Eyeonics, Inc. Am J Ophthalmol. Adjustment to surgical technique and prior experience with a femtosecond laser appeared to flatten the learning curve. 2015;7:CD008671. Both groups were comparable for baseline demographic parameters. These researchers used standard methodological procedures expected by Cochrane. The study was carried out in 42,466 eyes. The authors concluded that the IOL power estimation in challenging eyes with prior LASIK/photorefractive keratectomy was most accurately predicted by IRB/ORA. This limited the reliability of the conclusions. The device is not intended for use on patients who have had previous trauma to their eye. Contrast sensitivity testing is a measure of the contrast level required for detection of a specified size of a test object. The effect of the lenses on posterior synechiae was uncertain at 6 months' follow-up (RR 0.50, 95 % CI: 0.05 to 5.22). An unexpected loss of zonules during surgery may also support the medical necessity of a CTR. 2008;24(3):257-264. } L' Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES). an implantable conventional IOL (one that is not presbyopia-correcting), and. The SN6AT7 appears to be a type of AcrySof IQ toric posterior chamber IOL. In a Cochrane review, Keay et al (2012) examined the evidence for reductions in adverse events through pre-operative medical testing, and estimated the average cost of performing routine medical testing. Such trials should stratify participants by their age, the retinal disorder leading to vitrectomy, and the status of the underlying disease process in the contralateral eye. Since cataracts cannot be treated with medication, diet or eye drops, and they will not heal on their own, surgery is the only option. Cataract in Adults: Management of Functional Impairment. In comparison to a highly experienced cataract surgeon, the achieved results in size were similar. right: 30px; 2011;152(3):345-357. Neubauer AS, Priglinger S, Ullrich S, et al. The short answer is "Yes." Graefes Arch Clin Exp Ophthalmol. The images are then computed to give the local slope and character of the wavefront of light. The Panel also concluded that neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy should not be performed prophylactically or scheduled routinely at particular times after cataract surgery. San Francisco, CA: AAO; 1996. These investigators included 9 RCTs, with a total of 655 participants (657 eyes), and follow-up periods ranging from 12 to 30 months; 7 trials were conducted in Europe, 1 in Canada and South Africa, and 1 in the United States. Medscape, February 16, 2012. The degree of loss depends on the location of the cataract, its size, and its density. The short answer: Yes. American Academy of Ophthalmology (AAO)EyeWiki. In addition, the CADTH assessment stated that long-term follow-up is needed to confirm patient outcomes, and ascertain if the benefits justify the additional cost. background-color: #663399; A significant difference was noted among the sequential groups with respect to the number of docking attempts (p < 0.001), miosis after the laser procedure (p < 0.001), and free-floating capsulotomies (p < 0.001), suggesting an improving learning curve. However, cataract surgery may independently lower intra-ocular pressure (IOP), which may allow for greater IOP control among patients with co-existing cataract and glaucoma. Participants were hypothetical cohort of patients undergoing cataract surgery in the better eye based on a review of the current literature and the authors direct experience using FLACS. The refractive outcome was analyzed using the mean absolute error (MAE; difference between predicted and achieved post-operative spherical equivalent refraction), and multi-variable regression analysis was performed to compare the 2 groups. CTR was implanted in cases where zonular dialysis of greater than 3 clock hours was present or capsular bag instability was detected during capsulorhexis or subsequent intra-operative maneuvers. Aetna launched a troubling new prior authorization policy on July 1, that applies to all cataracts surgeries even when patients face emergency situations. However, the clinical benefits must be put into perspective due to the subsequent surgical manipulation of the incisions (during lens emulsification, aspiration and IOL injection), the lacking possibility to visualize the crystalline lens equator as the reference for correct capsulotomy centration and the relativity of US energy consumption on the corneal endothelial trauma. Cochrane Database Syst Rev. Interventional Procedure Guidance 264. FDA approves first intraocular lens with extended range of vision for cataract patients. background: #5e9732; Posterior capsular opacification in 1 eye (2.4 %), anterior capsule phimosis in 1 eye (2.4 %) and cystoid macular edema (CME) in 1 eye (2.4 %) were detected as late complications. However ethical considerations need to be addressed when delaying a potentially beneficial treatment and it may not be feasible to conduct a long-term study where surgery is withheld from the control group. No post-operative complication was reported. Since the intent of the multifocal and accommodating IOLs, is to preclude the need for reading glasses or contact lenses post- surgery, those types of IOLs are considered not medically necessary. Eye (Lond). 