Aqueous reaction quantification after phacoemulsification: Fourier-domain optical coherence tomography versus slitlamp biomicroscopy.

PURPOSE: To compare anterior chamber cell detection after phacoemulsification between Fourier-domain optical coherence tomography (OCT) and slitlamp biomicroscopy. DESIGN: Observational prospective comparative case series. SETTING: Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. METHODS: Eyes with preoperative nuclear opalescence (NO) grades 1 to 3 that had phacoemulsification with posterior chamber intraocular lens implantation were included. Slitlamp biomicroscopy and Fourier-domain OCT (Cirrus HD) of the anterior chamber were performed 1 day postoperatively. The results were evaluated, and a correlation analysis between the results and preoperative NO, effective phacoemulsification time (EPT), postoperative central corneal thickness (CCT), and intraocular pressure (IOP) was performed. RESULTS: The preoperative NO grade was 1 in 20 eyes, 2 in 55 eyes, and 3 in 42 eyes. Anterior chamber grading was possible by slitlamp biomicroscopy and Fourier-domain OCT in 106 eyes (90.5%) and 117 eyes (100.0%), respectively. A positive correlation between slitlamp biomicroscopy and OCT grading was noted (R(2) = 0.986, P=.000). Slitlamp grading was not possible in 11 eyes (9.4%) with corneal edema (mean CCT 754 µm ± 44.2 [SD]); OCT detected cells in all 11 eyes. There was a difference in slitlamp grading and OCT grading in 7 eyes (6.6%). There was a significant correlation between the OCT cell count and the EPT (P=.000) and NO (P=.000). CONCLUSION: Fourier-domain OCT was as reliable as slitlamp biomicroscopy in assessing postoperative anterior chamber cells.

Complications and visual outcomes after glued foldable intraocular lens implantation in eyes with inadequate capsules.

PURPOSE: To evaluate the complications and visual outcomes of glued intrascleral-fixated foldable intraocular lens (IOL) in eyes with deficient capsules. SETTING: Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. DESIGN: Case series. METHODS: Data were evaluated from the records of patients with a primary glued foldable IOL for intraoperative capsular loss or subluxated lens or secondary glued foldable IOL for aphakia. Exclusion criteria included preoperative glaucoma, aniridia, macular scar, traumatic subluxation, combined surgeries, incomplete operative medical records, and postoperative follow-up less than 6 months. The intraoperative and postoperative complication rates, reoperation rate, and visual outcomes were analyzed. RESULTS: The study comprised 208 eyes (185 patients). The mean follow-up was 16.7 months ± 10.2 (SD). The intraoperative complications were hyphema (0.4%), haptic breakage (0.4%), and deformed haptics (0.9%). Early complications occurred in 29 eyes (13.9%) and included corneal edema (5.7%), epithelial defect (1.9%), and grade 2 anterior chamber reaction (2.4%). Late complications occurred in 39 eyes (18.7%) and included optic capture (4.3%), IOL decentration (3.3%), haptic extrusion (1.9%), subconjunctival haptic (1.4%), macular edema (1.9%), and pigment dispersion (1.9%). Reoperation was required in 16 eyes (7.7%). Haptic position was altered in eyes with IOL decentration. Corrected distance visual acuity (CDVA) improved or remained unchanged in 84.6% of eyes. The postoperative CDVA was 20/40 or better and 20/60 or better in 38.9% and 48.5% of eyes, respectively. CONCLUSIONS: The foldable glued-IOL procedure showed satisfactory visual outcomes without serious complications. Intraocular lens decentration was due to haptic-related problems.