Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia

Sun Tangsheng; Chen Liangju; Zhao Guangyu; Liu Lijuan; Hong Linyong

doi:doi:10.11648/j.ijovs.20210604.11

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Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia

Sun Tangsheng, Chen Liangju, Zhao Guangyu, Liu Lijuan, Hong Linyong

Published in International Journal of Ophthalmology & Visual Science (Volume 6, Issue 4)

Received: 14 September 2021 Accepted: 5 October 2021 Published: 15 October 2021

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Abstract

Background: Uveitis can cause blindness if not be appropriately managed. Anterior segment is common and frequent site in uveitis, can result in different degrees iris posterior synechia, iris depigmentation and atrophy, earlier form of cataract, etc. Surgery of cataract is complicated and prone to inflammatory reaction, especially in patients who involve anterior and posterior segment. Better operation technique and gentle maneuver is very important in such surgery. Aim: To investigate the application of phacoemulsification with IOLs implantation in cataract surgery with posterior synechia of the iris, and analyze its clinical effect. Methods: 36 cases (45 eyes) were enrolled from March 2019 to October 2020, diagnosed with chronic uveitis complicated cataract, treated with phacoemulsification combined with implantation of intraocular lens. Postoperative visual acuity and complications during operation were recorded. Results: Postoperative day 1, the best corrected visual acuity (BCVA) of 25 eyes (55.6%) were no less than 0.5, 14 eyes (31.1%) were 0.3~0.5, 6 eyes (13.3%) were 0.1~0.25; Anterior chamber inflammation emerged in 9 eyes (20.0%), more severe and recurrence of iris posterior synechia in 8 eyes (17.8%), pigmentation lost on IOLs in 7 eyes (15.6%). Intraocular pressure (IOP) after operation was 14.35±9.43mmHg (11 eyes were above normal, 6.0~25.0mmHg), no significance difference with preoperation IOP (t=0.25, p=0.80). No infectious endopthalmitis was found. 1 week after operation, the BCVA of 30 eyes (66.7%) were no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. Anterior chamber inflammation disappeared in all cases, 4 eyes (8.9%) with iris posterior synechia couldn’t be debonded, 3 eyes (6.7%) with iris dystrophy. Average IOP was 11.27±6.81mmHg, no significance difference with preoperation IOP (t=0.46, p=0.65). 1 month after operation, the BCVA of 30 eyes (66.7%) no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (10.92±5.94mmHg) was stable, and no significance difference with preoperation IOP (t=0.51, p=0.61). 3 months after operation, the BCVA of 33 eyes (73.3%) were no less than 0.5, 10 eyes (22.2%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (11.06±5.71mmHg) was no change as preoperation (t=0.67, p=0.51). 4 (8.9%) and 3 (6.7%) eyes with iris posterior synechia and iris dystrophy respectively. Conclusion: Phacoemulsification and intraocular lens implantaion may be effective in the cataract surgery with iris posterior synechia, and timely mangement of possible complications after surgery maybe helpful for clinical outcomes.

Published in	International Journal of Ophthalmology & Visual Science (Volume 6, Issue 4)
DOI	10.11648/j.ijovs.20210604.11
Page(s)	181-186
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Uveitic Cataract, Phacoemulsification, Cataract Surgery, Inflammation Recurrence

