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The approach to cataract surgery procedures in Poland has changed significantly over the past few years. The authors outline the current principles of perioperative care in cataract surgery [ABSTRACT FROM AUTHOR]

Introduction: Cataract surgery with artificial intraocular lens implantation is one of the most frequently performed operations in ophthalmology. A standard monofocal intraocular lens does not correct preoperative astigmatism; such patients benefit from correction with a toric lens. In order to preserve optical properties of the toric lens, it must remain in a stable position in the postoperative period, as any rotation reduces its optical performance. Aim of the study: To evaluate functional results and to compare the spontaneous rotation of two models of toric intraocular lenses (IOLs) implanted during phacoemulsification in patients with preoperative corneal astigmatism. Material and methods: Two groups of patients were evaluated after planned standard phacoemulsification surgery with implantation of a toric IOL. Patients who fulfilled the inclusion criteria and consented to participate were randomly assigned to one of the groups. Based on the anterior segment photography the toric lens rotation was calculated with purpose-designed ToriCalc software. Results: No statistically significant between-group differences in mean best corrected distance visual acuity (BCDVA) or uncorrected distance visual acuity (UCDVA) were found preoperatively or during the follow-up. In both groups a postoperative significant increase in UCDVA and BCDVA was observed. The rotation of the toric IOL was similar and not significant in both groups (p > 0.05). Spherical and cylindrical residual refractive errors were significantly lower after the surgery in both groups. Conclusions: Both examined IOLs offer excellent and similar rotational stability and very good functional results. The software-guided postoperative evaluation of rotational stability of toric IOLs is a good method of evaluating their position. [ABSTRACT FROM AUTHOR]