2002;28(2):239-242. 2016;12:CD003169. A B-scan is used in place of the A-scan when the patient has a dense cataract. Situations that prevent normal examination include lid problems (e.g., severe edema, partial or total tarsorrhaphy), keratoprosthesis, corneal opacities (e.g., scars, severe edema), hyphema, hypopyon, miosis, pupillary membranes, dense cataracts, or vitreous opacities (e.g., hemorrhage, inflammatory debris). The mean age of patients included was 69.2 9.8 years. Alternatives to routine pre-operative medical testing have been proposed, including self-administered health questionnaires, which could substitute for health provider histories and physical examinations. An Nd:YAG laser posterior capsulotomy was performed in 153 (3.07 %) of the 4,970 eyes. WebCertain Aetna Medicare Advantage plans may offer coverage for routine vision care. Surv Ophthalmol. Marshall J, Cionni RJ, Davison J, et al. WebHere is how Aetna insurance plans may be able to help you cover the cost of your eye care (individual insurance policies differ). 1995;21(2):132-135. color: blue Centers for Medicare and Medicaid Services (CMS). Mean binocular distance best spectacle-corrected visual acuity (BSCVA) (logMAR) was 0.05 for controls, 0.08 for ZM900, 0.07 for ReZoom, and 0.11 for TwinSet, with mean binocular distance BSCVA at near of 0.49, 0.06, 0.22, and 0.11, respectively. In a Cochrane review, these investigators examined the safety and effectiveness of implantation with trifocal versus bifocal IOLs during cataract surgery among subjects with presbyopia. 2010;36(1):34-43. The member's medical and mental health should permit surgery to be performed safely. None of the included studies reported quality of life outcomes. Subjects received monofocal Tecnis Z9000 (AMO) (n = 24, 48 eyes); symmetric diffractive multi-focal Tecnis ZM900 (AMO) (n = 26, 52 eyes); zonal refractive multi-focal ReZoom (AMO) (n = 32, 64 eyes); or asymmetric diffractive multi-focal TwinSet (Acri.Tec) (n = 32, 64 eyes) IOLs. For example, eye examinations performed to determine the refractive state of the eyes following insertion of a presbyopia-correcting IOL are non-covered (McClellan, 2005). Comparison of foveal thickness measured with the retinal thickness analyzer and optical coherence tomography. 2008;19(1):1-4. In a Cochrane review, these investigators summarized the effects of different IOLs on visual acuity, other visual outcomes, and quality of life in people with uveitis. Both sets of patients had comparable results for good distance vision. Ophthalmology. The main outcome measure was the occurrence of acute clinical endophthalmitis within 6 weeks of the surgery. Glare was reported less frequently with accommodative lenses but the relative effect of the lenses on glare was uncertain (RR any glare 0.78; 95 % CI: 0.32 to 1.90, 1 study, 40 people, and RR moderate/severe glare 0.45; 95 % CI: 0.04 to 4.60, low quality evidence). The authors concluded that supplementing IC antibiotic with topical antibiotic post-operatively did not impact the occurrence of acute post cataract surgery endophthalmitis in rural India. Persons blind in one eye: Cataract removal surgery is considered medically necessary for one-eyed members with visual disability of 20/50 or worse due to a cataract; that is, a member with irreversible, untreatable legal blindness (20/200 or worse) in the other eye. Aliso Viejo, CA; Eyeonics; 2003. Keay L, Lindsley K, Tielsch J, et al. Day care versus in-patient surgery for age-related cataract. list-style-image: url('https://www.aetna.com/cpb/medical/data/assets/images/purplearrow.jpg') !important; Routine pre-operative medical testing did not reduce the risk of intra-operative (OR 1.02, 95 % CI: 0.85 to 1.22) or post-operative medical adverse events (OR 0.96, 95 % CI: 0.74 to 1.24) when compared to selective-testing or no-testing. In all bilateral implantation cases, the same model IOL was used in each eye. Another drawback was only 121 patients out of 289 patients had recorded anterior chamber lengths in chart review. They searched the reference lists of the retrieved articles and the abstracts from the Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) for the years 2005 to 2015. .newText { This was significantly more accurate than the other pre-operative methods: Median absolute error was 0.6, 0.53, and 0.51 D for surgeon best choice, Haigis L method, and Shammas method, respectively. Only 1 study reported on gender of subjects, and they were mostly women. The authors concluded that newer technology to estimate IOL power calculations in eyes after LVC showed promising results when compared with established methods. 