References

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[2]	Khairallah M, Kahloun R, Bourne R, Limburg H, Flaxman SR, Jonas JB. Number of people blind or visually impaired by cataract worldwide and in world regions, 1990 to 2010. Invest Ophthalmol Vis Sci, 2015; 56: 6762–6769.
[3]	Sudhalkar A, Vasavada A, Bhojwani D, Vasavada Vi, Vasavada S, Vasavada Va, Srivastava S. Intravitreal dexamethasone implant as an alternative to systemic steroids as prophylaxis for uveitic cataract surgery: a randomized trial. Eye (Lond), 2020; 34 (3): 491–498.
[4]	Takayama K, Fujii S, Ishikawa S, Takeuchi M. Short-term outcomes of coaxial microincision cataract surgery for uveitis-associated cataract without postoperative systemic steroid therapy. Ophthalmologica, 2014; 231 (2): 111–116.
[5]	Dana MR, Chatzistefanou K, Schaumberg DA, Foster CS. Posterior capsule pacification after cataract surgery in patients with uveitis. Ophthalmology, 1997; 10 (4): 1387–1393.
[6]	Gupta S, Haripriya A, Vardhan SA, Ravilla T, Ravindran RD. Residents' learning curve for manual small-incision cataract surgery at Aravind Eye Hospital, India. Ophthalmology, 2018; 125: 1692–9.
[7]	Nath M, Khodifad AM, Odayappan A, Christy JS, Manoharan S. Intraocular lens-sling technique: A safe approach for lens implantation in complicated cataract surgery and secondary intraocular lens implantation. Indian J Ophthalmol, 2020; 68 (4): 632–635.
[8]	Van Gelder RN, Leveque TK. Cataract surgery in the setting of uveitis. Curr Opin Ophthalmol, 2009; 20 (1): 42.
[9]	Rojas B, Foster CS. Cataract surgery in patients with uveitis. Curr Opin Ophthalmol, 1996; 7 (1): 11–16.
[10]	Menapace R. Pseudoexfoliation syndrome and cataract surgery. Avoidance and treatment of complications. Ophthalmology, 2012; 109 (10): 976.
[11]	Letov IJ, Hogewind BF. Phacoemulsification and intraoperative complications in 930 patients with uveitis. Int Ophthalmol Clin, 2016; 56 (3): 189-191.
[12]	Ren Y, Du SF, Zheng DP, Shi YY, Pan LP, Yan H. Intraoperative intravitreal triamcinolone acetonide injection for prevention of postoperative inflammation and complications after phacoemulsification in patients with uveitic cataract. BMC Ophthalmol, 2021; 21: 245.
[13]	Rohl A, Patnaik JL, Miller DC, Lynch AM, Palestine AG. Timing of Quiescence and Uveitis Recurrences After Cataract Surgery in Patients with a History of Uveitis. Ophthalmol Ther, 2021; 10 (3): 619–628.
[14]	Mehta S, Linton MM, Kempen JH. Outcomes of cataract surgery in patients with uveitis: a systematic review and meta-analysis. Am J Ophthalmol, 2014; 158 (4): 676–692.
[15]	Takai N, Kobayashi T, Kida T, Ikeda T. Clinical features of Japanese patients with ocular inflammation and their surgical procedures over the course of 20 years. Clin Ophthalmol, 2020; 14: 2799.
[16]	Merayo-L loves J, Power WJ, Rodriguez A, Pedroza-Seres M, Foster CS. Secondary glaucoma in patients with uveitis. Ophthalmologica, 1999; 213: 300–304.
[17]	Takahashi T, Ohtani S, Miyata K, Miyata N, Monchizuki M. A clinical evaluation of uveitis-associated secondary glaucoma. Jpn J Ophthalmol, 2002; 46: 556–562.

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APA Style

Sun Tangsheng, Chen Liangju, Zhao Guangyu, Liu Lijuan, Hong Linyong. (2021). Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia. International Journal of Ophthalmology & Visual Science, 6(4), 181-186. https://doi.org/10.11648/j.ijovs.20210604.11

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ACS Style

Sun Tangsheng; Chen Liangju; Zhao Guangyu; Liu Lijuan; Hong Linyong. Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia. Int. J. Ophthalmol. Vis. Sci. 2021, 6(4), 181-186. doi: 10.11648/j.ijovs.20210604.11

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AMA Style

Sun Tangsheng, Chen Liangju, Zhao Guangyu, Liu Lijuan, Hong Linyong. Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia. Int J Ophthalmol Vis Sci. 2021;6(4):181-186. doi: 10.11648/j.ijovs.20210604.11