Inroduction: To report the efficacy and safety of the EX-PRESS Glaucoma Filtration Device type P-50 in pseudophakic eyes with primary or secondary open angle glaucoma. Material and methods: This retrospective analysis included 36 pseudophakic eyes (14 eyes with primary open angle glaucoma and 22 eyes with secondary open angle glaucoma) after glaucoma surgery with the EX-PRESS type P-50 without mitomycin C. The preoperative and postoperative intraocular pressure (IOP), best corrected distance visual acuity (BCDVA) and topical antiglaucoma medications were evaluated. The postoperative complications and surgical failure were analyzed. The effectiveness of treatment was assessed at the follow-up visit (mean 8.63 months). Surgical success was defined as complete (without antiglaucoma medications) with IOP ≤ 18 mmHg in criterion A and IOP ≤ 14 mmHg in criterion B. Qualified success was determined as the same IOP levels, but with one or two topical antiglaucoma medications. Results: The mean intraocular pressure was 29.98 mmHg (SD = 10.85) before surgery and 13.67 mmHg (SD = 6.19) at the follow-up visit (p < 0.05). The complete success rate was 55.56% in criterion A and 44.44% in criterion B. The qualified success rate was 25.00% in criterion A and 16.67% in criterion B. No serious postoperative complications were observed. Conclusions: This study suggests that the EX-PRESS Glaucoma Filtration Device type P-50 reduces the IOP in most pseudophakic eyes with primary or secondary open angle glaucoma, but the reduction is not always sufficient to reach the target IOP. The use of antiglaucoma medications after EX-PRESS implantation is lowered. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated, in a real‐life setting, the effect of Mydrane® (ready‐to‐use combination of tropicamide, phenylephrine hydrochloride and lidocaine, injected into the anterior chamber at the beginning of cataract surgery to induce mydriasis and intraocular anaesthesia) on the pupil diameter during cataract surgery in patients with a preoperative pupil diameter <6 mm after the use of topical mydriatics. Methods: We collected and analysed the data of 59 consecutive patients whose pupils dilated to a diameter <6 mm after the administration of mydriatic eye drops during the preoperative visit and who received Mydrane® during cataract surgery. Results: In the group of 59 patients with a preoperative pupil diameter <6 mm after topical mydriatics, cataract surgery was performed in 36 patients (61.0%) using only Mydrane® to obtain mydriasis, with no additional drug or medical device. The mean pupil diameters in this group (36 of 59) during the preoperative assessment after topical mydriatics and just before capsulorhexis when Mydrane® was injected during surgery were 5.1 ± 0.74 and 6.15 ± 1.14 mm. Additional drugs were used in 23 patients (39%). In this group, the mean pupil diameters after topical mydriatics and just before capsulorhexis using Mydrane® were 4.58 ± 1.06 and 5.6 ± 1.26 mm, respectively. Conclusion: In a real‐life setting, the mean pupil diameter achieved during cataract surgery after the intracameral injection of Mydrane® in patients with a preoperative pupil diameter <6 mm was over 1 mm larger than the mean pupil diameter after topical mydriatics, despite the trauma caused by the operation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of Mydrane (contains tropicamide, phenylephrine hydrochloride, and lidocaine hydrochloride) on time needed to induce mydriasis and mydriasis stability during cataract surgery. Methods: This was an observational, non-interventional, multicenter study of patients undergoing cataract surgery who received Mydrane for mydriasis and intraocular anesthesia. The study was conducted at seven ophthalmology departments at university hospitals in Poland. Patients admitted for cataract surgery within a 2-week period were asked to participate in the study. Patients whose pupils dilated to a diameter ≥6 mm after topical mydriatic administration during preoperative examinations were scheduled to receive Mydrane and included in the registry. No additional inclusion criteria were used. Patients' medical histories, examination results, and operative details were recorded. Pupil diameter was measured during surgery. Surgeons were asked to complete a Likert-based survey in parallel. Results: A total of 307 patients were enrolled. The mean pupil diameter was 7.0 ± 1.0 mm before capsulorhexis and 6.9 ± 1.2 mm before lens implementation. A pupil diameter ≥6 mm was achieved in 91.9% and 87.6% of patients before capsulorhexis and lens implantation, respectively. We asked 58 surgeons whether they agreed with the statement "Mydriasis was obtained in a short time after the administration of Mydrane"; the surgeons agreed with this statement after 92.2% (283/307) of surgeries. In addition, after 88.2% of surgeries, the surgeons agreed with the statement "Mydriasis was stable after the administration of Mydrane." Conclusions: Mydriasis was rapidly and stably obtained after Mydrane injection, as demonstrated by pupil diameter measurements during surgery and surgeons' feedback. [ABSTRACT FROM AUTHOR]

The term iris coloboma refers to a hole or fissure in the iris from a congenital malformation or an acquired process. Closure defects can involve the iris, ciliary body, lens, retina, choroid and optic nerve. Eyes with congenital colobomata and cataracts are at greater risk for complications during cataract surgery. Dense brunescent cataracts represent a major challenge for surgeons. A 78-year-old patient presented to our office due to visual impairment in both eyes. The visual acuity in the right eye was counting fingers and was 0.2 in the left eye. Iris and chorio-retinal colobomata were seen in both eyes inferiorly. A dense brunescent cataract was present in the right eye and a brunescent but less advanced cataract in the left eye. We decided to perform ECCE in the right eye and phacoemulsification in the left eye. A foldable intraocular lens was implanted in both eyes. Coloboma repair was performed by suturing the iris sphincter with a single polypropylene suture. The vision and photophobia of the patient were improved in both eyes. The best corrected visual acuity was 0.3 in the right eye and 0.5 in the left eye post-operatively. The photophobia has significantly decreased. The patient's levels of satisfaction and comfort were very good. The surgical treatment of cataracts in eyes with iris coloboma may be very effective. The choice of cataract removal method should be made taking into consideration the cataract severity and nuclear sclerosis. ECCE should be considered in cases with dense brunescent cataracts. [ABSTRACT FROM AUTHOR]

