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1

Cataract Surgery  

Science.gov (United States)

... Replacement Cataract Vision Simulator Pre-operative tests for cataract surgery Before surgery, the length of your eye will ... surgeon calculate the correct IOL power. Medications and cataract surgery If you are having cataract surgery, be sure ...

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Cataract Surgery  

Medline Plus

Full Text Available ... to put this little cover over your right eye -- Announcer: Fifty-four year old Paul Wood, a ... is having cataract surgery today on his left eye. A month ago he had a cataract removed ...

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Small incision cataract surgery: Complications and mini-review  

Directory of Open Access Journals (Sweden)

Full Text Available This article reviews the literature on manual small incision cataract surgery (MSICS) and its complications. Various articles on MSICS published in indexed journals were reviewed, as well as the sections on complications of MSICS. The Pubmed search engine on the Internet was used to find out articles published since 1985 on MSICS in any language in indexed journals. Books published by Indian authors and the website of Indian Journal of Ophthalmology were also referred to. MSICS has become very popular technique of cataract surgery in India, and it is often used as an alternative to phacoemulsification. Studies on its efficacy and safety for cataract surgery show that, being a variant of extracapsular cataract surgery, MSICS also has similar intraoperative and postoperative complications. The considerable handling inside the anterior chamber during nucleus delivery increase the chances of iris injury, striate keratitis, and posterior capsular rupture. The surgeon has to be extra careful in the construction of the scleral tunnel and to achieve a good capsulorrhexis. Postoperative inflammation and corneal edema are rare if surgeons have the expertise and patience. The final astigmatism is less than that in the extracapsular cataract surgery and almost comparable to that in phacoemulsification. There is, however, a concern of posterior capsular opacification in the long term, which needs to be addressed. Although MSICS demands skill and patience from the cataract surgeon, it is a safe, effective, and economical alternative to competing techniques and can be the answer to tackle the large backlog of blindness due to cataract.

Gogate Parikshit

2009-01-01

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Small incision cataract surgery: Complications and mini-review  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This article reviews the literature on manual small incision cataract surgery (MSICS) and its complications. Various articles on MSICS published in indexed journals were reviewed, as well as the sections on complications of MSICS. The Pubmed search engine on the Internet was used to find out article...

Gogate Parikshit

5

CATARACT SURGERY  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: To assess the surgical results for cataract management versus the leading free eye camps to conclude the trend of cataract management and the postoperative complication frequency in Faisalabad to create orientation about cataract management in focused community. Study Design: Retrospective study. Setting: At DHQ and Allied Hospitals Faisalabad Period: From January 2008 to October 2008.Subject Total cataract operations conducted in two free eye camps arranged twice a year in March and October 2008 were noted. Data for postoperative complications were recorded from the said teaching hospitals and the doctors providing the follow up services for camp surgery. Statistical analysis of data was made by using SPSS. Results: It was depicted from the data that postoperative results were better in case of teaching hospitals as compared to free eye camps.

QAMAR-UL-HAQ

2009-01-01

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Advances in cataract surgery.  

Science.gov (United States)

Cataract surgery is a technique described since recorded history, yet it has greatly evolved only in the latter half of the past century. The development of the intraocular lens and phacoemulsification as a technique for cataract removal could be considered as the two most significant strides that have been made in this surgical field. This review takes a comprehensive look at all aspects of cataract surgery, starting from patient selection through the process of consent, anaesthesia, biometry, lens power calculation, refractive targeting, phacoemulsification, choice of intraocular lens and management of complications, such as posterior capsular opacification, as well as future developments. As the most common ophthalmic surgery and with the expanding range of intraocular lens options, optometrists have an important and growing role in managing patients with cataract. PMID:19570151

Ashwin, Pammal T; Shah, Sunil; Wolffsohn, James S

2009-07-01

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Advances in cataract surgery.  

UK PubMed Central (United Kingdom)

Cataract surgery is a technique described since recorded history, yet it has greatly evolved only in the latter half of the past century. The development of the intraocular lens and phacoemulsification as a technique for cataract removal could be considered as the two most significant strides that have been made in this surgical field. This review takes a comprehensive look at all aspects of cataract surgery, starting from patient selection through the process of consent, anaesthesia, biometry, lens power calculation, refractive targeting, phacoemulsification, choice of intraocular lens and management of complications, such as posterior capsular opacification, as well as future developments. As the most common ophthalmic surgery and with the expanding range of intraocular lens options, optometrists have an important and growing role in managing patients with cataract.

Ashwin PT; Shah S; Wolffsohn JS

2009-07-01

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CATARACT SURGERY  

Directory of Open Access Journals (Sweden)

Full Text Available Find out the prevalence and visual outcome of acute endophthalmitis after cataract surgery. StudyDesign: Retrospective. Period: 1st January 2001 to 31st December 2009. Setting: Wah Medical College, P.O.F. Hospital Wah Cantt,Rawalpindi. Materials and methods: Fifty cases of acute endophthalmitis who had undergone treatment. Each case of acute endophthalmitiswas evaluated in terms of presentation, detailed examination, treatment and outcome. Microbiological culture of the vitreous aspirates was alsodone to identify the causative organism. The analysis was also meant to identify the prognostic factors of visual outcome of these cases.Results: Fifty patients presented with acute endophthalmitis out of the fifteen thousand cataract surgeries performed during the 9 year period.The incidence of endophthalmitis was 0.33% (95 % CI). A vitreous biopsy with intravitreal injection of antibiotics was done in all the casespresenting with acute endophthalmitis. Decreased visual acuity (90%) and pain (75%) were the main presenting features in these cases.. Therewere 36 (72%) culture positive cases, with staphylococci (50%) being the most common organism found. Vitreous biopsy yielded positiveresults in 36 (72%) patients while negative results with no microbial growth was found in 14(28%) patients. There were 20 (40%) growths ofcoagulase negative staphylococci, 5 (10%) growths of streptococci, 8 (16%) growths of coagulase positive staphylococci, and 3 (6%) of gramnegative organisms. The final visual outcome was recorded after one month. 8 (16%) patients achieved 6/12 or better, 26 (52%) patientsachieved moderately good visual acuity 6/60 to 6/12, while 16 (32%) patients achieved poor visual acuity of less than 6/60. Of the latter groupwho had poor visual acuity, 2 (4%) patients had only perception of light while 1 (2%) patient had no perception of light and 1 (2%) patient hadblind and painful eye who had to undergo evisceration. 6 (16%) patients achieved 6/12 or better visual acuity. Conclusions: The incidence ofendophthalmitis is consistent with other studies. Laboratory diagnosis of the vitreous aspirates helps in the treatment. Achieving a good visualoutcome is possible with treatment of the cases of acute endophthalmitis.

MUHAMMAD MUMTAZ CHAUDHRY; AFZAL KHAN NIAZI

2011-01-01

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CATARACT SURGERY  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: To describe the variation of axial length in patients undergoingcataract surgery. Study design: A retrospective case series. Place and duration of study: At OpthalmologicalDepartment, Allied Hospital, PMC, Faisalabad from May 2006 to June 2007. Patients and methods: The axial lengthof 566 patients who were admitted for cataract surgery were measured with A. scan (Axis II, Quantel). The elevenpatients with age below 15 years and above 90 years and with history of trauma, corneal scarring were excluded. Sothere were 555 patients for this study. A careful history of diabetes mellitus, hypertension, trauma, previous history ofsurgery, glaucoma and uveitis was taken, and slit lamp examination, tonometry, pupillary reactions, perception andprojection of light was done. The data collected was entered in specially designed Performa. An average of tenreadings of axial lengths with A-Scan for each patient was taken. Results: Out of 555 patients, there were 350 male(63.06%) and 205 female (36.94%) patients. There were 250(45.05%) patients having age between 46 to 60 years.There were 27(4.86%) patients having age between 15 to 30 years and the same number 27(4.86%) of patients wasseem having age between 76 to 90 years. The most of the patients 273(49.18%) had axial length between 23mm to25 mm. There were only 3 patients with axial length between 29.01 to 31 mm. There were a significant number ofpatients, 230(41.45%) having axial length between 21.01 to 23mm. Conclusion: The biometry depends upon axiallength, kratometry and anterior chamber depth. Most of the formulae supposed for IOL calculations depend upon onlytwo factors, the axial length and the keratometry. In our community, short and long eyes are very rare and so SRK-Tformula for IOL calculations provides satisfactory postoperative results. The axial length carries more importance asits variation causes a gross change in IOL power and postoperative refractive errors.

EJAZ AHMAD JAVED

2008-01-01

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[Cataract surgery in Togo].  

Science.gov (United States)

Cataract remains a major cause of blindness in sub-Sahara and a major public health problem. Blindness prevalence in Togo is equal to 1%, more than half of it is due to cataract, while the number of cataract surgeries is low because of the lack of resources. We assessed the eye healthcare in Togo by cataract surgery. The aim was to estimate the number of cataract surgeries and the Cataract Surgery Rate (CSR) in the administrative regions. The demographic data (denominator) was collected from the Demography and Health Survey (1998) while the number of cataract surgeries (numerator) was obtained from medical registers. The Cataract Surgery Rate (CSR, operated cataracts per million) was assessed from 1995 to 2001. From 1995 to 2001, 3,885 cataract surgeries were performed. Public services predominated with 53.03% (n=2061) of the cataracts operated followed by confessional hospitals with 37.1% (n=1443) and private clinics 3.4% (n=143). Decentralised eye healthcares provided 241 cataract extractions. The University hospital centre of Lome Tokoin was the leader, with 32.5% (n=1,262) of operated cataracts followed by the confessional hospital of Glei, 27.2% (n=1,058). The average per centre per year was 43 cataract surgeries. The mean CSR was 126 and varied from 52 to 163 cataract surgeries per million people per year. There was an important concentration of cataract services in Lome where 41% (n=1,586) of cataracts were operated and the CSR was 334. The unequal distribution of cataract services (41% in Lome) leaves many regions without any resources. Since 1999, the CSR increased by 37% in 2000 and 14% in 2001. The Togolese eye healthcare system is poor and substantial further efforts are necessary to make it accessible and affordable to all those in need. This may be the way to reduce cataract surgery barriers and the unacceptable high prevalence of operable cataract blindness. PMID:12925316

Mensah, A; Balo, K P; Kondi, G; Banla, M; Koffigue, K B; Resnikoff, S; Astagneau, P; Brücker, G

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Cataract surgery - series (image)  

Science.gov (United States)

Cataract surgery usually works very well. The operation has few risks, the pain and recovery period are short, ... improved. Ninety-five percent or more of all cataract surgeries result in improved vision.

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Femtosecond cataract surgery: transitioning to laser cataract.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: The introduction of the femtosecond laser to the field of cataract surgery offers many potential benefits. The femtosecond laser is able to perform three important steps in cataract surgery: capsulotomy, lens fragmentation and corneal incisions. Although evidence in support of its efficacy is accumulating, there is a surgical learning curve that needs to be addressed. This review outlines key issues to consider when contemplating the transition to laser cataract surgery in clinical practice. RECENT FINDINGS: Laser cataract surgery has been shown to be associated with an initial learning curve. Femtosecond lasers produce a more accurate and precise anterior capsulotomy, improve intraocular lens centration and reduce intraocular lens tilt. Visual and refractive outcomes, although in a limited number of studies, have been shown to be at least as good as those of conventional phacoemulsification. The impact of reduced phacoemulsification energy on the corneal endothelium is still being investigated. SUMMARY: The automation of key steps by the use of femtosecond lasers in cataract surgery has several potential advantages. Emerging literature supports the transition from conventional phacoemulsification to the laser cataract surgery.

Sutton G; Bali SJ; Hodge C

2013-01-01

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Cataract surgery in developing countries  

Directory of Open Access Journals (Sweden)

Full Text Available With the aging population also increased the incidence of cataract, cataract has become the most common cause of blindness in the developing countries, the blind and vision damage has become a serious public, social and economic problem in developing countries. Although cataract surgery is the most cost-effective intervention, but to provide cataract surgical services in developing countries, there are still a lot of problems and challenges, manual small incision cataract surgery in the treatment of cataract in the past 10 years in some countrie shave achieved good results. In addition, the development of the different mode of the sustainable development of the prevention of blindness in these developing countries is also a challenge. We did a review of cataract surgery in developing countries in recent years.

Jia-Lin Huang; Bin Liu; Zeng-Qin Zhu; Wu Ou; Jing-Xi Yan

2013-01-01

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A review of femtosecond laser assisted cataract surgery for Hawai'i.  

UK PubMed Central (United Kingdom)

Hawai'i has had the first US Food and Drug Administration approved femtosecond laser (LenSx as shown in figure) for cataract surgery since early 2012, a brand new laser technology for modern cataract surgery in Hawai'i. This article intends to evaluate the cost, safety, efficacy, advantages, and limitations of femtosecond laser-assisted cataract surgery through a review of the literature for the public of Hawai'i. A search was conducted using keywords to screen and select articles from PubMed. In addition, recent published peer reviewed articles pertinent to the femtosecond laser-assisted cataract surgery were selected and reviewed. Safety and efficacy of femtosecond laser-assisted cataract surgery were demonstrated in the literature, with improvements in anterior capsulotomy, phacofragmentation, and corneal incision. However, there were limitations within these studies which included small sample size and short-term follow-up. In addition, cost-benefit analysis has not yet been addressed. Long-term studies to compare the complication rate and visual outcome between the laser and conventional cataract surgery are warranted.

Chen M

2013-05-01

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Cataract surgery to lower intraocular pressure  

Directory of Open Access Journals (Sweden)

Full Text Available Cataract and glaucoma are common co morbidities. Cataract surgery is frequently performed in patients with glaucoma. In this study, a review of literature with search terms of cataract, glaucoma and intraocular pressure is followed by evaluation and synthesis of data to determine the effect of cataract surgery on intraocular pressure. Cataract surgery seems to lower intraocular pressure on a sustained basis, especially in patients with higher preoperative intraocular pressure. The mechanism of action of these finds remains speculative.

Berdahl John

2009-01-01

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Daycase cataract surgery.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The increasing demand for cataract surgery, combined with limited resources, has created renewed interest in daycase admission. We have audited the results of all daycase and inpatient cataract surgery in a large unit over a six-month period to determine the factors influencing daycase admission and...

Strong, N P; Wigmore, W; Smithson, S; Rhodes, S; Woodruff, G; Rosenthal, A R

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Cluster headache after cataract surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: Symptomatic cluster-like headache has been described with some ophthalmological disorders such as glaucoma, orbital myositis, posterior scleritis, enucleation, herpes zoster ophthalmicus, and cataract surgery. CASE REPORT: We report a new case of a 79-year-old nonsmoker woman who developed cluster-like symptoms 2 days after a cataract surgery and review the 2 previously reported cases. DISCUSSION: The surgical technique of cataract removal involves corneal incision, which can trigger the trigeminal-autonomic reflex, a pathophysiological mechanism potentially implicated in idiopathic cluster headache. Differential diagnosis in these cases includes surgical and anesthetic complications.

Gil-Gouveia R; Fonseca A

2013-11-01

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Cluster Headache After Cataract Surgery.  

Science.gov (United States)

BACKGROUND:: Symptomatic cluster-like headache has been described with some ophthalmological disorders such as glaucoma, orbital myositis, posterior scleritis, enucleation, herpes zoster ophthalmicus, and cataract surgery. CASE REPORT:: We report a new case of a 79-year-old nonsmoker woman who developed cluster-like symptoms 2 days after a cataract surgery and review the 2 previously reported cases. DISCUSSION:: The surgical technique of cataract removal involves corneal incision, which can trigger the trigeminal-autonomic reflex, a pathophysiological mechanism potentially implicated in idiopathic cluster headache. Differential diagnosis in these cases includes surgical and anesthetic complications. PMID:23486235

Gil-Gouveia, Raquel; Fonseca, Ana

2013-03-12

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A systematic review of phacoemulsification cataract surgery in virtual reality simulators.  

UK PubMed Central (United Kingdom)

The aim of this study was to review the capability of virtual reality simulators in the application of phacoemulsification cataract surgery training. Our review included the scientific publications on cataract surgery simulators that had been developed by different groups of researchers along with commercialized surgical training products, such as EYESI® and PhacoVision®. The review covers the simulation of the main cataract surgery procedures, i.e., corneal incision, capsulorrhexis, phacosculpting, and intraocular lens implantation in various virtual reality surgery simulators. Haptics realism and visual realism of the procedures are the main elements in imitating the actual surgical environment. The involvement of ophthalmology in research on virtual reality since the early 1990s has made a great impact on the development of surgical simulators. Most of the latest cataract surgery training systems are able to offer high fidelity in visual feedback and haptics feedback, but visual realism, such as the rotational movements of an eyeball with response to the force applied by surgical instruments, is still lacking in some of them. The assessment of the surgical tasks carried out on the simulators showed a significant difference in the performance before and after the training.

