To investigate the characteristics and associated factors of intraocular lens(IOL)tilt and decentration in pediatric cataract patients undergoing primary IOL implantation and to explore their impact on postoperative o...To investigate the characteristics and associated factors of intraocular lens(IOL)tilt and decentration in pediatric cataract patients undergoing primary IOL implantation and to explore their impact on postoperative optical quality.Methods Children who underwent cataract extraction with posterior capsulotomy,primary anterior vitrectomy,and in-the-bag IOL implantation over 6 months were enrolled.Patient data and ocular biometric parameters were retrieved from electronic files.Retroillumination images were obtained to evaluate capsular outcomes.IOL tilt and decentration were assessed using the swept-source optical coherence tomography,and wavefront aberrations were measured with the OPD-Scan III.Results A total of 125 eyes from 125 patients with a mean age at surgery of 4.74±1.49 years were included.The IOLs demonstrated a mean tilt of 6.02±1.97°toward the temporal direction and a mean decentration of 0.28±0.13〓〓mm toward the superior-temporal direction.Multivariate analysis revealed that shorter axial length(AL;P=0.009)and significant cortical proliferation(P〓〓=〓〓0.021)were associated with greater IOL tilt.In addition,smaller corneal diameter(CD;P=0.008)and incomplete capsulorhexis-IOL overlap(P=0.022)were associated with larger IOL decentration.Patients with IOL tilt≥7°and decentration≥0.40〓〓mm exhibited higher internal total higher-order aberrations(tHOA)and internal astigmatism,both of which were positively correlated with IOL misalignment(all P〓〓<〓〓0.05)Conclusions Shorter AL,smaller CD,significant cortical proliferation,and incomplete capsulorhexis-IOL overlap contributed to greater IOL misalignment in pediatric cataract patients with primary in-the-bag IOL implantation,which may compromise postoperative optical quality by increasing internal tHOA and astigmatism.展开更多
Background:Complete nuclear disassembly of superhard cataracts cannot always be achieved by phaco chop,which is considered one of the best techniques for dealing with hard cataracts.We present a phaco chopprogressive ...Background:Complete nuclear disassembly of superhard cataracts cannot always be achieved by phaco chop,which is considered one of the best techniques for dealing with hard cataracts.We present a phaco chopprogressive cracking technique to divide superhard cataracts completely.Case presentation:We presented a case of cataract with over Grade V nucleus sclerosis and very low density of corneal endothelial cell(812 cells/mm^(2)).By performing the cataract surgery with our phaco chop-progressive cracking technique,the corneal endothelial cells were well protected and the patient’s visual acuity was markedly improved from finger counting at 40 cm to 20/200 the day after surgery without obvious corneal edema.Conclusions:Although an initial learning curve was needed,this phaco chop-progressive cracking technique could be of particular benefit to the superhard cataract,especially in patients with low density of corneal endothelial cells.展开更多
基金supported by the Wenzhou Basic Research Foundation(20240348)the National Natural Science Foundation of China(82371042),and the Provincial Construction Project of Zhejiang(WKJ-ZJ-2441).
文摘To investigate the characteristics and associated factors of intraocular lens(IOL)tilt and decentration in pediatric cataract patients undergoing primary IOL implantation and to explore their impact on postoperative optical quality.Methods Children who underwent cataract extraction with posterior capsulotomy,primary anterior vitrectomy,and in-the-bag IOL implantation over 6 months were enrolled.Patient data and ocular biometric parameters were retrieved from electronic files.Retroillumination images were obtained to evaluate capsular outcomes.IOL tilt and decentration were assessed using the swept-source optical coherence tomography,and wavefront aberrations were measured with the OPD-Scan III.Results A total of 125 eyes from 125 patients with a mean age at surgery of 4.74±1.49 years were included.The IOLs demonstrated a mean tilt of 6.02±1.97°toward the temporal direction and a mean decentration of 0.28±0.13〓〓mm toward the superior-temporal direction.Multivariate analysis revealed that shorter axial length(AL;P=0.009)and significant cortical proliferation(P〓〓=〓〓0.021)were associated with greater IOL tilt.In addition,smaller corneal diameter(CD;P=0.008)and incomplete capsulorhexis-IOL overlap(P=0.022)were associated with larger IOL decentration.Patients with IOL tilt≥7°and decentration≥0.40〓〓mm exhibited higher internal total higher-order aberrations(tHOA)and internal astigmatism,both of which were positively correlated with IOL misalignment(all P〓〓<〓〓0.05)Conclusions Shorter AL,smaller CD,significant cortical proliferation,and incomplete capsulorhexis-IOL overlap contributed to greater IOL misalignment in pediatric cataract patients with primary in-the-bag IOL implantation,which may compromise postoperative optical quality by increasing internal tHOA and astigmatism.
文摘Background:Complete nuclear disassembly of superhard cataracts cannot always be achieved by phaco chop,which is considered one of the best techniques for dealing with hard cataracts.We present a phaco chopprogressive cracking technique to divide superhard cataracts completely.Case presentation:We presented a case of cataract with over Grade V nucleus sclerosis and very low density of corneal endothelial cell(812 cells/mm^(2)).By performing the cataract surgery with our phaco chop-progressive cracking technique,the corneal endothelial cells were well protected and the patient’s visual acuity was markedly improved from finger counting at 40 cm to 20/200 the day after surgery without obvious corneal edema.Conclusions:Although an initial learning curve was needed,this phaco chop-progressive cracking technique could be of particular benefit to the superhard cataract,especially in patients with low density of corneal endothelial cells.
