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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]

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]

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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.

Nepafenac is an innovative non-steroidal anti-inflammatory drug used in ophthalmology for the prevention of macular edema after cataract surgery. Along with its anti-inflammatory effect, nepafenac has some unique properties which distinguish it from other non-steroidal anti-inflammatory drugs. It is a prodrug activated to amfenac after it penetrates through the corneal layers to the aqueous humour and the ciliary body. Having electrically neutral molecules of lipophilic properties, nepafenac does not accumulate in the cornea and does not cause its degeneration. Additionally, it quickly achieves higher concentrations in the aqueous humour as compared to other non-steroidal anti-inflammatory drugs. Nepafenac shows high selectivity and activity against COX-2 isoform, the key enzyme implicated in inducing inflammation, which is the main cause of macular edema. Furthermore, nepafenac has the unique scleral and suprachoroidal distribution pathways. Finally, its effect on the intraocular pressure is none to negligible. Nepafenac treatment should be initiated prior to cataract surgery and continued long enough to reduce the risk of late-onset macular edema. The Expert Group of the Polish Society of Ophthalmology consider using nepafenac in the prevention of post­operative macular edema in diabetic patients undergoing cataract surgery as expedient and reasonable. The proposed optimum pre- and postoperative treatment regimen can be modified for individualised therapy.

Introduction: In Benson’s disease (scintillatio albescens or asteroid hyalosis) slight, white condensations of phospholipids are seen in the vitreous. In advanced stages, the decrease of visual acuity or subjective discomfort of vision may follow due to floaters. The pars plana vitrectomy is the treatment of choice in these patients., Purpose: To evaluate surgical treatment outcomes in Bensons’ disease. Material and methods: The research was carried out in a group of patients with Benson’s disease, who had undergone 23G or 25G pars plana vitrectomy in 2012–2014. The evaluated data included: diagnosis, the pre- and postoperative best corrected visual acuity as well as the pre- and postoperative ocular ultrasound (B scans). The study group consisted of 7 patients (8 eyes), including 5 men and 2 women, at the age of 66 to 82 years (mean age of 74 years)., Results: In 5 patients with concomitant cataract, combined procedures of phacoemulsification and pars plana vitrectomy were performed. In one patient, pars plana vitrectomy was done first followed by phacoemulsification with intraocular lens implantation at a later date. In two cases, only pars plana vitrectomy was performed. All patients were examined 7 days postoperatively and the follow up period ranged from 1 month to 1 year (mean follow up duration of 8 months). Visual acuity and subjective comfort of vision improved in all cases., Conclusions: Pars plana vitrectomy enables improvement of visual acuity and subjective comfort of vision in patients with Benson’s disease. It was confirmed in both subgroups, i.e. in patients who underwent both pars plana vitrectomy and phacoemulsification with intraocular lens implantation, and those in whom only vitrectomy was performed

Objectives: To evaluate visual outcomes after bilateral implantation of Crystalens accommodative intraocular lenses. Material and methods: The study group consisted of 20 patients (40 eyes) who underwent uneventful phacoemulsification through a 2.8 mm wide clear corneal incision followed by the implantation of an accommodative intraocular lens Crystalens HD or Crystalens AO. Uncorrected visual acuity, best corrected visual acuity, distance corrected intermediate visual acuity, distance corrected near visual acuity, best near visual acuity 1, 3, 6, 12 months postoperatively were evaluated. Distance visual acuity was measured with Snellen test. Near (40 cm) and intermediate (80 cm) visual acuity were measured with Jeager test. Results: The mean uncorrected distance visual acuity was 0.94 and 0.89 at month 1. and 12., respectively. The distance corrected intermediate visual acuity was 0.9 and 0.86 at month 1. and 12., respectively. The distance corrected near visual acuity was J1 in 10% and J3 in 50% of patients at month 1. It was J1 in 10% and J3 in 55% of patients at month 12. Conclusions: Crystalens intraocular lens implantation in our patients enabled them to achieve good distance, near and intermediate visual acuity. The majority of patients did not require spectacle correction for distance and near (87.5% and 65%, respectively). The achieved results did not differ significantly at months 1., 6., and 12. postoperatively.

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.