Lam CK; Sundaraj K; Sulaiman MN

2013-01-01

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Postoperative pain after cataract surgery.  

UK PubMed Central (United Kingdom)

Cataract extraction surgery is the most common surgical procedure, but knowledge of postoperative pain related to cataract surgery is sparse. In this systematic review, the incidence, prevalence, and management of pain after phacoemulsification surgery were identified using PubMed and Scopus. Selected studies were restricted to randomized controlled trials with interventions on postoperative inflammation and pain. Data from 105 articles were extracted and 21 studies met the final inclusion criteria. Most studies reported no or only mild postoperative pain, but some reported moderate and severe pain and pain lasting several weeks. The interventions consisted of drug therapy including topical nonsteroidal antiinflammatory drugs, corticosteroids, paracetamol, perioperative intraocular injections, eye pads used after surgery, and various surgical techniques. The reviewed literature indicates that cataract surgery is associated with significant postoperative pain in some patients, who should be provided with appropriate counseling and pain treatment.

Porela-Tiihonen S; Kaarniranta K; Kokki H

2013-05-01

 
 
 
 
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Keratomycosis after cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate cases and results of keratomycosis that developed after cataract surgery. SETTING: Hospital de Guipúzcoa, San Sebastián, Spain. METHODS: This retrospective study comprised 8 patients who developed keratomycosis soon after cataract surgery. RESULTS: Culture analysis revealed 7 cases of Aspergillus fumigatus and 1 of Aspergillus flavus. After medical treatment with antifungal agents, 6 cases resolved and 2 required evisceration. CONCLUSIONS: The presence of fungi in corneal ulcers that develop after cataract surgery should be considered. Initiation of early treatment determines the prognosis. Among the therapeutic options, collagen shields soaked in amphotericin B may be effective.

Mendicute J; Orbegozo J; Ruiz M; Sáiz A; Eder F; Aramberri J

2000-11-01

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Surgery for Congenital Cataract  

Directory of Open Access Journals (Sweden)

Full Text Available The management of congenital cataract is very different to the treatment of a routine age-related cataract. In adults, surgery may be delayed for years without affecting the visual outcome. In infants, if the cataract is not removed during the first year of life, the vision will never be fully regained after surgery. In adults, if the aphakia is not corrected immediately, it can be corrected later. In young children, if the aphakia is not corrected, the vision will never develop normally.

David Yorston FRCS FRCOphth

2004-01-01

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Cataract Surgery to Lower Intraocular Pressure  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Cataract and glaucoma are common co morbidities. Cataract surgery is frequently performed in patients with glaucoma. In this study, a review of literature with search terms of cataract, glaucoma and intraocular pressure is followed by evaluation and synthesis of data to determine the effect of catar...

Berdahl, John P.

24

Cataract surgery in uveitis  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose:To study the visual outcome of cataract surgery in eyes with uveitis.Methods: A retrospective analysis of patients with uveitis operated for cataract. Results: 106 eyes of 89 patients with uveitis were operated for cataract. In 62.3% eyes (66/106), post -operative follow-up was at least 6 months. There was significant improvement (P<0.001) in visual acuity after cataract surgery. Provided the uveitis was well controlled for three months pre-operatively, additional pre-operative anti-inflammatory medications did not significantly affect (P=0.842) post -operative inflammation. Patients who received extracapsular cataract extraction (ECCE) or phacoemulsification with posterior chamber IOL (PCIOL) obtained better visual acuity at 6 weeks (P=0.009 and P=0.032 respectively ) than those with only ECCE without IOL. In 37 eyes vision did not improve due to persistent uveitis (23.9%, 16/67), cystoid macular oedeme (20.9%, 14/67), and posterior capsule opacification (14.9%, 10/67). Conclusion: Cataract extraction and PCIOL implantation is safe in eyes with uveitis. Additional preoperative medications may not alleviate post-operative inflammation if uveitis is well controlled for at least three months before surgery.

Hazari Ajit; Sangwan Virender

2002-01-01

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Cataract surgery in patients with corneal disease.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: Preexisting corneal disease can be exacerbated by cataract surgery and may prevent well tolerated cataract extraction. This article reviews the current literature and describes how corneal epithelial, stromal and endothelial disease may impact and be impacted by cataract surgery while highlighting recommendations for perioperative management and surgical technique. RECENT FINDINGS: Modifications to surgical techniques can allow for improved intraoperative visualization and safer cataract removal. Cataract surgery can be safely performed in conjunction with newer forms of corneal transplantation such as deep anterior lamellar keratoplasty and endothelial keratoplasty; however, guidelines for when to perform combined surgery have not been established. SUMMARY: Appropriate perioperative management and advances in surgical techniques and technologies allow for successful cataract surgery in patients with corneal disease. Signs of corneal disease should be identified preoperatively to allow for surgical planning and optimal visual outcomes.

Greene JB; Mian SI

2013-01-01

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Multifocal intraocular lenses in cataract surgery: literature review of benefits and side effects.  

UK PubMed Central (United Kingdom)

UNLABELLED: This literature review looks at the current status of multifocal intraocular lenses (IOLs) in cataract surgery. The results of implantation of multifocal IOLs of diffractive, refractive, and hybrid diffractive-refractive design are described with regard to uncorrected near and distance visual acuity and spectacle independence. The occurrence of photic phenomena and contrast sensitivity loss with multifocal IOLs are also addressed. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.

de Vries NE; Nuijts RM

2013-02-01

27

Cataract surgery among Medicare beneficiaries.  

UK PubMed Central (United Kingdom)

PURPOSE: To present descriptive epidemiology of cataract surgery among Medicare recipients in the United States. SETTING: Cataract surgery performed on Medicare beneficiaries in 2003 and 2004. METHODS: Medicare claims data were used to identify all cataract surgery claims for procedures performed in the United States in 2003-2004. Standard assumptions were used to limit the claims to actual cataract surgery procedures performed. Summary statistics were created to determine the number of procedures performed for each outcome of interest: cataract surgery rates by age, sex, race and state; surgical volume by facility type and surgeon characteristics; time interval between first- and second-eye cataract surgery. RESULTS: The national cataract surgery rate for 2003-2004 was 61.8 per 1000 Medicare beneficiary person-years. The rate was significantly higher for females and for those aged 75-84 years. After adjustment for age and sex, blacks had approximately a 30% lower rate of surgery than whites. While only 5% of cataract surgeons performed more than 500 cataract surgeries annually, these surgeons performed 26% of the total cataract surgeries. Increasing surgical volume was found to be highly correlated with use of ambulatory surgical centers and reduced time interval between first- and second-eye surgery in the same patient. CONCLUSIONS: The epidemiology of cataract surgery in the United States Medicare population documents substantial variation in surgical rates by race, sex, age, and by certain provider characteristics.

Schein OD; Cassard SD; Tielsch JM; Gower EW

2012-10-01

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Viscoless microincision cataract surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Guy SalletDepartment of Opthamology, Aalsters Stedelijk Ziekenhuis, BelgiumAbstract: A cataract surgery technique is described in which incisions, continuous circular capsulorhexis and hydrodissection are made without the use of any viscoelastics. Two small incisions are created through which the d...

Guy Sallet

29

Cataract.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Cataract accounts for over 47% of blindness worldwide, causing blindness in about 17.3 million people in 1990. Surgery for cataract in people with glaucoma may affect glaucoma control. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of surgery for age-related cataract without other ocular comorbidity? What are the effects of treatment for age-related cataract in people with glaucoma? What are the effects of surgical treatments for age-related cataract in people with diabetic retinopathy? What are the effects of surgical treatments for age-related cataract in people with chronic uveitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 20 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: for people with cataract without other ocular co-morbidity: cataract surgery alone, cataract surgery with non-concomitant glaucoma surgery, concomitant cataract and glaucoma surgery, intracapsular extraction, manual (large or small) incision extracapsular extraction, and phaco extracapsular extraction; for people with cataract with co-morbid diabetic retinopathy: cataract surgery alone, and adding diabetic retinopathy treatment to cataract surgery; for people with cataract and co-morbid chronic uveitis: cataract surgery, and medical control of uveitis at the time of cataract surgery.

Allen D

2011-01-01

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Pediatric Cataract Surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Normal 0 false false false MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Several aspects of cataract surgery in children differ from adults. Ocular anatomy, cataract morphology, exaggerated response to surgical trauma, and the need for amblyopia therapy are major concerns in pediatric cataract surgery. Moreover, intraoperative differences such as location and type of incisions, management of anterior and posterior capsules and need for anterior vitrectomy are other important issues to be considered. Achieving a successful result depends on adhering to all the pre-, intra- and post-operative considerations and their proper management.

Farid Karimian; Mohammad-Ali Javadi; Mohammad-Reza Jafarinasab

2008-01-01

31

Daily tonometric curves after cataract surgery  

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AIM—To evaluate daily tonometric curves after cataract surgery in patients with cataract only and in patients with cataract and glaucoma.?METHODS—108 patients scheduled for cataract surgery were randomly allocated to two groups: 57 patients with cataract only (normal) and 51 with cataract and primar...

Sacca, S; Marletta, A; Pascotto, A; Barabino, S; Rolando, M; Giannetti, R; Calabria, G

32

Risk Factors for Acute Endophthalmitis following Cataract Surgery: A Systematic Review and Meta-Analysis  

Science.gov (United States)

Background Acute endophthalmitis is one of the most serious complications of cataract surgery and often results in severe visual impairment. Several risk factors for acute postoperative endophthalmitis (POE) following cataract surgery have been reported but the level of evidence and strength of association is varied. The purpose of this study was to critically appraise published reports on and to summarize clinical risk factors associated with acute POE which could be easily assessed by ophthalmologists for the introduction and implementation of preventive measure. Methods A systematic review and meta-analysis of observational studies was performed. Six databases were searched with no limits on the year or language of publication. Study-specific odds ratios (Ors) or relative risk (RR) of each risk factor were pooled using a random effect model. Results A total of 6 686 169 participants with 8 963 endophthalmitis in 42 studies were analyzed. Of the nine risk factors identified in our systematic review and meta-analysis, extra- or intracapsular cataract extraction, a clear corneal incision, without intracameral cefazolin (1 mg in 0.1 ml solution), without intracameral cefuroxime (1 mg in 0.1 ml solution), post capsular rupture, silicone intraocular lenses and intraoperative complications were found strongly associated with acute endophthalmitis. Other significant factors with a lower strength of association (risk estimates generally 1.5 or less) were male gender and old age (85 years and older). Conclusions Our study provides summary data on the risk factors for acute POE. Identifying patients at high risk of this sight-threatening eye disease is important from both the public health and clinical perspectives as this would facilitate detection of disease before the onset of irreversible visual loss enabling earlier intervention.

Li, Liping; Lo, SingKai

2013-01-01

33

Cataract surgery in Fuchs corneal dystrophy.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: Patients with decreased vision due to Fuchs corneal dystrophy and cataract can present with a number of challenges to determine the best surgical option for restoring sight. The ophthalmologist must first distinguish how much of the vision loss is due to the cataract versus the Fuchs corneal dystrophy (FCD) before determining the best surgical course, either cataract surgery alone or cataract surgery combined with full thickness or lamellar keratoplasty. This review will discuss the various techniques and clinical signs to ascertain the source of vision loss and how to use this clinical information to help guide the surgical decision making process in order to optimize the best possible outcome. RECENT FINDINGS: Over the last several years, the technique of endothelial keratoplasty has evolved to become an important alternative in the treatment of FCD. Anticipating the correct intraocular lens power for a patient undergoing cataract surgery alone followed by Descemet stripping endothelial keratoplasty (DSEK) or combined cataract surgery with DSEK requires understanding the hyperopic shift that can occur with DSEK and incorporating this correction preoperatively in the intraocular lens power selection. SUMMARY: New developments in the surgical treatment of Fuchs corneal dystrophy have greatly enhanced our ability to restore vision and reduce the dependence on contact lenses in this genetic disease.

Eghrari AO; Daoud YJ; Gottsch JD

2010-01-01

34

Cataract surgery in patients with nanophthalmos.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the visual outcomes and complications of cataract surgery in a large series of patients with nanophthalmos. DESIGN: Retrospective, interventional case series. PARTICIPANTS: Forty-three eyes with an axial length ? 20.5 mm of 32 adult patients who underwent cataract surgery in a tertiary clinic. METHODS: Medical records of patients undergoing cataract surgery between 1994 and 2010 were reviewed. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA) at 6 months after surgery and postoperative complications occurring during the entire follow-up period. RESULTS: Forty-three eyes of 32 patients (aged 19-87 years; median, 69 years) were included. Cataract surgery resulted in improvement of ? 3 Snellen lines in 19 eyes (44.2%). Two eyes (4.7%) lost ? 3 Snellen lines because of corneal decompensation in one and angle-closure glaucoma in the other. During the entire follow-up period, complications occurred in 12 eyes (27.9%). The most frequent complications were uveal effusion (9.3%) and cystoid macular edema (CME) (7.0%). CONCLUSIONS: Cataract surgery in patients with nanophthalmos remains a surgical challenge, and complications often occur in these high-risk eyes.

Steijns D; Bijlsma WR; Van der Lelij A

2013-02-01

35

EARLY COMPLICATIONS OF CATARACT SURGERY  

Directory of Open Access Journals (Sweden)

Full Text Available BACKGROUND: There are different complications of the cataract surgery described in the literature. The impact of these complications on the visual function is in correlation with many factors, some of them being imprecise and unable to be used as prognostic factors before and after the surgery. The modern technique and the surgeon’s experience lowers the complications incidence to a minimum, but even so, some problems cannot be avoided. AIM: The aim of this study is to analyse the early cataract surgery complications for patients operated in 2012 at the Ophthalmology Unit, Railway Hospital, Ia?i. MATERIAL AND METHOD: We conducted a retrospective analysis of the medical records of the patients who underwent cataract surgery in 2012. There were a total of 480 cataract surgeries, the majority of them (92,7%) being age related cataracts in different stages of evolution, of which 31.45% being mature cataracts. In 476 eyes, artificial lens was inserted per-primam (474 eyes with posterior chamber intraocular lens and 2 eyes with anterior chamber intraocular lens), in one case the posterior chamber intraocular lens was sutured to the sclera, in 3 cases the eyes remained without lens. RESULTS: The incidence of severe complications or with potential of severe development was: severe corneal oedema 0.83% (4 cases), remaining lens fragments in the vitreous cavity 0.62% (3 cases), toxic anterior segment syndrome (TASS) 0.41% (2 cases). There were no endophthalmitis, expulsive haemorhage or retinal detachment after cataract surgery. CONCLUSIONS: The number of early complications of our patients is the same with numbers shown in other studies. With a better surgical technique, a good examination of the patient, a thorough explanation of the procedure to the patient, the use of high quality substances during surgery and proper technology we can lower even more the incidence of the complications.

C. Constantin; I. Cijevschi; Silvia S?lceanu; C. David

2013-01-01

36

Indications and clinical outcome of capsular tension ring (CTR) implantation: A review of 9528 cataract surgeries.  

UK PubMed Central (United Kingdom)

BACKGROUND: To report the indications and clinical outcomes of all capsular tension ring (CTR) implantations in a large series of consecutive cataract surgeries during a five year interval in a university eye hospital. METHODS: The study was designed as a restrospective analysis of a consecutive series of 9528 cataract surgeries. The records were checked for cases in which a CTR was implanted. The indications and clinical outcomes of CTR implantation were documented and an evaluation of posterior chamber intraocular lens (PCIOL) insertion, position, and centration. RESULTS: In this series, a CTR was implanted in 69 eyes of 67 patients. The indications were advanced or mature cataract in 40, post-traumatic cataract in 23, pseudoexfoliation syndrome in 4 and subluxated lens in 2 eyes. PCIOL implantation in the capsular bag was possible in 61 (90%) of these 69 eyes. In 5 (7%) additional eyes, PCIOL implantation in the ciliary sulcus was accomplished. In one eye (1%) no IOL implantation was performed because of high myopia. In only two of 69 eyes (2%), an anterior chamber intraocular lens had to be inserted despite prior CTR implantation. In 5 eyes (5%), a slight dislocation of the IOL was noted postoperatively, but none of these patients complained of visually relevant symptoms (eg, monocular diplopia). CONCLUSIONS: According to our experience CTRs are used very infrequently (0.7%), but remain useful in cataract surgeries with difficult preoperative or intraoperative conditions. If zonulolysis is less than two quadrants in extent, implantation of a PCIOL was possible in 98% of cases. Implantation of CTRs with special designs may have additional advantages (eg, inhibition of posterior capsule opacity) and warrant further investigation.