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In the differential diagnosis of nonspecific white matter lesions (NSWMLs) detected on magnetic resonance imaging (MRI), multiple sclerosis (MS) should be taken into consideration. Optical coherence tomography (OCT) is a promising tool applied in the differential diagnostic process of MS. We tested whether OCT may be useful in distinguishing between MS and NSWMLs patients. In patients with MS (n = 41) and NSWMLs (n = 19), the following OCT parameters were measured: thickness of the peripapillary Retinal Nerve Fibre Layer (pRNFL) in superior, inferior, nasal, and temporal segments; thickness of the ganglion cell-inner plexiform layer (GCIPL); thickness of macular RNFL (mRNFL); and macular volume (MV). In MS patients, GCIPL was significantly lower than in NSWMLs patients (p = 0.024). Additionally, in MS patients, mRNFL was significantly lower than in NSWMLs patients (p = 0.030). The average segmental pRNFL and MV did not differ between MS and NSWMLs patients (p > 0.05). GCIPL and macular RNFL thinning significantly influenced the risk of MS (18.6% [95% CI 2.7%, 25.3%]; 27.4% [95% CI 4.5%, 62.3%]), and reduced GCIPL thickness appeared to be the best predictor of MS. We conclude that OCT may be helpful in the differential diagnosis of MS and NSWMLs patients in real-world settings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose was to determine the effect of the corneal tunnel length in the 2.75 mm wide clear corneal incision, created during phacoemulsification on surgically induced astigmatism, central corneal thickness and corneal endothelial cell loss., Material and Methods: The study comprised 27 eyes (27 patients) who underwent phacoemulsification through 2.75 mm temporal clear corneal incision. Patients were examined preoperatively, 1 day, 7 days and 1 month postoperatively. Exclusion criteria were: previous intraocular surgery, corneal disorders and previous ocular trauma. Best corrected distance visual acuity, keratometry, slit-lamp examination, anterior segment optical coherence tomography and corneal endothelial cell density measurement were performed. Surgically induced astigmatism was calculated with vector method. Statistical analysis was done using non-parametric tests: Wilcoxon test, Mann-Whitney U test and Spearmann correlation coefficient., Results: Mean best-corrected distance visual acuity was 0.30±0.24 preoperatively and 0.94 ± 0.18 postoperatively (p<0.05). Mean corneal incision length 1 day postoperatively was 1.84±0.36 mm. Surgically induced astigmatism was 0.51 ± 0.41 D one month postoperatively. Clear corneal incision length and surgically induced astigmatism were positively correlated (p<0.05). Mean central corneal thickness was 0.51 ± 0.05mm preoperatively, 0.56± 0.09 mm one day and 0.51 ±0.05 mm one month postoperatively (p <0.05). Clear corneal incision length and central corneal thickness 30 days postoperatively were not corrdlated (p=0.27). Mean corneal endothelial cell density was 2483?417 cells/mm² preoperatively and 2325 ± 410 cells/mm² postoperatively. The difference was significant (p<0.05). Clear corneal incision length and corneal endothelial cell loss were not correlated (p>0.05)., Conclusions: The results suggest that the length of the 2.75 mm clear corneal incision influences the surgically induced astigmatism, but it doesn't influence the central corneal thickness and corneal endothelial cell loss. Shorter clear corneal incisions induce smaller surgically induced astigmatism in comparison with longer incisions of the same width and localization. Unequivocal confirmation.of the influence of clear corneal incision length on surgically induced astigmatism requires further investigation on a larger group of patients. Using laser techniques could help, as it would enable to examine patients in groups with different predefined clear corneal incision lengths.

Introduction: Contrast sensitivity assessment is an important additional examination, which enables the full insight into the patient's quality of vision, and early diagnosis of visual disturbances., Material and Methods: Forty six patients (92 eyes) with primary open angle glaucoma or ocular hypertension were enrolled in the study. The enrolment criteria were full or almost full visual acuity and the patients with visual field defects or any other ocular disease were excluded. Contrast sensitivity was assessed both under photopic and mesopic conditions (with and without glare) using the Functional Vision Analyzer separately for each eye. Furthermore, the retinal nerve fiber layer (RNFL) thickness was measured using scanning laser polarimetry (GDx)., Results: Contrast sensitivity was significantly reduced under both mesopic and photopic conditions in patients with primary open angle glaucoma or ocular hypertension., Conclusions: Evaluation of contrast sensitivity is a valuable diagnostic test, which enables the assessment of visual dysfunction in patients with primary open angle glaucoma or ocular hypertension persisting despite good visual acuity.