Introduction: Intraocular lens implantation is an important part of cataract surgery, as it has a significant influence on the final result. Accommodative intraocular lenses (IOLs) are the latest solution for the lack of accommodation in pseudophakic eyes., Purpose: To evaluate the quality of life of patients who underwent cataract surgery with accommodating IOL implantation and to compare the data with results of patients after standard monofocal IOL implantation., Material and Methods: The study group consisted of 20 patients (40 eyes), aged from 48 to 73 years old, who underwent phacoemulsification through a 2.75 mm clear corneal incision followed by the implantation of an accommodating IOL Crystalens HD (Bausch & Lomb, USA). The control group consisted of 20 patients (40 eyes), aged from 63 to 83 years old, who underwent phacoemulsification through a 2.75 mm clear corneal incision followed by the implantation of a standard monofocal single-piece acrylic intraocular lens AcrySof (Alcon, USA). All enrolled patients had no coexisting ocular diseases which could influence the final visual acuity. All surgeries were uneventful. At one month postoperatively, the patients were requested to answer 36 questions included in the questionnaire in order to evaluate the quality of visual function., Results: There was a significant improvement in the quality of life in both groups after cataract surgery. The study group tended to assess their own eyesight higher than the control group. Patients from the study group use spectacle correction for a lower number of activities, they find it easier to use fine motor skills when performing activities without spectacle correction in comparison with patients from the control group. Patients from the study group use spectacle correction for reading significantly less frequently, they also find it easier to read the normal size and small print without spectacle correction, in comparison with patients from the control group., Conclusions: Patients with accommodating IOLs self-evaluate their own eyesight highly, use spectacle correction for a lower number of activities and find it significantly easier to perform precise activities without spectacle correction, in comparison with patients after the standard monofocal intraocular lens implantation.

Introduction: Post-operative endophthalmitis, although infrequent, leads to severe, often irreversible consequences. For many years in the medical literature there have been reports on the effectiveness of various forms of prevention including antibiotics used., Aim: The aim of this study was to systematize the principles of prevention on the basis of the literature., Material: Medical reports published in recent years were compared to the conclusions of the European Society of Cataract and Refractive Surgeons (ESCRS) conducted in 16 European countries between 2003 and 2005., Results: The results indicate the lack of a uniform pattern of conduct not only in a global context, but even within European countries. Povidone iodine remains the basis of prophylaxis used before surgery to decontaminate the skin of eyelids and conjunctival sac. Topical antibiotics, mainly the new generation fluoroquinolones, are also commonly used perioperatively. Intracameral injections of cefuroxime at the end of surgery are increasingly used in endophthalmitis prophylaxis. Although their high efficacy and safety have been confirmed a few years ago, the drug formulation intended and registered for use in ophthalmology has been available in most countries since 2013., Conclusions: Contemporary post-operative endophthalmitis prophylaxis, although varied in different countries, allowed for a significant reduction in the incidence of this complication in recent years. Most ophthalmologists in European countries declare to follow the ESCRS recommendations.

Purpose: 10 describe a rare case ot a patient wiTh megalocorneas wno underwent cataract surgery., Material and Methods: A 52 years old patient with extremely wide corneas 16 mm in diameter in both eyes, was admitted to our department with cataract diagnosis. Four other male members of his family are known to have megalocorneas. This suggests X-linked recessive inheritance. The visual acuities were; 0.9 with correction -3.00 Dsph in the right eye and 0.6 with correction -5.50 Dsph in the left eye. Mosaic corneal dystrophy and slight iridodonesis was found in both eyes. Posterior subcapsular cataracts were seen in both eyes with predominance in the left eye. Moreover, flat peripheral retinal detachment in the lower part of the eye fundus was found, which was presumably long-lasting. Phacoemulsification through the clear corneal temporal micro-incision of 1.8 mm and the foldable intraocular lens IOL) implantation in the left eye were performed. The IOL refractive power was calculated with 101 Master and with standard contact ultrasound biometry. Preventive laser photocoagulation of the retina was performed in the right eye., Results: No intraoperative and postoperative complications were observed. Two weeks after cataract surgery corrected visual acuity in the left eye was ii] with correction + 1.00 Dsph. The patient was very satisfied with the surgery result., Conclusions: Phacoemulsification with an implantation of foldable 101 in patients with megalocornea may be a safe procedure with very good functional results. Precise IOL power calculation may be difficult to achieve.