Tribus C; Alge CS; Haritoglou C; Lackerbauer C; Kampik A; Mueller A; Priglinger SG

2007-03-01

37

Handtool for cataract surgery  

UK PubMed Central (United Kingdom)

A handtool for use in emulsifying and aspirating a cataract from an eye has a cylindrical, motor-containing barrel to which irrigation and aspiration conduits are rigidly mounted. The motor drives a microdrill having a generally spherical head having dull teeth thereon. The drill shaft passes through an interior passageway connected to the aspiration conduit and the irrigation conduit is connected to an annular passageway concentric to the interior passageway. The drill head can be inserted into contact with the cataract through an opening in the capsule surrounding the lens and as it rotates it churns the cataract material into an emulsion which is aspirated, along with irrigation fluid from the vicinity of the rotating drill head.

Pop Mihai M.

38

Diabetic retinopathy before and after cataract surgery.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

AIMS/BACKGROUND: Increased retinopathy progression has been reported after cataract surgery in patients with diabetes mellitus. To assess the influence of cataract surgery on visual acuity and retinopathy progression, all diabetic patients who were subjected to cataract surgery during 1991-3 have be...

Henricsson, M; Heijl, A; Janzon, L

39

Non-steroidal anti-inflammatory agents for cystoid macular oedema following cataract surgery: a systematic review  

Science.gov (United States)

Aim: To examine the effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of cystoid macular oedema (CMO) following cataract surgery. Methods: Systematic literature review of randomised controlled trials (RCTs) that evaluated the effects of NSAIDs in the treatment of CMO following cataract surgery was done according to the Cochrane Collaboration methodology. Results: Seven trials involving a total of 266 participants were included. Four trials studied the effects of NSAIDs in chronic CMO while the other three trials examined the effect of NSAIDs in acute CMO. Little evidence of effectiveness was found for oral indomethacin and topical fenoprofen for chronic CMO in two small trials. Treatment with topical 0.5% ketorolac for chronic CMO was found to be effective in two trials. Three trials examined the effect of topical NSAIDs on acute CMO. The comparisons among these studies were of a NSAID to placebo, prednisolone or another NSAID. Because of considerable heterogeneity between these study designs, their results were not combined in a meta-analysis. Conclusion: A positive effect of topical NSAID (0.5% ketorolac tromethamine ophthalmic solution) on chronic CMO was noted. However, there is not enough evidence to show the effectiveness of NSAIDs in acute CMO following cataract surgery.

Sivaprasad, S; Bunce, C; Wormald, R

2005-01-01

40

Visual outcome of cataract surgery.  

UK PubMed Central (United Kingdom)

The aim of this study was to assess whether the visual outcome of cataract surgery in the institution was in accordance with the World Health Organization recommendations. In this retrospective case series, all patients who underwent cataract surgery by a single surgeon from January 2009 till June 2011 were included. Date were collected from medical records on age, gender, visual acuity and causes of sub-optimal outcome. The main outcome was best-corrected visual acuity in the operated eye, measured 4 - 6 weeks after surgery. Data on visual outcome was grouped using WHO's classification. Of the 495 eyes that underwent cataract surgery, 58% were female. Overall, 93.3% of the operated eyes had good visual outcome, while 4.4% and 2.2% had borderline and poor outcomes, respectively. Pre-existing diseases accounted for 93.9% of the borderline/poor outcome. The study showed good visual outcome of cataract surgeries performed using phacoemulsification with intraocular lens (IOL) insertion.

Hashmi FK; Khan QA; Chaudhry TA; Ahmad K

2013-06-01

 
 
 
 
41

The impact of cataract surgery on quality of life.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: This review summarizes the recent literature of the impact of cataract surgery from the patient's perspective, with a focus on second-generation patient reported outcome (PRO) measures that used Rasch analysis to explore their data. RECENT FINDINGS: Irrespective of the instrument utilized, the overriding conclusion is that cataract surgery unequivocally improves vision-specific functioning and several aspects of vision-specific quality of life. The benefit of cataract surgery, however, on generic health is less clear, due to limited vision-related items. Evidence suggests that cataract surgery also improves visual functioning in comorbid eye disease, especially in the early stages. Similarly, second eye cataract surgery appears to improve visual ability beyond that achieved with first eye surgery. Recently, there has been a shift toward second-generation, Rasch-validated PROs to assess cataract surgery outcomes and large gains in visual function have been demonstrated. Importantly, measurement precision is dramatically improved compared with the original first-generation instruments. SUMMARY: Cataract surgery-induced improvements in visual acuity are translated by considerable gains in real life activities, emotional and social life components. The utilization of second-generation instruments and modern psychometric methods, however, appears to be the best current strategy to optimize the impact of cataract surgery on health-related quality of life.

Lamoureux EL; Fenwick E; Pesudovs K; Tan D

2011-01-01

42

Long-term risk of glaucoma after congenital cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the long-term risk of glaucoma development in children following congenital cataract surgery. DESIGN: Retrospective interventional consecutive case series. METHODS: We retrospectively reviewed the records of 62 eyes of 37 children who underwent congenital cataract surgery when <7 months of age by the same surgeon using a limbal approach. The Kaplan-Meier method was used to calculate the probability of an eye's developing glaucoma and/or becoming a glaucoma suspect over time. RESULTS: The median age of surgery was 2.0 months and the median follow-up after cataract surgery was 7.9 years (range, 3.2-23.5 years). Nine eyes (14.5%) developed glaucoma a median of 4.3 months after cataract surgery and an additional 16 eyes (25.8%) were diagnosed as glaucoma suspects a median of 8.0 years after cataract surgery. The probability of an eye's developing glaucoma was estimated to be 19.5% (95% CI: 10.0%-36.1%) by 10 years after congenital cataract surgery. When the probability of glaucoma and glaucoma suspect were combined, the risk increased to 63.0% (95% CI: 43.6%-82.3%). CONCLUSIONS: Long-term monitoring of eyes after congenital cataract surgery is important because we estimate that nearly two thirds of these eyes will develop glaucoma or become glaucoma suspects by 10 years after cataract surgery.

Lambert SR; Purohit A; Superak HM; Lynn MJ; Beck AD

2013-08-01

43

Patient satisfaction with cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Measuring the patient satisfaction is a very important issue that will help very much in improving the service provided to patients and improve the level of satisfaction. Aim To evaluate patient satisfaction with the cataract surgery service and identify any areas for improvement, determination of patient satisfaction with referral, out-patient consultation, pre-assessment clinic, surgery and post-operative care, also to report patients' comments relating to improvement in service provision. Methodology A retrospective study was undertaken for 150 patients underwent cataract surgery at Barrow General Hospital, UK, the survey sample was by postal questionnaires. We collected our data from the theatre lists for a period of 4 month. Results This study included 150 patients; the response rate was (72%) 108 patients, Most patients were referred from their general practitioner 86.1%, 93 (86.1%) patients were happy with the time interval from seeing their GP to eye clinic. In the eye out patient department many factors significantly affected the level of patient satisfaction, in general the more information provided for the patient the more the satisfaction. Conclusion Patient satisfaction is on important health outcome old understanding both the domains of satisfaction as well as their relative importance to patients is necessary to improve the overall quality of patient care. Meeting the doctor, presenting all relevant information and giving printed information are very important factors in improving the patient's satisfaction with cataract surgery.

Wasfi Ehab I; Pai P; Abd-Elsayed Alaa A

2008-01-01

44

Cataract surgery and diabetic retinopathy.  

UK PubMed Central (United Kingdom)

The introduction of extracapsular cataract extraction (or phacoemulsification) with placement of a posterior chamber intraocular lens is a major benefit to diabetics because it probably does not lead to as rapid an acceleration of retinopathy as does intracapsular cataract extraction. Nevertheless, because many patients develop anterior chamber complications and neovascularization or severe macular edema, considerable caution is required. All patients must have close postoperative follow-up. Patients with preoperative macular edema have the worst prognosis, but the timing of treatment for postoperative macular edema remains to be worked out. All of the papers included in this review shed light on this challenging problem.

Benson WE

1992-06-01

45

Cataract surgery and diabetic retinopathy.  

Science.gov (United States)

The introduction of extracapsular cataract extraction (or phacoemulsification) with placement of a posterior chamber intraocular lens is a major benefit to diabetics because it probably does not lead to as rapid an acceleration of retinopathy as does intracapsular cataract extraction. Nevertheless, because many patients develop anterior chamber complications and neovascularization or severe macular edema, considerable caution is required. All patients must have close postoperative follow-up. Patients with preoperative macular edema have the worst prognosis, but the timing of treatment for postoperative macular edema remains to be worked out. All of the papers included in this review shed light on this challenging problem. PMID:10149703

Benson, W E

1992-06-01

46

[Pediatric cataract surgery in Malawi.  

UK PubMed Central (United Kingdom)

PURPOSE: The aim of this study was to evaluate the postoperative refractive status after pediatric cataract surgery with age-determined intraocular lens (IOL) implantation in children (age 0-8 years) in Malawi. MATERIALS AND METHODS: Hospital-based retrospective study from January to June 2011 analyzing age, sex, origin, type of cataract surgery, IOL power and postoperative refractive status. In the absence of biometry, IOL powers were chosen according to the child's age and IOL availability. RESULTS: A total of 58 eyes from 33 children were surgically treated of which 25 (76?%) were bilateral and 8 (24?%) unilateral. Best refractive outcome was achieved with a 25 diopter (D) IOL implanted in children 5-8 years old. None of the children aged 1-7 years achieved the previously calculated target refraction. Results showed a marked myopic variability. The range of postoperative refraction was from -?15 D to +?12.5 D and a large number of children (n=11, 33?%) did not attend for follow-up. CONCLUSION: Implanting IOLs according to age groups is not a suitable surgical strategy even in resource-poor settings. Refractive outcomes were too variable with a marked myopic shift. Biometry and keratometry are required in order to undertake pediatric cataract surgery. Developing regional pediatric centres should be a focus of the VISION 2020 initiative.

Schulze Schwering M; Msukwa G; Spitzer MS; Kalua K

2013-06-01

47

Surgical correction of astigmatism during cataract surgery.  

UK PubMed Central (United Kingdom)

High levels of corneal astigmatism are prevalent in a significant proportion of the population. During cataract surgery pre-existing astigmatism can be corrected using single or paired incisions on the steep axis of the cornea, using relaxing incisions or with the use of a toric intraocular lens. This review provides an overview of the conventional methods of astigmatic correction during cataract surgery and in particular, discusses the various types of toric lenses presently available and the techniques used in determining the correct axis for the placement of such lenses. Furthermore, the potential causes of rotation in toric lenses are identified, along with techniques for assessing and quantifying the amount of rotation and subsequent management options for addressing post-operative rotation.

Buckhurst PJ; Wolffsohn JS; Davies LN; Naroo SA

2010-11-01

48

Surgical correction of astigmatism during cataract surgery.  

Science.gov (United States)

High levels of corneal astigmatism are prevalent in a significant proportion of the population. During cataract surgery pre-existing astigmatism can be corrected using single or paired incisions on the steep axis of the cornea, using relaxing incisions or with the use of a toric intraocular lens. This review provides an overview of the conventional methods of astigmatic correction during cataract surgery and in particular, discusses the various types of toric lenses presently available and the techniques used in determining the correct axis for the placement of such lenses. Furthermore, the potential causes of rotation in toric lenses are identified, along with techniques for assessing and quantifying the amount of rotation and subsequent management options for addressing post-operative rotation. PMID:20735787

Buckhurst, Phillip J; Wolffsohn, James S; Davies, Leon N; Naroo, Shehzad A

2010-08-24

49

Approaches to corneal astigmatism in cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: To outline current options for managing astigmatism during cataract surgery and update readers on new techniques for improving the final refractive outcome in these patients. RECENT FINDINGS: Recent studies continue to show the effectiveness of peripheral corneal relaxing incisions (PCRIs) for correcting astigmatism in combination with monofocal, multifocal, and toric intraocular lens (IOL) implants. The options in toric IOLs are expanding. Intraoperative aberrometry is a new tool that can improve the accuracy of PCRIs and toric IOLs. SUMMARY: PCRIs and toric IOLs are currently the two main options for astigmatism management during cataract surgery. Refractive outcomes are improved by new techniques, which refine the effectiveness and accuracy of these two options.

Rubenstein JB; Raciti M

2013-01-01

50

Femtosecond laser cataract surgery: technology and clinical practice.  

UK PubMed Central (United Kingdom)

The recent introduction of femtosecond lasers to cataract surgery has generated much interest among ophthalmologists around the world. Laser cataract surgery integrates high-resolution anterior segment imaging systems with a femtosecond laser, allowing key steps of the procedure, including the primary and side-port corneal incisions, the anterior capsulotomy and fragmentation of the lens nucleus, to be performed with computer-guided laser precision. There is emerging evidence of reduced phacoemulsification time, better wound architecture and a more stable refractive result with femtosecond cataract surgery, as well as reports documenting an initial learning curve. This article will review the current state of technology and discuss our clinical experience.

Roberts TV; Lawless M; Chan CC; Jacobs M; Ng D; Bali SJ; Hodge C; Sutton G

2013-03-01

51

Incidence and management of cataract after glaucoma surgery.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: This review summarizes the recent literature regarding the incidence and management of cataract following glaucoma surgery. RECENT FINDINGS: Half of the total number of phakic patients that have either trabeculectomy or tube shunt surgery will go on to develop visually significant cataract within 5 years. Phacoemulsification following trabeculectomy is significantly associated with bleb failure and loss of intraocular pressure (IOP) control. Recent studies suggest that the risk of bleb failure increases, the earlier cataract surgery is performed, and recommend a delay of at least 1-2 years after trabeculectomy to enable the bleb to stabilize. Bleb failure occurs because of scarring secondary to postoperative inflammation. Evidence suggests that intraoperative subconjunctival 5-fluorouracil (5-FU) may be protective, and repeated postoperative 5-FU injections may have a role in high-risk individuals along with aggressive anti-inflammatory treatment. Phacoemulsification following tube shunt surgery improves vision and does not affect IOP control. Novel glaucoma procedures are emerging, but they are often combined with cataract surgery, and/or clinical studies are at an early stage. SUMMARY: The development of visually significant cataract is common after glaucoma surgery. Subsequent cataract surgery can affect IOP control following trabeculectomy but not after tube shunt surgery. Measures to minimize the risk of bleb failure and loss of IOP control following trabeculectomy are critical in the management approach to patients who have had trabeculectomy.

Patel HY; Danesh-Meyer HV

2013-01-01

52

[New progresses in micro-incision cataract surgery].  

Science.gov (United States)

Micro-incision cataract surgery (MICS) was developed in the last decades, which was derived from the traditional phacoemulsification cataract surgery. MICS consists of mainly two types, bimanual and coaxial micro-incision cataract surgeries, which are classified by the separation of irrigation and aspiration systems or not. According to their obvious advantages in minimum surgery trauma, slight surgically induced astigmatism and rapid postoperative vision recovery, MICS has gradually possessed widespread clinical use. Combined with the development of cold phaco technique and intraocular lens for ultra-small incision, greater achievements have been made to improve the cataract surgery quality. We review the clinical applications of these two types of MICS and the cold phaco technique which supports the former. PMID:22800458

Han, Yu; Wang, Jun

2012-04-01

53

[New progresses in micro-incision cataract surgery].  

UK PubMed Central (United Kingdom)

Micro-incision cataract surgery (MICS) was developed in the last decades, which was derived from the traditional phacoemulsification cataract surgery. MICS consists of mainly two types, bimanual and coaxial micro-incision cataract surgeries, which are classified by the separation of irrigation and aspiration systems or not. According to their obvious advantages in minimum surgery trauma, slight surgically induced astigmatism and rapid postoperative vision recovery, MICS has gradually possessed widespread clinical use. Combined with the development of cold phaco technique and intraocular lens for ultra-small incision, greater achievements have been made to improve the cataract surgery quality. We review the clinical applications of these two types of MICS and the cold phaco technique which supports the former.

