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Article
14-MANUAL PHACOEMULSIFICATION IN BASRAH; THE FIRST SERIES FROM IRAQ

Author: Sajid Al Assadyd
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 Year: 2009 Volume: 15 Issue: 2 Pages: 81-87
Publisher: Basrah University جامعة البصرة

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Abstract

This prospective study includes 80 eyes of 78 patients with cataract, who had manualphacoemulsification operated upon by the same surgeon at Basrah Hospitals between Feb,2006 and Jul, 2007. They were 35 males and 43 females, 2 of them (females) have cataract inboth eyes. The age of patients range from 35-70 years, 23 eyes of 21 patients (28.7%) at age ofbetween 35-45 years, 20 eyes (25%) at age of between 46-55 years, 27 eyes (33.7%) at age ofbetween 56-65 years, 10 eyes (12.5%) at age . 66 years. The pre-operative visions for thosepatients were ranged from 6/24 to projection of light (PL), depend on the type and extent ofcataract. There was selected with no significant corneal astigmatism in all of these patients.Surgery was done on 21 eyes (26%) with posterior subcapsular cataract, 20 eyes (25%) withnuclear cataract, 30 eyes (38%) with mature cataract and 9 eyes (11%) with hypermaturecataract. On the first postoperative day, according to Oxford Cataract Treatment and EvaluationTeam Grade (OCTET) classification the observation was: Grade 0 was reported in 46 eyes(58%), Grade I developed in 25 eyes (31%), Grade II developed in 8 eyes (10%), and Grade IIIdeveloped in 1 eye (1%). On the 7th postoperative day, 54 eyes (67.5%) had UncorrectedVisual Acuity (UCVA) of good outcome, 23 eyes (28.7%) had of borderline. On day 40postoperative, 75 eyes (93.7%) achieved a best corrected visual acuity (BCVA) of goodoutcome. The final refractive states in 73 eyes (91.2%) was emmetropic or within (-1) dioptericsphere of the desired refractive target without a significant astigmatism.


Article
The Effect Of Phacoemulsification And Intra OcularLensImplantation On The Intra Ocular Pressure In Glaucomatous And Non Glaucomatous Eyes

Author: Ahmed Majeed Rasheed
Journal: Kerbala Jorunal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2012 Volume: 5 no 2 Issue: 12 Pages: 1473-1479
Publisher: Kerbala University جامعة كربلاء

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Abstract

Abstractbackground: Cataract and glaucoma are two common diseases affecting a large spectrum of the population worldwide. This prospective study aimed to study the effect of phacoemulsification with intraocular lens implantation in non glaucomatous and glaucomatous eyes on the intraocular pressure(IOP).Materials: intraocular pressure before and after phacoemulsification with IOL implantation was recorded. Eyes were divided into 3 groups according to preoperative IOP. Data were recorded preoperatively, 6 months postoperatively, and 1 year postoperatively. Comparison was made between preoperative IOP versus IOP 1 year postoperatively.Results: 70 patients were included in the study. The final mean IOP reduction was 6.411 mm hg (24.65%) in the 24 to 30 mm hg group, 4.439 mm hg (20.41%) in the 20 to 23 mm hg group, and 1.44 mm hg (8.47%) in the 15 to 19 mm hg group.Conclusion: intraocular pressure reduction was proportional to preoperative IOP;the highest preoperative IOP decreased the most and the lowest preoperative IOP decreased the least. Phacoemulsification with iol implantation may help treating adult glaucoma.Keywords:phacoemulsification;IOP.

Background: Cataract and glaucoma are two common diseases affecting a large spectrum of the population worldwide. This prospective study aimed to study the effect of phacoemulsification with intraocular lens implantation in non glaucomatous and glaucomatous eyes on the intraocular pressure(IOP).Materials: intraocular pressure before and after phacoemulsification with IOL implantation was recorded. Eyes were divided into 3 groups according to preoperative IOP. Data were recorded preoperatively, 6 months postoperatively, and 1 year postoperatively. Comparison was made between preoperative IOP versus IOP 1 year postoperatively.Results: 70 patients were included in the study. The final mean IOP reduction was 6.411 mm hg (24.65%) in the 24 to 30 mm hg group, 4.439 mm hg (20.41%) in the 20 to 23 mm hg group, and 1.44 mm hg (8.47%) in the 15 to 19 mm hg group.Conclusion: intraocular pressure reduction was proportional to preoperative IOP;the highest preoperative IOP decreased the most and the lowest preoperative IOP decreased the least. Phacoemulsification with iol implantation may help treating adult glaucoma.

Keywords

phacoemulsification --- IOP.


