Risk of posterior capsule rupture in patients with type 2 diabetes mellitus and diabetic retinopathy during phacoemulsification cataract surgery

Dawson, Valerie J; Patnaik, Jennifer L; Wildes, Michael; Bonnell, Levi; Miller, Dayton T.; Taravella, Michael J.; Lynch, Anne M.; Christopher, Karen L

doi:10.1111/aos.15121

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…T2DM with a history of intravitreal injections and with DR, on the other hand, were independent risk factors for PC tear. 31 Intraoperatively, we did find that compared with patients without DM, patients with either type of DM required additional aids intraoperatively such as Malyugin rings, iris hooks, stretch pupilloplasty, trypan blue, or capsular tension rings.…”

Section: Discussionmentioning

confidence: 77%

Comparison of cataract surgery outcomes in patients with type 1 vs type 2 diabetes mellitus and patients without diabetes mellitus

Xia

Patnaik

Lynch

et al. 2023

J Cataract Refract Surg

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Section: Discussionmentioning

confidence: 77%

Comparison of cataract surgery outcomes in patients with type 1 vs type 2 diabetes mellitus and patients without diabetes mellitus

Xia

Patnaik

Lynch

et al. 2023

J Cataract Refract Surg

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“…Therefore, pupil expansion devices are required in up to 6.0% of cases to mechanically augment pharmacological dilation. [ 22 - 25 ]…”

Section: Discussionmentioning

confidence: 99%

Improved visibility of illuminated chopper-assisted cataract surgery involving iris challenges

Kim

Hwang

Eom

et al. 2023

Indian Journal of Ophthalmology

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Purpose: The aim of this study was to evaluate the efficacy of the illuminated chopper-assisted cataract surgery in terms of shortening the surgical time and reducing the use of pupil expansion devices in eyes with iris challenges. Methods: This was a retrospective case series of a university hospital. Four hundred forty-three eyes of 433 consecutive patients who underwent illuminated chopper-assisted cataract surgery were included in this study. Cases with preoperative or intraoperative miosis, iris prolapse, and intraoperative floppy iris syndrome were included in the iris challenge group. Use of tamsulosin, iris hooks, pupil size, surgical time, and improved visibility (100/surgical time × pupil size) were compared between eyes with and without iris challenges. Mann–Whitney U test, Pearson’s Chi-square test, and Fisher’s exact test were used for statistical analysis. Results: Of 443 eyes, 66 were included in the iris challenge group (14.9%). Tamsulosin use was more common in patients with iris challenges and iris hooks were used more frequently (9.1% vs. 0%, P < 0.001) in patients with iris challenges than in those without iris challenges. Pupil size was smaller in patients with iris challenges (6.01 vs. 7.64 mm, P < 0.001). However, surgical time was not different (16.9 vs. 16.5 min, P = 0.064) between the two groups. As a result, improved visibility was calculated to be higher in patients with iris challenges (1.05 vs. 0.81, P < 0.001). Conclusion: In terms of surgical time and improved visibility, using the illuminated chopper simplified cataract surgery involving iris challenges. The use of an illuminated chopper is expected to be a good solution for challenging cataract surgeries.

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Intraoperative challenges and complications of cataract surgery between cataract surgery alone and phacovitrectomy in eyes with diabetic retinopathy: efficacy of illuminated chopper-assisted cataract surgery

et al. 2023

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Background To compare the intraoperative challenges, complications, and operation time of illuminated chopper-assisted cataract surgery between cataract surgery only and phacovitrectomy in eyes with diabetic retinopathy. Methods One university hospital, retrospective case series. Two hundred ninety-five eyes of 295 consecutive patients with diabetic retinopathy who underwent cataract surgery only or phacovitrectomy were retrospectively reviewed. Intraoperative challenges and complications of cataract surgery were thoroughly analyzed by 3D viewing of digitally recorded videos. The pupil diameter, operation time, and improved efficacy (100/operation time × pupil diameter) were compared between the cataract surgery only and phacovitrectomy groups. Results Of the 295 eyes, 211 underwent cataract surgery only, and 84 underwent phacovitrectomy. Intraoperative challenges such as small pupil, miosis, or poor red reflex occurred more frequently (46 [21.8%] vs. 28 [33.3%], p = 0.029); pupil diameter was smaller (7.34 ± 0.94 vs. 6.89 ± 0.88 mm, p < 0.001) in the phacovitrectomy group than in the cataract surgery only group; however, rates of posterior capsule rupture and operation time were not different between the two groups (0 [0%] vs. 1 [1.2%], p = 0.285; 16.54 ± 2.65 vs. 16.31 ± 4.30 min, p = 0.434). Improved efficacy was higher in the phacovitrectomy group (0.85 ± 0.18 vs. 0.97 ± 0.28, p = 0.002). Conclusions The use of an illuminated chopper is a potential solution for diabetic cataract surgery, particularly in phacovitrectomy, by decreasing the use of supplemental devices, operation time, and posterior capsule rupture. Trial registration Retrospectively registered.

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Risk of posterior capsule rupture in patients with type 2 diabetes mellitus and diabetic retinopathy during phacoemulsification cataract surgery

Cited by 3 publications

References 30 publications

Comparison of cataract surgery outcomes in patients with type 1 vs type 2 diabetes mellitus and patients without diabetes mellitus

Comparison of cataract surgery outcomes in patients with type 1 vs type 2 diabetes mellitus and patients without diabetes mellitus

Improved visibility of illuminated chopper-assisted cataract surgery involving iris challenges

Intraoperative challenges and complications of cataract surgery between cataract surgery alone and phacovitrectomy in eyes with diabetic retinopathy: efficacy of illuminated chopper-assisted cataract surgery

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