|Year : 2022 | Volume
| Issue : 2 | Page : 123
Cataract surgery update
Department of Ophthalmology, Stein Eye Institute, Geffen School of Medicine, UCLA, Los Angeles, United States of America
|Date of Submission||11-Aug-2022|
|Date of Acceptance||11-Aug-2022|
|Date of Web Publication||29-Aug-2022|
Prof. Samuel Masket
Stein Eye Institute, Geffen School of Medicine, UCLA, Los Angeles
United States of America
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Masket S. Cataract surgery update. Saudi J Ophthalmol 2022;36:123
It is encouraging to note that despite the ongoing COVID-19 pandemic, our colleagues continue to move the art and science of cataract surgery forward through clinical research, compiling data, and developing manuscripts for submission to this Special Issue of the Saudi Journal of Ophthalmology, dedicated to Cataract. In keeping with a wide diversity of the demographics served by the Journal, there is a welcomed variety of articles in this issue. The subjects of the articles range from high-technology intraocular lenses (IOLs) (antidysphotopic and multifocal) and how to optimize their performance, to combined MIGS surgery (Kahook Blade) for glaucoma and cataract, to management of cataract in the uveitic patient, and to near-vision performance of monofocal IOLs in a rural Indian setting. There are also contributions regarding biometry for routine eyes, eyes with keratoconus, and eyes that underwent postexcimer laser corneal refractive surgery. Finally, there are papers that discuss cataract surgery in eyes with phakic IOLs (bilensectomy), posterior polar cataracts, ocular surface preparation for optimal cataract surgery outcomes, surgical methodology for eyes with microspherophakia, IOL implant options in the absence of posterior capsule support, and outcomes of eyes complicated by retained lens fragments at cataract surgery.
One controversial matter is raised by Arbisser who contends that routine cataract surgery should include primary posterior capsulorhexis with posterior optic capture into Berger's space. This strategy is employed in an attempt to prevent later posterior capsule opacification and the potential need for laser capsulotomy while yielding improved IOL stability and preservation of the anterior hyaloid membrane. Although her points are clear and substantiated by the work of others, there has been only limited acceptance of the concept to date.,,
Another subject worthy of debate addressed in this issue of the Journal is routine simultaneous bilateral cataract surgery (immediate sequential bilateral cataract surgery [ISBCS] as it is currently known), presented in an article from Alio and Nowrouzi. They suggest that this is a method whose time has come owing to improved optical biometry, intraoperative aberrometry, greater safety with regard to prevention of endophthalmitis; moreover, in light of the pandemic, ISBCS reduces patient visits to healthcare facilities and thus reduces the risk of COVID infection and transmission. In addition, they indicate that ISBCS reduces overall healthcare costs of cataract surgery for those patients in need of bilateral procedures. However, there is not a universal acceptance of ISBCS for a number of concerns, in particular that the rigid protocols established by the International Society of Bilateral Cataract Surgeons for the safe performance of bilateral surgery may not be adhered to across all surgeons, all cultures, and all healthcare systems.
In all, this special issue dedicated to Cataract should be of great interest and value to the readership while stimulating further thought and research into the subject. The contributors, editors, and editorial board should all be congratulated on this enormous task and its results.
| References|| |
Arbisser LB. Review of primary posterior capsulorhexis in cataract surgery. Saudi J Ophthalmol 2022;36:149-56. [Full text]
Menapace R. Posterior capsulorhexis combined with optic buttonholing: an alternative to standard in-the-bag implantation of sharp-edged intraocular lenses? A critical analysis of 1000 consecutive cases. Graefes Arch Clin Exp Ophthalmol 2008;246:787-801.
Tassignon MJ, De Groot V, Vrensen GF. Bag-in-the-lens implantation of intraocular lenses. J Cataract Refract Surg 2002;28:1182-8.
Vasavada AR, Vasavada V, Shah SK, Trivedi RH, Vasavada VA, Vasavada SA, et al.
Postoperative outcomes of intraocular lens implantation in the bag versus posterior optic capture in pediatric cataract surgery. J Cataract Refract Surg 2017;43:1177-83.
Alio JL, Nowrouzi A. Immediately sequential bilateral cataract surgery importance during the COVID-19 pandemic. Saudi J Ophthal 2022;36:124-8.
Masket S. Same day bilateral cataract surgery-Who benefits? Ophthalmology 2021;128:11-2.