The study evaluated visual acuity at near, intermediate and far ranges; contrast sensitivity (the ability to distinguish small differences between light and dark); and adverse events for six months after implantation. Electrophysiologic tests (including electroretinography). The indications were hyper-mature senile cataract in 9 cases, hyper-mature senile cataract with lens induced glaucoma in 9 cases, pseudo-exfoliation syndrome in 9 cases, post-blunt injury traumatic cataract in 6 cases, iridochoroidal coloboma in 6 cases, hyper-mature cataract with pseudo-exfoliation and Marfan syndrome in 3 cases, respectively. Intraocular lens removal patients with uveitis. This was associated with a 36.1 % reduction in endothelial cell loss in the femtosecond group. These images are used to calculate the patients total refractive error, from all aberrations due to the eyes optical imperfections, at any point during the surgical procedure: phakic, aphakic or pseudophakic. J Cataract Refract Surg. Statistical analysis was carried out using STATA software v13.1 (StataCorp, Texas); p value of < 0.05 was considered statistically significant. They also noted that "[g]iven our study limitations, we found successful distance and near vision results with the implantation of Crystalens IOL. In addition, the CADTH assessment stated that long-term follow-up is needed to confirm patient outcomes, and ascertain if the benefits justify the additional cost. Phakic intraocular lenses. The alternative lens was then implanted in the second eye 4 to 6 weeks later. In a prospective, randomized, controlled clinical trial, Martnez Palmer et al (2008) evaluated visual function of 3 types of multi-focal IOLs and 1 monofocal IOL (as the control group) after cataract surgery. Chen CL, Lin GA, Bardach NS, et al. They searched the reference lists of the retrieved articles and the abstracts from the Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) for the years 2005 to 2015. background: #5e9732; A total of 295 eyes were reviewed, 61 had only pre-operative IOLMaster measurements and 234 had both IOLMaster and ORA measurements. Glare testing measures the effect of simulated glare on vision function. One specialized ophthalmologic service is frequently needed prior to cataract surgery in routine cases. 2002;28(2):239-242. An Nd:YAG laser posterior capsulotomy was performed in 153 (3.07 %) of the 4,970 eyes. Rai et al (2015) noted that surgery in the presence of zonular weakness or subluxated lens was a great surgical challenge and included intra-capsular cataract extraction with anterior chamber IOL implantation or pars plana lensectomy and vitrectomy with a sutured IOL. The authors concluded that at this time, it is not possible to draw reliable conclusions from the available data to determine whether cataract surgery is beneficial or harmful in people with ARMD. However, cataract surgery may independently lower intra-ocular pressure (IOP), which may allow for greater IOP control among patients with co-existing cataract and glaucoma. These pre-operative tests include contrast sensitivity testing, glare testing, potential vision testing, and specular photographic microscopy (endothelial cell photography). 2014;111(7):624-637. The eyes in both the groups underwent standard phacoemulsification and were implanted with a toric IOL. margin-top: 38px; list-style-type: upper-roman; U.S. Food and Drug Administration (FDA), Center for Devices and Radiologic Health (CDRH). J Cataract Refract Surg. The studies summarized in this review should assist recommendations for the standard of care of cataract surgery, at least in developed settings. Filkorn and associates (2012) compared IOL power calculation and refractive outcome between patients who underwent laser refractive cataract surgery with a femtosecond laser and those with conventional cataract surgery. Comparison of postoperative visual performance between bifocal and trifocal intraocular Lens based on randomized controlled trails: A meta-analysis. In a prospective, interventional case-series study, Roberts and co-workers (2013) reported the surgical outcomes and safety of FLACS with greater surgeon experience, modified techniques, and improved technology. Cases underwent anterior capsulotomy, lens fragmentation, and corneal