2015;25(2):112-8. The relative effect of the lenses on reading speed and spectacle independence was uncertain. Teichmann KD. The mean diameter of the manual and the femtosecond laser capsule disk group were not statistically significantly different (manual 4.91 0.34; femtosecond: 4.93 0.03; p = 0.58). 2000;44(6):541. OL OL LI { Waldron RG. In a Cochrane review, these investigators defined. An inpatient setting for cataract removal surgery generally is not considered medically necessary. All 5 studies examined uncorrected distance VA (primary outcome of the review), while some also examined secondary outcomes including uncorrected near, intermediate, and best-corrected distance VA, as well as CS. color: blue!important; A meta-analysis by Takakura et al (2010) found no clear evidence of near visual acuity improvement with accommodating IOLs compared to monofocal IOLs. All eyes undergoing LCS between April 2011 and March 2012 were included in the study. The authors concluded that based on the trials identified in this review, there is uncertainty as to which type of IOL provides the best visual and clinical outcomes in people with uveitis undergoing cataract surgery. Two intra-individual studies also compared HSM PMMA IOLs with unmodified PMMA IOLs at 3 or 6 months of follow-up. 2015;122(6):1096-1101. It may be useful in the future studies to focus on this issue as a possible limitation of ORA. In cases of more profound zonulopathy, other options include capsular retractors, a modified capsular tension ring, or a capsular tension segment for scleral suture fixation. In 23 eyes undergoing surgery without the use of OVDs, no complications were observed within a 1-month follow-up period. The decision between undergoing combined glaucoma and cataract surgery versus cataract surgery alone is complex. Based on the simulated complication rates of PCS and FLACS and assuming resultant VA outcome improvement of 5 % in uncomplicated cases of LCS, the cost-effectiveness (dollars spent per QALY) gained from LCS was not cost-effective at $92,862 Australian Dollars. Linebarger EJ, Hardten DR, Shah GK, Lindstrom RL. Their coverage for dogs is around $59 a month, and coverage for cats will run you around $30 a month. A total of 30 patients (60 eyes) with bilateral cataracts but otherwise normal eyes were recruited from a single university hospital cataract waiting list. Cataract in children. Comparison of femtosecond laser-assisted cataract surgery and conventional cataract surgery: A meta-analysis and systematic review. For additional language assistance: Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife), laser surgery (e.g., YAG laser) (one or more stages), Ophthalmic ultrasound, diagnostic; quantitative A-scan only, Ophthalmic biometry by ultrasound echography, A-scan, Ophthalmologic services: medical examination and evaluation with initiation of diagnostic and treatment program, new patient, Ophthalmologic services: medical examination and evaluation with initiation of diagnostic and treatment program, established patient, Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation, Visual evoked potential, screening of visual acuity, automated, Electroretinography (ERG) with interpretation and report, pattern (PERG), Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness), Computerized corneal topography, unilateral or bilateral, with interpretation and report, Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve, Needle oculoelectromyography, one or more extraocular muscles, one or both eyes, with interpretation and report, Electro-oculography with interpretation and report, Electroretinography (ERG), with interpretation and report; full field (ie, ffERG, flash ERG, Ganzfeld ERG, Color vision examination, extended, e.g., anomaloscope or equivalent, External ocular photography with interpretation and report for documentation of medical progress (e.g., close-up photography, slit lamp photography, goniophotography, stereo-photography), Special anterior segment photography with interpretation and report; with specular endothelial microscopy and cell count, Visual evoked potentials (VEP) testing central nervous system, checkerboard or flash, Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter, anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (e.g., diurnal curve or medical treatment of acute elevation of intraocular pressure), Lens, intraocular (new technology) [standard fixed monofocal posterior chamber intraocular lenses (IOL) for aphakia only], New technology intraocular