Intraocular Lens-Shell Technique: Adjustment of the Surgical Procedure Leads to Greater Safety When Treating Dense Nuclear Cataracts
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{"title"=>"Intraocular lens-shell technique: Adjustment of the surgical procedure leads to greater safety when treating dense nuclear cataracts e112663", "type"=>"journal", "authors"=>[{"first_name"=>"Luo", "last_name"=>"Lixia", "scopus_author_id"=>"55948486100"}, {"first_name"=>"Lin", "last_name"=>"Haotian", "scopus_author_id"=>"56433657100"}, {"first_name"=>"Chen", "last_name"=>"Weirong", "scopus_author_id"=>"57200194859"}, {"first_name"=>"Qu", "last_name"=>"Bo", "scopus_author_id"=>"56432541400"}, {"first_name"=>"Zhang", "last_name"=>"Xinyu", "scopus_author_id"=>"57188723386"}, {"first_name"=>"Lin", "last_name"=>"Zhuoling", "scopus_author_id"=>"56433653500"}, {"first_name"=>"Chen", "last_name"=>"Jingjing", "scopus_author_id"=>"57127160400"}, {"first_name"=>"Liu", "last_name"=>"Yizhi", "scopus_author_id"=>"24391405800"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"600550434", "sgr"=>"84913582248", "issn"=>"19326203", "scopus"=>"2-s2.0-84913582248", "doi"=>"10.1371/journal.pone.0112663"}, "id"=>"2b213b08-8c05-358b-a192-a3af4bd68517", "abstract"=>"OBJECTIVE: To compare the efficacy and safety of the intraocular lens (IOL)-shell procedure versus conventional phacoemulsification for the surgical treatment of dense cataracts., METHODS: Eighty eyes with dense nuclear cataracts were enrolled in a prospective, randomized controlled study. Patients were assigned to two groups. In Group I, the IOL was traditionally implanted after all nuclear fragments were completely removed, and in Group II, the IOL was innovatively implanted in the bag before the last residual nuclear fragment was removed. This novel adjusted surgical procedure, named the \"IOL-shell technique\", features use of the IOL as a protective barrier rather than simply as a refractive alternative, and it is conceptually different from the traditional step-by-step procedure. Clinical examinations, including uncorrected visual acuity, central corneal thickness (CCT), temporal clear corneal incision thickness and corneal endothelial cell density, were carried out., RESULTS: The inter-group difference in temporal corneal thickness was found to be of no statistical significance at any of the visits. Compared to eyes in Group I, those in Group II were shown to have significantly less corneal endothelial cell loss on both the 7th and 30th day following surgery. At 7 days after surgery, the mean corneal endothelial cell loss in Group II was 10.29%, compared to 14.37% in Group I (P<0.05). The mean endothelial cell loss measured on postoperative day 30 was 16.88% in Group II compared to 23.32% in Group I (P<0.05). On the 1st day after surgery, the mean CCT of eyes in Group II was significantly smaller compared to Group I (Group I vs. Group II: 19.42% vs. 13.50%, P<0.05)., CONCLUSIONS: Compared to conventional phacoemulsification, the IOL-shell technique was shown to be a relatively safer procedure without compromised efficiency for dense cataracts, and it caused less corneal endothelial cell loss and milder postoperative corneal edema (Clinical Trials Identifier: NCT02138123)., TRIAL REGISTRATION: ClinicalTrials.gov NCT02138123.", "link"=>"http://www.mendeley.com/research/intraocular-lensshell-technique-adjustment-surgical-procedure-leads-greater-safety-treating-dense-nu", "reader_count"=>4, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Researcher"=>1, "Student > Ph. D. Student"=>1, "Student > Master"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Researcher"=>1, "Student > Ph. D. Student"=>1, "Student > Master"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Medicine and Dentistry"=>2, "Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>2}, "Unspecified"=>{"Unspecified"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "group_count"=>1}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1798147"], "description"=>"<p><b>A–F:</b> A. Hard mature cataract (naked-nucleus), B. The hard nucleus is divided in half with a phaco chop, C. The hard nuclear fragments are emulsified one by one, D. The IOL is inserted between the remaining fragments and the posterior capsule, E. The remaining hard fragments, ready to be emulsified, F. Completion of the surgery.</p>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244830, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112663.g002", "stats"=>{"downloads"=>0, "page_views"=>17, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Overview_of_the_IOL_shell_technique_/1244830", "title"=>"Overview of the IOL-shell technique.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-17 03:47:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1798161", "https://ndownloader.figshare.com/files/1798162"], "description"=>"<div><p>Objective</p><p>To compare the efficacy and safety of the intraocular lens (IOL)-shell procedure versus conventional phacoemulsification for the surgical treatment of dense cataracts.</p><p>Methods</p><p>Eighty eyes with dense nuclear cataracts were enrolled in a prospective, randomized controlled study. Patients were assigned to two groups. In Group I, the IOL was traditionally implanted after all nuclear fragments were completely removed, and in Group II, the IOL was innovatively implanted in the bag before the last residual nuclear fragment was removed. This novel adjusted surgical procedure, named the “IOL-shell technique”, features use of the IOL as a protective barrier rather than simply as a refractive alternative, and it is conceptually different from the traditional step-by-step procedure. Clinical examinations, including uncorrected visual acuity, central corneal thickness (CCT), temporal clear corneal incision thickness and corneal endothelial cell density, were carried out.</p><p>Results</p><p>The inter-group difference in temporal corneal thickness was found to be of no statistical significance at any of the visits. Compared to eyes in Group I, those in Group II were shown to have significantly less corneal endothelial cell loss on both the 7th and 30th day following surgery. At 7 days after surgery, the mean corneal endothelial cell loss in Group II was 10.29%, compared to 14.37% in Group I (P<0.05). The mean endothelial cell loss measured on postoperative day 30 was 16.88% in Group II compared to 23.32% in Group I (P<0.05). On the 1st day after surgery, the mean CCT of eyes in Group II was significantly smaller compared to Group I (Group I vs. Group II: 19.42% vs. 13.50%, P<0.05).</p><p>Conclusions</p><p>Compared to conventional phacoemulsification, the IOL-shell technique was shown to be a relatively safer procedure without compromised efficiency for dense cataracts, and it caused less corneal endothelial cell loss and milder postoperative corneal edema (Clinical Trials Identifier: NCT02138123).