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@article{10.11648/j.ijovs.20210604.11,
  author = {Sun Tangsheng and Chen Liangju and Zhao Guangyu and Liu Lijuan and Hong Linyong},
  title = {Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {6},
  number = {4},
  pages = {181-186},
  doi = {10.11648/j.ijovs.20210604.11},
  url = {https://doi.org/10.11648/j.ijovs.20210604.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20210604.11},
  abstract = {Background: Uveitis can cause blindness if not be appropriately managed. Anterior segment is common and frequent site in uveitis, can result in different degrees iris posterior synechia, iris depigmentation and atrophy, earlier form of cataract, etc. Surgery of cataract is complicated and prone to inflammatory reaction, especially in patients who involve anterior and posterior segment. Better operation technique and gentle maneuver is very important in such surgery. Aim: To investigate the application of phacoemulsification with IOLs implantation in cataract surgery with posterior synechia of the iris, and analyze its clinical effect. Methods: 36 cases (45 eyes) were enrolled from March 2019 to October 2020, diagnosed with chronic uveitis complicated cataract, treated with phacoemulsification combined with implantation of intraocular lens. Postoperative visual acuity and complications during operation were recorded. Results: Postoperative day 1, the best corrected visual acuity (BCVA) of 25 eyes (55.6%) were no less than 0.5, 14 eyes (31.1%) were 0.3~0.5, 6 eyes (13.3%) were 0.1~0.25; Anterior chamber inflammation emerged in 9 eyes (20.0%), more severe and recurrence of iris posterior synechia in 8 eyes (17.8%), pigmentation lost on IOLs in 7 eyes (15.6%). Intraocular pressure (IOP) after operation was 14.35±9.43mmHg (11 eyes were above normal, 6.0~25.0mmHg), no significance difference with preoperation IOP (t=0.25, p=0.80). No infectious endopthalmitis was found. 1 week after operation, the BCVA of 30 eyes (66.7%) were no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. Anterior chamber inflammation disappeared in all cases, 4 eyes (8.9%) with iris posterior synechia couldn’t be debonded, 3 eyes (6.7%) with iris dystrophy. Average IOP was 11.27±6.81mmHg, no significance difference with preoperation IOP (t=0.46, p=0.65). 1 month after operation, the BCVA of 30 eyes (66.7%) no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (10.92±5.94mmHg) was stable, and no significance difference with preoperation IOP (t=0.51, p=0.61). 3 months after operation, the BCVA of 33 eyes (73.3%) were no less than 0.5, 10 eyes (22.2%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (11.06±5.71mmHg) was no change as preoperation (t=0.67, p=0.51). 4 (8.9%) and 3 (6.7%) eyes with iris posterior synechia and iris dystrophy respectively. Conclusion: Phacoemulsification and intraocular lens implantaion may be effective in the cataract surgery with iris posterior synechia, and timely mangement of possible complications after surgery maybe helpful for clinical outcomes.},
 year = {2021}
}

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TY  - JOUR
T1  - Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia
AU  - Sun Tangsheng
AU  - Chen Liangju
AU  - Zhao Guangyu
AU  - Liu Lijuan
AU  - Hong Linyong
Y1  - 2021/10/15
PY  - 2021
N1  - https://doi.org/10.11648/j.ijovs.20210604.11
DO  - 10.11648/j.ijovs.20210604.11
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 181
EP  - 186
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20210604.11
AB  - Background: Uveitis can cause blindness if not be appropriately managed. Anterior segment is common and frequent site in uveitis, can result in different degrees iris posterior synechia, iris depigmentation and atrophy, earlier form of cataract, etc. Surgery of cataract is complicated and prone to inflammatory reaction, especially in patients who involve anterior and posterior segment. Better operation technique and gentle maneuver is very important in such surgery. Aim: To investigate the application of phacoemulsification with IOLs implantation in cataract surgery with posterior synechia of the iris, and analyze its clinical effect. Methods: 36 cases (45 eyes) were enrolled from March 2019 to October 2020, diagnosed with chronic uveitis complicated cataract, treated with phacoemulsification combined with implantation of intraocular lens. Postoperative visual acuity and complications during operation were recorded. Results: Postoperative day 1, the best corrected visual acuity (BCVA) of 25 eyes (55.6%) were no less than 0.5, 14 eyes (31.1%) were 0.3~0.5, 6 eyes (13.3%) were 0.1~0.25; Anterior chamber inflammation emerged in 9 eyes (20.0%), more severe and recurrence of iris posterior synechia in 8 eyes (17.8%), pigmentation lost on IOLs in 7 eyes (15.6%). Intraocular pressure (IOP) after operation was 14.35±9.43mmHg (11 eyes were above normal, 6.0~25.0mmHg), no significance difference with preoperation IOP (t=0.25, p=0.80). No infectious endopthalmitis was found. 1 week after operation, the BCVA of 30 eyes (66.7%) were no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. Anterior chamber inflammation disappeared in all cases, 4 eyes (8.9%) with iris posterior synechia couldn’t be debonded, 3 eyes (6.7%) with iris dystrophy. Average IOP was 11.27±6.81mmHg, no significance difference with preoperation IOP (t=0.46, p=0.65). 1 month after operation, the BCVA of 30 eyes (66.7%) no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (10.92±5.94mmHg) was stable, and no significance difference with preoperation IOP (t=0.51, p=0.61). 3 months after operation, the BCVA of 33 eyes (73.3%) were no less than 0.5, 10 eyes (22.2%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (11.06±5.71mmHg) was no change as preoperation (t=0.67, p=0.51). 4 (8.9%) and 3 (6.7%) eyes with iris posterior synechia and iris dystrophy respectively. Conclusion: Phacoemulsification and intraocular lens implantaion may be effective in the cataract surgery with iris posterior synechia, and timely mangement of possible complications after surgery maybe helpful for clinical outcomes.
VL  - 6
IS  - 4
ER  -