lens category 4 as defined in Federal Register notice, New technology intraocular lens category 5 as defined in Federal Register notice, Astigmatism correcting function of intraocular lens, Presbyopia correcting function of intraocular lens, Vision supply, accessory, and/or service component of another HCPCS vision code, Cataract extraction status, right eye, left eye, and unspecified eye, B-scan (with or without superimposed non-quantitative A-scan), Vitamin A deficiency with xerophthalmic scars of cornea, Other congenital malformations of anterior segment of eye [persistent pupillary membranes], Congenital malformation of vitreous humor [congenital vitreous opacity], Visual disparity existing between the two eyes. 2015;9(12):NC05-NCO7. After laser pre-treatment, the anterior chamber was stabilized with balanced salt solution during lens and cortex aspiration. For near distances, patients with the Tecnis Symfony IOL were able to read two additional, progressively smaller lines on a standard eye chart than those with the monofocal IOL. Ottawa, ON: Canadian Agency for Drugs and Technologies in Health (CADTH); August 2006. These researchers also performed forward and backward searching using the Science Citation Index and the reference lists of the included studies, respectively, in August 2013. Most health insurance plans cover cataract surgery. Aetna considers the following procedures medically necessary as a diagnostic test prior to cataract surgery: In addition to a comprehensive or brief/intermediate eye examination, A-mode ultrasound (A-scan) may be considered medically necessary prior to cataract surgery to determine the appropriate pseudophakic power of the IOL.Footnote1*. The authors concluded that multi-focal IOLs were effective at improving near vision relative to mono-focal IOLs although there was uncertainty as to the size of the effect. OL OL OL OL LI { There was no statistically significant difference among the methods. J Cataract Refract Surg. Surgical treatment of cataract involves replacing the patient's opacified lens with an artifical lens, which is usually of fixed power (monofocal), requiring the use of reading glasses for near vision. Participants were randomized to immediate cataract surgery (within 2 weeks of enrollment) (n = 29) or delayed cataract surgery (6 months after enrollment) (n = 31). They used standard methodological procedures expected by The Cochrane Collaboration. A prospective study. 2009;(2):CD007293. Second, several studies in this meta-analysis did not report sufficient data on risk assessment, especially random sequence generation, allocation concealment and setting blinding, which may have led to bias. Trifocal IOL implantation may improve uncorrected intermediate VA at 1 year (MD -0.16, 95 % CI: -0.22 to -0.10; I2= 0 %; 2 studies, 107 subjects; low-certainty evidence), but showed no evidence of effect on best-corrected distance VA at 1 year (MD 0.00, 95 % CI: -0.03 to 0.04; I2= 0 %; 2 studies, 107 subjects; low-certainty evidence). Rai G, Sahai A, Kumar PR. Several instruments such as the VF-14, the activities of daily vision scale and the visual activities questionnaire are available for assessing functional impairment related to cataract. Eyes with corneal pathology, lens subluxation, and a specular endothelial cell count less than 2,000/mm2 were excluded from the study. CPB 0130 - Computerized Corneal Topography. These researchers judged all studies to be at high risk of performance bias. Moreover, these researchers stated that in order to achieve more significant findings, RCTs with larger sample size are needed. Accommodative IOLs have been designed to overcome loss of accommodation after cataract surgery. Patients with bilateral age-related cataracts who were willing and able to wait at least 30 days between cataract procedures and had verified normal pre-operative color vision were eligible for the study. Ophthalmology. The mean follow-up time was 84 months for all of the IOL groups. Of the 1CU eyes, 9 patients (30 %) could read J6 or better at a reading speed of 80 words/min or better. In 2 studies, these researchers observed that subjects' satisfaction or spectacle independence may be higher in the trifocal group at 6 months, although another study found no evidence of a difference in subject satisfaction or spectacle independence between groups; AEs reporting varied among studies 2 studies reported information on AEs at 1 year; and 1 study reported that subjects showed no intra-operative or post-operative complications, while the other study reported that 4 eyes (11.4 %) in the bifocal and 3 eyes (7.5 %) in the trifocal group developed significant posterior capsular opacification requiring YAG capsulotomy. Post-operatively, contrast sensitivity and color perception were measured up to 180 days and up to 1 year (for visual acuity) after implantation. These investigators searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2011, Issue 12), MEDLINE (January 1950 to December 2011), EMBASE (January 1980 to December 2011), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to December 2011), the metaRegister of Controlled Trials (mRCT), ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP). The Alcon AcrySof Natural UV and blue light filtering acrylic foldable multi-piece posterior chamber lenses are optical implants for the replacement of the human crystalline lens in the visual correction of aphakia in adult patients following cataract surgery. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. Will vision insurance cover cataract surgery? Complication rates of cataract surgery were obtained from a review of the current literature to complete the cohort of patients and outcomes. Curr Opin Ophthalmol. Stevens G Jr, Long B, Hamann JM, Allen RC. Philadelphia, PA: W.B. # font-weight: bold; Rahti et al (2020b) stated that IC antibiotic in cataract surgery has shown level I evidence as prophylaxis for post-operative endophthalmitis. } Unfortunately, the answer to this question is not The difference was statistically significant (p = 0.003). They stated that additional long-term clinical studies should show whether the IOL actually provides the theoretical benefits to retinal health. The reduction in the incidence of endophthalmitis following ICC was 0.017 % and that after ICM was 0.049 %. They used reference lists and the Science Citation Index to search for additional studies. The authors concluded that femtosecond laser could perform a capsulotomy with high reliability. Cochrane Database Syst Rev. 2000;26(10):1435-1437. This was of particular relevance against the background of the significantly higher costs. At 6 months there was a standardized mean difference of -0.04 standard deviations (95 % CI: -0.37 to 0.30, 2 studies, 106 people, 136 eyes, low quality evidence). Cataract Surgery Comprehensive Ophthalmology Lenses Lifestyle Lenses Implantable Collamer Lens (ICL) Vivity Extended Vision IOL Keratoconus Treatments Cross-Linking INTACS Corneal Implants Oculoplastic Cosmetic Treatments Cosmetic Treatments Blepharoplasty Dry Eye Treatments Dry Eye Treatments TearCare Glaucoma Surgery Surv Ophthalmol. Nd:YAG laser capsulotomy when performed 6 months or more following cataract extraction in members with visually significant clouding (opacification) of the posterior portion of the membrane that surrounds the lens (the posterior capsule). A total of 150 patients received the AcrySof Natural IOL and 147 patients received the AcrySof single-piece IOL as a control. The difference was the greatest in short (axial length less than 22.0 mm, 0.43 0.41 versus 0.63 0.48) and long (axial length greater than 26.0 mm, 0.33 0.24 versus 0.63 0.42) eyes. J Clin Epidemiol. June 21, 2022 Note: For Medicare and HMO members who have had cataract surgery with This was associated with a 36.1 % reduction in endothelial cell loss in the femtosecond group. Aetna considers the following Experimental and Investigational (not an all inclusive list): The following specialized ophthalmologic services for the pre-operative work-up for cataract surgery, unless there is another indication in addition to cataracts, because they are of no proven value in routine pre-operative evaluation of cataracts: The pre-operative tests listed above are considered experimental and investigational in most cases before cataract surgery. There were no lens-related adverse events in either group. Ruling No. In a prospective, interventional case-series study, Roberts and co-workers (2013) reported the surgical outcomes and safety of FLACS with greater surgeon experience, modified techniques, and improved technology. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance (MD = 0.02, 95 % CI: - 0.03 to 0.06). In a Cochrane review, Casparis et al (2012) noted that cataract and age-related macular degeneration (ARMD) are common causes of decreased vision that often occur simultaneously in people over age 50. The authors concluded that intra-operative wavefront aberrometry with the ORA system provided post-operative refractive results comparable to conventional biometry with the IOLMaster for mono-focal IOL selection. ), and this may prove beneficial in the future research by providing additional data to aid in comparison between groups. Standardized surgery included a 4.0to5.0 mm capsulorhexis and phacoemulsification. Cases underwent pre-treatment with the femtosecond laser followed by phacoemulsification cataract extraction and IOL insertion. Abell RG, Vote BJ. Duman et al (2015) evaluated the impact of 4 different IOLs on PCO by comparing the Nd:YAG laser capsulotomy rates. } Toward zero effective phacoemulsification time using femtosecond laser pretreatment. 