incisions with the Alcon/LenSx FS laser (Alcon/LenSx, Aliso Viejo, CA). There was no difference between the long-term PCO rates when 1- and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared. Both IC cefuroxime and moxifloxacin proved effective. Pediatric cataract surgery. Glaucoma surgery can accelerate cataract progression, and performing both surgeries may increase the rate of post-operative complications and compromise the success of either surgery. In a prospective, comparative, non-randomized study, these investigators examined the effectiveness of IC antibiotic with and without post-operative topical antibiotic in reducing the incidence of acute endophthalmitis following cataract surgery in rural India. J Refract Surg. The indications of CTR implantation were zonular dehiscence or weakness associated with mature cataract (29.2 %), trauma (24.3 %), pseudo-exfoliation syndrome (19.5 %), retinitis pigmentosa (14.6 %), degenerative myopia (9.7 %), and lens coloboma (2.4 %). ul.ur li{ ORA depends on several variables (e.g., IOP, hydration, and external pressure), and these data were not recorded in this retrospective study. 1995;4(4):69-83. The mean area of the capsule disks was 18.85 2.69 mm2 in the manual and 19.03 0.26 mm2 in the femtosecond group (p = 0.64). The relative effect of the lenses on reading speed and spectacle independence was uncertain. The demographic details of patients, indications and clinical outcomes of CTR implantation were evaluated. padding: 15px; Ophthalmology. the extent to which accommodative IOLs improve unaided near visual function, in comparison with mono-focal IOLs; the extent of compromise to unaided distance visual acuity; and. 2006;17(1):99-104. Aspheric intraocular lens selection: The evolution of refractive cataract surgery. Verhulst E, Vrijghem JC. The accommodative IOL appears to produce improved near vision in some eyes, but it does not work in all eyes, and in eyes where there is apparent accommodation, there is a discrepancy between subjective reading performance and the modest measured increase of accommodative amplitude. Main outcome measures included EPT, intra-operative complications, corneal endothelial cell loss, as well as post-operative BCVA, IOP, and refractive outcomes. However, the terms and conditions around the coverage and the amount you can claim may vary for each patient. It is unclear which IOL type is optimal for use in cataract surgery for eyes with uveitis. Rai G, Sahai A, Kumar PR. These criteria include a waiting period of 2 years, an average expense of Rs. Dick HB, Gerste RD, Rivera RP, Schultz T. Femtosecond laser-assisted cataract surgery without ophthalmic viscosurgical devices. Glare was reported less frequently with accommodative lenses but the relative effect of the lenses on glare was uncertain (RR any glare 0.78; 95 % CI: 0.32 to 1.90, 1 study, 40 people, and RR moderate/severe glare 0.45; 95 % CI: 0.04 to 4.60, low quality evidence). Cochrane Database Syst Rev. Physical disability prevents satisfactory immediate post-operative care. Transient IOP increased in 5 eyes (12 %) and corneal edema in 14 eyes were noted. A total of 150 patients received the AcrySof Natural IOL and 147 patients received the AcrySof single-piece IOL as a control. 2011;(7):CD004242. If you are considering having cataract surgery, you may wonder if you have insurance to cover the procedure. border: none; 1995;21(4):457-460. They used standard methodological procedures expected by the Cochrane Collaboration. In such cases, diagnostic B-scan ultrasound can accurately image intra-ocular structures and give valuable information on the status of the lens, vitreous, retina, choroid, and sclera. People with accommodative lenses were more likely to be spectacle-independent but the estimate was very uncertain (RR 8.18; 95 % CI: 0.47 to 142.62, 1 study, 40 people, very low quality evidence). In a Cochrane review, these investigators examined the safety and effectiveness of implantation with trifocal versus bifocal IOLs during cataract surgery among subjects with presbyopia. Fellow eye comparison between the 1CU accommodative intraocular lens and the Acrysof MA30 monofocal intraocular lens. McClellan MB. Indian J Ophthalmol. Heterogeneity was assessed using the I2 test. The authors