Han Y; Wang J

2012-04-01

54

Factors associated with second eye cataract surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

AIMS—To analyse the clinical and sociodemographic characteristics associated with second eye cataract surgery.?METHODS—An observational, longitudinal study of patients scheduled for first eye cataract surgery that did not involve a combined procedure was carried at two teaching hospitals and one non...

Castells, X.; Alonso, J.; Ribo, C.; Nara, D.; Teixido, A.; Castilla, M.

55

Impairment of lacrimal drainage after cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available BACKGROUND: Complaining of tearing was found in some of our patients after phacoemulsification surgery for senile cataract. Secondary acquired lacrimal drainage obstruction has been proposed to happen due to different causes. This study was performed at Feiz hospital in Isfahan, Iran from September to December of 2004 to evaluate the effects of phacoemulsification surgery on tear drainage in eyes with senile cataract. METHODS: This cohort study was performed on 110 patients with senile cataract who had phacoemulsification and posterior chamber lens (PCL) implantation surgery under topical anesthesia in one eye. Included patients had fluorescein disappearance and taste test duration of xxx; 5.5 minutes in both eyes before operation. Tear drainage function tests were repeated for one week and one month after surgery in both eyes and obtained data were compared. RESULTS: The incidence of lacrimal drainage impairment in eyes treated for senile cataract was 35% at one week and 20% at one month after phacoemulsification surgery. The mean taste test duration time was 3.84 ± 0.77 minutes before surgery, 7.30 ± 4.80 minutes at one week and 6.31 ± 4.42 minutes at one month after surgery (P < 0.001 and P < 0.001 respectively). No post operation tear drainage impairment was observed in the sound eyes of the patients. CONCLUSIONS: Impairment of lacrimal drainage can be predisposed by cataract surgery in eyes with senile cataract. KEY WORDS: Lacrimal drainage, cataract surgery, phacoemulsification

Hamid Fesharaki; Hasan Razmjoo; Masoud Aghajani

2007-01-01

56

Benign prostatic hyperplasia: clinical treatment can complicate cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english PURPOSE: To investigate the effects of alpha-1 adrenergic receptor antagonists for the treatment of benign prostatic hyperplasia (BPH) regarding potential risks of complications in the setting of cataract surgery. AIM: To address recommendations, optimal control therapy, voiding symptoms and safety within the setting of cataract surgery. MATERIALS AND METHODS: A comprehensive literature review was performed using MEDLINE with MeSH terms and keywords "benign prostatic hype (more) rplasia", "intraoperative floppy iris syndrome", "adrenergic alpha-antagonist" and "cataract surgery". In addition, reference lists from identified publications were reviewed to identify reports and studies of interest from 2001 to 2009. RESULTS: The first report of intraoperative floppy iris syndrome (IFIS) was observed during cataract surgery in patients taking systemic alpha-1 AR antagonists in 2005. It has been most commonly seen related to use of tamsulosin. Changes of medication and washout periods of up to 2 weeks have been attempted to reduce the risk of complications in the setting of cataract surgery. CONCLUSION: Patients under clinical treatment for BPH should be informed about potential risks of this drug class so that it can be discuss with their healthcare providers, in particular urologist and ophthalmologist, prior to cataract surgery.

Facio, Fernando; Kashiwabuschi, Renata; Nishi, Yutaro; Leao, Ricardo; Mcdonnell, Peter; Burnett, Arthur

2010-10-01

57

[Combined cataract and glaucoma surgery. Current options].  

UK PubMed Central (United Kingdom)

Trabeculectomy is no longer the gold standard for combined cataract glaucoma surgery considering the successful results following cataract surgery combined with trabeculotomy, viscocanalostomy and canaloplasty. The main disadvantage of these mostly non-penetrating procedures is the induction of conjunctival scarring which jeopardizes subsequent filtering surgery. Ab interno glaucoma surgery, including trabecular surgery and endocyclophotocoagulation, does not interfere with the conjunctival situation. These surgical options have a relatively minor risk profile for combined cataract glaucoma surgery compared to traditional filtering surgery; however, the pressure reducing efficacy of these ab interno approaches is limited with respect to the absolute reduction of intraocular pressure (IOP) and the achievable level of IOP. This has to be kept in mind when planning surgery.

Dietlein TS; Widder RA; Jordan JF; Jonescu-Cuypers C; Rosentreter A

2013-04-01

58

Adjuvant treatment modalities to control macular edema in diabetic patients undergoing cataract surgery.  

UK PubMed Central (United Kingdom)

Cataract surgical outcomes in diabetic patients has been subject to changes with the advances in the surgical techniques. Recent studies suggest that cataract surgery does not cause the progression of diabetic retinopathy and intravitreal bevacizumab and/or triamcinolone injections combined with cataract surgery may contribute in short term improvement of macular edema in diabetic patients. This article reviews the progression of diabetic retinopathy after cataract surgery with phacoemulsification and the use of adjuvant intravitreal treatments combined with phacoemusification in diabetic patients undergoing cataract surgery.

Cetin EN; Y?ld?r?m C

2013-10-01

59

Adjuvant treatment modalities to control macular edema in diabetic patients undergoing cataract surgery.  

Science.gov (United States)

Cataract surgical outcomes in diabetic patients has been subject to changes with the advances in the surgical techniques. Recent studies suggest that cataract surgery does not cause the progression of diabetic retinopathy and intravitreal bevacizumab and/or triamcinolone injections combined with cataract surgery may contribute in short term improvement of macular edema in diabetic patients. This article reviews the progression of diabetic retinopathy after cataract surgery with phacoemulsification and the use of adjuvant intravitreal treatments combined with phacoemusification in diabetic patients undergoing cataract surgery. PMID:23248073

Cetin, Ebru Nevin; Y?ld?r?m, Cem

2012-12-18

60

Cataracts  

Medline Plus

Full Text Available ... doctor may recommend cataract surgery to enhance your vision. The decision to have cataract surgery will be ... some light from reaching the retina, and reducing vision. Clouded areas on the lens of the eye ...

 
 
 
 
61

Secondary glaucoma after pediatric cataract surgery.  

UK PubMed Central (United Kingdom)

AIM: To determine the incidence and risk factors of secondary glaucoma after pediatric cataract surgery. METHODS: Two hundred and forty nine eyes of 148 patients underwent cataract surgery without intraocular lens (IOL) implantation (group 1), and 220 eyes of 129 patients underwent cataract surgery with IOL implantation (group 2) retrospectively, were evaluated between 2000 and 2011. The outcome measure was the presence or absence of post-cataract surgery glaucoma, defined as an intraocular pressure (IOP) ?26mmHg, as measured on at least two occasions along with corneal or optic nerve changes. RESULTS: The mean follow-up periods of group 1 and 2 were (60.86±30.95) months (12-123 months) and (62.11±31.29) months (14-115 months) respectively. In group 1, 12 eyes of 8 patients (4.8%) developed glaucoma. None of the patients developed glaucoma after surgery in group 2. The mean age of the patients at the cataract surgery was (2.58±0.90) months (1 month-4 months) and the average period for glaucoma development after surgery was (9.50±4.33) months (4-16 months) in group 1. Three of the 12 glaucomatous eyes were controlled with antiglaucomatous medication and 9 eyes underwent trabeculectomy+mitomycin C surgery. One patient underwent a second trabeculectomy + mitomycin C operation for both of his eyes. CONCLUSION: The incidence of glaucoma after pediatric cataract surgery is very low in patients in whom IOL is implanted. The aphakic eyes after pediatric cataract surgery are at an increased risk for glaucoma development particularly if they underwent surgery before 4 months of age.

Sahin A; Caça I; Cingü AK; Türkcü FM; Yüksel H; Sahin M; Cinar Y; Ari S

2013-01-01

62

Secondary glaucoma after pediatric cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available AIM:To determine the incidence and risk factors of secondary glaucoma after pediatric cataract surgery. METHODS: Two hundred and forty nine eyes of 148 patients underwent cataract surgery without intraocular lens (IOL) implantation (group 1), and 220 eyes of 129 patients underwent cataract surgery with IOL implantation (group 2) retrospectively, were evaluated between 2000 and 2011.The outcome measure was the presence or absence of post-cataract surgery glaucoma, defined as an intraocular pressure (IOP) ?26mmHg, as measured on at least two occasions along with corneal or optic nerve changes. RESULTS: The mean follow-up periods of group 1 and 2 were (60.86±30.95) months (12-123 months) and (62.11±31.29) months (14-115 months) respectively. In group 1, 12 eyes of 8 patients (4.8%) developed glaucoma. None of the patients developed glaucoma after surgery in group 2. The mean age of the patients at the cataract surgery was (2.58±0.90) months (1 month-4 months) and the average period for glaucoma development after surgery was (9.50±4.33) months (4-16 months) in group 1. Three of the 12 glaucomatous eyes were controlled with antiglaucomatous medication and 9 eyes underwent trabeculectomy+mitomycin C surgery. One patient underwent a second trabeculectomy + mitomycin C operation for both of his eyes. CONCLUSION: The incidence of glaucoma after pediatric cataract surgery is very low in patients in whom IOL is implanted. The aphakic eyes after pediatric cataract surgery are at an increased risk for glaucoma development particularly if they underwent surgery before 4 months of age.

Alparslan ?ahin,; Ihsan Çaça,; Abdullah Kür?at Cingü; Fatih Mehmet Türkcü; Harun Yüksel; Muhammed ?ahin; Yasin Çinar; ?eyhmus Ari

2013-01-01

63

Role of mannitol in cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Hypertonic mannitol solution has been found to be most effec-tive in preventing vitreous loss in cataract surgery due to profound hypotony and detergence of vitreous following intravenous in-fusion. Routine use of mannitol is hence recommended prior to cataract surgery, especially in all one-eyed patients or in cases where there is an increased risk of vitreous disturbances.

Shah B; Maskati B

1978-01-01

64

Predicting the success of cataract surgery.  

UK PubMed Central (United Kingdom)

Fifty-four elderly patients with cataracts were tested with a questionnaire and a series of visual-motor learning and performance tasks immediately before, 7 weeks after, and 16 weeks after cataract surgery. The goal was to learn whether postoperative performance and questionnaire responses could be predicted from the preoperative tasks. Twenty-two elderly people without diagnosed cataracts did the same tasks at comparable intervals to establish normal performance levels and reliabilities. The amount of activity before surgery (walking, shopping, gardening, sewing, etc.) and the ability to learn a new visual-motor coordination were positively correlated with successful recovery as assessed by several measures including spontaneously expressed satisfaction.

Murphy SB; Donderi DC

1980-03-01

65

Review of the publications of the Nigeria national blindness survey: methodology, prevalence, causes of blindness and visual impairment and outcome of cataract surgery.  

Science.gov (United States)

This is a review of the major publications from the Nigeria national blindness survey in order to highlight major findings and challenges of eye care in Nigeria. The review summarizes methodology and key findings. Survey publications on methodology, prevalence and causes of visual impairment and outcome of cataract surgery were retrieved, reviewed and relevant data extracted, reported and discussed. The study was the largest and more detailed eye survey in Nigeria (15,375 people 40 years and older recruited). Participants had detailed eye examination including visual acuity, autorefractokeratometry, A- scan biometry, visual field and basic eye examination. Cause(s) of visual impairment in each eye using WHO algorithm was determined among participants with vision < 6/12. Some of the participants also had qualitative questions on barriers to uptake of services, quality of life and visual function. Major highlights of the results as contained in the publications include a high prevalence of blindness with 4.2% (95% CI: 3.8-4.6%;),of the study population having blindness (using presenting vision (PVA)) even with best correction the prevalence was 3.4% (95% CI: 3.0-3.8%. The prevalence of SVI using PVA was 1.5% (95% CI: 1.3-1.7%).and with best correction 0.8% (95% CI: 0.7-1.0%). Blindness varied by age groups, sex, literacy level and geopolitical zone. Furthermore, 84% of blindness was due to avoidable causes with cataract responsible for 43% of blindness, glaucoma 16.7%, uncorrected aphakia 8.4% and corneal opacity 7.9%. Of the total 538 eyes that had cataract surgery procedures, 42.7% had couching and the remaining had cataract surgery, but only 41.4% of cataract operated eyes had IOL surgery. Outcome of cataract surgery was good at presentation for only 30.8% of eyes (84 eyes) which improved to 56.8% with correction. The possible remedy for the high burden of needless blindness and harmful eye health practices in Nigeria are discussed. PMID:22684129

Rabiu, M Mansur; Kyari, Fatima; Ezelum, Christian; Elhassan, Elizabeth; Sanda, Safiya; Murthy, Gudlavalleti V S; Sivasubramaniam, Selvaraj; Glibert, Clare; Abdull, M M; Abiose, A; Bankole, O; Entekume, G; Faal, H; Imam, A; Sang, Lee Pak; Abubakar, Tafida

66

Review of the publications of the Nigeria national blindness survey: methodology, prevalence, causes of blindness and visual impairment and outcome of cataract surgery.  

UK PubMed Central (United Kingdom)

This is a review of the major publications from the Nigeria national blindness survey in order to highlight major findings and challenges of eye care in Nigeria. The review summarizes methodology and key findings. Survey publications on methodology, prevalence and causes of visual impairment and outcome of cataract surgery were retrieved, reviewed and relevant data extracted, reported and discussed. The study was the largest and more detailed eye survey in Nigeria (15,375 people 40 years and older recruited). Participants had detailed eye examination including visual acuity, autorefractokeratometry, A- scan biometry, visual field and basic eye examination. Cause(s) of visual impairment in each eye using WHO algorithm was determined among participants with vision < 6/12. Some of the participants also had qualitative questions on barriers to uptake of services, quality of life and visual function. Major highlights of the results as contained in the publications include a high prevalence of blindness with 4.2% (95% CI: 3.8-4.6%;),of the study population having blindness (using presenting vision (PVA)) even with best correction the prevalence was 3.4% (95% CI: 3.0-3.8%. The prevalence of SVI using PVA was 1.5% (95% CI: 1.3-1.7%).and with best correction 0.8% (95% CI: 0.7-1.0%). Blindness varied by age groups, sex, literacy level and geopolitical zone. Furthermore, 84% of blindness was due to avoidable causes with cataract responsible for 43% of blindness, glaucoma 16.7%, uncorrected aphakia 8.4% and corneal opacity 7.9%. Of the total 538 eyes that had cataract surgery procedures, 42.7% had couching and the remaining had cataract surgery, but only 41.4% of cataract operated eyes had IOL surgery. Outcome of cataract surgery was good at presentation for only 30.8% of eyes (84 eyes) which improved to 56.8% with correction. The possible remedy for the high burden of needless blindness and harmful eye health practices in Nigeria are discussed.

Rabiu MM; Kyari F; Ezelum C; Elhassan E; Sanda S; Murthy GV; Sivasubramaniam S; Glibert C; Abdull MM; Abiose A; Bankole O; Entekume G; Faal H; Imam A; Sang LP; Abubakar T

2012-07-01

67

Simultaneous pterygium and cataract surgery.  

Directory of Open Access Journals (Sweden)

Full Text Available In our country both pterygium and cataract have a high incidence. Hence in this study, thirty patients with pterygium and cataract were treated with a simultaneous pterygium excision and cataract extraction procedure. These patients after pterygium excision were treated intra-operatively with 500 rads of beta radiation over the pterygium site. Then, the cataract was extracted and the patients were treated post-operatively with topical betamethasone 0.1% for a duration of three months. They were followed up for a duration of 6 months postoperatively. Nineteen patients (63%) had visual recovery to 6/12. Twelve of 30 patients (40%) had recurrence of pterygium. The combined procedure did not result in any surgical complications following cataract removal. Post-operatively, after 6 months 13 patients had with the rule astigmatism (WRA) for a mean WRA of 1.3 D, and 17 had against the rule astigmatism (ARA) for a mean ARA of 1.2 D.

Gulani A; Dastur Y

1995-01-01

68

The latest generation of intraocular lenses, the problem of the eye refraction after cataract surgery.  

UK PubMed Central (United Kingdom)

Nowadays cataract surgery is refractive surgery as well. Intraocular lens implantation is gold standard, but there is plenty types of intraocular lenses, monofocal, multifocal, accommodating, and toric. Problem is to pick up correct one according life style, profession, health status and age. The aim is review current possibilities in cataract, refractive surgery and aphakia management.

