Hyejin Seo1, Dong Heun Nam2, Jong Yeon Lee1, Su Jin Park1, Yu Jeong Kim1, Seong-Woo Kim1, Tae-Young Chung1, Makoto Inoue1, Terry Kim1. 1. From the Department of Ophthalmology (Seo, Nam, Lee, Park, Y.J. Kim), Gachon University Gil Hospital, Incheon, the Department of Ophthalmology (S.-W. Kim), Korea University College of Medicine, and the Department of Ophthalmology (Chung), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; the Kyorin Eye Center (Inoue), Kyorin University School of Medicine, Mitaka, Tokyo, Japan; the Department of Ophthalmology (T. Kim), Duke University Eye Center, Durham, North Carolina, USA. 2. From the Department of Ophthalmology (Seo, Nam, Lee, Park, Y.J. Kim), Gachon University Gil Hospital, Incheon, the Department of Ophthalmology (S.-W. Kim), Korea University College of Medicine, and the Department of Ophthalmology (Chung), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; the Kyorin Eye Center (Inoue), Kyorin University School of Medicine, Mitaka, Tokyo, Japan; the Department of Ophthalmology (T. Kim), Duke University Eye Center, Durham, North Carolina, USA. Electronic address: eyedawns@gilhospital.com.
Abstract
PURPOSE: To evaluate macular photostress and visual experience between coaxial microscope illumination versus oblique intracameral illumination during cataract surgery. SETTING: Gachon University Gil Hospital, Incheon, South Korea. DESIGN: Prospective case series. METHODS: Consecutive patients who had cataract surgery using microscope illumination and intracameral illumination were included. The patients were asked to complete a questionnaire (seeing strong lights, feeling photophobia, feeling startled (fright) when seeing lights, seeing any colors, seeing any instruments or surgical procedures, and estimating intraoperative visual function) designed to describe their cataract surgery experience. The images projected on the retina of the model eye (rear view) with artificial opaque fragments in the anterior chamber during simulating cataract surgery were compared between the 2 illumination types. RESULTS: Sixty patients completed the questionnaire. Scores for strong lights, photophobia, fright, and color perception were significantly higher with microscope illumination than with intracameral illumination (all P < .001). More patients preferred the intracameral illumination (45 [75.0%]) to the microscope illumination (13 [21.7%]). In the rear-view images created in a model eye, only the bright microscope light in the center was seen without any lens image in the microscope illumination. However, in the intracameral illumination, the less bright light from the light pipe in the periphery and the lens fragments were seen more clearly. CONCLUSIONS: In a view of the patients' visual experience, oblique intracameral illumination caused less subjective photostress and was preferred over coaxial microscope illumination. Objective findings from the model-eye experiment correlated to the result of visual experience.
PURPOSE: To evaluate macular photostress and visual experience between coaxial microscope illumination versus oblique intracameral illumination during cataract surgery. SETTING: Gachon University Gil Hospital, Incheon, South Korea. DESIGN: Prospective case series. METHODS: Consecutive patients who had cataract surgery using microscope illumination and intracameral illumination were included. The patients were asked to complete a questionnaire (seeing strong lights, feeling photophobia, feeling startled (fright) when seeing lights, seeing any colors, seeing any instruments or surgical procedures, and estimating intraoperative visual function) designed to describe their cataract surgery experience. The images projected on the retina of the model eye (rear view) with artificial opaque fragments in the anterior chamber during simulating cataract surgery were compared between the 2 illumination types. RESULTS: Sixty patients completed the questionnaire. Scores for strong lights, photophobia, fright, and color perception were significantly higher with microscope illumination than with intracameral illumination (all P < .001). More patients preferred the intracameral illumination (45 [75.0%]) to the microscope illumination (13 [21.7%]). In the rear-view images created in a model eye, only the bright microscope light in the center was seen without any lens image in the microscope illumination. However, in the intracameral illumination, the less bright light from the light pipe in the periphery and the lens fragments were seen more clearly. CONCLUSIONS: In a view of the patients' visual experience, oblique intracameral illumination caused less subjective photostress and was preferred over coaxial microscope illumination. Objective findings from the model-eye experiment correlated to the result of visual experience.