concluded that there is moderate-quality evidence that study participants who received accommodative IOLs had a small gain in near visual acuity after 6 months. The surgeons with prior experience with femtosecond lasers had fewer complications in the first 100 cases (p < 0.001). } The device is not intended for use on patients who have had previous trauma to their eye. Celik E, Koklu B, Dogan E, et al. padding-right: 18px; Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. The RR of developing endophthalmitis was 2.94 (95 % CI: 1.07 to 8.12; p = 0.037) in eyes that did not receive IC antibiotics. Footnote1*B-scan ultrasound is considered medically necessary in place of A-scan ultrasound where direct visualization of the retina is difficult or impossible including lid problems (e.g., severe edema, partial or total tarsorrhaphy), keratoprosthesis, corneal opacities (e.g., scars, severe edema), hyphema, hypopyon, miosis, dense cataract, pupillary membranes, or vitreous opacities (e.g., hemorrhage, inflammatory debris). Accessed February 6, 2004. Takakura A, Iyer P, Adams JR, Pepin SM. Fram NR, Masket S, Wang L. Comparison of intraoperative aberrometry, OCT-based IOL formula, Haigis-L, and Masket formulae for IOL power calculation after laser vision correction. Mean EPT was reduced by 83.6 % in the femtosecond pre-treatment group (p < 0.0001) when compared with controls, with 30 % having 0 EPT (p < 0.0001). At least 6 weeks after surgery, MAE was significantly lower in the laser group (0.38 0.28 diopters [D]) than in the conventional group (0.50 0.38 D) (p = 0.04). WebIs cataract surgery covered by health insurance? Model eye for Nd:YAG laser capsulotomy. Laser refractive surgery. Two authors independently screened search results, assessed risk of bias and extracted data. Compared with trifocal group, the uncorrected intermediate VA (UIVA) [MD = 0.09, 95 % CI: 0.01 to 0.17) was significantly worse in the bifocal group. However, there may be some out-of-pocket costs associated with the procedure, such as the deductible, Other uses for intra-operative wavefront aberrometry included the measurement of cylindrical power and axes to determine the placement of limbal relaxing incisions (LRI) for astigmatism and as well as orientation and power of toric IOL implants. One RCT with 60 participants with visually significant cataract and ARMD was included in this review. background: url('https://www.aetna.com/cpb/medical/data/assets/images/purplearrow.jpg') no-repeat; The member has been educated about the risks and benefits of cataract surgery, including alternatives to treatment and the member determines if the expected reduction in the disability outweighs the potential risk, cost and inconvenience of surgery. Posterior subcapsular and nuclear cataract after vitrectomy. This testing, however, may be useful for corroborating glare symptoms in a small percentage of cataract patients who complain of glare, yet measure good Snellen visual acuity. the member's own assessment of visual disability (e.g., impact on driving, viewing television, and special occupational or avocational needs) and, in particular, disability at near sight (e.g., reading, occupational activities requiring near vision); the member's perception of the impact of the disability on lifestyle (e.g., loss of independence, loss of income); the member's complaints of glare disabling eyesight in daylight conditions is inconsistent with the visual acuity measured in a darkened room; however, it must be confirmed by the documented assessment of visual functions under conditions of bright ambient light. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs (RR = 0.89, 95 % CI: 0.71 to 1.12 for spectacle independence; RR = 1.81, 95 % CI: 0.50 to 6.54 for PCO incidence; RR = 0.98, 5 % CI: 0.86 to 1.12) for patient satisfaction. American Academy of Ophthalmology Preferred Practice Pattern Cataract/Anterior Segment Panel: Olson RJ, Braga-Mele R, Chen SH, et al. Patients implanted with the Tecnis diffractive ZM900 were those reporting more photic phenomena. Posterior capsular opacification in 1 eye (2.4 %), anterior capsule phimosis in 1 eye (2.4 %) and cystoid macular edema (CME) in 1 eye (2.4 %) were detected as late complications.

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