Cataract

11–17 of 17 articles Page 2 of 2
All Cornea 36 Cataract 17 Glaucoma 13 Retina & Vitreous 72 Neurophthalmology 8 Oculoplasty 15 Uvea & Inflammatory Diseases 24 Miscellaneous 20 Oncology 9 Pediatric Ophthalmology 15
  1. 1 Apr 2021 9 min read

    Ten Pearls for Phacoemulsification in a Soft Cataract

    Soft cataracts are usually seen in pediatric or young adult patients. We encounter them more frequently nowadays due to the increasing patient awareness and evolving lifestyle requirements which bring the patients earlier to the clinic. Another important reason behind the increasing number of soft cataracts in our surgical practice is the fact that the number of pars plana vitrectomies is increasing and we tend to perform combined cataract surgery with pars plana vitrectomy in patients with early cataract. Soft cataract phaco can be quite challenging especially in situations where the pupil starts coming down in the face of an uncooperative patient and positive posterior pressure during surgery. It is no surprise that soft cataract has been termed as “Neither Here-Nor-There” cataract! We will be offering 10 pearls on how to successfully manage such cases with good outcomes. Pearl 1: Need for precise IOL calculations: Most soft cataracts encountered in younger visually active patients c

    Dr. Arup Chakrabarti · Dr. Nirupama Kasturi
  2. 1 Apr 2021 12 min read

    Ten Tips for Phacoemulsification in Small Pupil

    Phacoemulsification in eyes with preoperative non-dilating pupil or with intraoperative miosis is fraught with complications [1,2]. The following tips will help understand the small pupil and optimize strategy to deliver better outcomes. 1. Every eye is an IFIS candidate; Reduce threshold for using Pupil expansion devices: Since its original association with tamsulosin intake, Intraoperative Floppy Iris Syndrome (IFIS) has been positively correlated with a plethora of risk factors which include: gender, age, hypertension, other a1-adrenergic receptor antagonists, finasteride, angiotensin II receptor inhibitors, benzodiazepines, antipsychotics, hypertension drugs and decreased dilated pupil diameter [1,3,4]. The risk of IFIS exists regardless of alpha antagonist treatment, in eyes with 7.0 mm or smaller pupil [5]. Hence, it would be prudent to consider every eye a potential IFIS candidate. Increased patient expectations, surgeon's desire to consistently deliver good outcomes, use of tor

    Dr. Suven Bhattacharjee
  3. 1 Apr 2021 7 min read

    Ten Pearls for Phacoemulsification in a Hard Cataract

    Phacoemulsification of the very dense cataract presents the surgeon with a series of specific and difficult challenges. How hard is hard and what level of hardness makes it challenging depends largely on the experience of the surgeon. LOCS III classification does not always reveal the real hardness of the cataract, and that aside there is no definition in the literature that classifies the hardness of cataract. A hard cataract is a relative term relative to the surgeon’s experience and confidence! I have over the years put some criteria for myself when I call it a difficult situation. These are dark brown to the black nucleus, no visibility of the posterior slit beam due to the nuclear sclerosis, an older patient, diabetic patient, and preoperative poor vision. Ocular co-morbidities such as pseudo exfoliation, absence of pupillary ruff and calcific spots on the anterior capsule are some of my personal markers which add further to an already challenging surgery Pearl 1: Preoperative con

    Dr. Ashok Rangarajan, MS; DNB; FRCS (Glasgow)
  4. 1 Apr 2021 2 min read

    Ten Pearls of Phacoemulsification in Subluxated Cataracts

    Phacoemulsification in subluxated cataracts is a challenging situation for the phaco surgeon due to lot of variables like management of the subluxation, management of the cataract, vitreous etc. Here are the top ten Pearls for Phaco in subluxated Cataracts. 1 Pre-Op Assessment Careful slit-lamp examination for a) Extent of Subluxation b) The density of the cataract c) Presence or absence of vitreous in Anterior chamber d) Status of the corneal endothelium e) Age of the patient 2 Devices & Instrumentation a) Capsular Tension Ring (CTR) size 10 – 12 mm size 11 – 13 mm b) CIONNI Ring (1 or 2 eyelets) c) CT Segment (Ahmed Segment) d) Capsular Hooks e) Iris Hooks f) Micro Surgical instrumentation like Microrhexis forceps etc. 3 Proper Surgical Planning Zonule loss less than 1 quadrant: Place 3 piece IOL in the axis of the Zonular loss 1 to 2 quadrants: CTR Standard 2 to 3 quadrants: CIONNI 1 or 2 or CT segment (Ahmed) More than 3 quadrants: Above or scleral fixated IOL 4 Surgical Plan Site

    Dr. Mohan Rajan
  5. 1 Apr 2021 2 min read

    Ten Tips to Achieve a Complete Curvilinear Capsulorhexis

    1. See clearly: Focus the microscope in such a way that the anterior capsule is exactly in focus. Low magnification would help in increasing depth perception, even though things don’t appear grossly magnified. Even if the patient moves the eye a little, things don’t go out of focus. 2. Stain if needed: If the red glow is not very clearly seen, and the cut end of the anterior capsular flap may not be easily visible, its best to stain the capsule by trypan blue. This should be done before starting the capsulorhexis. 3. The pressure above should be more than the pressure below. The capsulorhexis flap shall not extend to the periphery if the pressure above it is more than the pressure below it. If superior rectus muscle suture has been taken, loosen it. Loosen a tight speculum. Both increase the pressure on the globe, pushing the vitreous up and putting strain on the posterior capsule. 4. Do CCC slowly: The time spent on it is completely worth it. The success of surgery, especially in phac

    Dr. Parikshit Gogate
  6. 1 Apr 2021 6 min read

    Ten Tips for Youngsters to Increase Proficiency in Phacoemulsification

    Phacoemulsification, like any other surgery, comes with its learning curve. Here are some pearls, from my experience, to help you ‘shorten’ and ‘Flatten the curve’. 1. Believe in yourself: The first step to successfully doing anything in life is to believe in yourself. Believe you can and you are half way there. 2. Observe, Observe, Observe & Learn I am a firm believer of this quote by Marilyn vos Savant, “To acquire knowledge, one must study; but to acquire wisdom, one must observe.” Each skill in life can be improved by observing others. It is the same case for surgeries too. The more you observe a particular type of surgery, the better you get at it. Observe your seniors. Observe their hand movements, observe how they complete a straight-forward case and observe how they tackle complications. Try and observe as many people surgeons as you can, as each and every phacoemulsification procedure teaches you something new. Residents in today’s era are blessed with easy availability of the

    Prof. (Dr.) Mahipal S. Sachdev
  7. 5 Apr 2020 14 min read

    In Vitro Cataract Classification Systems : A Review

    In early days, since the whole lenses were readily available from intracapsular cataract surgery, so the early systems of cataract classification1,2,3 were developed for use almost exclusively with isolated lenses. These systems were largely qualitative, and they emphasized nuclear color as the index of the severity of cataract formation; lighting systems that improved visualization of cortical and subcapsular morphologic detail had not been developed. Before 1976, lens and cataract research emphasized studies of animal lenses, and researchers erroneously believed these animal lenses to be adequate models of the human lens. In 1976, the CCRG was established to increase understanding of the mechanisms of human cataract formation. One of the CCRG's goals was to establish a lens classification system to help lens researchers study the biochemical and biophysical properties of the cataractous lens and compare them with those of normal lenses. Such a system would facilitate biochemical, bio

    Baweja V · Brar GS