Clinical Results of Cataract Surgery in Nanophthalmic Eyes

Kyoung In Jung; Ji Wook Yang; Young Chun Lee; Su Young Kim

doi:10.3341/jkos.2010.51.7.941

Journal List > J Korean Ophthalmol Soc > v.51(7) > 1008857

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Jung, Yang, Lee, and Kim: Clinical Results of Cataract Surgery in Nanophthalmic Eyes

Original Article

J Korean Ophthalmol Soc 2010;51(7):941-948.

Published online: 31 August 2010

DOI: https://doi.org/10.3341/jkos.2010.51.7.941

Clinical Results of Cataract Surgery in Nanophthalmic Eyes

Kyoung In Jung, MD, Ji Wook Yang, MD, Young Chun Lee, MD, Su Young Kim, MD

Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea

Address reprint requests to Su-Young Kim, MD, Department of Ophthalmology, Uijeongbu St. Mary's Hospital, The catholic University of Korea School of Medicine #65-1, Gumoh-dong, Uijeongbu 480-130, Korea Tel: 82-31-820-3587, Fax: 82-31-847-3418, E-mail: cassiopeia@catholic.ac.kr

Received 9 November 2009 Accepted 5 14 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the outcomes in patients with nanophthalmos that had phacoemulsification and intraocular lens (IOL) implantation.

Methods

This retrospective study included 13 eyes of eight patients with nanophthalmos who had phacoemulsification with IOL implantation: Preoperative and postoperative manifest refraction, best-spectacle corrected visual acuity (BSCVA), preoperative axial length, anterior chamber depth, corneal diameter, manual keratometry, intraocular pressure (IOP), and postoperative complications were analyzed.

Results

Eight patients (13 eyes) had phacoemulsification with IOL implantation, 11 eyes by posterior chamber IOL implantation, and two eyes by ciliary sulcus fixation. The mean change in visual acuity from preoperative to postoperative was 2.1±2.0 lines. IOP was well controlled postoperatively, but one eye required a trabeculectomy. No patients required partial sclerotomy during the operation. Choroidal effusions or choroidal detachment was not observed intraoperatively or postoperatively. The mean en-dothelial cell loss was 12.6±17.7% at two months postoperative.

Conclusions

The results of phacoemulsification and IOL implantation through clear corneal incision in nanophthalmic patients are encouraging. Most patients showed improved visual acuity without severe complications.

Keywords: Intraocular lens implantation, Nanophthalmos, Phacoemulsification

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Table 1.

Patients' demographics, ocular diagnoses, refraction, axial length, anterior chamber depth (ACD), keratometry (K1, K2)

Case	Sex	Age	OD/OS^*	Ocular diagnoses	Spherical equivalent (D)	Preop UCVA^†	Preop BSCVA^‡	Axial length (mm)	ACD^§(mm)	Corneal diameter (mm)	K1/K2(D)
1	F	57	OS	Hyperopia, angle closure glaucoma, cataract	7	0.04	0.01	20.02	1.44	11	46.50/43.50
2	F	42	OD	Hyperopia, angle closure glaucoma, cataract	10	0.32	0.05	17.93	1.24	10.8	46.50/47.50
			OS	Hyperopia, angle closure glaucoma, cataract	9	0.25	0.25	17.95	Uncheckable	11.1	47.75/47.25
3	F	48	OD	Hyperopia cataract	8.6	0.1	0.1	19.33	2.01	12.3	45.75/44.25
			OS	Hyperopia cataract	6.8	0.2	0.2	19.81	2.10	11.4	47.25/47.75
4	F	76	OS	Hyperopia, amblyopia, cataract	6	0.63	0.63	20.49	1.85	12.1	43.50/44.25
5	F	66	OD	Hyperopia, angle closure glaucoma, cataract	9.8	0.06	0.32	20.21	1.81	12	40.62/43.25
		66	OS	Hyperopia, angle closure glaucoma, cataract	10	0.04	0.32	19.87	1.91	11.7	41.37/43.87
6	F	61	OD	Hyperopia, angle closure glaucoma, cataract	5.3	0.16	0.4	20.32	1.37	11.2	41.00/42.12
7	F	75	OD	Hyperopia, cataract	3.2	0.15	0.3	20.48	2.23	10.5	47.00/47.87
		75	OS	Hyperopia, cataract	3.6	0.2	0.4	20.40	2.27	10.4	47.50/47.50
8	F	61	OD	Angle closure glaucoma, cataract	error	0.25	0.25	17.00	NM∏	NM∏	50.25/50.25
		61	OS	Angle closure glaucoma, cataract	error	0.16	0.16	16.91	NM∏	NM∏	49.50/50.25

^* OD=right eye; OS=left eye, _† UCVA=uncorrected visual acuity, ^‡ BSCVA=best spectacle-corrected visual acuity, ^§ ACD=anterior chamber depth, ^∏ NM=not measured

Table 2.

