Phacoemulsification and polymethylmethacrylate intraocular lens implantation. Prevention of postsurgical astigmatism through scleral approach
Keywords:
phacoemulsification, lens implantation, intraocular, polymethyl methacrylate, postsurgical astigmatism, scleral approach, preventionAbstract
Introduction: cataract is the most common eye condition worldwide and is considered a cause of decreased visual acuity that can be remedied through a relatively easy and safe surgical intervention. Phacoemulsification is the preferred surgical technique among Anterior Segment Ophthalmic Surgery Specialists worldwide.Objective: to find a viable option to perform cataract surgery using the phacoemulsification technique in the absence of foldable intraocular lenses and to evaluate the induction of astigmatism after this variation.
Methods: a quasi-experimental study was carried out, with before/after evaluation, in a group of patients who underwent phacoemulsification and intraocular lens implantation of a polymethylmethacrylate intraocular lens at the Ophthalmological Center of the “Arnaldo Milián Castro” Hospital.
Results: the average age of the patients was 62.88 (±8.93) years, with a range between 45 and 76 years of age, 12 of the 23 patients (52.17%) belonged to the female sex and 11 (47.83%) to the male. The time required for the proposed variations and the steps added to the standard phacoemulsification technique to place an intraocular lens do not represent a substantial increase over it of about 20 minutes on average.
Conclusions: this option can be used when only rigid polymethylmethacrylate intraocular lenses are available. It is recommended for situations in which the insertion of a folding lens through opercula in the posterior capsule is not recommended.
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1.Riccardi Palacios JG, Paliz Sanchez CR, Robles Campoverde DA. La catarata como dolencia oftalmológica progresiva o degenerativa. Univ Cienc Tecnol [Internet]. 2022 [citado 12/07/2023];26(115):135-145. Disponible en: https://uctunexpo.autanabooks.com/index.php/uct/article/view/627/1178. https://doi.org/10.47460/uct.v26i115.627
2.Hernández Silva JR, Ramos Pereira Y, Qiang F, Hernández Ramos H. Control del astigmatismo en la facoemulsificación. En: Hernández Silva JR. Facoemulsificación [Internet]. La Habana: Editorial Ciencias Médicas; 2022 [citado 12/07/2023]. p. 253-271. Disponible en: http://www.ecimed.sld.cu/2022/06/14/facoemulsificacion/
3.Borkenstein AF, Packard R, Dhubhghaill SN, Lockington D, Donnenfeld ED, Borkenstein EM. Clear corneal incision, an important step in modern cataract surgery: a review. Eye [Internet]. 2023 [citado 12/07/2023];37:2864–2876. Disponible en: https://www.nature.com/articles/s41433-023-02440-z. https://doi.org/10.1038/s41433-023-02440-z
4.Mittal R, Peter J, Mani T, Davis S. Visual outcome and patient satisfaction after cataract surgery: A pragmatic study. Clin Epidemiol Glob Health [Internet]. 2019 [citado 12/07/2023];7(3):509–512. Disponible en: https://www.sciencedirect.com/science/article/pii/S2213398418302069. https://doi.org/10.1016/j.cegh.2018.08.008
5.Sekharreddy MR, Sugantharaj V, Hegde SP. Surgically Induced Astigmatism in Manual Small-Incision Cataract Surgery: A Comparative Study between Superotemporal and Temporal Scleral Incisions. TNOA J Ophthalmic Sci Res [Internet]. 2019 [citado 12/07/2023];57(2):105-108. Disponible en: https://journals.lww.com/tnoa/fulltext/2019/57020/surgically_induced_astigmatism_in_manual.2.aspx. https://doi.org/10.4103/tjosr.tjosr_23_19
6.Rathi M, Dabas R, Verma R, Rustagi IM, Mathur S, Dhania S. Comparison of surgically induced astigmatism in chevron, straight, and frown incisions in manual small-incision cataract surgery. Indian J Ophthalmol [Internet]. 2022 [citado 12/07/2023];70(11):3865-3868. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9907301/. https://doi.org/10.4103/ijo.ijo_1589_22
7.Martínez Urbay JG, Peña Canario M, Casanova Hernández TA, Fleitas Hernández A. Astigmatismo en la cirugía de catarata por facoemulsificación. Acta Méd Centro [Internet]. 2022 [citado 12/07/2023];16(1):1-10. Disponible en: http://scielo.sld.cu/scielo.php?pid=S2709-79272022000100001&script=sci_arttext
8.Pérez Candelaria E, Río Torres M, Padilla González CM, Ríos Caso R. Cirugía manual del cristalino: alternativa de extracción del núcleo cristaliniano en casos complejos. En: Centurion V, Nicoli C, Havez Mondragón E. Cristalino de las Américas. La Cirugía del Cristalino Hoy. 2da ed. Panamá: Hayppe Higthligth; 2016. p. 673-678.