Synek S

2013-04-01

69

MRSA and cataract surgery – reflections for practice  

Directory of Open Access Journals (Sweden)

Full Text Available LF Porter1, RU Khan2, A Hannan3, SP Kelly11Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 2Departments of Microbiology, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 3Haughton Thornley Medical Centers, NHS Tameside and Glossop, UKIntroduction: Postoperative bacterial endophthalmitis is a devastating complication of cataract surgery. Methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis is rare. Recent debate over MRSA screening in United Kingdom (UK) National Health Service (NHS) hospital services has implications for cataract patients and ophthalmology services.Aims: To discuss issues for clinical practice as based on reflective experience at a UK district general NHS hospital in relation to care of MRSA-positive cataract patients.Methods: Retrospective case series and reflective practice.Results: Three cases presented highlight practice points around cataract patients colonized with MRSA. Known or determined MRSA-colonized patients should be treated with anti-microbial agents at time of cataract surgery known to be active against MRSA. Preventative treatment with intracameral vancomycin or intravenous teicoplanin alongside appropriate topical treatments may be of merit. Importantly fluoroquinolones, often prescribed by cataract surgeons, may have a selective effect favoring the proliferation of MRSA.Conclusion: MRSA screening may cause unnecessary delays in cataract care and may represent a patient safety concern in its own right. Patients colonized with MRSA may safely undergo cataract surgery provided there is no evidence of periorbital infection and provided appropriate infection control and antibiotic prophylaxis measures are used. The well-prepared cataract surgeon needs to be aware of developments in infection control and should liaise with local clinical microbiology colleagues in relation to bacterial resistance to antibiotics.Keywords: methicillin-resistant Staphylococcus aureus (MRSA), endophthalmitis, screening

LF Porter; RU Khan2; A Hannan; et al

2010-01-01

70

Application progress of capsular tension ring and iris hook in the surgery of cataract  

Directory of Open Access Journals (Sweden)

Full Text Available Application of surgical assistive devices can effectively improve surgical safety, reduce surgical complications, and improve the quality of vision in patients with cataract surgery. Capsular tension ring and iris hook are the most important of surgical assistive devices in the cataract surgery, they have been used widely in recent years. Their development in material and design, alone or in combination in cataract surgery are reviewed in this paper.

Jun-Ling Wang; Ping Wang

2013-01-01

71

Applications of optical coherence tomography in cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: The rapid emergence and widespread adoption of optical coherence tomography (OCT) has spurred the development of many ophthalmic applications. Spectral domain OCT provides high-resolution in-vivo images of both anterior and posterior segments of the eye. Innovations in anterior segment OCT (AS-OCT) aim to improve refractive accuracy and reduce surgical risks. This review focuses on the utility of AS-OCT in cataract surgery for preoperative assessment, intraoperative assistance, and postoperative management to improve surgical outcomes. RECENT FINDINGS: Recent advances in AS-OCT for preoperative planning include characterization of dry eye and ocular surface conditions, calculation of intraocular lens (IOL) power, delineation of anterior chamber structures, and assessment of risk factors for postoperative complications. Successful intraoperative use of AS-OCT has been described for in-vivo assessment of clear cornea wound architecture and OCT-guided femtosecond laser-assisted cataract surgery. The essential roles of OCT in managing postoperative complications include characterization of maculopathy or corneal wound integrity, assessment of IOL stability or optical changes, and evaluation of laser-assisted in situ keratomileusis flaps after cataract surgery. SUMMARY: In its rapidly evolving state, the utility of OCT in cataract surgery continues to broaden with applications from preoperative planning, intraoperative image-based treatments, and postoperative care. We advocate the judicious use of OCT, wherever clinically indicated, because routine use may not be clinically necessary or economically feasible for each stage of cataract evaluation and management.

Nguyen P; Chopra V

2013-01-01

72

A sudden total loss of vision after routine cataract surgery.  

UK PubMed Central (United Kingdom)

We share our experience of a 50-year-old controlled hypertensive woman who had routine cataract surgery in her left eye. She was given retrobulbar Xylocaine with adrenalin and postoperative gentamycin. She subsequently became blind in the operated eye after developing macular infarction by the first day post operative and optic atrophy by 2 months postoperative. This could have been caused by vascular occlusion in an already compromised artherosclerosed vessels. It could also have been due to gentamyin toxicity. Gentamycin injection given subconjunctivally is known to rarely result in severe retinal toxicity. This case illustrates that even though cataract surgery is considerd a simple routine procedure, and is performed in high volumes, it is not without its blinding complications. We recommend that the use of adrenaline in xylocaine should be used with caution in hypertensive patients and also the routine use of subconjunctival gentamycin injection after cataract surgery should be reviewed and other modes of endophthalmitis prophylaxis be considered.

Lartey S; Armah P; Ampong A

2013-06-01

73

Cataract and cognitive impairment: a review of the literature.  

UK PubMed Central (United Kingdom)

Acquired cataract and cognitive impairment are both common age-related problems, and ophthalmologists are increasingly likely to encounter patients who have both. Patients with dementia types who display early visuoperceptual impairment may present first to ophthalmology services. When these patients have coexisting cataract, it may be difficult to distinguish visual complaints due to cataract from those due to dementia. The interaction between visual impairment due to cataract and neurodegenerative disorders affecting the central visual pathways, is not fully understood. Visual impairment due to cataract may stress impaired attentional mechanisms and cataract extraction may improve cognitive performance in some patients with early cognitive impairment; however, the benefits of cataract surgery in established dementia are less clear. In this study, the literature on this subject was reviewed and the implications for practice were considered.

Jefferis JM; Mosimann UP; Clarke MP

2011-01-01

74

Cataract and cognitive impairment: a review of the literature.  

Science.gov (United States)

Acquired cataract and cognitive impairment are both common age-related problems, and ophthalmologists are increasingly likely to encounter patients who have both. Patients with dementia types who display early visuoperceptual impairment may present first to ophthalmology services. When these patients have coexisting cataract, it may be difficult to distinguish visual complaints due to cataract from those due to dementia. The interaction between visual impairment due to cataract and neurodegenerative disorders affecting the central visual pathways, is not fully understood. Visual impairment due to cataract may stress impaired attentional mechanisms and cataract extraction may improve cognitive performance in some patients with early cognitive impairment; however, the benefits of cataract surgery in established dementia are less clear. In this study, the literature on this subject was reviewed and the implications for practice were considered. PMID:20807709

Jefferis, J M; Mosimann, U P; Clarke, M P

2010-08-31

75

Evaluation of povidone-iodine applications in cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available As a routine measure to prevent intraocular inflammation, rinsing conjunctival sac with povidone-iodine(PVP-I)has been increasingly adopted in cataract surgery. It can effectively reduce the complications of cataract surgery, including endophthalmitis and corneal complications. However, PVP-I itself has certain side effects. Therefore, to achieve the best bactericidal effect and to avoid eye injury, it is necessary to find out the optimal treatment duration and concentration. This article offers a review on the latest researches worldwide in this field.

Xi Zhang; Ping Wang

2013-01-01

76

Limbal relaxing incision during cataract surgery.  

Science.gov (United States)

Limbal relaxing incisions are one of the more commonly performed procedures with phacoemulsification to correct preexisting astigmatism during cataract surgery. The aim of the study was to evaluate the effect and stability of limbal relaxing incisions in reducing preexisting astigmatism at the time of phacoemulsification. The study included 10 eyes in 12 patients who underwent limbal relaxing incisions during cataract surgery, with preexisting astigmatism of 1-2 diopter (D). Assessments were made preoperatively, and 1 and 3 months postoperatively. Outcome measures included uncorrected distance visual acuity, best corrected distance visual acuity and keratometric astigmatism measures. The mean preoperative and postoperative refractive astigmatism was 1.50 D (+/- 0.75D) and 0.25 D (+/- 0.25 D), respectively. There were no serious postoperative complications. Limbal relaxing incisions provide a viable option for correcting preexisting astigmatism at the time of cataract surgery with mild complications. PMID:23115958

Loncar, Valentina Lacmanovi?; Vickovi?, Ivanka Petric; Ivekovi?, Renata; Mandi?, Zdravko

2012-06-01

77

Limbal relaxing incision during cataract surgery.  

UK PubMed Central (United Kingdom)

Limbal relaxing incisions are one of the more commonly performed procedures with phacoemulsification to correct preexisting astigmatism during cataract surgery. The aim of the study was to evaluate the effect and stability of limbal relaxing incisions in reducing preexisting astigmatism at the time of phacoemulsification. The study included 10 eyes in 12 patients who underwent limbal relaxing incisions during cataract surgery, with preexisting astigmatism of 1-2 diopter (D). Assessments were made preoperatively, and 1 and 3 months postoperatively. Outcome measures included uncorrected distance visual acuity, best corrected distance visual acuity and keratometric astigmatism measures. The mean preoperative and postoperative refractive astigmatism was 1.50 D (+/- 0.75D) and 0.25 D (+/- 0.25 D), respectively. There were no serious postoperative complications. Limbal relaxing incisions provide a viable option for correcting preexisting astigmatism at the time of cataract surgery with mild complications.

Loncar VL; Vickovi? IP; Ivekovi? R; Mandi? Z

2012-06-01

78

[Cataract surgery in glaucoma patients. Perioperative aspects].  

Science.gov (United States)

The development of intraocular pressure (IOP) following standard cataract surgery is extremely dependent on the type of glaucoma and the prognosis is especially good for primary angle-closure glaucoma. Cataract extraction usually induces a mid-term and long-term increase of IOP in a well-working filtering bleb. Concerning the choice of intraocular lens (e.g. multifocal or toric) the surgeon has to consider the probability of subsequent incisional glaucoma surgery and the risk of decentration of the capsular bag (e.g. in exfoliative glaucoma or hydrophthalmos). According to the results of recent studies topical prostaglandin therapy does not seem to increase the risk of postoperative macular edema if given before cataract surgery. PMID:23519499

Dietlein, T S; Kohnen, T; Rosentreter, A; Lappas, A

2013-04-01

79

[Cataract surgery in glaucoma patients. Perioperative aspects].  

UK PubMed Central (United Kingdom)

The development of intraocular pressure (IOP) following standard cataract surgery is extremely dependent on the type of glaucoma and the prognosis is especially good for primary angle-closure glaucoma. Cataract extraction usually induces a mid-term and long-term increase of IOP in a well-working filtering bleb. Concerning the choice of intraocular lens (e.g. multifocal or toric) the surgeon has to consider the probability of subsequent incisional glaucoma surgery and the risk of decentration of the capsular bag (e.g. in exfoliative glaucoma or hydrophthalmos). According to the results of recent studies topical prostaglandin therapy does not seem to increase the risk of postoperative macular edema if given before cataract surgery.

Dietlein TS; Kohnen T; Rosentreter A; Lappas A

2013-04-01

80

Femtosecond laser-assisted cataract surgery compared with conventional cataract surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: To investigate the safety and efficacy of the Catalys (Optimedica, Santa Clara, CA, USA) femtosecond laser-assisted cataract surgery system compared with conventional phacoemulsification cataract extraction. DESIGN: Prospective, consecutive, parallel cohort study. PARTICIPANTS: The first 200 eyes undergoing conventional cataract surgery to the first 200 eyes undergoing femtosecond laser-assisted cataract surgery between April and July 2012. METHODS: Femtosecond laser-assisted cataract surgery involved anterior capsulotomy and lens fragmentation based on optical coherence tomography-guided treatment mapping. Conventional cataract surgery involved manual continuous curvilinear capsulorhexis. Both procedures were completed by standard phacoemulsification and insertion of an intraocular lens. MAIN OUTCOME MEASURES: Effective phacoemulsification time and intraoperative complication rates. RESULTS: Patient demographics were similar between both groups. There was no statistically significant difference in intraoperative complications between femtosecond laser-assisted cataract surgery and conventional surgery. There was one posterior capsule rupture in both groups (0.5%; not significant). One hundred per cent of cases treated with the femtosecond laser had a complete capsulotomy. Vacuum time decreased with experience. Effective phacoemulsification time was reduced by 70% in the femtosecond group (P?cataract surgery appears to be as safe as conventional cataract surgery in the short term and results in significantly lower effective phacoemulsification time. Although it may allow for greater efficiency and decreased postoperative complications, further research is needed into long-term safety aspects such as corneal endothelial cell loss.

Abell RG; Kerr NM; Vote BJ

2013-07-01

 
 
 
 
81

[Visual outcome of cataract surgery in adults].  

UK PubMed Central (United Kingdom)

INTRODUCTION: The treatment of cataract blindness is surgical, allowing restored vision. The purpose of this study was to evaluate the functional results of cataract surgery in adults in a tertiary care referral center. PATIENTS AND METHODS: Prospective study of 2012 eyes operated for adult cataract from September 1, 2009 to August 31, 2010 (12 months). The results were analyzed by the Monitoring Cataract Surgical Outcomes software (MCSO). The postoperative functional data and the causes of poor outcomes were identified. RESULTS: A total of 1044 women (51.9%) and 968 men (48.1%) underwent cataract surgery. Mean age was 65 years. Extracapsular cataract extraction (ECCE), and manual sutureless small incision cataract surgery (SICS) with posterior chamber IOL implantation in 98%, were the main surgical techniques. Functional results indicated that 45.5% of our patients had good visual acuity (?3/10) with current spectacles, 33% had limited visual acuity (1/10-2/10), and 21.6% had poor visual acuity (<1/10). The proportion of patients with good results improved with best spectacle correction to 63%, vs. 22.9% with limited visual acuity and 14.1% with poor outcomes. The causes of poor outcomes were mainly related to surgical complications (42.1%) and refractive errors (34.8%). DISCUSSION: These results are inferior to WHO standards, which recommend a rate greater than or equal to 80% for good outcomes and a rate below 5% for bad outcomes. CONCLUSION: The identification of the causes of poor outcomes underscores the importance of improving surgical skills and the need for postoperative refraction.

Guirou N; Napo A; Dougnon A; Bakayoko S; Sidibé F; Sidibé MK; Conaré I; Traoré L; Traoré J

2013-01-01

82

The carbon footprint of cataract surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: Climate change is predicted to be one of the largest global health threats of the 21st century. Health care itself is a large contributor to carbon emissions. Determining the carbon footprint of specific health care activities such as cataract surgery allows the assessment of associated emissions and identifies opportunities for reduction. AIM: To assess the carbon footprint of a cataract pathway in a British teaching hospital. METHODS: This was a component analysis study for one patient having first eye cataract surgery in the University Hospital of Wales, Cardiff. Activity data was collected from three sectors, building and energy use, travel and procurement. Published emissions factors were applied to this data to provide figures in carbon dioxide equivalents (CO2eq). RESULTS: The carbon footprint for one cataract operation was 181.8 kg CO2eq. On the basis that 2230 patients were treated for cataracts during 2011 in Cardiff, this has an associated carbon footprint of 405.4 tonnes CO2eq. Building and energy use was estimated to account for 36.1% of overall emissions, travel 10.1% and procurement 53.8%, with medical equipment accounting for the most emissions at 32.6%. CONCLUSIONS: This is the first published carbon footprint of cataract surgery and acts as a benchmark for other studies as well as identifying areas for emissions reduction. Within the procurement sector, dialogue with industry is important to reduce the overall carbon footprint. Sustainability should be considered when cataract pathways are designed as there is potential for reduction in all sectors with the possible side effects of saving costs and improving patient care.

Morris DS; Wright T; Somner JE; Connor A

2013-04-01

83

Microphakonit: 700 micron cataract surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We describe the smallest incision cataract removal technique, Microphakonit, in which bimanual phacoemulsification can be performed with a 0.7 mm phaco tip and 0.7 mm irrigating chopper. Cortical removal is done using 22 gauge or 0.7 mm irrigation/aspiration instruments. The technique was used for 2...

Agarwal, Amar; Trivedi, Rupal H; Jacob, Soosan; Agarwal, Athiya; Agarwal, Sunita

84

[The development of cataract surgery after 1745].  

Science.gov (United States)

Nowadays, cataract surgery is the most commonly performed surgical procedure in the Netherlands. This is due to the increasing incidence of cataracts, the changing indication for surgery in our society where good vision is becoming increasingly important, and the quality of the operation. How was this modern procedure developed? Cataracts were treated by couching until the middle of the 18th century. Since then, many discoveries by a number of doctors changed the procedure gradually from couching to lens extraction and through extracapsular to intracapsular extraction with the simultaneous implantation of an intraocular lens. This article outlines the development and also discusses some of the many inventions in the field of instrumentation and materials that have brought this intervention to its current high level; these include the cryo-probe, implantation of artificial lenses, the use of hyaluronic acid, phaco-emulsification, smaller incisions without sutures and the development of foldable intraocular lenses. PMID:23548190

Pouw, C A M Karin; Zegers, Richard H C

2013-01-01

85

Cataract surgery following KAMRA presbyopic implant.  

