confidence: 99%

Vascular Occlusions following Ocular Surgical Procedures: A Clinical Observation of Vascular Complications after Ocular Surgery

Fischer

Brüggemann

Hager

et al. 2017

Journal of Ophthalmology

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Background Ocular vascular occlusions following intraocular procedures are a rare complication. We report a case series of patients with retinal vascular occlusions or anterior ischemic optic neuropathy (AION) after anterior and posterior segment surgery and demonstrate possible risk factors. Methods Observational case series. Results In ten patients, vascular occlusions were observed within ten weeks after intraocular surgery: branch retinal arterial occlusion (BRAO) (n = 2), central retinal artery occlusion (CRAO) (n = 2), central retinal vein occlusion (CRVO) (n = 1), branch retinal vein occlusion (BRVO) (n = 1), anterior ischemic optic neuropathy (AION) (n = 3), and combined central artery and vein occlusion (n = 1). AION occurred later (27–69 d) than arterial occlusions (14–60 d) or venous occlusions (1-2 d). In all cases, either specific surgical manipulations or general vascular disorders were identified as risk factors. In addition to general cardiovascular risk factors (arterial hypertension n = 6, diabetes mellitus n = 4), internal workup disclosed bilateral stenosis of the carotid arteries (n = 1) and myeloproliferative syndrome (n = 1). Conclusion Vascular occlusions after surgical ocular procedures seem to be more frequent when cardiovascular diseases coexist. Surgical maneuvers and intra- or postoperative pressure changes may act as a triggering mechanism in patients with underlying systemic cardiovascular disorders. Affected patients should undergo thorough internal examination to identify possible underlying diseases.

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Real-Time Dynamic Intraocular Pressure Fluctuations During Microcoaxial Phacoemulsification Using Different Aspiration Flow Rates and Their Impact on Early Postoperative Outcomes: A Randomized Clinical Trial

Abstract: Higher aspiration flow rate and bottle heights are associated with high intraoperative IOPs of up to 85 mm Hg. Prolonged elevated IOP during cataract surgery was found to have more anterior segment inflammation and more edematous corneas.

Cited by 33 publications

References 32 publications

Publication rates from the All India Ophthalmic Conference 2010 compared to 2000: Are we improving?

Publication rates from the All India Ophthalmic Conference 2010 compared to 2000: Are we improving?

Branch retinal vein occlusion following cataract surgery

Vascular Occlusions following Ocular Surgical Procedures: A Clinical Observation of Vascular Complications after Ocular Surgery

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