Long-term follow-up for bimanual microincision cataract surgery: Comparison of results obtained by surgeons in training and experienced surgeons

Purpose: To determine the efficacy of bimanual microincision cataract surgery (B-MICS) performed by surgeons in training, evaluating clinical results, posterior capsule opacification (PCO) incidence, and clear corneal incision (CCI) architecture in a long-term follow-up and comparing results with those obtained by experienced surgeons. Patients and methods: Eighty eyes of 62 patients operated on by three surgeons in training who used B-MICS technique for the first time were included in the study (Group A). Eighty eyes of 59 patients who underwent B-MICS by three experienced surgeons were included as a control group (Group B). Best corrected visual acuity, astigmatism, corneal pachymetry, and endothelial cell count were evaluated before surgery and at 1 month and 18 months after surgery. Anterior segment optical coherence tomography images were obtained to study the morphology of CCIs. PCO incidence was evaluated using EPCO2000 software. Results: Out of 160 surgeries included in the study, mean best-corrected visual acuity improvement at 18 months was 0.343\ub10.246 logMAR for Group A, and 0.388\ub10.175 logMAR for Group B, respectively. We found no statistically significant induced astigmatism nor corneal pachymetry changes in either group, while we noticed a statistically significant endothelial cell loss postoperatively in both groups (P < 0.05). In Group A, mean PCO score was 0.163\ub10.196, while for Group B, it was 0.057\ub10.132 (P=0.0025). Mean length and inclination of the CCIs for Group A and Group B were, respectively, 1,358\ub1175 \ub5m and 1,437\ub1256 \ub5m and 141.8\ub0\ub16.4\ub0 and 148.7\ub0\ub15.1\ub0. As regards corneal architecture in the 320 CCIs considered, we found posterior wound retractions and endothelial gaps, respectively, 9.8% and 11.6% for Group A and 7.8% and 10.8% for Group B. Conclusion: B-MICS performed by surgeons in training is an effective surgical technique even when assessed after a long-term follow-up. PCO incidence resulted in being higher for less experienced surgeons. Corneal incisions were shorter and less angled in surgeons in training in comparison with results obtained by expert surgeons

Results and complications of surgeons-in-training learning bimanual microincision cataract surgery

PURPOSE: To evaluate visual outcomes and complications of bimanual microincision cataract surgery performed by surgeons in training. SETTING: Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy. DESIGN: Prospective case series. METHODS: The corrected distance visual acuity (CDVA), astigmatism, corneal pachymetry, and endothelial cell count were evaluated before and 7 and 30 days after bimanual MICS performed by surgeons in training. Intraoperative and postoperative complications were also recorded. RESULTS: Three surgeons in training performed bimanual MICS in 150 eyes of 131 patients. There were 18 intraoperative complications (12.0%) (10 iris traumas [6.6%]; 4 capsule ruptures without vitreous loss [2.7%]; 3 capsule ruptures with vitreous loss [2.0%]; 1 intraocular lens [IOL] implantation in the sulcus due to zonular laxity [0.7%]). There were 5 postoperative complications (3.3%) (2 iris prolapses [1.3%]; 1 IOL loop malposition [0.7%]; 1 narrowing of anterior chamber [0.7%]; 1 capsulorhexis phimosis [0.7%]). Thirty days postoperatively, the mean CDVA improvement was 0.53 ± 0.20 (Snellen decimal) (P &lt; .05), the mean decrease in astigmatism was 0.09 ± 0.54 diopter (P = .29), and the mean increase in corneal pachymetry was 7.42 ± 22.01 μm (P = .12). There was statistically significant endothelial cell loss (mean 496.50 ± 469.66 cells/mm(2)) (P &lt; .05). CONCLUSIONS: Bimanual MICS performed by surgeons in training was safe and effective. Visual outcomes and complication rates were similar to those reported for coaxial cataract surgery performed by surgeons in training

Metodo di conversione dei dati di perimetria cinetica in formato statico

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Studio mediante perimetria computerizzata degli effetti degli oligomeri procianidolici da vitis vinifera sulla sensibilit\ue0 retinica nei soggetti miopi

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Metodo di calcolo per l’assegnazione di un punteggio al campo visivo computerizzato in soglia

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Studio sull’efficacia del Diclofenac in collirio allo 0,1% nel mantenimento della midriasi farmacologica, durante chirurgia extracapsulare di cataratta

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Anestesia oculare loco-regionale (acinesia e retrobulbare) versus anestesia peribulbare nella chirurgia della cataratta

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Comparison of the clinical performance of Healon 5 and Healon in phacoemulsification

PURPOSE, Healon 5 is a high-molecular-mass fraction of sodium hyaluronate. Its density endows it with a number of viscoelastic characteristics. In this prospective, randomised clinical study we compared the performance of Healon 5 and Healon in phacoemulsification. SETTING. Institute of Ophthalmology, University of Modena and Reggio Emilia, Italy. METHODS. Two groups of patients underwent phacoemulsification and intraocular tens (IOL) implantation. In the first 27 patients Heaton 5 was used as viscoelastic substance during surgery, and in the second 27 Heaton was used. The surgeons subjective comments on the performance of these viscoelastic agents were recorded at the different steps of surgery: injection, capsulorhexis, phacoemulsification, IOL implantation, removal of viscoelastic agent and trasparency throughout the operation. The surgeon's overall impression of the viscoelastics during the whole operation was noted. Tonometry and endothelial cell count were performed in all patients before and after operation. RESULTS. There was no statistical difference between the two groups as regards visual acuity, ocular pressure and endothelial damage. Heaton 5 showed excellent ability to maintain the anterior chamber during capsulorhexis, phacoemulsification and IOL implantation. Removal time with Healon 5 was not appreciably longer than Heaton. CONCLUSIONS. Healon 5 emerges as a very interesting viscoelastic substance. Visibility is better if the anterior chamber is filled completely, Removal is easier if it is aspirated while moving the irrigation aspiration tip with circular movements over the top and around the border of the IOL