October 2013

 

NEWS & OPINION

 

In The Journal Of Cataract & Refractive Surgery October 2013


   

Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract surgery

Juwan Park, MD, PhD, Hae Ri Yum, MD, Man Soo Kim, MD, PhD, Andrew R. Harrison, MD, Eun Chul Kim, MD, PhD

Investigators in this prospective, randomized clinical trial compared how cataract density during microincision cataract surgery affected outcomes. Included here were eyes with grades 2 to 4 cataracts, which were randomized to undergo cataract surgery using phaco-chop, divide-and-conquer, or stop-and-chop techniques. Investigators found that in grade 4 cataracts when the phaco-chop technique was used this took significantly less ultrasound time and reduced mean cumulative dissipated energy and balanced salt solution use compared with either of the other two techniques. In addition, at the two-month mark, eyes in this group with grade 4 cataracts showed significantly lower endothelial cell loss. Investigators concluded that while for mild to moderate cataracts all three techniques may be effective using coaxial microincision cataract surgery, the phaco-chop technique can be more effective for harder cataracts. Using this technique in such cases can result in more effective lens removal, with a decrease in endothelial damage when compared to the other two methods.

Shape of the anterior cornea: Comparison of height data from four corneal topographers

Tim de Jong, MSc, Matthew T. Sheehan, MSc, PhD, Michiel Dubbelman, MSc, PhD, Steven A. Koopmans, MD, PhD, Nomdo M. Jansonius, MD, PhD

For an accurate description of optical properties, knowledge of the anterior shape is crucial, contributing about 70% of the power of the eye. With this in mind, investigators considered how the shape of the anterior cornea compared when using four different topographers. With the aid of the Atlas Placido disk (Carl Zeiss Meditec, Jena, Germany), Galilei dual Scheimpflug (Ziemer Ophthalmic Systems, Port, Switzerland), Orbscan scanning slit (Bausch + Lomb, Rochester, N.Y.), and Pentacam single Scheimpflug (Oculus, Arlington, Wash.) topographers, investigators assessed anterior corneal shape in healthy eyes. At 5.5 mm, investigators determined that it was the single Scheimpflug topographer that showed the smallest coefficient of repeatability here. Such coefficients of repeatability were found to be up to 10 times larger for the other topographers. They also found that the topographic data of the Placido disk topographer and single Scheimpflug topographer corresponded the best. At 8.0 mm investigators had similar findings. However, when it came to determining detailed descriptions of the anterior corneal shape for individuals, test-retest variability hampered their ability. Likewise, the ability to exchange the devices was compromised by inter-device variability.

Evaluating the benefits of second-eye cataract surgery among the elderly

Takuro Ishikawa, BA, Ediriweera Desapriya, PhD, Maneesh Puri, MB BS, John M. Kerr, BSc, D. Sesath Hewapathirane, PhD, Ian Pike, PhD

In this systematic review investigators set out to determine how vision, patient-reported quality of life, driving ability, and likelihood of falls were all affected by undergoing cataract removal in the second eye. After searching MEDLINE, investigators culled 10 studies that met quality and inclusion criteria. In considering these, they determined that there was an improvement in visual acuity, contrast sensitivity and visual functioning as reported by patients, over and above first-eye results, terming the evidence here "moderate." Investigators stressed, however, that there was no definitive evidence from the studies provided that factors such as visual fields, quality of life, driving ability, or fall prevention were affected by second-eye surgery. Investigators concluded that for both clinicians and healthcare policymakers outcomes had implications and stressed, given how widely performed the procedure is, that there is a need for additional trials on this.

In The Journal Of Cataract & Refractive Surgery October 2013 In The Journal Of Cataract & Refractive Surgery October 2013
Ophthalmology News - EyeWorld Magazine
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