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Author Information

Sun Tangsheng

Department of Cataract, Fuzhou South-East Eye Hospital, Fuzhou, China
Chen Liangju

Department of Cataract, Fuzhou South-East Eye Hospital, Fuzhou, China
Zhao Guangyu

Department of Cataract, Fuzhou South-East Eye Hospital, Fuzhou, China
Liu Lijuan

Department of Cataract, Fuzhou South-East Eye Hospital, Fuzhou, China
Hong Linyong

Department of Cataract, Fuzhou South-East Eye Hospital, Fuzhou, China

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APA Style

Sun Tangsheng, Chen Liangju, Zhao Guangyu, Liu Lijuan, Hong Linyong. (2021). Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia. International Journal of Ophthalmology & Visual Science, 6(4), 181-186. https://doi.org/10.11648/j.ijovs.20210604.11

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ACS Style

Sun Tangsheng; Chen Liangju; Zhao Guangyu; Liu Lijuan; Hong Linyong. Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia. Int. J. Ophthalmol. Vis. Sci. 2021, 6(4), 181-186. doi: 10.11648/j.ijovs.20210604.11

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AMA Style

Sun Tangsheng, Chen Liangju, Zhao Guangyu, Liu Lijuan, Hong Linyong. Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia. Int J Ophthalmol Vis Sci. 2021;6(4):181-186. doi: 10.11648/j.ijovs.20210604.11

Copy | Download

@article{10.11648/j.ijovs.20210604.11,
  author = {Sun Tangsheng and Chen Liangju and Zhao Guangyu and Liu Lijuan and Hong Linyong},
  title = {Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {6},
  number = {4},
  pages = {181-186},
  doi = {10.11648/j.ijovs.20210604.11},
  url = {https://doi.org/10.11648/j.ijovs.20210604.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20210604.11},
  abstract = {Background: Uveitis can cause blindness if not be appropriately managed. Anterior segment is common and frequent site in uveitis, can result in different degrees iris posterior synechia, iris depigmentation and atrophy, earlier form of cataract, etc. Surgery of cataract is complicated and prone to inflammatory reaction, especially in patients who involve anterior and posterior segment. Better operation technique and gentle maneuver is very important in such surgery. Aim: To investigate the application of phacoemulsification with IOLs implantation in cataract surgery with posterior synechia of the iris, and analyze its clinical effect. Methods: 36 cases (45 eyes) were enrolled from March 2019 to October 2020, diagnosed with chronic uveitis complicated cataract, treated with phacoemulsification combined with implantation of intraocular lens. Postoperative visual acuity and complications during operation were recorded. Results: Postoperative day 1, the best corrected visual acuity (BCVA) of 25 eyes (55.6%) were no less than 0.5, 14 eyes (31.1%) were 0.3~0.5, 6 eyes (13.3%) were 0.1~0.25; Anterior chamber inflammation emerged in 9 eyes (20.0%), more severe and recurrence of iris posterior synechia in 8 eyes (17.8%), pigmentation lost on IOLs in 7 eyes (15.6%). Intraocular pressure (IOP) after operation was 14.35±9.43mmHg (11 eyes were above normal, 6.0~25.0mmHg), no significance difference with preoperation IOP (t=0.25, p=0.80). No infectious endopthalmitis was found. 1 week after operation, the BCVA of 30 eyes (66.7%) were no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. Anterior chamber inflammation disappeared in all cases, 4 eyes (8.9%) with iris posterior synechia couldn’t be debonded, 3 eyes (6.7%) with iris dystrophy. Average IOP was 11.27±6.81mmHg, no significance difference with preoperation IOP (t=0.46, p=0.65). 1 month after operation, the BCVA of 30 eyes (66.7%) no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (10.92±5.94mmHg) was stable, and no significance difference with preoperation IOP (t=0.51, p=0.61). 3 months after operation, the BCVA of 33 eyes (73.3%) were no less than 0.5, 10 eyes (22.2%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (11.06±5.71mmHg) was no change as preoperation (t=0.67, p=0.51). 4 (8.9%) and 3 (6.7%) eyes with iris posterior synechia and iris dystrophy respectively. Conclusion: Phacoemulsification and intraocular lens implantaion may be effective in the cataract surgery with iris posterior synechia, and timely mangement of possible complications after surgery maybe helpful for clinical outcomes.},
 year = {2021}
}