Purpose: To assess the incidence, and to identify medications and clinical features associated with intraoperative floppy iris syndrome in patients undergoing cataract surgery. Material and methods: The non-randomized, observational, prospective study was performed in 616 eyes (610 patients) after cataract surgery to determine the incidence of intraoperative floppy iris syndrome and the medications associated with its higher prevalence. We used a slit lamp adapted optical coherence tomography to evaluate anterior segment of 155 eyes (154 patients), measuring pupil diameter before and after the use of mydriatics and assessing the pre-dilated iris thickness at the dilator and sphincter muscle region. Results: The overall incidence of intraoperative floppy iris syndrome was 4% (25/616 eyes). The highest prevalence of intraoperative floppy iris syndrome was shown in patients exposed to tamsulosin (39%). Pupil diameter in mm before and after mydriasis was significantly smaller in patients with intraoperative floppy iris syndrome as compared to the syndrome-free ones (pre-dilated – 1.85 ± 0.43 vs. 2.16 ± 0.37; p < 0.01; dilated – 5.04 ± 1.01 vs. 5.70 ± 0.87; p < 0.01). The thickness of the iris in sphincter muscle region in µm was similar in patients with and without intraoperative floppy iris syndrome (520.3 ± 76.1 vs. 520.6 ± 72.4; p > 0.05). Significantly thinner iris in dilator muscle region was found in patients with intraoperative floppy iris syndrome as compared to the syndrome-free ones (409.9 ± 55.7 vs. 448.6 ± 55.8; p < 0.05). The presence of intraoperative floppy iris syndrome was correlated with a higher risk of intraoperative complications. Conclusions: Patients with intraoperative floppy iris syndrome have decreased pupil diameter and a thinner iris in dilator muscle region. Slit lamp optical coherence tomography is a useful device to preoperatively detect clinical features associated with intraoperative floppy iris syndrome. These findings may warn the surgeon of potential intra-operative difficulties. Słowa kluczowe: zespół śródoperacyjnie wiotkiej tęczówki (IFIS), epidemiologia, operacja zaćmy, optyczna koherentna tomografia skojarzona z lampą szczelinową (sl-OCT).

Introduction: The purpose of the study was to evaluate early postoperative visual acuity outcomes of coaxial phacoemulsification with a foldable intraocular lens implantation, performed through a 1.8 mm wide clear corneal microincision (C-MICS) and to compare it with standard phacoemulsification through a 2.75 mm incision., Material and Methods: The examined group consisted of a non-randomised, prospective series of 130 eyes of 130 patients who underwent coaxial 1.8 mm microincision cataract surgery with foldable intraocular lens implantation (MI60, Bausch & Lomb). The reference group comprised 123 eyes of 123 patients who underwent standard phacoemulsification through the 2.75 mm incision with foldable intraocular lens implantation (Akreos Adapt AO, Bausch & Lomb). The following parameters were evaluated preoperatively and one day after the surgery: distance uncorrected visual acuity, distance best corrected visual acuity, intraocular pressure, anterior and posterior segment of the eye. All patients were divided into groups according to the LOCS III scale., Results: The improvement of distance uncorrected visual acuity and distance best corrected visual acuity was observed postoperatively in both groups. The mean uncorrected visual acuity in the examined group was significantly better than in the reference group on the first postoperative day (0.88 +/- 0.18 vs 0.79 +/- 0.26)., Conclusions: The early postoperative visual acuity results of C-MICS were better than the results of standard small incision phacoemulsification. As far as fast visual rehabilitation after MICS is concerned, the early uncorrected visual acuity should be considered as an important yardstick in measuring success in cataract surgery. These results are due to the MICS technique, which seems to be the minimally invasive surgery, and should be regarded nowadays as a procedure of choice.