UK PubMed Central (United Kingdom)

Intrastromal corneal inlays are an emerging treatment for presbyopic patients. The KAMRA™ small aperture inlay was the first such inlay to receive Conformité Européenne (CE) marking in 2005. It has been shown to improve uncorrected near and intermediate visual acuity without adversely affecting uncorrected distance visual acuity. Due to the age of presbyopic patients, they may eventually develop cataracts. In two such cases, we found that cataract surgery with the KAMRA implant left in place was not technically more difficult, and that the surgical procedure could be improved by additional ocular rotations to improve visualization. Biometry readings were reliable, and it appeared that the SRK/T formula was accurate for calculation of intraocular lens power. Cataract surgery with the KAMRA implant left in situ is a viable option for patients.

Tan TE; Mehta JS

2013-01-01

86

Cataract surgery following KAMRA presbyopic implant  

Science.gov (United States)

Intrastromal corneal inlays are an emerging treatment for presbyopic patients. The KAMRA™ small aperture inlay was the first such inlay to receive Conformité Européenne (CE) marking in 2005. It has been shown to improve uncorrected near and intermediate visual acuity without adversely affecting uncorrected distance visual acuity. Due to the age of presbyopic patients, they may eventually develop cataracts. In two such cases, we found that cataract surgery with the KAMRA implant left in place was not technically more difficult, and that the surgical procedure could be improved by additional ocular rotations to improve visualization. Biometry readings were reliable, and it appeared that the SRK/T formula was accurate for calculation of intraocular lens power. Cataract surgery with the KAMRA implant left in situ is a viable option for patients.

Tan, Tien-En; Mehta, Jodhbir S

2013-01-01

87

Uptake of cataract surgery in Sava Region, Madagascar: role of cataract case finders in acceptance of cataract surgery.  

UK PubMed Central (United Kingdom)

The number of people coming for cataract surgery in Madagascar remains low and most ophthalmologists could do many more surgeries than currently done. Knowing why people identified with cataract do not accept surgery will help to design programs that use existing resources more effectively. The study was carried out in Sava Region of Madagascar. People with blinding (<6/60) cataract were identified by cataract case finders in the community, interviewed, and given a referral card for surgery at the hospital. We then monitored uptake of surgery at the hospital. Overall, 142 people were identified, interviewed and referred. Among the referrals, 35 (24.6%) presented at the hospital for surgery. The most important factors associated with acceptance were proximity to hospital (people from Sambava district were twice as likely to present as people from more distant districts) and perceived price of transport and food (being higher for people not accepting). The actual price of surgery was not the main barrier to acceptance of surgery; instead it appears that distance to the hospital and the willingness to pay are important predictors. Strategies to improve uptake need to be revised in order to ensure that people have access to and use cataract surgical services.

Razafinimpanana N; Nkumbe H; Courtright P; Lewallen S

2012-04-01

88

A Virtual Cataract Surgery Course for Ophthalmologists-in-Training.  

UK PubMed Central (United Kingdom)

Virtual reality (VR) surgery simulation is an emerging teaching tool to train residents in cataract surgery. The widespread adoption of virtual surgery has been limited, however, by high costs and the absence of standardized curricula and evidence demonstrating the impact of VR training on resident surgical outcomes. We outline a resident virtual cataract surgery course-freely accessible online-that we hope will contribute to the development of a standardized VR cataract surgery curriculum.

Li E; Fay P; Greenberg PB

2013-01-01

89

Small incision cataract surgery: tips for avoiding surgical complications  

Directory of Open Access Journals (Sweden)

Full Text Available Small incision cataract surgery (SICS) is one of the cataract surgical techniques commonly used in developing countries. This technique usually results in a good visual outcome and is useful for high-volume cataract surgery.1–3This article describes how to minimise surgical complications in SICS.

Reeta Gurung; Albrecht Hennig

2008-01-01

90

Cataract surgery following KAMRA presbyopic implant  

Directory of Open Access Journals (Sweden)

Full Text Available Tien-En Tan,1,2 Jodhbir S Mehta2–4 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 2Singapore National Eye Centre, Singapore; 3Singapore Eye Research Institute, Singapore; 4Department of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore Abstract: Intrastromal corneal inlays are an emerging treatment for presbyopic patients. The KAMRA™ small aperture inlay was the first such inlay to receive Conformité Européenne (CE) marking in 2005. It has been shown to improve uncorrected near and intermediate visual acuity without adversely affecting uncorrected distance visual acuity. Due to the age of presbyopic patients, they may eventually develop cataracts. In two such cases, we found that cataract surgery with the KAMRA implant left in place was not technically more difficult, and that the surgical procedure could be improved by additional ocular rotations to improve visualization. Biometry readings were reliable, and it appeared that the SRK/T formula was accurate for calculation of intraocular lens power. Cataract surgery with the KAMRA implant left in situ is a viable option for patients. Keywords: cataract surgery, KAMRA, corneal inlay, AcuTarget, presbyopia

Tan TE; Mehta JS

2013-01-01

91

Uptake of cataract surgery in Sava Region, Madagascar: role of cataract case finders in acceptance of cataract surgery.  

Science.gov (United States)

The number of people coming for cataract surgery in Madagascar remains low and most ophthalmologists could do many more surgeries than currently done. Knowing why people identified with cataract do not accept surgery will help to design programs that use existing resources more effectively. The study was carried out in Sava Region of Madagascar. People with blinding (Sambava district were twice as likely to present as people from more distant districts) and perceived price of transport and food (being higher for people not accepting). The actual price of surgery was not the main barrier to acceptance of surgery; instead it appears that distance to the hospital and the willingness to pay are important predictors. Strategies to improve uptake need to be revised in order to ensure that people have access to and use cataract surgical services. PMID:22430293

Razafinimpanana, Narivony; Nkumbe, Henry; Courtright, Paul; Lewallen, Susan

2012-03-20

92

The impact of bilateral or unilateral cataract surgery on visual functioning: when does second eye cataract surgery benefit patients?  

UK PubMed Central (United Kingdom)

AIM: To examine the impact of bilateral or unilateral cataract surgery on visual functioning. METHODS: The Singapore Malay Eye Study is a population-based study of 3280 Singapore Malay patients aged 40-80 years, of which 3225 had data available for inclusion. Cataracts were graded from digital lens photographs according to the Wisconsin scale. Study subjects were categorised as having: bilateral cataract surgery performed; unilateral cataract surgery performed with minimal cataract in the fellow eye; unilateral cataract surgery performed with significant cataract in the fellow eye; and bilateral cataract. Visual functioning was assessed using the modified VF-9 scale culturally adapted for Singaporean individuals, validated by Rasch analysis. The overall Rasch-modified vision-specific functioning score was compared across the four groups after adjusting for confounders such as age, gender, ocular and systemic comorbidities. RESULTS: Persons with bilateral cataract had poorer visual functioning than those who had bilateral cataract surgery (mean visual functioning scores 3.38 vs 3.11, respectively, p=0.029). When compared with bilateral surgery, visual functioning improvements among patients with unilateral cataract surgery depended on the status of the fellow eye, with improvements only seen if the fellow eye had significant cataract (mean visual functioning scores 2.81 vs 3.25, p=0.019) or poor visual acuity (mean visual functioning scores 2.78 vs 3.25, p=0.018) after adjusting for confounders. CONCLUSIONS: Bilateral cataract surgery was associated with greater visual functioning over unilateral cataract surgery when the fellow eye had a significant cataract or poor presenting visual acuity, supporting the current practice of second eye surgery depending on the fellow eye's cataract status and visual acuity.

Tan AC; Tay WT; Zheng YF; Tan AG; Wang JJ; Mitchell P; Wong TY; Lamoureux EL

2012-06-01

93

The role of femtolaser in cataract surgery.  

Science.gov (United States)

Having been very successful in corneal surgery, femtolasers were recently introduced into the surgery of crystalline lens. The most important indications and advantages include: perfectly centered and sized capsulotomy, liquefaction of softer lenses and fragmentation of harder lenses which allows for chopping the nucleus without the use of phaco energy. Femtolaser can also be used for creating corneal wounds (tunnels) of any size at any location, and in order to manage the preoperative astigmatism using arcuate incisions at the desired depth within the cornea. Because of controlled steps in cataract surgery, wide acceptance and spread is to be expected. PMID:23461165

Nagy, Zoltán Z; Szaflik, Jacek P

2012-01-01

94

The role of femtolaser in cataract surgery.  

UK PubMed Central (United Kingdom)

Having been very successful in corneal surgery, femtolasers were recently introduced into the surgery of crystalline lens. The most important indications and advantages include: perfectly centered and sized capsulotomy, liquefaction of softer lenses and fragmentation of harder lenses which allows for chopping the nucleus without the use of phaco energy. Femtolaser can also be used for creating corneal wounds (tunnels) of any size at any location, and in order to manage the preoperative astigmatism using arcuate incisions at the desired depth within the cornea. Because of controlled steps in cataract surgery, wide acceptance and spread is to be expected.

Nagy ZZ; Szaflik JP

2012-01-01

95

Clinical applications of Scheimpflug imaging in cataract surgery.  

UK PubMed Central (United Kingdom)

Since the Scheimpflug principle was first described over a century ago, there has been a great interest among ophthalmologists for the use of Scheimpflug camera in anterior segment imaging. Scheimpflug imaging has since advanced significantly and modern day instruments provide comprehensive imaging and topographic data of the anterior segment. In this article the clinical applications and limitations of Scheimpflug imaging in modern cataract surgery patients are discussed. This article reviews recent work on assessment of lens transparency for cataract grading and integrity, using preoperative lens density measurements to help predict phacoemulsification parameters, its utility in challenging situations like capsular bag distension syndrome and traumatic cataract and assessment of density of the posterior capsule for objectively quantifying posterior-capsule opacification.

Grewal DS; Grewal SP

2012-01-01

96

Predicting activity and satisfaction following cataract surgery.  

UK PubMed Central (United Kingdom)

This was the second in a series of studies intended to develop a method for predicting the degree of recovery and satisfaction of elderly patients following cataract surgery. Sixty-six patients (mean age, 68 years; 27 men and 39 women) completed an activity questionnaire and a series of walking, reaching, and hand-eye coordination tasks 1 day prior to cataract surgery. An average of 6 months later, the patients completed the activity questionnaire and some of the motor tasks again and then made a four-point assessment of satisfaction with their recovery. Postoperative reaching, walking, activity, and satisfaction ere all positively correlated with scores on some of the preoperative tasks. Together with earlier published data, these data also show that patients report less postoperative activity after an eyeglass correction than after a lens-implant or contact-lens correction.

Donderi DC; Murphy SB

1983-09-01

97

Cataract and its surgery in Fiji.  

UK PubMed Central (United Kingdom)

BACKGROUND: To characterize cataract and its surgery among adults aged ?40 years in Fiji. DESIGN: Population-based cross-sectional survey using multistage cluster random sampling. PARTICIPANTS: 1381 (= 73.0% participation); eight provinces on Viti Levu. METHODS: Interview-based questionnaire; visual acuity measured; autorefraction; dilated ocular examination. MAIN OUTCOME MEASURES: Prevalence; predictors; surgical outcomes. RESULTS: Being Indian (P = 0.001), elderly (P < 0.001), and previous/current smoker (P = 0.036) were predictive of at least one unoperated vision-impairing or operated cataract. Gender (P = 0.062) and diabetes (P = 0.384) were not. Unoperated cataract (predominantly nucleosclerosis) was the second most frequent (25.0%) cause of low vision (<6/18, ?6/60) and commonest (71.1%) of blindness (<6/60). Ethnicity-gender-age-domicile adjusted and extrapolating to the Fiji population aged ?40 years, prevalence of cataract-induced low vision and blindness were each 1.7% (95% confidence interval [CI] 1.0-2.4%). At least one eye of 4.6% and both of 1.8% participants had surgery (86.4% extracapsular). Gender (P = 0.213), age (P = 0.472) and rural/urban domicile (P = 0.895) were not predictors of surgery among those who required it in at least one eye. After intraocular lens surgery: 50.7% had pupillary posterior capsular opacification; mean spherical equivalent was -1.37 ± 1.95D (range, -6.38 to +2.25D); mean cylindrical error was 2.31 ± 1.75D (range, 0.0 to 8.75D); ?N8 for 39.5%; ?6/18 for 56.6%; <6/60 for 19.7%, with 2.6% no light perception. Ethnicity-gender-age-domicile adjusted and extrapolating to the Fiji population aged ?40 years, Cataract Surgical Coverage (Person) was 47.5% (95%CI 29.2-65.8%) at <6/18, and 65.2% (95%CI 37.8-92.6%) at <6/60. CONCLUSIONS: Fiji cataract services and outcomes compare favourably with those of neighbouring Papua New Guinea and Timor Leste.

Brian G; Ramke J; Szetu J; Qoqonokana MQ

2011-07-01

98

Improving the operative rate for cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To establish a cataract referral patient pathway that is of high quality and of greater efficiency and to compare the operative rates (conversion to surgery from referral) for patients referred via the new refined direct optometrist (RDO) pathway and for those referred by general practitioners (GPs). SETTING: Bristol Eye Hospital, Bristol, United Kingdom. DESIGN: Cohort study. METHODS: A retrospective cohort of patients referred to the "1-stop cataract clinic" at Bristol Hospital Eye Service between November 1, 2008, and May 31, 2010, were identified. The operative rates between the 2 pathways were compared. RESULTS: Of the patients, 4657 were referred; 4222 were referred via the traditional GP route and 435 via the RDO route. Operative rates (conversion to surgery from referral) were higher for the RDO pathway than for the GP pathway (91.9% versus 82.4%) (P=.0043). CONCLUSIONS: By combining referral information from optometrists and GPs, a high-quality and efficient cataract surgery patient pathway can be established. This has major economic advantages, and this scheme could be adopted at a national level.

Holmes K; Park J; Tole D

2013-05-01

99

Surgical blade for cataract surgery  

UK PubMed Central (United Kingdom)

Production of a scalpel blade used in cataract operations comprises hot isostatically pressing the blade as a porous crude form, lapping, pre-grinding to form a blade, polishing and cleaning the blade, and coating with an amorphous carbon Production of a scalpel blade made from a ceramic comprises hot isostatically pressing the blade as a porous crude form in a noble gas atmosphere to bond the pores; lapping the crude form having the bonded pores; pre-grinding the lapped crude form to form a blade; polishing and cleaning the blade; and coating with an amorphous carbon. Preferred Features: The hot isostatic pressing is carried out at a pressure of 1350 bar and a temperature of 1960 degrees C. The noble gas is argon. The lapping is carried out using a monocrystalline diamond powder having a grain size of 0.5-0.75 mu m and polished with a monocrystalline diamond powder having a grain size of maximum 0.1 mu m.

Die Erfindernennung liegt noch nicht vor

100

Simultaneous bilateral cataract surgery: economic analysis; Helsinki Simultaneous Bilateral Cataract Surgery Study Report 2.  

UK PubMed Central (United Kingdom)

PURPOSE: To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. SETTING: Helsinki University Eye Hospital, Helsinki, Finland. DESIGN: Economic analysis. METHODS: Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. RESULTS: The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included. CONCLUSION: Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care-related costs. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Leivo T; Sarikkola AU; Uusitalo RJ; Hellstedt T; Ess SL; Kivelä T

2011-06-01

 
 
 
 
101

The Impact on Vision of Aspheric to Spherical Monofocal Intraocular Lenses in Cataract Surgery: A Systematic Review with Meta-analysis.  

