Comparison between opposite clear corneal incision versus toric intraocular lens in correcting astigmatism.

PURPOSE: To compare the visual outcomes and efficacy of opposite clear corneal incision (OCCI) and toric intraocular lens (IOL) implantation in correcting preexisting astigmatism (PEA) in patients undergoing phacoemulsification. METHODS: This prospective interventional comparative study was conducted between June 2022 and January 2023 in patients having cataract with PEA undergoing phacoemulsification. Patients were divided into two groups - group A underwent phacoemulsification with OCCI and group B underwent phacoemulsification with toric IOL implantation. Uncorrected distance visual acuity (UDVA), manifest refractive cylinder, and corneal astigmatism using corneal tomography were measured preoperatively and at 6 weeks postoperatively. The eyes were categorized into three groups with PEA ranging from 1 to 1.5 D, 1.6 to 2 D, and 2.1 to 3 D. Depending upon the white-to-white corneal diameter, the eyes were also categorized into four groups with corneal diameter ranging from 10.5 to 10.9 mm, 11 to 11.4 mm, 11.5 to 11.9 mm, and 12 to 12.4 mm. RESULTS: Sixty eyes of 60 patients were studied. At postoperative 6 weeks, 83.3% (25 eyes) in the OCCI group and 96.7% (29 eyes) in the toric IOL group achieved UDVA of 6/9 or better. No statistically significant difference was noted between the groups (P = 0.37). The reduction in mean corneal astigmatism was 0.63 ± 0.37 D in the OCCI group and 0.15 ± 0.12 D in the toric IOL group (P < 0.001). The residual mean refractive cylinder was 0.60 ± 0.38 D in the OCCI group and 0.05 ± 0.15 D in the toric IOL group at 6 weeks (P = 0.007). CONCLUSION: Both OCCI and toric IOL are effective in correcting PEA. However, in a resource-limited setting, OCCI is a better alternative surgical option for correcting astigmatism of 1-1.5 D during phacoemulsification without requiring additional skills or instruments.

Comparison of different endophthalmitis prophylactic measures in cataract surgery - An analysis of 2.4 lakh cases.

Purpose: To compare different endophthalmitis prophylaxis methods adopted in cataract surgery (manual small-incision cataract surgery and phacoemulsification) between the years 2013 and 2021 in the community eye care section of a tertiary eye care hospital in South India and report their outcomes. Methods: All cataract surgeries performed from January 2013 to December 2021 (2,46,874 surgeries) at a single center were included in this retrospective study. The different endophthalmitis rates with each regimen were analyzed and evaluated. Results: 70,081 surgeries were performed from January 2013 to February 2015, where Tobramycin was added to Balanced Salt Solution (BSS) (Group A). From March 2015 to January 2017, 63,245 surgeries were performed when intracameral Moxifloxacin was given (Group B). From February 2017 to December 2021, 1,13,548 surgeries were performed were Amikacin was added to BSS (Group C). In total, 42 cases of postoperative endophthalmitis were reported during the study period (0.02%). There was no significant difference in the endophthalmitis rates between groups A and B (P = 0.4152); however, there was a significant decrease in endophthalmitis rates in group C when compared with group A (P = 0.04) and group B (P = 0.006). Conclusion: There was a significant reduction in the rates of endophthalmitis following the addition of amikacin in irrigating BSS. Nocardia was one of the predominant organisms isolated from these endophthalmitis patients. This is the first single-center study to report a comparative analysis of different endophthalmitis prophylactic measures in a community eye care set up with a high incidence of Nocardia endophthalmitis prevented with amikacin in BSS irrigating solution.

Performance of a New-Generation Extended Depth of Focus Intraocular Lens-A Prospective Comparative Study.

PURPOSE: The aim was to study the visual performance of a new refractive extended depth of focus (EDOF) intraocular lens (IOL). DESIGN: Prospective, comparative study. METHODS: Consenting patients with age-related cataract willing for bilateral cataract surgery within 2 weeks were implanted with the Supraphob EDOF IOL and those willing for 1 eye surgery were implanted with a monofocal IOL. The uncorrected and best-corrected distance, intermediate and near visual acuity, and contrast sensitivity were evaluated at 1 and 3 months postoperatively. We also inquired about glare, halos, difficulties in night driving, requirement for spectacles, and overall satisfaction with vision. RESULTS: The Supraphob EDOF group (n = 72 eyes) and the monofocal IOL group (n = 54 eyes) were comparable with respect to all preoperative parameters including biometry, visual acuity, and cataract status. The mean age of participants was 58.4 ±â€Š10.6 years. Both groups had similar distance vision but the EDOF group had significantly better intermediate (0.2 ±â€Š0.2 logMAR vs 0.75 ±â€Š0.19 logMAR, P < 0.001) and near vision (median = N6 vs N12, P < 0.001) compared to the monofocal group at 3 months. The contrast sensitivity was similar in both groups. Patients in the EDOF IOL group had much greater satisfaction for intermediate and near vision. Less than 10% patients reported glare, halos, and difficulty in driving at night in the EDOF group. CONCLUSIONS: The Supraphob EDOF IOL was effective in improving the distance, intermediate and near vision in majority of patients, and retained good contrast sensitivity with most patients reporting excellent satisfaction.

Safety & efficacy of single subconjunctival triamcinolone 5 mg depot vs topical loteprednol post cataract surgery: less drop cataract surgery.

AIM: To do a randomized prospective interventional study for comparing the effects of a single subconjunctival triamcinolone acetonide (SCTA) injection to tapering topical loteprednol in patients undergoing phacoemulsification surgery under topical anesthesia. METHODS: A total of 400 patients were randomized into 2 groups; Group A (200 patients) received 5 mg SCTA at the end of surgery and topical ketorolac tromethamine (0.5%) with ofloxacin (0.3%) combination for 3wk. Group B (200 patients) received tapering topical loteprednol etabonate (0.5%) along with ofloxacin (0.3%) and ketorolac tromethamine (0.5%) for 3wk. Outcomes evaluated were intraocular pressure (IOP), anterior chamber cells/flare and macular oedema postoperatively at 1, 6 and 12wk. RESULTS: Baseline parameters were almost similar in both the groups. No statistical difference was seen between the preoperative and postoperative IOP values for Group A (P=0.82) and Group B (P=0.61) and postoperative IOP values in between both groups (P=0.14) at 1wk. Incidence of cells/flare postoperative was statistically not significant (P=0.82) in both groups at all follow up visits. Postoperative macular oedema was not observed at any follow up visit. CONCLUSION: SCTA appears to be an effective alternative to prolong postoperative topical steroid use.