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367 ± 0.066 mm vs 2.369 ± 0.062 mm [SD], P = .815. The corrected distance visual acuity was 6/6 at 1 month in 80% of the participants in the UltraSert group and 86% in the Vivinex group. After adjusting for age, sex, grade of cataract, and IOL power, no significant difference was found in the magnitude of surgically induced astigmatism (SIA) in the Vivinex group compared with the UltraSert group (0.06, 95% CI, -0.11 to 0.24; P = .47). CONCLUSIONS No significant difference was found in the change in the incision size, visual acuity, and SIA between UltraSert and Vivinex IOL delivery systems. This suggests that both IOL delivery systems are comparable in terms of post-IOL delivery incision enlargement for incisions of 2.2 mm.PURPOSE To determine the amount of waste produced from phacoemulsification surgeries and ways to curtail the problem. SETTING Miri Hospital, Sarawak, Malaysia. DESIGN Prospective study. METHODS Phacoemulsification surgery cases were included in this study; nonphacoemulsification surgeries were excluded. The waste was subdivided into 3 main categories, general waste, clinical waste, and sharps. The waste produced by ophthalmologists and trainees was accounted for separately. The mean weight of waste per case was obtained by dividing the total weight of waste produced with the total number of cases. RESULTS The total waste produced from a total of 203 cases of phacoemulsification surgeries was 167.965 kg, of which, 95.063 kg (56.6%) were clinical waste, 63.197 kg (37.6%) were general waste, and 9.705 kg (5.8%) were sharps; 32.193 kg (50.9%) out of the general waste pool were recyclable waste products. The mean waste production per case of phacoemulsification surgery for an ophthalmologist was 0.814 kg, 1.086 kg per case for a trainee. A case of phacoemulsification surgery would produce 0.282 kg of carbon dioxide equivalents in the setup based on the recyclable general waste. CONCLUSIONS The average waste produced per case of phacoemulsification surgery in Miri Hospital was 0.827 kg. After excluding the recyclable material, the average waste produced per case was 0.669 kg. Quisinostat nmr Following the 3 R's principles (reduce, reuse, and recycle) in the handling of waste production might reduce environmental impact.PURPOSE To study the safety of phacoemulsification in eyes with long anterior zonules (LAZs). SETTING Institute. DESIGN Retrospective interventional case series. METHODS All patients with clinically proven LAZs who had undergone phacoemulsification by a single surgeon from January 2014 to December 2018 were included. All cases of LAZs with cataract extraction by procedures other than phacoemulsification or combined with any other ocular surgery were excluded. Sixty-five eyes of 52 patients were analyzed. Phacoemulsification with capsulorhexis that involves sacrificing the LAZs was performed. The primary outcome measures were the incidence of capsulorhexis extension or the need to rescue intraoperatively and the rate of intraoperative complications. Secondary outcomes assessed were the percentage of eyes within ±0.5 diopters (D) and ±1 D of the target refraction. RESULTS Sixty-five eyes (52 patients) were analyzed; the mean age of patients was 67.3 ± 7.4 years. The successful completion of an adequately sized capsulorhexis without extension or rescue was seen in 100% of cases. The incidence of intraoperative complications was 1.5% (posterior capsular rupture in 1 eye). The mean postoperative corrected distance visual acuity was 0.05 ± 0.1 (logarithm of the minimum angle of resolution) at a mean of 26.8 ± 7.6 days. The mean spherical equivalent was -0.15 ± 0.7 D. Eyes within ±0.5 D and ±1.00 D of the target refraction were 77% and 94%, respectively. CONCLUSIONS Phacoemulsification in eyes with LAZs can be safely performed through an adequately sized capsulorhexis by sacrificing, ie, cutting or breaking, the anteriorly inserted zonules 360 degrees without significant intraoperative complications.PURPOSE To investigate whether previous intravitreal antivascular endothelial growth factor (VEGF) injections are a predictor for posterior capsular rupture (PCR) during phacoemulsification cataract surgery. SETTING Whipps Cross University Hospital Eye Treatment Centre, London, United Kingdom. DESIGN Single-center, retrospective, electronic medical record (EMR) database study with univariate analysis. METHODS Data were extracted from an EMR system on eyes undergoing phacoemulsification surgery between August 1, 2016, and January 1, 2018. Patient demographics, indication for intravitreal therapy, treatment type, the number of previous intravitreal injections (IVIs), diabetic status, surgeon grade, and operative complications were included as variables for analysis. RESULTS Data were available for 4047 cataract operations. Of these, 108 (2.7%) had undergone previous anti-VEGF IVI treatment. Three eyes were noted to have preoperative PC trauma and were excluded from the final analysis. The logistic regression analysis after exclusion of the eyes with pre-existing damage to the PC confirmed that previous anti-VEGF IVI treatment was associated with an increased risk of PCR when compared with the non-IVI group (6.67% vs 1.88%, P less then .0001). There is a dose-dependent relationship between the number of anti-VEGF injections and the likelihood of PCR. CONCLUSIONS Previous intravitreal anti-VEGF injections are significantly correlated with an increased risk of surgical PCR, despite the absence of visible structural damage to the posterior capsule preoperatively.PURPOSE To compare visual outcomes, reading ability, and visual quality between the Symfony extended depth-of-focus intraocular lens (IOL) and the trifocal AT LISA tri 839MP IOL. SETTING University Eye Clinic Maastricht, The Netherlands. DESIGN Prospective randomized controlled trial. METHODS Patients were randomly assigned to bilateral Symfony IOL or AT LISA tri 839MP IOL implantation. The primary outcome measure was uncorrected intermediate visual acuity (UIVA measured at 66 cm). Secondary outcomes included uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), reading ability, and comparison of defocus curves, contrast sensitivity, optical adverse effects, and quality of vision. RESULTS The study enrolled 60 eyes of 30 patients. The mean UIVA was -0.02 ± 0.03 (SD) vs 0.01 ± 0.03 logarithm of the minimal angle of resolution (logMAR) in the Symfony and AT LISA tri 839MP groups, respectively (P = .047). The UDVA was 0.01 ± 0.12 and -0.05 ± 0.07 logMAR (P = .11) and the UNVA was 0.09 ± 0.
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