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TY  - JOUR
T1  - Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia
AU  - Sun Tangsheng
AU  - Chen Liangju
AU  - Zhao Guangyu
AU  - Liu Lijuan
AU  - Hong Linyong
Y1  - 2021/10/15
PY  - 2021
N1  - https://doi.org/10.11648/j.ijovs.20210604.11
DO  - 10.11648/j.ijovs.20210604.11
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 181
EP  - 186
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20210604.11
AB  - Background: Uveitis can cause blindness if not be appropriately managed. Anterior segment is common and frequent site in uveitis, can result in different degrees iris posterior synechia, iris depigmentation and atrophy, earlier form of cataract, etc. Surgery of cataract is complicated and prone to inflammatory reaction, especially in patients who involve anterior and posterior segment. Better operation technique and gentle maneuver is very important in such surgery. Aim: To investigate the application of phacoemulsification with IOLs implantation in cataract surgery with posterior synechia of the iris, and analyze its clinical effect. Methods: 36 cases (45 eyes) were enrolled from March 2019 to October 2020, diagnosed with chronic uveitis complicated cataract, treated with phacoemulsification combined with implantation of intraocular lens. Postoperative visual acuity and complications during operation were recorded. Results: Postoperative day 1, the best corrected visual acuity (BCVA) of 25 eyes (55.6%) were no less than 0.5, 14 eyes (31.1%) were 0.3~0.5, 6 eyes (13.3%) were 0.1~0.25; Anterior chamber inflammation emerged in 9 eyes (20.0%), more severe and recurrence of iris posterior synechia in 8 eyes (17.8%), pigmentation lost on IOLs in 7 eyes (15.6%). Intraocular pressure (IOP) after operation was 14.35±9.43mmHg (11 eyes were above normal, 6.0~25.0mmHg), no significance difference with preoperation IOP (t=0.25, p=0.80). No infectious endopthalmitis was found. 1 week after operation, the BCVA of 30 eyes (66.7%) were no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. Anterior chamber inflammation disappeared in all cases, 4 eyes (8.9%) with iris posterior synechia couldn’t be debonded, 3 eyes (6.7%) with iris dystrophy. Average IOP was 11.27±6.81mmHg, no significance difference with preoperation IOP (t=0.46, p=0.65). 1 month after operation, the BCVA of 30 eyes (66.7%) no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (10.92±5.94mmHg) was stable, and no significance difference with preoperation IOP (t=0.51, p=0.61). 3 months after operation, the BCVA of 33 eyes (73.3%) were no less than 0.5, 10 eyes (22.2%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (11.06±5.71mmHg) was no change as preoperation (t=0.67, p=0.51). 4 (8.9%) and 3 (6.7%) eyes with iris posterior synechia and iris dystrophy respectively. Conclusion: Phacoemulsification and intraocular lens implantaion may be effective in the cataract surgery with iris posterior synechia, and timely mangement of possible complications after surgery maybe helpful for clinical outcomes.
VL  - 6
IS  - 4
ER  -

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