• Changes in intraocular pressure and anterior segment morphometry after uneventful phacoemulsification cataract surgery.

      Dooley, I; Charalampidou, S; Malik, A; Loughman, J; Molloy, L; Beatty, S; Department of Ophthalmology, Waterford Regional Hospital, Waterford, Ireland., iandooley@eustace.net (2012-02-01)
      PURPOSE: To study changes in anterior segment morphometry after uneventful phacoemulsification cataract surgery, and to investigate whether there is a relationship between any observed changes and intraocular pressure (IOP) reduction after the procedure. METHODS: The anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), central corneal thickness (CCT), and IOP were measured in 101 non-glaucomatous eyes before and after uneventful phacoemulsification cataract surgery. RESULTS: After cataract surgery, the mean ACD, ACV, and ACA values increased by 1.08 mm, 54.4 mm(3), and 13.1 degrees , respectively, and the mean IOP (corrected for CCT) decreased by 3.2 mm Hg. The predictive value of a previously described index (preoperative ACD/preoperative IOP (corrected for CCT) or CPD ratio) for IOP (corrected for CCT) reduction after cataract surgery was confirmed, reflected in an r(2) value of 23.3% between these two parameters (P<0.001). Other indices predictive of IOP reduction after cataract surgery were also identified, including preoperative IOP/preoperative ACV and preoperative IOP/preoperative ACA, reflected in r(2) values of 13.7 and 13.7%, respectively (P<0.001 and P<0.001, respectively). CONCLUSIONS: Our study confirms the predictive value of the CPD ratio for IOP reduction after cataract surgery, and may contribute to the decision-making process in patients with glaucoma or ocular hypertension. Furthermore, two novel indices of preoperative parameters that are predictive for IOP reduction after cataract surgery were identified, and enhance our understanding of the mechanisms underlying IOP changes after this procedure.
    • Estimation of effective lens position using a method independent of preoperative keratometry readings.

      Dooley, Ian; Charalampidou, Sofia; Nolan, John; Loughman, James; Molloy, Laura; Beatty, Stephen; Department of Ophthalmology, Waterford Regional Hospital, Institute of Eye, Surgery, Dublin, Ireland. iandooley@eustace.net (2012-02-01)
      PURPOSE: To evaluate the validity of a keratometry (K)-independent method of estimating effective lens position (ELP) before phacoemulsification cataract surgery. SETTING: Institute of Eye Surgery, Whitfield Clinic, Waterford, Ireland. DESIGN: Evaluation of diagnostic test or technology. METHODS: The anterior chamber diameter and corneal height in eyes scheduled for cataract surgery were measured with a rotating Scheimpflug camera. Corneal height and anterior chamber diameter were used to estimate the ELP in a K-independent method (using the SRK/T [ELP(rs)] and Holladay 1 [ELP(rh)] formulas). RESULTS: The mean ELP was calculated using the traditional (mean ELP(s) 5.59 mm +/- 0.52 mm [SD]; mean ELP(h) 5.63 +/- 0.42 mm) and K-independent (mean ELP(rs) 5.55 +/- 0.42 mm; mean ELP(rh) +/- SD 5.60 +/- 0.36 mm) methods. Agreement between ELP(s) and ELP(rs) and between ELP(h) and ELP(rh) were represented by Bland-Altman plots, with mean differences (+/- 1.96 SD) of 0.06 +/- 0.65 mm (range -0.59 to +0.71 mm; P=.08) in association with ELP(rs) and -0.04 +/- 0.39 mm (range -0.43 to +0.35 mm; P=.08) in association with ELP(rh). The mean absolute error for ELP(s) versus ELP(rs) estimation and for ELP(h) versus ELP(rh) estimation was 0.242 +/- 0.222 mm (range 0.001 to 1.272 mm) and 0.152 +/- 0.137 mm (range 0.001 to 0.814 mm), respectively. CONCLUSION: This study confirms that the K-independent ELP estimation method is comparable to traditional K-dependent methods and may be useful in post-refractive surgery patients.
    • Severe retropharyngeal abscess after the use of a reinforced laryngeal mask with a Bosworth introducer.

      Casey, Eoin D; Donelly, Martin; McCaul, Conan L; Department of Anesthesia, Waterford Regional Hospital, Waterford, Ireland. (2012-02-01)