</p><p>Trial Registration</p><p><a href=\"http://clinicaltrials.gov/ct2/show/NCT02138123?term=NCT02138123&rank=1\" target=\"_blank\">ClinicalTrials.gov NCT02138123</a></p></div>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244844, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0112663.s001", "https://dx.doi.org/10.1371/journal.pone.0112663.s002"], "stats"=>{"downloads"=>28, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Intraocular_Lens_Shell_Technique_Adjustment_of_the_Surgical_Procedure_Leads_to_Greater_Safety_When_Treating_Dense_Nuclear_Cataracts_/1244844", "title"=>"Intraocular Lens-Shell Technique: Adjustment of the Surgical Procedure Leads to Greater Safety When Treating Dense Nuclear Cataracts", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-11-17 03:47:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1798156"], "description"=>"<p>UST = ultrasound time; CDE = cumulative dissipated energy; V<sub>BSS</sub> = total volume of balanced salt solution.</p>▴<p>Expressed as mean ± SD.</p><p>Comparison of intraoperative parameters measured in the two groups.</p>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244839, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112663.t002", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Comparison_of_intraoperative_parameters_measured_in_the_two_groups_/1244839", "title"=>"Comparison of intraoperative parameters measured in the two groups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-17 03:47:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1798157"], "description"=>"<p>All values are mean ± SD.</p><p>LP = light perception.</p><p>HM = hand move.</p><p>FC = finger count.</p><p>UCVA = uncorrected visual acuity.</p>†<p>Fisher’s exact test.</p>‡<p>Mann-Whitney test.</p><p>Uncorrected visual acuity in the two groups after surgery.</p>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244840, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112663.t003", "stats"=>{"downloads"=>3, "page_views"=>20, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Uncorrected_visual_acuity_in_the_two_groups_after_surgery_/1244840", "title"=>"Uncorrected visual acuity in the two groups after surgery.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-17 03:47:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1798155"], "description"=>"<p>*t-test, otherwise chi-squared test.</p><p>Clinical and demographic data from the subjects in the two groups.</p>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244838, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112663.t001", "stats"=>{"downloads"=>3, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinical_and_demographic_data_from_the_subjects_in_the_two_groups_/1244838", "title"=>"Clinical and demographic data from the subjects in the two groups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-17 03:47:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1798151"], "description"=>"<p>Changes in central corneal thickness (CCT) between two groups at each visit.</p>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244835, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112663.g004", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Changes_in_central_corneal_thickness_CCT_between_two_groups_at_each_visit_/1244835", "title"=>"Changes in central corneal thickness (CCT) between two groups at each visit.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-17 03:47:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1798159"], "description"=>"†<p>Treatment effect defined as the change in the intervention group-the change in the control group.</p><p>CCIT = clear corneal incision thickness.</p><p>CCT =  central corneal thickness.</p><p>Changes in maximal CCIT = postoperative maximal CCIT - preoperative CCIT.</p><p>Changes in CCT = postoperative CCT - preoperative CCT.</p><p>Changes in maximal clear corneal incision thickness (µm)and central corneal thickness (µm) for Intervention and Control groups at 1,7 and 30 Days.</p>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244842, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112663.t004", "stats"=>{"downloads"=>4, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Changes_in_maximal_clear_corneal_incision_thickness_181_m_and_central_corneal_thickness_181_m_for_Intervention_and_Control_groups_at_1_7_and_30_Days_/1244842", "title"=>"Changes in maximal clear corneal incision thickness (µm)and central corneal thickness (µm) for Intervention and Control groups at 1,7 and 30 Days.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-17 03:47:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1798141"], "description"=>"<p>Flowchart of patients included and excluded in the study.</p>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244824, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112663.g001", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flowchart_of_patients_included_and_excluded_in_the_study_/1244824", "title"=>"Flowchart of patients included and excluded in the study.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-17 03:47:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1798154"], "description"=>"<p>Central corneal endothelial cell loss.</p>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244836, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112663.g005", "stats"=>{"downloads"=>1, "page_views"=>19, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Central_corneal_endothelial_cell_loss_/1244836", "title"=>"Central corneal endothelial cell loss.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-17 03:47:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1798148"], "description"=>"<p>Changes in clear corneal incision thickness (CCIT) between two groups at each visit.</p>", "links"=>[], "tags"=>["cct", "iol", "postoperative day 30", "Clinical Trials Identifier", "procedure", "1 st day", "group II", "Dense Nuclear Cataracts ObjectiveTo", "cell loss", "nct"], "article_id"=>1244831, "categories"=>["Uncategorised"], "users"=>["Lixia Luo", "Haotian Lin", "Weirong Chen", "Bo Qu", "Xinyu Zhang", "Zhuoling Lin", "Jingjing Chen", "Yizhi Liu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112663.g003", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Changes_in_clear_corneal_incision_thickness_CCIT_between_two_groups_at_each_visit_/1244831", "title"=>"Changes in clear corneal incision thickness (CCIT) between two groups at each visit.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-17 03:47:19"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Medicine and health sciences/Surgical and invasive medical procedures", "average_usage"=>[248, 388]}]}
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