Osman Melih CEYLAN, Turgut YILMAZ, Elif Betül TÜRKOĞLU, Seyhan DİKCİ, Emrah ÖZTÜRK, Soner DEMİREL, Harika Gözde GÖZÜKARA BAĞ, Penpe Gül FIRAT, Abuzer GUNDUZ

Pre-, intra- and post-operative management in phacoemulsification surgery for completely monocular cases

Aim: To evaluate the results of phacoemulsification (PE) surgery in completely monocular cases and to emphasize the importantpoints in the pre-, intra- and post-operative periods.Material and Methods: A total of 42 patients who had no light perception in one eye and had underwent PE surgery in the othereye at our clinic between January 2014 and March 2016 were included in the study. The charts of the patients were evaluatedretrospectively. The age and gender of the cases, whether there was an additional pathology in the eye undergoing surgery, thereason of visual loss in the other eye, the type of anesthesia used, pre- and post-operative best corrected visual acuity (BCVA) withthe Snellen chart, intraocular pressure and intra- and post-operative complications were investigated.Results: There were17 (40.5%) female and 25 (59.5%) male patients with a mean age of 74.2±10.5 (45-93) years. The most commoncauses of the monocular state were glaucoma, cataract and trauma, the most common accompanying pathologies in the eyesundergoing cataract surgery were glaucoma, zonular weakness and age-related macular degeneration. Mean BCVA was 0.07±0.1(0.01-0.4) pre-operatively and 0.5±0.3 (0.01-1) post-operatively (p≤0.001). The mean follow-up duration was 3.9±5.6 months (1week to 24 months). The most common post-operative complication was corneal edema.Conclusion: The stress created by cataract surgery on the physician and patient is quite high in monocular cases. However,satisfactory results with PE are obtained in these cases by carefully using pre-, intra- and post-operative methods.

PDF

___

1. Dewey S, Beiko G, Braga-Mele R, et al. Microincisions in cataract surgery. J Cataract Refract Surg 2014;40:1549-57.
2. Alió J, Rodriguez-Prats JL, Galal A. Advances in microincision cataract surgery intraocular lenses. Review. Curr Opin Ophthalmol 2006;17:80-93.
3. Haddad NM, Sun JK, Abujaber S, et al. Cataract surgery and its complications in diabetic patients. Review. Semin Ophthalmol 2014;29:329-37.
4. Mehta S, Linton MM, Kempen JH. Outcomes of cataract surgery in patients with uveitis: a systematic review and meta-analysis. Review. Am J Ophthalmol 2014;158:676- 692.e7.
5. Miller AR, Miller KM. Outcomes of cataract extraction in seeing eyes of functionally monocular versus completely monocular patients. J Cataract Refract Surg 2010;36:712-7.
6. Addou-Regnard M, Fajnkuchen F, Bui A, et al. Impact of lens thickness on complications of hypermature cataract surgery: A prospective study. J Fr Ophtalmol 2016;39:631-5.
7. Robinson MS, Olson RJ. Simple approach to prevent capsule tear-out during capsulorhexis creation in hypermature cataracts. J Cataract Refract Surg 2015;41:1353-5.
8. Bergwerk KL, Miller KM. Outcomes of cataract surgery in monocular patients. J Cataract Refract Surg 2000;26:1631- 7.
9. Cavallini GM, Saccarola P, D’Amico R, et al. Impact of preoperative testing on ophthalmologic and systemic outcomes in cataract surgery. Eur J Ophthalmol 2004;14:369-74.
10. Trotter WL, Miller KM. Outcomes of cataract extraction in functionally monocular patients; case-control study. J Cataract Refract Surg 2002;28:1348-54.
11. Pomberg ML, Miller KM. Functional visual outcomes of cataract extraction in monocular versus binocular patients. Am J Ophthalmol 2004;138:125-32.
12. Levkovitch-Verbin H, Habot-Wilner Z, Burla N, et al. Intraocular pressure elevation within the first 24 hours after cataract surgery in patients with glaucoma or exfoliation syndrome. Ophthalmology 2008;115:104-8.
13. Verges C, Cazal J, Lavin C. Surgical strategies in patients with cataract and glaucoma. Curr Opin Ophthalmol 2005;16:44-52.
14. Wang JJ, Klein R, Smith W, et al. Cataract surgery and the 5-year incidence of late stage age-related maculopathy: pooled findings from the Beaver Dam and Blue Mountains eye studies. Ophthalmology 2003;110:1960-7.
15. 15.Kaiserman I, Kaiserman N, Elhayany A, et al. Cataract surgery is associated with a higher rate of photodynamic therapy for age-related macular degeneration. Ophthalmology 2007;114:278-82.
16. Mehta S, Kempen JH. Cataract surgery in patients with uveitis. IntOphthalmolClin 2015;55:133-9.
17. Haddad NM, Sun JK, Abujaber S, et al. Cataract surgery and its complications in diabetic patients. Semin Ophthalmol 2014;29:329-37.
18. Peterson SR, Silva PA, Murtha TJ, et al. Cataract surgery in patients with diabetes: Management Strategies. Semin Ophthalmol 2018;33:75-82.
19. Haiman MH, Burton TC, Brown CK. Epidemiology of retinal detachment. Arch Ophthalmol 1982;100:289-92.