Introduction: Corneal endothelium is a single layer of cells, which do not regenerate. Damage to the endothelium can take place in the course of certain diseases and after intraocular operations. When the number of endothelial cells decreases, corneal decompensation can occur. Pre- and postoperative measurement of the number of the corneal endothelial cells can help assess the degree of corneal damage during the surgery., Purpose: To compare the effect of various factors, such as: sex, age, corneal incision, intraocular pressure, cataract density, visual acuity and surgeon's experience on corneal endothelial cell loss following uneventful phacoemulsification., Material and Methods: 365 patients (114 men and 251 women aged 19 to 91 years) undergoing phacoemulsification were examined preoperatively and postoperatively at 4 weeks. 68 eyes underwent phacoemulsification through a 1.8 mm microincision and 297 eyes through a standard 2.75 mm incision. Patients were operated on by four surgeons., Results: There was a significant difference in the postoperative endothelial cell loss relative to the degree of cataract hardness (p < 0.001). Endothelial cell loss was significantly higher in patients aged 71 and above than in the remaining age groups. Significant differences in the postoperative endothelial cell loss were observed in relation to the clear corneal incision size (p < 0.01). Preoperative best corrected visual acuity influenced the postoperative endothelial cell loss in a statistically significant way (p < 0.05). Endothelial cell loss was strongly influenced by the surgeon's experience., Conclusions: Surgeon's experience, hardness of cataract, type of corneal incision, age and preoperative visual acuity influenced endothelial cell loss at 4 weeks following uneventful phacoemulsification, however such factors as sex and intraocular pressure showed no statistically significant influence on corneal endothelial cell loss.

Background: Ocular motility impairment associated with orbital trauma may have several causes and manifest with various clinical symptoms. In some cases orbital reconstructive surgery can be very challenging and the results are often unsatisfactory. The use of modern imaging techniques aids proper diagnosis and surgical planning., Case Report: The authors present the case of a 29-year-old male who sustained trauma to the left orbit. Orthoptic examination revealed limited supra- and infraduction of the left eye. The patient reported diplopia in upgaze and downgaze with primary position spared. Dynamic magnetic resonance imaging (dMRI) was performed, which revealed restriction of the left inferior rectus muscle in its central section. A patient-specific anatomical model was prepared on the basis of 3-dimensional computed tomography (CT) study of the intact orbit, which was used to prepare a custom pre-bent titanium mesh implant. The patient underwent reconstructive surgery of the orbital floor., Conclusions: Modern imaging techniques such as dMRI and 3-dimensional CT reconstruction allow us to better understand the pathophysiology of orbital floor fractures and to precisely plan surgical treatment.

Background and Objective: To assess the results of coaxial phacoemulsification through 1.8-mm coaxial microincision cataract surgery (C-MICS) phacoemulsification with foldable intraocular lens implantation in eyes with hard cataracts in comparison to eyes with soft cataracts., Patients and Methods: Group 1 consisted of 40 eyes of 40 patients with hard cataracts (grade ≥ 4, Lens Opacities Classification System III scale) and group 2 consisted of 45 eyes of 45 patients with non-mature cataracts (grade ≤ 2, Lens Opacities Classification System III scale). All surgeries were performed by two experienced surgeons under topical and intracameral anesthesia. Examinations were performed preoperatively and 1 month after the surgery. Examined parameters included distance-corrected visual acuity (DCVA), autorefractometry, keratometry, tonometry, endothelial cell counts, and biomicroscopy of the anterior and posterior segment. Surgically induced astigmatism was calculated with vector analysis., Results: Mean DCVA was 0.16 ± 0.16 preoperatively and 0.92 ± 0.21 postoperatively in group 1 (P < .05) and 0.62 ± 0.18 preoperatively and 0.97 ± 0.08 postoperatively in group 2 (P < .05). Mean surgically induced astigmatism was 0.48 ± 0.44 in group 1 and 0.53 ± 0.38 in group 2 (P > .05). Mean endothelial cell loss was 11.37% ± 12.87% in group 1 and 2.87% ± 9.66% in group 2 (P < .05)., Conclusion: Although density of cataract has an unfavorable influence on early postoperative corneal endothelial cell loss, it did not significantly influence final DCVA and surgically induced astigmatism. C-MICS is a safe and effective method of treatment of cataracts, including cataracts with hard nuclei, and usually leads to good functional outcomes., (Copyright 2011, SLACK Incorporated.)

