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Purpose: To investigate corneal astigmatism in children with congenital cataract before surgery., Materials and Methods: We retrospectively reviewed the charts of 99 eyes of 62 patients (74 paired eyes and 25 single eyes) who had undergone congenital cataract surgery from March, 2000 to April, 2012. The mean age at surgery was 32.1 +/- 26.9 months. All eyes were examined using an autorefract-keratometer. Cases were divided into 3 groups according to the axis of astigmatism (with-the-rule, against-the-rule and oblique astigmatism)., Result: The mean corneal astigmatism was 2.45 +/- 1.28 diopters (D) (range 0.25-6.87D). The prevalence of corneal astigmatism of 2.0 D or more was 65.7%. The most frequent was astigmatism with-the-rule (83.8%) (mean 2.64 +/- 1.25 D), oblique astigmatism was 11.1% (mean 1.43 +/- 0.98 D), and 5.1% of the cases had astigmatism against-the-rule (mean 1.55 +/- 1.07 D). The mean corneal astigmatism of the eye with cataract (2.46 D) was significantly higher than that of the normal eye (1.66 D) in unilateral cases., Conclusions: Children with congenital cataract had a high prevalence of large corneal astigmatism > or = 2.00D, that was generally with-the-rule. In the unilateral cataract patients, cataract eyes had higher corneal astigmatism than normal eyes.

Purpose: We report the opacification of Hydroview intraocular lenes necessitating lens replacement., Subjects and Methods: This study includes 9 eyes of 7 patients (4 eyes of 3 men and 5 eyes of 4 womens, 52-92 years old) who underwent lens replacement at our hospital. A clinicopathological study and speculation on the incidence of Hydroview opacification were carried over., Results: All patients had hypertension and 3 had diabetes mellitus. Four eyes of 3 cases and 2 eyes of 2 cases demonstrated diabetic retinopathy and pseudoexfoliaton syndrome, respectively. Four of 6 cases, who underwent bilateral lens implantation, showed unilateral opacification. The duration from lens implantation to exchange ranged from 17 to 38 months. Slit-lamp examination revealed generalized opacification with white granular deposits on the lens optic surface, but transparency inside the optic. Three explanted lenses were stained with 1% alizarin red, and were positive for calcium in all cases. The remaining 6 lenses were analyzed with scanning electron microscopy, and showed electrondense granular deposits of 1 to 4 microm diameter. It is theorized that the incidence of Hydroview opacification and necessity of replacement were more than 3.8% and 3.6%, respectively, from the data at one hospital., Conclusion: Calcium deposition on Hydroview might occur in more than 3.8% of cases.

Purpose: To evaluate surgery on white cataracts using trypan blue capsule staining., Methods: A retrospective study comprised 64 eyes of 60 patients with white cataract that had surgery with trypan blue capsule staining. The average age was 62.4 years and progress observation periods were 5.6 months. The rate of successful continuous curvilinear capsulorrhexis(CCC), complications, visual acuity, intraocular pressure(IOP), flare value, and corneal endothelial cell loss were studied., Results: The CCC was completed uneventfully in 93.8% eyes. Posterior capsule rupture occurred in 2 eyes, and early perforation in 1 eye. Accidental vitreous staining and endothelial staining with trypan blue were observed in 1 eye each. There were no postoperative complications associated with trypan blue. Forty-five eyes had a best corrected visual acuity of 0.8 or better at the last visit. Twelve eyes had some ocular pathology resulting in visual loss, and a reliable visual acuity test could not be performed in 6 eyes. The mean postoperative IOP was within the normal range. The mean postoperative flare returned to within normal range 1 month after surgery. The mean corneal endothelial loss was 13.7%, and that of eyes with nucleus of grade 2 or softer was only 2.9%., Conclusions: Cataract surgery using trypan blue was safe and effective in managing white cataracts.

Purpose: To identify risk factors of poor visual outcome with vitrectomy for early-onset endophthalmitis after cataract surgery., Patients and Methods: Clinical records of 29 consecutive eyes with endophthalmitis developing within 6 weeks after cataract surgery and that underwent therapeutic vitrectomy between June 1996 and April 2001 were retrospectively reviewed. Twenty-two of the eyes received intravitreal injections of vancomycin and ceftazidime at the time of vitrectomy, and all patients received intravenous antibiotics. Eyes were divided into two groups; group A consisted of 22 eyes with a final visual acuity of 0.2 or greater, and group B consisted of 7 eyes with a final visual acuity of less than 0.2., Results: Fifteen eyes (52%) in group A achieved a visual acuity of 0.5 or better and 8(28%) achieved a visual acuity of 1.0, while 4 eyes in group B developed phthisis bulbi. For eyes with a preoperative visual acuity of hand motions or worse, there was no correlation between final visual acuity and preoperative visual acuity. The overall culture-positive rate was 57%. In group A, methicillin-resistant Staphylococcus epidermidis was identified in 6 eyes, methicillin-resistant Staphylococcus aureus (MRSA) in 3 eyes and enterococcus in 2 eyes. In group B, alpha-hemolytic streptococcus (AHS) was identified in 4 eyes, aspergillus in 1 eye, and MRSA in 1 eye. All isolates were sensitive to vancomycin with the exception of the aspergillus. AHS infection appeared to be associated with wound failure from the initial cataract surgery and a poor visual outcome. Among 3 of the eyes that developed phthisis bulbi, intravitreal injection of antibiotics was not performed., Conclusion: Early vitrectomy and intravitreal injection of vancomycin may improve visual outcomes, but infection with AHS may be associated with cataract surgery wound failure and poor visual outcomes.

We compared the postsurgical results of two small incision cataract surgery procedures: silicone intraocular lens implantation through a 3.2 mm incision and polymethylmethacrylate intraocular lens implantation through a 5.5 mm incision. One hundred fifty eyes of 124 patients were randomly assigned to either procedure, and the patients underwent phacoemulsification and intraocular lens implantation without sutures or scleral cautery. Identical surgical techniques were employed in each case except for the size of the incision. Patients in the 3.2 mm incision group showed: (1) better uncorrected and corrected visual acuity in the early postoperative period, (2) lower aqueous flare intensity immediately after surgery, (3) less operatively induced corneal astigmatism throughout the study period up to 3 months after surgery, and (4) less corneal topographic change, i.e., less corneal flattening, 3 months after surgery. There were no significant differences between groups in the corneal endothelial cell loss, blood-aqueous barrier permeability measured by fluorophotometry, or postoperative complications. It was concluded that both procedures offer highly satisfactory clinical results, but that the 3.2 mm incision surgery allows a significantly earlier recovery of visual function and less surgery-induced corneal astigmatism.