Article
Aiming For Emmetropia after Cataract Surgery

Author: Ahmed Majeed Rasheed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: supplement Pages: 721-726
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Emmetropia after cataract removal and posterior chamber intraocular lens implantation is vital for the achievement of a clear postoperative vision . Any significant deviation from this target leads to patient dissatisfaction. OBJECTIVE:The aim of this study is to evaluate the importance of various factors in causing deviation from post-cataract surgery emmetropia.Design: prospective non comparative observational study.METHODS: 114 eyes from 114 patients with uncomplicated cataract were enrolled for this study, biometry was done for the patients then they were operated on by phacoemulsification and foldable posterior chamber intraocular lens implantation .After one month from the surgery retinoscopy and manual refraction was done for all patients.RESULTS: Operated patients had a mean age of 61.4±5.6 years. Of the 114 eyes, 73 eyes (64.03%) were within 1 diopter (D) spherical equivalent (SE) of emmetropia. The number of eyes with postoperative astigmatism was 104 (91.22%); the mean absolute postoperative astigmatism amplitude was 1.346 D±0.421(SD). The mean absolute biometry prediction error was 1.007 D±0.246 (SD). The number of eyes with biometry error was 65 eyes (62.5%).CONCLUSION: Emmetropia is the goal in most cataract surgeries but only 64.03% of eyes were within 1.0 D (SE) of this target. Factors precluding emmetropia include postoperative astigmatism and biometry prediction errors.


Article
Evaluation Of Corneal Endothelial Cells Hysteresis After Phacoemulsification
تقييم التغيرات ألتخلفيه على الطبقة البطانية للقرنية بعد إزالة الساد بطريقة الاستحلاب-الفاكو

Author: Dr. Alyaa Abood Kareem. M.B.Ch.B, F.I.C.M.S ophth., C.A.B ophth.
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2012 Volume: 15 Issue: 1 Pages: 362-371
Publisher: University of Kufa جامعة الكوفة

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Abstract

BACKGROUND: The corneal endothelial cellular monolayer cannot regenerate after injury. Endothelial cell loss is a commonly studied relevant postoperative variable because it is associated with the long-term risk for corneal decompensation.Analysis of cell shape and pattern is a more sensitive indicator of endothelial damage than cell density alone.PURPOSE: To evaluate hysteresis changes that occur in the corneal endothelium at different times (one week, three months, six months) after cataract extraction with phacoemulsification using noncontact specular microscope .PATIENTS AND METHOD: Seventy-five patients scheduled for cataract extraction with phacoemulsification were examined with non contact specular microscopy (SP-3000P) performed at the center of the cornea. Corneal thickness (T), average cell area (AVG), cell density (CD), and percentage of cell hexagonality (HEX) were measured. Statistical analysis was performed using a 2-tailed Student t-test, Pearson correlation.RESULTS: In all patients there was an increase in corneal thickness, widening in cell area, decrease in cell density, and extreme variability in their hexagonality after surgery. The results were as follows:- mean T was 480.5µm, 526.8µm, 534.3µm, and 541.3µm; mean AVG was 380.25mm2, 465.4mm2, 492.97mm2, and 527.77mm2; mean CD was 2809.00 cell/mm2, 2220.72 cell/mm2 , 2053.56 cell/mm2 , and 1899.97 cell/mm2 ; mean HEX was 72.27%, 27.35%, 39.35%, and 51.76% preoperatively, one week, three months, and six months postoperatively respectively. P value was <0.01 for all the findings (significant).DISCUSSION: Although endothelial cell density in the early postoperative period is highly deranged but it is not the only valuable parameter to maintain corneal morphology. The ability of endothelial cells to function properly and rearrange themselves is a potential element for corneal architecture. Significant changes in the measured parameters were obtained during the entire period of the study reflecting the effect of phacoemulsification on the corneal endothelial features and function. CONCLUSION & RECOMMENDATIONS: Corneal endothelial cells can be damaged by many factors during and after cataract surgery. Future refinements of the phacoemulsification techniques should aim to minimize early postoperative compromise of corneal endothelial function. A comparative study of the effect of phacoemulsification and other variety of surgeries will be a good indicator of endothelial cell damage induced by either technique