Science.gov (United States)

PURPOSE: To provide a summary of the impact on vision of an aspheric intraocular lens (IOL) compared with a spherical IOL in cataract surgery. DESIGN: Systematic review with meta-analysis. PARTICIPANTS: Patients from published randomized controlled trials (RCTs) of cataract surgery with aspheric compared with spherical monofocal IOL implantation. METHODS: We systematically searched the peer-reviewed literature in MEDLINE, EMBASE, Web of Science, BIOSIS, and the Cochrane Library according to the Cochrane Collaboration method to identify relevant RCTs. The inclusion criteria were RCTs on cataract surgery comparing the use of aspheric versus spherical IOL implantation that assessed visual acuity, contrast sensitivity, or quality of vision. The effects were calculated as mean differences or standardized mean differences (Hedges' g) and pooled using random-effect models. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), contrast sensitivity, and subjective perception of the quality of vision. RESULTS: Forty-three studies provided data and were included, comprising 2076 eyes implanted with aspheric IOLs and 2034 eyes implanted with spherical IOLs. The BCVA showed a significant difference for aspheric IOLs (-0.01 logarithm of the minimum angle of resolution; 95% confidence interval [CI], -0.02 to -0.00). For contrast sensitivity, a significant advantage for aspheric IOLs was found under photopic and mesopic light conditions (photopic: Hedges' g 0.42, 95% CI 0.24-0.61 (3 cycles per degree [cpd]) to 0.53, 95% CI 0.33-0.73 (12 cpd); mesopic: Hedges' g 0.49, 95% CI 0.23-0.75 (1.5 cpd) to 0.76, 95% CI 0.52-1.00 (18 cpd)). Questionnaires targeting the subjective perception of quality of vision yielded less conclusive results. CONCLUSIONS: Overall, a patient may achieve better contrast sensitivity with an aspheric IOL than with a spherical IOL, especially under dim light. There was no clinically relevant difference in BCVA between aspheric and spherical IOL implantation. The findings on the subjective perception of visual quality were heterogeneous with no clear result favoring either option. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article. PMID:23751220

Schuster, Alexander K; Tesarz, Jonas; Vossmerbaeumer, Urs

2013-06-01

102

The Impact on Vision of Aspheric to Spherical Monofocal Intraocular Lenses in Cataract Surgery: A Systematic Review with Meta-analysis.  

UK PubMed Central (United Kingdom)

PURPOSE: To provide a summary of the impact on vision of an aspheric intraocular lens (IOL) compared with a spherical IOL in cataract surgery. DESIGN: Systematic review with meta-analysis. PARTICIPANTS: Patients from published randomized controlled trials (RCTs) of cataract surgery with aspheric compared with spherical monofocal IOL implantation. METHODS: We systematically searched the peer-reviewed literature in MEDLINE, EMBASE, Web of Science, BIOSIS, and the Cochrane Library according to the Cochrane Collaboration method to identify relevant RCTs. The inclusion criteria were RCTs on cataract surgery comparing the use of aspheric versus spherical IOL implantation that assessed visual acuity, contrast sensitivity, or quality of vision. The effects were calculated as mean differences or standardized mean differences (Hedges' g) and pooled using random-effect models. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), contrast sensitivity, and subjective perception of the quality of vision. RESULTS: Forty-three studies provided data and were included, comprising 2076 eyes implanted with aspheric IOLs and 2034 eyes implanted with spherical IOLs. The BCVA showed a significant difference for aspheric IOLs (-0.01 logarithm of the minimum angle of resolution; 95% confidence interval [CI], -0.02 to -0.00). For contrast sensitivity, a significant advantage for aspheric IOLs was found under photopic and mesopic light conditions (photopic: Hedges' g 0.42, 95% CI 0.24-0.61 (3 cycles per degree [cpd]) to 0.53, 95% CI 0.33-0.73 (12 cpd); mesopic: Hedges' g 0.49, 95% CI 0.23-0.75 (1.5 cpd) to 0.76, 95% CI 0.52-1.00 (18 cpd)). Questionnaires targeting the subjective perception of quality of vision yielded less conclusive results. CONCLUSIONS: Overall, a patient may achieve better contrast sensitivity with an aspheric IOL than with a spherical IOL, especially under dim light. There was no clinically relevant difference in BCVA between aspheric and spherical IOL implantation. The findings on the subjective perception of visual quality were heterogeneous with no clear result favoring either option. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Schuster AK; Tesarz J; Vossmerbaeumer U

2013-06-01

103

Cost-effectiveness of cataract surgery in Japan.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the cost-effectiveness of cataract surgery through measurement of the cost per quality-adjusted life-year (QALY) in Japan. METHODS: A total of 549 patients scheduled for cataract surgery at 12 clinical sites from November 2008 through February 2010 were included in the study. Prospective assessment of patient preference-based quality of life (utility) was performed before and after the surgery using the time tradeoff method, EuroQol, and Health Utilities Index Mark 3. Multiple regression analysis was used to determine the correlation between utility and visual acuity. The QALYs gained through cataract surgery were estimated, and cost-utility analysis was performed. RESULTS: The utilities significantly correlated with the visual acuity in the better seeing eye. In all the subgroups (first eye surgery, second eye surgery, and bilateral surgery), mean utility improvement was statistically significant. Average QALYs for unilateral cataract surgery and bilateral cataract surgery were 2.40 and 3.40, respectively. The cost per QALY gained from surgery was estimated at ¥122,472 (US $1,307) for unilateral surgery and ¥145,562 (US $1,553) for bilateral surgery. CONCLUSIONS: Routine cataract surgery in Japan is highly cost-effective. Factors that contribute to this are the high clinical effectiveness of the surgery, the substantial improvement in patient-perceived quality of life, and the reasonable cost of the surgery.

Hiratsuka Y; Yamada M; Murakami A; Okada AA; Yamashita H; Ohashi Y; Yamagishi N; Tamura H; Fukuhara S; Takura T

2011-07-01

104

Republished review: cataract and cognitive impairment: a review of the literature.  

Science.gov (United States)

Acquired cataract and cognitive impairment are both common age-related problems, and ophthalmologists are increasingly likely to encounter patients who have both. Patients with dementia types who display early visuoperceptual impairment may present first to ophthalmology services. When these patients have coexisting cataract, it may be difficult to distinguish visual complaints due to cataract from those due to dementia. The interaction between visual impairment due to cataract and neurodegenerative disorders affecting the central visual pathways, is not fully understood. Visual impairment due to cataract may stress impaired attentional mechanisms and cataract extraction may improve cognitive performance in some patients with early cognitive impairment; however, the benefits of cataract surgery in established dementia are less clear. In this study, the literature on this subject was reviewed and the implications for practice were considered. PMID:21862502

Jefferis, J M; Mosimann, U P; Clarke, M P

2011-09-01

105

Republished review: cataract and cognitive impairment: a review of the literature.  

UK PubMed Central (United Kingdom)

Acquired cataract and cognitive impairment are both common age-related problems, and ophthalmologists are increasingly likely to encounter patients who have both. Patients with dementia types who display early visuoperceptual impairment may present first to ophthalmology services. When these patients have coexisting cataract, it may be difficult to distinguish visual complaints due to cataract from those due to dementia. The interaction between visual impairment due to cataract and neurodegenerative disorders affecting the central visual pathways, is not fully understood. Visual impairment due to cataract may stress impaired attentional mechanisms and cataract extraction may improve cognitive performance in some patients with early cognitive impairment; however, the benefits of cataract surgery in established dementia are less clear. In this study, the literature on this subject was reviewed and the implications for practice were considered.

Jefferis JM; Mosimann UP; Clarke MP

2011-09-01

106

Phacoemulsification cataract surgery in vitrectomized eyes.  

UK PubMed Central (United Kingdom)

PURPOSE: To determine the problems, safety, and results of phacoemulsification cataract surgery in previously vitrectomized eyes. SETTING: Department of Ophthalmology of Galdácano Hospital, Galdacano, Spain. METHODS: In this prospective study, phacoemulsification was performed in 23 eyes that had had vitrectomy between February 1992 and May 1994. Surgical and postsurgical difficulties and complications and visual acuity results were analyzed. Follow-up ranged from 12 to 24 months. RESULTS: The incidence of surgical problems and complications was higher than usual: 7 eyes presented small pupil size (< 3.0 mm); sudden changes in anterior chamber depth and pupil size during surgery occurred in 6 eyes; unusual mobility and flaccidity of the posterior capsule was observed in 6 cases, which was associated with posterior subcapsular cataract and young age (< 50 years); posterior capsule tear occurred in 2 eyes, 1 of which required anterior vitrectomy. Postoperatively, best visual acuity improved two Snellen lines or more in 17 eyes (73.91%), did not change in 3 (13.04%), and worsened in 3. CONCLUSION: Phacoemulsification in vitrectomized eyes presented more problems and complications than usual. However, it seems to be safer than manual extracapsular surgery because it minimized the risk of intraoperative eye hypotony or collapse.

Díaz Lacalle V; Orbegozo Gárate FJ; Martinez Alday N; López Garrido JA; Aramberri Agesta J

1998-06-01

107

Monitoring visual outcome of cataract surgery in India.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Two simple methods of assessing visual outcome following cataract surgery were evaluated in India. The first used data obtained from standardized patient records of cataract surgery. The second used data from population-based rapid epidemiological assessments. Analysis of 4168 hospital and eye camp ...

Limburg, H.; Foster, A.; Vaidyanathan, K.; Murthy, G. V.

108

Increasing incidence of cataract surgery: Population-based study.  

UK PubMed Central (United Kingdom)

PURPOSE: To estimate the incidence of cataract surgery in a defined population and to determine longitudinal cataract surgery patterns. SETTING: Mayo Clinic, Rochester, Minnesota, USA. DESIGN: Cohort study. METHODS: Rochester Epidemiology Project (REP) databases were used to identify all incident cataract surgeries in Olmsted County, Minnesota, between January 1, 2005, and December 31, 2011. Age-specific and sex-specific incidence rates were calculated and adjusted to the 2010 United States white population. Data were merged with previous REP data (1980 to 2004) to assess temporal trends in cataract surgery. Change in the incidence over time was assessed by fitting generalized linear models assuming a Poisson error structure. The probability of second-eye cataract surgery was calculated using the Kaplan-Meier method. RESULTS: Included were 8012 cataract surgeries from 2005 through 2011. During this time, incident cataract surgery significantly increased (P<.001), peaking in 2011 with a rate of 1100 per 100?000 (95% confidence interval, 1050-1160). The probability of second-eye surgery 3, 12, and 24 months after first-eye surgery was 60%, 76%, and 86%, respectively, a significant increase compared with the same intervals in the previous 7 years (1998 to 2004) (P<.001). When merged with 1980 to 2004 REP data, incident cataract surgery steadily increased over the past 3 decades (P<.001). CONCLUSION: Incident cataract surgery steadily increased over the past 32 years and has not leveled off, as reported in Swedish population-based series. Second-eye surgery was performed sooner and more frequently, with 60% of residents having second-eye surgery within 3 months of first-eye surgery. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Gollogly HE; Hodge DO; St Sauver JL; Erie JC

2013-09-01

109

Cataracts  

Medline Plus

Full Text Available ... resting for a while in a recovery area. Risks and complications Cataract surgery is a very safe and successful operation. Risks and complications are, however, possible; knowing about them ...

110

Cataracts  

Medline Plus

Full Text Available ... home after resting for a while in a recovery area. Risks and complications Cataract surgery is a ... instructions is essential for a good and speedy recovery. It may take six weeks before the eye ...

111

Recent advances in femtosecond laser-assisted cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Perfect vision and fewer complications is our goal in cataract surgery, femtosecond laser-assisted cataract surgery hold the promise. Applications of femtosecond laser technology for capsulotomy, nuclear fragmentation and corneal incision in cataract surgery bring a new level of accuracy, reproducibility and predictability over the current cataract surgery. The femtosecond laser produces capsulotomies that are more precise, accurate, reproducible, and stronger than those created with the conventional manual technique, and further helps maintain proper positioning of the IOL. Femtosecond laser in nuclear fragmentation lead to a lower effective phacoemulsification time, and the corneal incision is more stable. But currently there are some complications and a clear learning curve associated with the use of femtosecond lasers for cataract surgery. The long-term safety and visual outcomes still need further investigation.

Zhao-Jie Chu; Dan-Yu Gao

2013-01-01

112

Anterior chamber flare after femtosecond laser-assisted cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To determine whether postoperative ocular inflammation is less after femtosecond laser-assisted cataract surgery than after conventional phacoemulsification (manual) cataract surgery. SETTING: Private clinic, Launceston, Tasmania, Australia. DESIGN: Prospective consecutive investigator-masked nonrandomized parallel cohort study. METHODS: Consecutive cataract patients who had femtosecond laser-assisted cataract surgery or manual cataract surgery by the same surgeon at a single center were assessed. The primary endpoint was postoperative aqueous flare measured by laser flare photometry at 1 day and 4 weeks. Secondary endpoints included retinal thickness measured by optical coherence tomography and slitlamp examination findings at 4 weeks. RESULTS: The per-protocol population comprised 176 patients (100 in laser group; 76 in manual group). Postoperative aqueous flare was significantly greater in the manual cataract surgery group at 1 day (P=.0089) and at 4 weeks (P=.003). There was a significant correlation between effective phacoemulsification time and 1-day postoperative aqueous flare (r = 0.35, P<.0001). The increase in outer zone thickness measured by optical coherence tomography was less in the laser group (P=.007). CONCLUSION: Anterior segment inflammation was less after femtosecond laser-assisted cataract surgery than after manual cataract surgery, and this appeared to be due to a reduction in phacoemulsification energy. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Abell RG; Allen PL; Vote BJ

2013-09-01

113

Endophthalmitis following cataract surgery: the role of prophylactic postoperative chloramphenicol eye drops.  

UK PubMed Central (United Kingdom)

PURPOSE: The main aim of the study was to assess whether omitting prophylactic postoperative topical antibiotics (chloramphenicol) influenced the risk of developing endophthalmitis after cataract surgery. METHODS: We conducted a retrospective study including all patients who had cataract surgery at our outpatient cataract unit between 2004 and 2011. Postoperative topical antibiotics (chloramphenicol) were omitted from 2007 onwards, as was the first postoperative day review. Patients with a diagnosis of endophthalmitis after cataract surgery were extracted, and the rate of postoperative endophthalmitis (PE) before and after changing these routines was compared. The diagnosis of PE was defined as severe intraocular inflammation requiring prompt vitreous sampling for culture. RESULTS: Seven thousand one hundred and twenty-three and 8131 cataract surgeries were performed in the following periods: January 2004 through December 2006 (period 1) and January 2007 through December 2010 (period 2), respectively. Five cases of PE were identified in period 1 (0.070%) and four patients in period 2 (0.049%). The median time between cataract surgery and onset of symptoms was 6 days in period 1 and 4.5 days in period 2. Median time for intervention was 7 and 5 days postsurgery, respectively. CONCLUSION: We found no difference in the frequency of PE following cataract surgery when changing the postoperative topical medication from a mixture of corticosteroids and antibiotics to only corticosteroids.

Råen M; Sandvik GF; Drolsum L

2013-03-01

114

Cataract surgery in aged patients: phacoemulsification or small-incision extracapsular cataract surgery.  

UK PubMed Central (United Kingdom)

AIM: To evaluate the effects and safety of phacoemulsification (Phaco) or small-incision extracapsular cataract surgery (SICS) and intraocular lens (IOL) implantation for aged patients. METHODS: Totally 137 aged patients (149 eyes) underwent cataract operation in the case of stable systemic condition, the blood pressure less than 160/95mmHg, blood glucose less than 8mmol/L, and under the help of electrocardiogram surveillance by anesthesiologists during the operation. 106 aged patients (114 eyes) underwent Phaco while 31 aged patients (35 eyes) underwent SICS. The postoperative visual acuity, corneal endothelial cell loss, surgery time and major complications were observed and analyzed retrospectively. RESULTS: The best-corrected visual acuity(BCVA) of ?0.6 was achieved in 135 eyes (92.6%) at 1 month postoperatively (?(2)=259.730, P<0.001). For aged patients, both Phaco and SICS could significantly improve visual acuity with no significant difference (?(2)=4.535, P>0.05). Postoperative corneal endothelial cell loss was 18.6%, in PHACO group, the rate was 18.5%; in SICS group, the rate was 19.0%, the difference of which was no significant (?(2)=0.102, P>0.05). The surgery time was different in two groups. No severe complications occurred. CONCLUSION: Both Phaco and SICS combined with IOL implantation for aged patients are effective and safe. Before surgery, detailed physical examination should be performed. When the systemic condition is stable, cataract surgery for aged patients is safe.

Jiang T; Jiang J; Zhou Y; Zhao GQ; Li H; Zhao SY

2011-01-01

115

Feasibility and Complications between Phacoemulsification and Manual Small Incision Surgery in Subluxated Cataract  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Purpose. To compare the feasibility of cataract surgery with implantation of endocapsular supporting devices and intraocular lens (IOL) in subluxated cataract in phacoemulsification and manual small incision cataract surgery (MSICS). Design. Prospective randomized intervention case series consistin...

