RESUMO
PURPOSE: To evaluate corneal endothelial health after cataract surgery without viscoelastic substance (VS). METHODS: A prospective, non-randomized, case-series study was developed, and phacoemulsification cataract surgery without VS was performed on 1324 eyes between September 2015 and September 2018. As main outcomes, mean endothelial cell density (ECD) and mean central corneal thickness (CCT) were assessed before surgery and then 6 and 12 months after surgery. Data are summarized as mean, standard deviation (SD), and 95% confidence intervals (CI). RESULTS: A total of 1324 eyes were operated, and 31 were excluded by intraoperative complications. The mean ECD baseline was 2506 cells/mm2 (SD = 215, CI = 2494-2518); 6 months after surgery, it was 2328 cells/mm2 (SD = 213, CI = 2316-2340); and 1 year after surgery, it was 2265 cells/mm2 (SD = 214, CI = 2253-2277). In terms of percentage differences, the mean ECD decrease was 9.4% after 1 year. The mean preoperative CCT was 531.6 µm (SD = 34.8, CI = 529.7-533.5); 6 months after surgery, it was 537.7 µm (SD = 38.2, CI = 535.6-539.8); and 1 year after surgery, it was 537.9 µm (SD = 37.9, CI = 535.8-540.0). The mean CCT increased 1.2% 1 year after surgery. CONCLUSIONS: Phacoemulsification cataract surgery can be completely performed without VS, with very low intraoperative complications. The postoperative ECD and CCT changes occurred primarily during the first 6 months, and the changes decreased during the second semester.
RESUMO
Our aim was to review clinical outcome and patient satisfaction after cataract surgery to obtain spectacle independence following multifocal intraocular lens (IOL) implantation. A prospective case-series study was designed to evaluate the safety and efficacy of the Hanita FullRange pseudophakic multifocal intraocular lens in patients with programmed cataract surgery, performed between October 2017 and May 2018, with follow-up after 12 months. Manifest refraction spherical equivalent (SE), SE refractive accuracy, uncorrected distance (UDVA), intermediate (UIVA) and near visual acuity (UNVA) and a binocular defocus curve were evaluated. In addition, a short "satisfaction questionnaire" was developed. Surgeries were performed without viscoelastic substance. The corneal endothelial cell density (ECD), central corneal thickness (CCT) and intraocular pressure (IOP) were also evaluated. A total of 480 eyes of 240 patients with mean ± standard deviation (SD) of age of 75 ± 6.12 years were included. The mean ± standard deviation (SD) of preoperative SE was 2.0 ± 2.18 D (range; -5.50 to 4.75) which decreased to -0.04 ± 0.28 D (range; -0.75 to 0.625) 12 months after surgery. Regarding SE refractive accuracy 82.9 % of eyes obtained SE values between -0.5 and 0.5 D. There was no loss of lines of vision and 98.3% of patients achieved UDVA between 20/20 and 20/25. The UNVA (binocular) obtained was J1 for 72.5% and J2 for 27.5% of patients. Regarding defocus curve, 0.04 logMAR for -3.0 D, 0.09 logMAR for -1.5 D and 0.03 logMAR for 0 D was achieved. The mean CCT was increased by 6.62 ± 2.79 micrometer (1.24%), the mean ECD was decreased by 226.08 ± 11.63 cell/mm2 (9.00 %) and the IOP remained stable one year after surgery. In response to the satisfaction questionnaire, 92% of patients stated that they had obtained spectacle independence. Finally, spectacle independence was achieved in most of the cases, with a high level of patient satisfaction one year after implantation of a FullRange IOL. No complications were detected. We concluded that the refractive efficacy of FullRange multifocal IOL was proved in majority of cases. A large follow up period is necessary in future studies to confirm the results.
RESUMO
The aim of this study was to evaluate the corneal safety, intraocular pressure (IOP), vault and refractive efficiency of the new implantable phakic contact lens, IPCL V2.0 (Care Group, India). A prospective case series study was performed to evaluate 100 consecutive surgeries with IPCL V2.0 (spherical and toric models). Refractive results, corneal endothelial cell density (CD) and central corneal thickness (CCT) were measured at baseline and 6 months after surgery. Intraocular pressure was measured at baseline, 1 day and 6 months, and vault, 3 and 6 months after surgery. Surgical complications and cataract development were also evaluated. The mean corneal endothelial CD decreased by 2.9% with a statistically significance difference (p: 0.03). The mean CCT decreased by 0.87% at 6 months postoperative, without a statistical significance difference (p: 0.35). The mean ± standard deviation (SD) of IOP at baseline was 13.72 ±1.4 mm Hg, at 1 day postoperative was 13.88 ±1.2 mm Hg, and at 6 months was 13.62 ±1.3 mm Hg. These differences were not statistically significant (p: 0.37). The difference in vault between 3 and 6 months after surgery was not statistically significant (p: 0.97). The coefficient of correlation between the attempted versus achieved spherical equivalent (SE) change was R2: 0.958. Postoperative SE was between -0.50 D to +0.50 D in 52% of cases. The remaining of the eyes had SE values ranging from -1.5 D to +1.35 D. No intra or postoperative complications occurred and specifically cataract was not developed. The corneal endothelial CD, CCT, vault and IOP remained stable 6 months after surgery. Refraction was improved and the IPCL V 2.0 was implanted safely.