Refractive Outcomes for Combined Phacoemulsification and Glaucoma Drainage Procedure

Abstract

Introduction: To evaluate the refractive outcome of combined cataract extraction and glaucoma drainage device (GDD) surgery. Methods: Patients who had undergone combined phacoemulsification with GDD surgery [Baerveldt, Abbott Medical, Abbott Park (IL) or Ahmed valve, New World Medical, Rancho Cucamonga (CA)] between June 2009 and August 2017 were included in the study. The main outcome measure evaluated was whether or not spherical equivalent (SE) between ± 1D from target refraction was achieved at 3-6 months postoperatively. Results: The final analysis included 42 eyes of 38 patients who underwent combined phacoemulsification and GDD surgery. A refractive outcome of spherical equivalent (SE) between ± 1D of the target refraction was achieved in 30 of 42 eyes (71.43%) at 3-6 months after surgery. Mean preoperative axial length (AL) of eyes with postoperative SE outside ± 1D from target (SD = 0.98, p = 0.003) was noted to be 25.37 ± 0.98 mm (longer mean AL) and that of eyes with SE between ± 1D (SD = 0.89, p = 0.000) was found to be 23.34 ± 0.89 mm (average mean AL). Twelve (29%) eyes were noted to have a mean 0.52D (SD = 0.49; range 0.02-1.49) of corneal astigmatism induced by combined surgery. Age, central corneal thickness, preoperative anterior chamber depth, and pre-and postoperative intraocular pressure did not significantly affect refractive outcomes. Conclusion: Refractive outcomes within 1.00D of the target refraction were achieved in most patients undergoing a combined surgical approach. Longer AL was a risk factor among patients with refractive change [ 1.00D from target.

Premium Intraocular Lenses in Glaucoma—A Systematic Review

“…Successful pseudo-phakic rehabilitation after combined cataract and glaucoma surgery requires accurate IOL power calculation, which depends on precise measurements of the AL and ACD [ 90 ]. Eyes with glaucoma are associated with extremes in AL, with open angle glaucoma associated with high myopia [ 91 ] and increased AL [ 92 ], while angle-closure eyes have been shown to have shorter ALs [ 93 ].…”

Kết quả khúc xạ sau phẫu thuật Phaco/IOL áp dụng công thức Barrett Universal II kết hợp mở góc tiền phòng

“…Nghiên cứu của Anju Gastogi năm 2022 khi nghiên cứu 60 mắt tác giả so sánh giữa các công thức Barrett Universal II, Hoffer Q, Holladay 1, SRK/T thì cho kết quả của công thức Barrett Universal II tốt nhất với khúc xạ tương đương cầu trung bình thực tế là 0,64 ± 0,73D [7]. Năm 2022 tác giả Rajvi Mehta và cộng sự khi nghiên cứu về kết quả khúc xạ sau phẫu thuật Phaco/IOL (công thức Hoffer Q và SRK/T) kết hợp đặt van dẫn lưu hạ nhãn áp ở 42 mắt bị Glôcôm kèm theo đục thể thủy tinh có đưa ra kết quả: Có 30/42 mắt có kết quả khúc xạ trong khoảng ±1D chiếm tỷ lệ 71,43% [8]. Tương tự như vậy, trong nghiên cứu của mình Mohamed Attia Ali Ahmed và cộng sự 2019 cũng đạt kết quả khúc xạ khá tốt với khúc xạ tương đương cầu sau mổ đạt trong khoảng ±0,5D chiếm 66,67% [9].…”

The Precision of Calculating the Optical Power of the IOL in Various Methods of Out-Bag IOL Fixation

“…Retropupillary implantation of an iris-claw lens during complicated phacoemulsification significantly increases visual acuity without correction, frequency calculation precision within ±0.5 diopters, significantly reduces the average absolute calculation error compared to transscleral suture fixation of the IOL. Наиболее физиологичным положением интраокулярной линзы (ИОЛ) для коррекции афакии при факоэмульсификации является, безусловно, ее расположение внутри капсульного мешка [1][2][3][4][5]. Однако в клинической практике хирургу часто приходится сталкиваться с ситуациями, когда имплантация ИОЛ в капсульный мешок невыполнима, а также может быть сопряжена с высоким риском децентрации и дислокации ИОЛ в послеоперационном периоде.…”