لغرض تقييم التغيرات التخلفية الحاصلة في الخلايا البطانية للقرنية بعد إجراء عملية إزالة الساد بطريقة الاستحلاب (الفاكو) اجريت هذه الدراسة على 75 مريض بالساد تمت تهيئتهم لرفع الساد بهذه الطريقة.تم اخذ القراءات التالية للغشاء البطاني باستخدام المنظار المجهري غير التلامسي قبل اجراء العمليه: (سمك القرنية- معدل المساحة السطحية للخلية البطانية-كثافة الخلايا ونسبة الخلايا البطانية سداسية الشكل).اعيدت القراءات بعد مرور اسبوع ، ثلاثة اشهر وستة اشهر على العملية الجراحية. وجد أن فقدان في كثافة الخلايا البطانية وزيادة في معدل المساحة السطحية للخلية مع زيادة في سمك القرنية واختلاف كبير في نسبة التشكل السداسي للخلايا قد حصل بعد العملية. أن إجراء عملية الساد بطريقة الاستحلاب (الفاكو) تؤدي إلى فقدان في عدد الخلايا البطانية للقرنية بشكل كبير مع زيادة في سمك القرنية وهذا مايحصل في الأنواع الأخرى من عمليات رفع الساد والذي لايمكن تجنبه عادة.على الرغم من أن كثافة الخلايا البطانية للقرنية قد انخفض بشكل واضح لكنه ليس العامل الوحيد للحفاظ على شكل وهيكلية القرنية فالوظيفة الفيزياوية للخلايا وقدرتها على إعادة ترتيب شكلها هو عامل مهم في هذا الجانب وهذا ما تم استنتاجه من ملاحظة التغيير الحاصل في المساحة السطحية للخلايا وشكلها.


Article
lINTRAOPERATIVE INTRAVITREAL TRIAMCINOLONE ACETONIDE DURING CATARACT SURGERY FOR THE PROPHYLAXIS AND MANAGEMENT OF POSTOPERATIVE DIABETIC MACULAR EDEMA
حقن مادة التريامسينولون داخل الجسم الزجاجي اثناء عملية المياه البيضاء للوقاية و العلاج من وذمة الشائبه الصفراء

Author: Dr Wajida Saad Bunian د. واجدة سعد بنيان
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2011 Volume: 5 Issue: 2 Pages: 45-59
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

ABSRACTCataract extraction in diabetic patients is commonly indicated, both for visual rehabilitation and for improved visualization of the fundus. Unfortunately the visual prognosis for diabetic patients undergoing cataract surgery is guarded, mainly because of the risk for worsening retinopathy levels and exacerbation of macular edema. The Aim of this study is to evaluate the efficacy of intravitreal Triamcinolone acetonide injected during cataract surgery in the prophylaxis and management of postoperative macular edema following uneventful cataract surgery in diabetics.The study included 2 groups, Group A included 15 patients divided into 2 subgroups 1)-Diabetic patients without any excising macular oedema., 2)-Diabetic patients with pre-existing macular edema. Patients in Group A were subjected to phacoemulsification with Posterior chamber intraocular lens implantation. Subjects and methods: Group B included 15 diabetic patients with or without preoperatively existing macular edema including patients with previous macular laser treatment with visually significant cataract. Patients were subjected to Phacoemulsification with PCIOL implantation and Intravitreal triamcinolone injection (dose of 8 mg in 0.2 ml will be injected slowly through the inferior pars plana).Results: The results of this study showed that phacoemulsification with intravitreal TA in patients with CSME appears to be a safe intervention to avoid the postoperative exacerbation of the edema in patients with dense cataract precluding macular laser treatment. TA may serve as mean to control postoperative inflammation and prevent exacerbation of the macular edema. Postoperative laser treatment may be needed in some cases to augment the effect of intravitreal TA.

ألخِلاصه : وذمة البقعة الصفراء هو السبب الأكثر شيوعا لفقدان البصر بين المرضى الذين يعانون من اعتلال الشبكية السكري. قد تكون موجودة في أي مستوى من اعتلال الشبكية. ويتسبب في المقام الأول للوذمة انهيار حاجز الدم في الشبكية الداخلية وزيادة نفوذية الأوعية الدموية. الدراسات الأخيرة تشير إلى أن وسطاء مثل التهابات في بروستاجلاندين (لPG) والبطانة الوعائية نمو عامل (VEGF) ، ومسؤولة جزئيا عن زيادة نفاذية الأوعية الدموية .ويشار عادة استخراج الساد في مرضى السكري قد بسبب خطر لمستويات اعتلال الشبكية وتفاقم تدهور وذمة البقعة الصفراء.والهدف من هذه الدراسة هو تقييم فعالية حقنة التريامسينولون داخل السائل الزجاجي خلال جراحة الساد في الوقاية ما بعد الجراحة من وذمة البقعة الصفراء في مرضى السكري.أثبتت نتائج البحث حقن مادة التريامسينولون داخل الجسم الزجاجي اثناء عملية المياه البيضاء يعتبر من الحلول الجيدة لعلاج الارتشاح السكري للمقولة في المرضى الذين يعانون من مياه بيضاء متقدمة تحول دون اجراء ليزر. في بعض الحالات يحتاج المرضى الي عمل جلسة ليزر بعد الجراحة لتوثيق تاثير التريمسينولون.

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