Summary of ocular surgeries, previous procedures, intraocular pressure (IOP), number of antiglaucomatics (preop and postop) Number of antiglaucomatics (Postop)

Case	Ocular surgery	Previous procedures	Preop IOP^*(mmHg)	Postop IOP^*(mmHg)	Number of antiglaucomatics (Preop)	Number of antiglaucomatics (Postop)
1	PE†/PC‡ IOL§	Laser iridotomy	28	18	3	2
2	PE†/PC‡ IOL§	Laser iridotomy, SLT	19	24	2	3
	PE†/IOL§ insertion in the sulcus	Laser iridotomy, SLT	22	46	3	3
3	PE†/IOL§ insertion in the sulcus		16	14	0	0
	PE†/PC‡ IOL§		20	13	0	0
4	PE†/PC‡ IOL§		15	14	0	0
5	PE/PCIO	Laser iridotomy, Trabeculectomy c MMCsoaking	16	16	0	0
	PE†/PC‡ IOL§	Laser iridotomy	16	13	1	1
6	PE†/PC‡ IOL§	Laser iridotomy	16	12	2	2
7	PE†/PC‡IOL§		13	12	0	0
	PE†/PC‡ IOL§		12	9	0	0
8	PE†/PC‡ IOL§	Iridectomy	12	12	1	1
	PE†/PC‡ IOL§	Laser iridotomy	20	11	1	1

Postoperative intraocular pressure was measured at 2 months postoperatively. _* IOP=intraocular pressure, _† PE=phacoemulsification, ^‡ PC=posterior chamber, ^§ IOL=intraocular lens, _∏ SLT=Selective laser trabeculoplasty, ^＃ MMC=mitomycin C.

Table 3.

Summary of postoperative results and complications: BSCVA^*, implanted IOL^† diopter, endothelial cell counts

Case	Ocular surgery	Preop BSCVA^*	Postop BSCVA^*	IOL^† (D)	Preop endothelial cell (cells/mm²)	Postop endothelial cel (cells/mm²)	Complications
1	PE^‡/PC^§ IOL^†	0.1	0.4	34	3,246	NM
2	PE^‡/PC^§ IOL^†	0.5	0.25	40	3,267	3,200	Broken IOL^† haptic, uncontrolled IOP^∏
	PE^‡/IOL^† insertion i	n 0.25	0.4	40	3,311	2,976	Uncontrolled IOP^∏, the sulcus → trabeculectomy
3	PE^‡ /IOL^† insertion in the sulcus	0.1	0.16	30	2,267	2,260
	PE^‡/PC^§ IOL^†	0.2	0.63	30	2,369	2,298
4	PE^‡/PC^§ IOL^†	0.63	0.63	30	2,242	NM^＃
5	PE^‡/PC^§ IOL^†	0.32	0.5	36	2,739	NM^＃
	PE^‡/PC^§ IOL^†	0.32	0.5	36	2,816	NM^＃
6	PE^‡/PC^§ IOL^†	0.4	0.32	36	3,105	2,832
7	PE^‡/PC^§ IOL^†	0.3	1.0	26	2,688	2,680
	PE^‡/PC^§ IOL^†	0.4	1.0	25.5	2,923	2,785
8	PE^‡/PC^§ IOL^†	0.25	0.4	40	1,879	1,002
	PE^‡/PC^§ IOL^†	0.16	0.32	40	2,242	1,342

Postoperative endothelial counts was measured at 2 months postoperatively. ^* BSCVA=best spectacle-corrected visual acuity, ^† IOL=intraocular lens, ^‡ PE=phacoemulsification, ^§ PC=posterior chamber, ^∏ IOP= intraocular pressure, ^＃ NM=not measured.

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