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The goal of this observational study is to evaluate the location of phacoemulsification tip measured by intraoperative OCT during cataract surgeries and its impact on early postoperative changes of cornea and visual acuity. The main question it aims to answer is:
In patients with age-related cataracts undergoing phacoemulsification, does the location (supracapsular, iris-lens diaphragm, or endocapsular) of the phaco tip affect postoperative corneal changes and visual acuity at early postoperative stage? Eyes having phacoemulsification for cataracts will receive intraoperative OCT imaging to evaluate the location of the phaco tip during surgery, and corneal changes and visual acuity will be measured postoperatively.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phacoemulsification |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cataract surgery | Procedure | Cataract phacoemulsification combined with intraocular lens implantation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in corneal thickness | Corneal thickness measured by corneal endothelial specular microscope | postoperative day 1, week 1, and month 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Change in corneal endothelial cell density | Measured using corneal endothelial specular microscope | 1 day, 1 week, and 1 month postoperatively |
| Best-corrected visual acuity | Measured using ETDRS visual acuity protocol with ETDRS visual acuity chart by a masked examiner |
| Measure | Description | Time Frame |
|---|---|---|
| Position of Phacoemulsification | Swept-source intraoperative optical coherence tomography (SS-iOCT) will be used for real-time measurements throughout the surgery. The imaging depth will be set to 12 mm to ensure full visualization from the anterior corneal surface to the posterior lens surface. During phacoemulsification, a five-line scanning pattern will be applied, with the central line aligned with the phaco tip. The iris-lens diaphragm plane will be used as the reference standard on iOCT images. The phaco tip will be considered to be in the supracapsular space when positioned above this plane, at the iris-lens diaphragm plane when exactly at the plane, and in the endocapsular space when positioned below the plane. The duration of phaco tip manipulation in the supracapsular space, at the iris-lens diaphragm plane, and in the endocapsular space will be recorded throughout the phacoemulsification process. |
Inclusion Criteria:
Exclusion Criteria:
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Patients who are planning to receive phacoemulsification combined with intraocular lens implantation for unilateral/bilateral age-related cataract
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zhongshan Ophthalmic Center, Sun Yat-sen University | Recruiting | Guangzhou | Guangdong | 510000 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37166786 | Background | Liu Z, Lin H, Jin L, Qu B, Liu J, Zheng Y, He M, Luo L, Liu Y. Swab Pressing vs Stromal Hydration to Prevent Incision Leakage and Transient Collapse of Anterior Chamber in Phacoemulsification: A Randomized Clinical Trial. JAMA Ophthalmol. 2023 Jun 1;141(6):574-581. doi: 10.1001/jamaophthalmol.2023.1491. | |
| 17276271 | Background |
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| ID | Term |
|---|---|
| D002387 | Cataract Extraction |
| ID | Term |
|---|---|
| D054140 | Refractive Surgical Procedures |
| D013508 | Ophthalmologic Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| 1 day, 1 week, and 1 month postoperatively |
| Intraoperative and postoperative complications | Monitored by cataract surgeons using intraoperative OCT and postoperative slit-lamp examination. Complications include Descemet membrane detachment, posterior capsule rupture, incision leakage, and etc. | Intraoperative, 1 day, 1 week, and 1 month postoperatively |
| During phacoemulsification |
| Liu Y, Zeng M, Liu X, Luo L, Yuan Z, Xia Y, Zeng Y. Torsional mode versus conventional ultrasound mode phacoemulsification: randomized comparative clinical study. J Cataract Refract Surg. 2007 Feb;33(2):287-92. doi: 10.1016/j.jcrs.2006.10.044. |
| 31371150 | Background | Dewan T, Malik PK, Kumari R. Comparison of effective phacoemulsification time and corneal endothelial cell loss using 2 ultrasound frequencies. J Cataract Refract Surg. 2019 Sep;45(9):1285-1293. doi: 10.1016/j.jcrs.2019.04.015. Epub 2019 Jul 29. |
| 35326010 | Background | Dewan T, Malik PK, Tomar P. Comparison of effective phacoemulsification time and corneal endothelial cell loss using three different ultrasound frequencies: A randomized controlled trial. Indian J Ophthalmol. 2022 Apr;70(4):1180-1185. doi: 10.4103/ijo.IJO_2163_21. |
| 18939349 | Background | Liu Y, Jiang Y, Wu M, Liu Y, Zhang T. Bimanual microincision phacoemulsification in treating hard cataracts using different power modes. Clin Exp Ophthalmol. 2008 Jul;36(5):426-30. |
| 15953433 | Background | Lundberg B, Jonsson M, Behndig A. Postoperative corneal swelling correlates strongly to corneal endothelial cell loss after phacoemulsification cataract surgery. Am J Ophthalmol. 2005 Jun;139(6):1035-41. doi: 10.1016/j.ajo.2004.12.080. |