2001;21(6):596-601. 2010;36(4):603-608. Of the 200 eyes, 74.5 % underwent a complete procedure of laser capsulotomy, lens fragmentation, and corneal incisions; 5 eyes had suction breaks during the laser procedure that led to the remainder of the laser procedure being aborted; 21 (10.5 %) eyes showed the presence of small anterior capsular tags. Rana and colleagues (2021) stated that MSICS is a widely used technique for cataract surgery in the developing world. There were no date or language restrictions in the electronic searches for trials. Multi-variate sensitivity analyses revealed that FLACS would need to significantly improve visual outcomes and complications rates over PCS, along with a reduction in cost to patient, to improve cost effectiveness. Effect of intraocular lens size on posterior capsule opacification after phaecoemulsification. The studies were small, not all lens materials were compared in all studies, and not all lens materials were available in all study sites. At all follow-up visits, a full assessment was made of distance, near and reading visual performance, and accommodative amplitude. Restoration of Distance Vision Following Cataract Surgery, and. While some surgeons already use this technology for LRIs, further studies to elucidate the value of intra-operative aberrometry specifically for toric IOL implantation, rotation, and residual post-operative cylinder would be useful. padding: 15px; In the group without historical data (n = 39), 49 % of eyes were within 0.25 D, 69 % to 74 % of eyes were within 0.50 D, 87 % to 97 % of eyes were within 0.75 D, and 92 % to 97 % of eyes were within 1.00 D of targeted refractive IOL power prediction error. The authors concluded that this new technique for patients with insufficiently dilated pupils associated with ectopia lentis has the potential to improve surgical results and minimize complications in selected cases. In the group with historical data (n = 20), 35 % to 70 % of eyes were within 0.25 D, 60 % to 85 % of eyes were within 0.50 D, 80 % to 95 % of eyes were within 0.75 D, and 90 % to 95 % of eyes were within 1.00 D of targeted refractive IOL power prediction error. This Clinical Policy Bulletin may be updated and therefore is subject to change. At 1 year, trifocal IOL showed no evidence of effect on uncorrected distance VA (MD 0.00, 95 % CI: -0.04 to 0.04; I2 = 0 %; 2 studies, 107 subjects; low-certainty evidence) and uncorrected near VA (MD 0.01, 95 % CI: -0.04 to 0.06; I2 = 0 %; 2 studies, 107 subjects; low-certainty evidence). In Cataract Surgery: Technique, Complications, and Management. If you are considering having cataract surgery, you may wonder if you have insurance to cover the procedure. In a Cochrane review, these investigators evaluated the safety and effectiveness of surgery versus no surgery for post-vitrectomy cataract with respect to VA, quality of life (QOL), and other outcomes. Heterogeneity was assessed using the I2 test. The member's decision is based on: The loss of vision mimicking the member's complaints should be verified before the member is considered a candidate for cataract surgery. Keay L, Lindsley K, Tielsch J, et al. Electrophysiologic testing in the form of visual evoked potential (VEP) is helpful in total cataracts to assess the function of the visual pathway. Health Care Financing Administration. What is cost of cataract surgery? They searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2013), EMBASE (January 1980 to August 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2013), the metaRegister of Controlled Trials (mRCT), ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP). With this maneuver, the pupillary expansion ring was placed in alignment with the center of the ectopic lens. San Francisco, CA: AAO;modified March 21, 2019. The indications were hyper-mature senile cataract in 9 cases, hyper-mature senile cataract with lens induced glaucoma in 9 cases, pseudo-exfoliation syndrome in 9 cases, post-blunt injury traumatic cataract in 6 cases, iridochoroidal coloboma in 6 cases, hyper-mature cataract with pseudo-exfoliation and Marfan syndrome in 3 cases, respectively. McClellan MB. 2015;38(10):955-959. In 2020, the average cost for At 3 months, there were no statistical or clinical differences between hydrophobic and hydrophilic acrylic IOL types in the proportions of participants with 2 or more Snellen lines of visual improvement (RR 1.03, 95 % CI: 0.87 to 1.22). Rana K, Bahrami B, van Zyl L, et al. Accessed March 12, 2018. van Gaalen KW, Koopmans SA, Jansonius NM, Kooijman AC. Implantation cases, the anterior chamber was stabilized with balanced salt solution during lens and cortex aspiration 30px! Koopmans SA, Jansonius NM, Kooijman AC Priglinger S, et al 21 ( 2 ):132-135.:. 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