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PURPOSE: To demonstrate the demographic features, causative agents, and outcome of pediatric traumatic cataract surgery in eyes without posterior segment involvement at Assiut University Hospital, Upper Egypt. PATIENTS AND METHODS: This is a retrospective study on children (aged <18 years old) who underwent traumatic cataract surgery from January to June 2019. Children with posterior segment injury and those who did not complete 6 months of postoperative follow-up were excluded. The demographic features, mechanism and time of eye injury, clinical features, surgical approach, and outcome were recorded and analyzed. RESULTS: The study included 34 eyes of 34 children, 23 (68%) of them were boys. The mean age at the time of cataract surgery was 10±3.97 years. Twenty-one eyes sustained open globe injury (62%) with the most common cause of trauma was wooden sticks, while 13 eyes had closed globe injury (38%) with the most common cause of injury was thrown stones. The time interval between eye injury and cataract surgery ranged from 1 day to 9 years with a median of 2.05 months. Posterior chamber intraocular lenses were implanted in all eyes; in 33 eyes, the posterior chamber intraocular lenses were implanted primarily at the time of cataract extraction. Corrected distance visual acuity significantly improved from 2.63±0.66 LogMAR preoperatively, to 0.41±0.38 LogMAR postoperatively (p < 0.001). CONCLUSION: Pediatric traumatic cataract is commonly present in primary school age especially after open globe injury. Primary prevention through health awareness should target this age population. Useful vision can be regained with timely proper surgical intervention and posterior chamber intraocular lens implantation. CLINICALTRIALSGOV ID: NCT04630509.
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BACKGROUND: To evaluate the clinical results and rotational stability of V4c toric implantable collamer lens (TICL, STAAR Surgical Company, Monrovia, CA, USA) in patients with moderate to high myopic astigmatism. Retrospective, interventional case series was performed at Shenzhen Eye Hospital, Shenzhen, Guangdong, China. METHODS: This study enrolled 43 patients (72 eyes) who received TICL implantation to correct myopia and myopic astigmatism. The patients underwent visual and refractive examinations before and 1 month after surgery. Astigmatic changes were estimated using polar value analysis. The difference between the achieved axis and the intended axis at the last follow-up was taken as the rotation of the V4c TICL. RESULTS: At 1 month postoperatively, the mean safety and efficacy indices were 1.17 and 1.13, respectively. A significant reduction of 8.92±2.58 D was observed in the spherical equivalent refraction (SER), which decreased from -9.29±2.41 D preoperatively to -0.37±0.55 D postoperatively. The astigmatic error of treatment in cylinder format was calculated to 0.50±0.41 @ 15.08° relative to the preoperative stronger meridian at 1 month, postoperatively. At 1 month postoperatively, the mean absolute rotation was 8.30±10.00 degrees (median =5.46 degrees; range, 0.00-58.88 degrees). CONCLUSIONS: TICL could achieve good astigmatic outcomes for correcting moderate to high myopic astigmatism. After TICL implantation, corneal astigmatism remained unchanged. To optimize postoperative astigmatic outcomes in TICL, polar value analysis can be used to build a nomogram.
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PURPOSE: To assess long-term positioning of posterior chamber intraocular lenses within the capsular bag in eyes with pseudoexfoliation syndrome. METHODS: The study includes 44 patients with pseudoexfoliation syndrome and 85 age-matched controls, who underwent cataract surgery in 2001 and 2002 at the Eye Department, Oslo University Hospital. In 2008, all patients were re-examined. A comparison of the extent of possible decentration in eyes with and without pseudoexfoliation syndrome was made by evaluating Scheimpflug images (Pentacam) of the anterior segment. RESULTS: It was found that, 6-7 years following cataract surgery, posterior chamber intraocular lenses were positioned lower in eyes with pseudoexfoliation syndrome than in control eyes. The difference was statistically significant (p=0.01). Downward shift was associated with presence of glaucoma only in eyes with pseudoexfoliation syndrome (p=0.01). No patients had visual disturbances related to displacement of the intraocular lens. Three of the patients with pseudoexfoliation syndrome (6.8%) had observable pseudophacodonesis by slit-lamp examination, compared to one in the control group (1.2%). The study demonstrated that Pentacam is an appropriate instrument to measure decentration of intraocular lenses. CONCLUSION: The study suggests that, 6-7 years after cataract surgery, the intraocular lenses within the capsular bag are more prone to decentration in pseudoexfoliation syndrome eyes, compared to controls.