Unlabelled: Improvements in technology connected with cataract surgery have made it possible to decrease significantly the size of corneal incision created during phacoemulsification. Recently, coaxial phacoemulsification through a 1.8 mm microincision (C-MICS) has been introduced. This technique is perceived as the next step in development of phacoemulsification., Purpose: To compare surgically induced astigmatism (SIA) after coaxial 1.8 mm microincision cataract surgery (C-MICS) and standard phacoemulsification through 2.75 mm incision, calculated with three mathematical methods., Material and Methods: A consecutive, prospective series of 55 eyes of 55 patients who underwent uneventful C-MICS with foldable IOL implantation using 1.8 mm temporal clear corneal incision were included in group 1. Reference group (group 2) included 55 eyes of 55 patients who underwent uneventful phacoemulsification through 2.75 mm temporal clear corneal incision with a foldable IOL implantation. SIA was calculated using three methods., Results: All patients had uneventful surgery and were examined before the surgery and one month postoperatively. There was a significant postoperative increase in corrected distance visual acuity in both groups (p < 0.01), and the visual outcomes in both groups were similar (p > 0.05). In vector analysis, mean SIA was 0.42 +/- 0.30 in group 1 and 0.77 +/- 0.55 in group 2. In vector decomposition, the mean SIA (C90) in group 1 was 0.24 +/- 0.29 and 0.49 +/- 0.54 in group 2 (p < 0.05). In Naeser's polar values method, deltaKP-0 was -0.06 +/- 0.43 in group 1 and -0.21 +/- 0.84 in group 2 (p > 0.05)., Conclusions: 1.8 mm coaxial MICS induces a significantly smaller value of SIA than standard 2.75 mm phacoemulsification.

Unlabelled: In aphakic patients, lack of capsular support or insufficient capsular support require an implantation of an anterior chamber intraocular lens or a sclerally fixated lens. Rigid PMMA (polymethylmetacrylate) anterior chamber intraocular lenses or transscleral intraocular lenses require an incision 6.0-7.0 mm wide., Purpose: Of this study was to evaluate anatomic and functional results of a new foldable acrylic anterior chamber intraocular lens (Acri.Lyc 15A, Acritec) through a small incision (2.8 mm)., Material and Methods: The examined group consisted of 30 eyes in 30 patients, at the age from 48 to 87 years (mean 70.90 years, SD +/- 10.57 years), who received a new type foldable acrylic anterior chamber intraocular lens (AC IOL). Examinations were performed before operation and 1-3 days, 1-2 weeks, 3-4 months, 6-8 months after the surgery. During all control examinations visual acuity, intraocular pressure, refraction, corneal endothelium density, pachymetry, keratometry, anterior and posterior segment of the eye were evaluated., Results: Preoperative mean best corrected visual acuity (BCVA) was 0.32 +/- 0.36 and increased to 0.63 +/- 0.33, 6-8 months after the surgery. We observed that mean corneal endothelial cell density (ECD) gradually decreased in the postoperative period. We observed some minor complications after implantation of the AC IOL (e.g. corneal edema, Descemet folds, raised IOP, hyphaema, distorted pupil shape, "iris bombe", blood in the vitreous, displaced IOL and cystic macular edema), most of them were minor and did not influence the final results., Conclusions: The application of foldable anterior chamber intraocular lenses through a small incision is a safe alternative for rigid PMMA anterior chamber intraocular lenses and transscleral intraocular lenses.