9.Ammous I, Bouayed E, Mabrouk S, Boukari M, Erraies K, Zhioua R, et al. Phacoemulsification versus manual small incision cataract surgery: Anatomic and functional results. J Fr Ophtalmol [Internet]. 2017 [citado 12/07/2023];40(6):460-466. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28576403/. https://doi.org/10.1016/j.jfo.2017.02.005
10.Khokhar S, Gupta S, Tewari R, Agarwal R, Gogia V, Sinha G, et al. Scleral tunnel phacoemulsification: Approach for eyes with severe microcornea. Indian J Ophthalmol [Internet]. 2016 [citado 12/07/2023];64(4):320–322. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4901853/. https://doi.org/10.4103/0301-4738.182949
11.Hernández Silva JR, Padilla González CM, Barroso Lorenzo R, Rodríguez Rodríguez B. Epidemiología de la ceguera por cataratas y acciones para su prevención en Cuba. En: Hernández Silva JR. Facoemulsificación [Internet]. La Habana: Editorial de Ciencias Médicas; 2022 [citado 12/07/2023]. p. 12-16. Disponible en: http://www.ecimed.sld.cu/2022/06/14/facoemulsificacion/
12.Pathak M, Odayappan A, Nath M, Raman R, Bhandari S, Nachiappan S. Comparison of the outcomes of phacoemulsification and manual small-incision cataract surgery in posterior polar cataract - A retrospective study. Indian J Ophthalmol [Internet]. 2022 [citado 12/07/2023];70(11):3977–3981. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9907252/. https://doi.org/10.4103/ijo.IJO_1787_22
13.Hashemi H, Khabazkhoob M, Soroush S, Shariati R, Miraftab M, Yekta A. The location of incision in cataract surgery and its impact on induced astigmatism. Curr Opin Ophthalmol [Internet]. 2016 [citado 12/07/2023];27(1):58-64. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26569524/. https://doi.org/10.1097/ICU.0000000000000223
14.Khan AM, Waldner DM, Luong M, Sanders E, Crichton ACS, Ford BA. Stabilization of refractive error and associated factors following small incision phacoemulsifcation cataract surgery. BMC Ophthalmol [Internet]. 2022 [citado 12/07/2023];22(1):13. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8734338/. https://doi.org/10.1186/s12886-021-02221-w
15.Ramos Pereira Y, Medina Perdomo JC, Hernández Silva JR, Rodríguez Suárez B, Pérez Candelaria EC, Gutiérrez Castillo M, et al. Diagnóstico y control del astigmatismo en la cirugía del cristalino. Rev Cubana Oftalmol [Internet]. 2015 [citado 20/01/2020];28(2):205–219. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762015000200007
16.Núñez MX, Henriquez MA, Escaf LJ, Ventura BV, Srur M, Newball L, et al. Consensus on the management of astigmatism in cataract surgery. Clin Ophthalmol [Internet]. 2019 [citado 20/01/2020];13:311–324. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376888/. https://doi.org/10.2147/OPTH.S178277
17.Lee YC. Astigmatism considerations in cataract surgery. Tzu Chi Medical Journal [Internet]. 2013 [citado 20/01/2020];25(1):19-22. Disponible en: https://www.sciencedirect.com/science/article/pii/S1016319012001243. https://doi.org/10.1016/j.tcmj.2012.12.001
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