Fast development of ophthalmology which can be observed in the recent years, is connected with the development of modern technology used in the diagnostics and treatment of ocular diseases. Eyes with a narrow pupil, which doesn't respond to standard pharmacologic management applied preoperatively, are a challenge for any ophthalmic surgeon. The purpose of the study is to describe various surgical devices used for achieving adequate intraoperative pupillary diameter in cataract patients who for various reasons do not respond to pharmacologic mydriasis.

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: The purpose was to compare surgically induced after bimanual phacoemulsification performed through a 1.7 mm superotemporal clear corneal microincision (B-MICS), and after coaxial phacoemulsification performed through a 3.2 mm superotemporal clear corneal incision, calculated with various mathematical methods., Material and Methods: Group 1 consisted of 29 eyes after bimanual phacoemulsification performed through a 1.7 mm superotemporal clear corneal microincision. Group 2 consisted of 31 eyes after coaxial phacoemulsification performed through a 3.2 mm superotemporal clear corneal incision. Ophthalmic examination was performed preoperatively, 1 day, 7 days, 1, 3 and 6 months postoperatively. We performed auto-refractometry, keratometry, tonometry and visual acuity testing (UCVA and BCVA). SIA was calculated using: vector method, vector decomposition, Cravy's and Naeser's method., Results: There was no difference in mean UCVA and BCVA between the groups in the whole observation period. In vector method SIA did not differ significantly between the groups during the whole follow-up. In vector decomposition (C90 component), SIA was higher in group 2 than in group 1, one day and 1 month postoperatively. Cravy's and Naeser's method showed that SIA in group 2 was significantly higher as long as the 1-st month postoperatively. In the final examination, there was no significant difference in SIA values between the groups for all methods of calculations., Conclusions: Technique B-MICS through a 1.7 mm incision offers equally good functional results, as standard phacoemulsification through 3.2 mm superotemporal clear corneal incision. The SIA axis was more stable in microincision group in the whole follow-up period.

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.

Introduction: The use of modern technologies enables constructing and producing perfected intraocular lenses. Recently, aspheric implants have become widely available., Purpose: The purpose of the study was to evaluate functional results, contrast sensitivity in scotopic conditions and spherical aberrations of the optical system of the eye after phacoemulsification with implantation of aspheric intraocular lens., Materials and Methods: The material was gathered prospectively from January until July 2006. The examined group included patients who received aspheric intraocular lenses Adapt AO or AcrySof SN60WF and who previously had received a conventional foldable spherical lens in the fellow eye. The examined group with an intraocular lens Adapt AO consisted of 25 eyes (25 patients) and the examined group with an intraocular lens AcrySof SN60WF consisted of 12 eyes (12 patients). We examined best corrected visual acuity (BCVA) and intraocular pressure. Contrastometry in scotopic conditions and aberrometry were performed. Intraoperative and early postoperative complications were noted. For statistical analysis non-parametric U Mann-Whitney test was used, all calculations were performed for the level of significance alpha = 0.05., Results: In the examined groups there were no intraoperative and early postoperative complications. In both groups, there was no statistically significant difference in mean postoperative BCVA between eyes with an aspheric implant and eyes with a spherical lens. Assuming the mean contrast sensitivity in eyes with spherical implants as 100%, we observed that in eyes with an aspheric lens it was better nearly by one third. Mean value of spherical aberrations with a pupil diameter of 5mm (Zernike RMS 5 mm) in eyes with an aspheric lens was significantly lower in comparison with eyes with a spherical implant (p < 0.05). Similarly, mean value of higher order spherical aberrations with a pupil diameter of 5 mm (Higher Order Zernike RMS 5 mm), in eyes with an aspheric lens was significantly lower in comparison with eyes with a spherical implant (p < 0.05)., Conclusions: Using aspheric lenses Adapt AO and AcrySof SN60WF allows for achieving very good functional and anatomic results and it enables to achieve better contrast sensitivity in scotopic conditions, as well as significantly decreases spherical aberrations of the optical system of the eye, in comparison with conventional spherical lenses.