Purpose: To evaluate retrospectively anatomic and functional results of phacoemulsification with posterior chamber intraocular lens implantation, complicated by intraoperative posterior capsular rupture (PCR)., Material and Methods: Data were gathered from medical records of 930 patients (one thousand eyes), who underwent phacoemulsification. The examined group consisted of 52 eyes of 52 patients, 27 women (52%), and 25 men (48%), 50 to 84 years old (mean age 73.52 +/- 7.8), who underwent phacoemulsification complicated by intraoperative posterior capsular rupture. The control group consisted of 427 patients, including 263 women (61.59%) and 164 men (38.41%), at the age 44 to 93 (mean age 70.3 +/- 10.2), who underwent uncomplicated cataract phacoemulsification. All patients had ophthalmic examination preoperatively, one day postoperatively and 10 to 14 days postoperatively. The evaluated data included: patients' age and gender, pre- and postoperative best corrected visual acuity, intraocular pressure, state of the anterior and posterior segment, early postoperative complications, type of implanted intraocular lens and whether anterior vitrectomy was performed. Nonparametric tests were used for statistical analysis (Wilcoxon signed-ranks test and Mann-Whitney U test)., Results: A statistically significant difference in postoperative BCVA between both groups was found. Mean postoperative BCVA in the PCR group was 0.63 +/- 0.27, whereas mean postoperative BCVA in the reference group was 0.78 +/- 0.18 (p < 0.001). Ten patients in the PCR group (19%), required anterior vitrectomy. In-the-bag implantation was performed in all eyes from the reference group, but it constituted only 31% (16 eyes), of the PCR group. We found that eyes with PCR are 2.6 times more likely to develop other intraoperative complications and early postoperative complications in comparison with controls. In our study eyes with PCR were about 5 times more likely to have a final BCVA worse than 0.5 than eyes from uncomplicated surgery group., Conclusions: Eyes with intraoperative PCR during phacoemulsification have a higher risk of reduced BCVA, however, it is possible to achieve good final BCVA in the majority of eyes. Appropriate intraoperative and postoperative management will usually allow to perform a successful procedure with safe placement of an intraocular lens, thus ensuring a relatively favourable outcome.

Purpose: Implantation of intraocular lenses (IOLS) has become a standard practice in cataract surgery, however, similar to any other type of surgery, using IOLs is not complication-free and sometimes explantation of intraocular lenses may be necessary. This study was to gather data and analyze causes of intraocular lens explantations, performed in the Department of Ophthalmology, Medical University of Łódź., Materials and Methods: The data were gathered from medical documentation of all patients who underwent intraocular lens removal from January 2003 to July 2006. The examined group consisted of 16 patients (16 eyes): 9 women (fraction 0.56), and 7 men (fraction 0.44), at the age from 21 to 82 years (mean age 62.4 years, SD +/- 15.5). In all patients IOL explantation was performed under local, peribulbar anaesthesia., Results: Two groups of patients were distinguished: patients who had an anterior chamber lens explanted (3 patients, fraction 0.19) and patients who underwent posterior chamber lens explantation (13 patients, fraction 0.81). Causes of AC IOL explantations were: vaulting of the IOL (1 eye, fraction 0.06), luxation of the IOL to the vitreous cavity (1 eye, fraction 0.06), and painful eyeball after anterior chamber lens implantation (1 eye, fraction 0.06). Causes of PC IOL explantations were: subluxation of the IOL (6 eyes, fraction 0.38), luxation of the lens to the vitreous cavity (3 eyes, fraction 0.19), luxation of the lens to the anterior chamber (1 eye, fraction 0.06), endophthalmitis (2 eyes, fraction 0.13) and incorrect lens power (1 eye, fraction 0.06)., Conclusions: In the majority of eyes (n = 13, fraction 0.81) the removed implant was replaced by another intraocular lens, but 3 eyes (fraction 0.19) were left aphakic. We did not observe serious intra- or early postoperative complications which might influence the final result of the operation.