Goel, Ruchi; Kamal, Saurabh; Kumar, Sushil; Kishore, Jugal; Malik, K. P. S.; Angmo Bodh, Sonam; Bansal, Smriti; Singh, Madhu

116

Cataract Surgery Tied to Lower Death Risk for Patients with Vision Loss  

Science.gov (United States)

... sharing features on this page, please enable JavaScript. Cataract Surgery Tied to Lower Death Risk for Patients With ... News) -- Beside enjoying better eyesight, people who undergo cataract surgery may see another advantage: Those with cataract-related ...

117

Anaphylactic reaction following intracameral cefuroxime injection during cataract surgery.  

UK PubMed Central (United Kingdom)

UNLABELLED: We report a patient who developed an anaphylactic reaction several minutes after intracameral injection of cefuroxime at the end of uneventful phacoemulsification and intraocular lens implantation surgery. The patient had a known allergy to penicillin but not to cefuroxime. This rare life-threatening complication was recognized and immediately treated by the surgeon. The literature on the use of intracameral cefuroxime for endophthalmitis prophylaxis and its risk for anaphylaxis is reviewed. Cataract surgeons should be aware of this potentially fatal complication and be prepared to handle it. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.

Moisseiev E; Levinger E

2013-09-01

118

Outbreak of Ochrobactrum anthropi endophthalmitis following cataract surgery.  

Science.gov (United States)

Postoperative endophthalmitis often progresses to significant visual impairment. This paper describes an outbreak of Ochrobactrum anthropi endophthalmitis following cataract surgery, and propose a new sterilization protocol to minimize the risk of further cases. Medical records of patients with O. anthropi endophthalmitis or with suggestive clinical findings during the outbreak were reviewed. Seven cases of O. anthropi pseudophakic endophthalmitis were confirmed between 24 July and 10 November 2010. The most probable cause of the outbreak of Ochrobactrum anthropi endophthalmitis was contamination of the tubing of the phaco-emulsification machine. Following introduction of a new sterilization protocol, no further cases occurred in over 1000 subsequent procedures. PMID:23415718

Mattos, F B; Saraiva, F P; Angotti-Neto, H; Passos, A F

2013-02-14

119

Outbreak of Ochrobactrum anthropi endophthalmitis following cataract surgery.  

UK PubMed Central (United Kingdom)

Postoperative endophthalmitis often progresses to significant visual impairment. This paper describes an outbreak of Ochrobactrum anthropi endophthalmitis following cataract surgery, and propose a new sterilization protocol to minimize the risk of further cases. Medical records of patients with O. anthropi endophthalmitis or with suggestive clinical findings during the outbreak were reviewed. Seven cases of O. anthropi pseudophakic endophthalmitis were confirmed between 24 July and 10 November 2010. The most probable cause of the outbreak of Ochrobactrum anthropi endophthalmitis was contamination of the tubing of the phaco-emulsification machine. Following introduction of a new sterilization protocol, no further cases occurred in over 1000 subsequent procedures.

Mattos FB; Saraiva FP; Angotti-Neto H; Passos AF

2013-04-01

120

Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results  

Science.gov (United States)

Background Stenotrophomonas maltophilia is a Gram-negative organism known to cause opportunistic infections. It is a rare source of endophthalmitis, often in the setting of trauma, but has been reported following cataract extraction. The purpose of this study was to evaluate antimicrobial sensitivities, clinical characteristics, and treatment outcomes in patients with endophthalmitis caused by S. maltophilia following cataract extraction. Methods A retrospective case review of records from January 1, 1990 to June 30, 2010 was performed at the Bascom Palmer Eye Institute. Results Eight cases of S. maltophilia endophthalmitis were identified following cataract surgery. Initial visual acuity ranged from 20/200 to light perception. Time to diagnosis with cultures was 2–118 days. Patients received either intravitreal tap and inject (n = 5) or pars plana vitrectomy with intravitreal antibiotic injections (n = 3). All patients had vitreous or anterior chamber cultures positive for S. maltophilia. Seven of seven isolates tested were found to be sensitive to ceftazidime. Seven of eight isolates were sensitive to polymyxin B, six of eight isolates were sensitive to amikacin, and five of the seven isolates tested were sensitive to ciprofloxacin. Two of four tested isolates were sensitive to trimethoprim-sulbactam. All eight isolates were resistant to gentamicin and seven of the seven tested isolates were resistant to imipenem. All patients received intravitreal ceftazidime as part of the initial treatment regimen. Final visual acuity ranged from 20/25 to 4/200. Conclusion S. maltophilia endophthalmitis is a rare source of endophthalmitis following cataract surgery. A case series of eight independent patients is reported, along with antibiotic resistance profiles and clinical outcomes. Isolates showed sensitivity to ceftazidime, amikacin, and polymyxin, with variable sensitivity to other antibiotics, therefore differing from previous reports.

Chang, Jonathan S; Flynn, Harry W; Miller, Darlene; Smiddy, William E

2013-01-01

 
 
 
 
121

Cataract prevalence and prevention in Europe: a literature review.  

UK PubMed Central (United Kingdom)

This literature review is aimed at the evaluation of the potential for cataract prevention in Europe. It was performed using PubMed with Mesh and free-text terms. Studies included were (i) performed on a population of Caucasian origin at an age range of 40-95 years, (ii) cataract was clinically verified, (iii) drug record of prescriptions, their indication, a record of every diagnosis, dosage and quantity of prescribed medicine were available, (iv) sample size >300 and (v) published between 1990 and 2009. The results of 29 articles were reviewed. Former [3.75 (2.26-6.21)] or current smoking [2.34 (1.07-5.15)], diabetes of duration >10 years [2.72 (1.72-4.28)], asthma or chronic bronchitis [2.04 (1.04-3.81)], and cardiovascular disease [1.96 (1.22-3.14)] increased the risk of cataract. Cataract was more common in patients taking chlorpromazine during ?90 days with a dosage ?300 mg [8.8 (3.1-25.1)] and corticosteroids >5 years [3.25 (1.39-7.58)] in a daily dose >1600 mg [1.69 (1.17-2.43)]. Intake of a multivitamin/mineral formulation [2.00 (1.35-2.98)] or corticosteroids [2.12 (1.93-2.33)] also increased the risk of cataract. Corticosteroids applied orally [3.25 (1.39-7.58)], parenteral [1.56 (1.34-1.82)] or inhalational [1.58 (1.46-1.71)] lead to cataract more frequently than those applied topically: nasal [1.33 (1.21-1.45)], ear [1.31 (1.19-1.45)] or skin [1.43 (1.36-1.50)]. Outpatient cataract surgery was negatively associated with total cataract surgery costs, and chlorpromazine, corticosteroids and multivitamin/mineral formation increase the risk of posterior subcapsular cataract dependent on dose, treatment application and duration. This review presented a comprehensive overview of specific and general cataract risk factors and an update on most recent experimental studies and randomized control trials directed at cataract prevention.

Prokofyeva E; Wegener A; Zrenner E

2013-08-01

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Ocular safety limits for 1030nm femtosecond laser cataract surgery  

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Application of femtosecond lasers to cataract surgery has added unprecedented precision and reproducibility but ocular safety limits for the procedure are not well-quantified. We present an analysis of safety during laser cataract surgery considering scanned patterns, reduced blood perfusion, and light scattering on residual bubbles formed during laser cutting. Experimental results for continuous-wave 1030 nm irradiation of the retina in rabbits are used to calibrate damage threshold temperatures and perfusion rate for our computational model of ocular heating. Using conservative estimates for each safety factor, we compute the limits of the laser settings for cataract surgery that optimize procedure speed within the limits of retinal safety.

Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel V.

2013-03-01

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Glaucoma following congenital cataract surgery – the role of early surgery and posterior capsulotomy  

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Full Text Available Abstract Background To determine the rate of glaucoma following congenital cataract surgery at Moorfields Eye Hospital (MEH), and to investigate potential risk factors for glaucoma in our case series. Methods A retrospective case notes review was undertaken of all congenital cataract lensectomies performed at MEH between 1994 and 2000. The following parameters were ascertained: age at surgery, unilateral or bilateral cataract, whether a posterior capsulotomy (PC) was performed at the time of surgery, whether an intraocular lens (IOL) was inserted, duration of follow-up, and if aphakic glaucoma (AG) developed. All lensectomies were performed through a limbal incision by a single consultant surgeon. Results A total of 47 subjects were identified – 40 patients with bilateral cataracts and 7 with unilateral. Of the 40 bilateral cataract patients, 76 eyes had lensectomies; with 37 of these patients (71 lensectomies) having at least 5 year follow-up. Based on patient count, the 5 year risk of AG in at least one eye following surgery was 21.6%. Based on eye count, the 5 year risk of AG after lensectomy was 15.5%. The average age at surgery of patients who did not develop AG, and had at least 5 years follow-up, was 28.7 months (range 2 weeks to 6 years), with 20% having surgery within the first month of life. In comparison, the average age at surgery of patients with at least 5 years follow-up, who developed AG was 1.6 months (range 2 weeks to 7 months), with 60% having surgery within the first month of life. In subjects with at least 5 years follow-up, a PC rate of 100% was identified in the eyes that developed AG, compared to 61% in eyes that did not develop AG. An IOL was inserted in O% of eyes with AG, compared to 57% in eyes that did not develop AG. Onset of AG ranged from one month post surgery to 7 years, with an average yearly incidence of 5.3%. Conclusion Early surgery in patients with bilateral cataracts is associated with a marked increase in risk of AG. Our data suggest that an intact posterior capsule may be associated with a lower rate of AG.

Michaelides Michel; Bunce Catey; Adams Gillian GW

2007-01-01

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Simultaneous bilateral versus sequential bilateral cataract surgery: Helsinki Simultaneous Bilateral Cataract Surgery Study Report 1.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the refractive outcomes, complication rates, and changes in patients' functional state and satisfaction with simultaneous compared with sequential bilateral cataract surgery. SETTING: Helsinki University Eye Hospital, Helsinki, Finland. DESIGN: Clinical trial. METHODS: Consecutive patients scheduled for bilateral cataract surgery were enrolled based on appropriate inclusion criteria and randomized to be operated on in 1 session (study group) or sequentially (control group) 4 to 6 weeks apart. RESULTS: Four hundred ninety-one (94.4%) of the 520 patients completed the study. Of the eyes, 493 (247 patients) had bilateral surgery in 1 session and 506 (257 patients) in separate sessions. In the study group, 240 patients (96.0%) were treated per protocol. In the control group, 250 patients (97.3%) were treated per protocol. The refraction was within ± 0.50 diopter (D) of the target in 67.2% of eyes in the study group and 69.2% of eyes in the control group and within ± 1.00 D in 91.0% and 90.3%, respectively (P = .92). The only complication that affected postoperative visual acuity was chronic cystoid macular edema, which occurred in 1 eye in the study group (0.2%) and in 2 eyes (0.4%) of 1 patient in the control group (P = .57). Ninety-five percent of patients in both groups reported being very satisfied with surgery. CONCLUSION: The refractive outcomes, rates of complications, and patient-rated satisfaction were similar whether bilateral cataract surgery was performed simultaneously or sequentially. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Sarikkola AU; Uusitalo RJ; Hellstedt T; Ess SL; Leivo T; Kivelä T

2011-06-01

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Glaucoma in aphakia and pseudophakia after congenital cataract surgery.  

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Full Text Available Glaucoma is one of the most common causes of visual loss despite successful congenital cataract surgery. The overall incidence does not appear to have decreased with modern microsurgical techniques. The onset of glaucoma may be acute or insidious and notoriously refractory to treatment. Angle closure glaucoma may occur in the early postoperative period; but the most common type of glaucoma to develop after congenital cataract surgery is open angle glaucoma. Several risk factors have been identified and both chemical and mechanical theories have been proposed for its pathogenesis. Unlike children with congenital glaucoma, those with paediatric glaucoma following congenital cataract surgery are usually asymptomatic despite high intraocular pressure. They may require regular evaluation under anaesthesia, whenever there are any suspicious findings. Unlike congenital glaucoma, the first line of treatment for glaucoma in aphakia/pseudophakia may be medical. Traditional trabeculectomy in paediatric glaucoma following congenital cataract surgery has met with limited success. The addition of antimetabolites to trabeculectomy is known to inhibit fibrosis and enhance the success, but carries the lifelong risk of bleb-related endophthalmitis. Drainage implant surgery is a viable option to achieve longterm intraocular pressure control in this refractory group of patients. Cycloablative procedures may provide temporising treatment and should be reserved for patients with low visual potential. Diagnosis of glaucoma following congenital cataract surgery requires lifelong surveillance and continuous assessment of the problem. Further research is needed to understand the pathophysiology, prevention and treatment of this sight-threatening complication following successful cataract surgery in children.

Mandal Anil; Netland Peter

2004-01-01

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Research Shows Cataract Surgery Can Reduce Hip Fracture Risk  

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American Academy of Ophthalmology-sponsored Research Shows Cataract Surgery Can Reduce Hip Fracture Risk 08/01/2012 09:00:00 AM Medicare patient study finds significant health benefit in older patients SAN ...

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An Evaluation Of Short Cataract Surgery In Rural Haryana  

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Full Text Available Research question: Whether short post operative stay after cataract surgery affects the visual acuity & complications as compared to routine post operative stay? Objective: To study the outcome of short post operative stay after cataract surgery with that of routine cataract surgery. Study design: Cross-sectional Setting: Ophthalmology deptt. Pt. B.D. Sharma PGIMS, Rohtak Participants: 180 patients of senile cataract from rural area. Statistical Analysis: Chi-square test Results: During 6 months follow up 94.44% patients in group I and 92.22% in group II had comparable outcome in relation to visual acuity and complications. The reduction in post operative stay from 6 days to 3 days in rural population can be helpful in increasing the capacity of existing eye care facility without compromising the quality of surgery.

Sharma R; Dhull C.S; Sharma A.P

1998-01-01

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Combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery in cases with cataract and posterior segment diseases  

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Background: Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. Aim: To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and ca...

Yazici Ahmet; Kara Necip; Bozkurt Ercument; Cakir Mehmet; Goker Hasan; Demirok Ahmet; Yilmaz Omer

129

Reducing older driver motor vehicle collisions via earlier cataract surgery.  

UK PubMed Central (United Kingdom)

Older adults who undergo cataract extraction have roughly half the rate of motor vehicle collision (MVC) involvement per mile driven compared to cataract patients who do not elect cataract surgery. Currently in the U.S., most insurers do not allow payment for cataract surgery based upon the findings of a vision exam unless accompanied by an individual's complaint of visual difficulties that seriously interfere with driving or other daily activities and individuals themselves may be slow or reluctant to complain and seek relief. As a consequence, surgery tends to occur after significant vision problems have emerged. We hypothesize that a proactive policy encouraging cataract surgery earlier for a lesser level of complaint would significantly reduce MVCs among older drivers. We used a Monte Carlo model to simulate the MVC experience of the U.S. population from age 60 to 89 under alternative protocols for the timing of cataract surgery which we call "Current Practice" (CP) and "Earlier Surgery" (ES). Our base model finds, from a societal perspective with undiscounted 2010 dollars, that switching to ES from CP reduces by about 21% the average number of MVCs, fatalities, and MVC cost per person. The net effect on total cost - all MVC costs plus cataract surgery expenditures - is a reduction of about 16%. Quality Adjusted Life Years would increase by about 5%. From the perspective of payers for healthcare, the switch would increase cataract surgery expenditure for ages 65+ by about 8% and for ages 60-64 by about 47% but these expenditures are substantially offset after age 65 by reductions in the medical and emergency services component of MVC cost. Similar results occur with discounting at 3% and with various sensitivity analyses. We conclude that a policy of ES would significantly reduce MVCs and their associated consequences.

Mennemeyer ST; Owsley C; McGwin G Jr

2013-01-01

130

Monovision: a refractive consideration in cataract surgery after vitrectomy?  

UK PubMed Central (United Kingdom)

Cataract is the most common complication of vitrectomising surgery in the phakic eye. Progressive nuclear sclerosis (NS) causes a myopic shift. This change in refractive status can predispose to the development of monovision in presbyopic individuals. Recognition of adaptation to monovision is important when undertaking sequential cataract surgery. Our case describes a patient whose adaptation to monovision was only recognised after its reversal. Predisposing factors are discussed and lessons highlighted.

Carrim ZI; Hickley NM; Bishop F

2012-12-01

131

Monovision: a refractive consideration in cataract surgery after vitrectomy?  

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Cataract is the most common complication of vitrectomising surgery in the phakic eye. Progressive nuclear sclerosis (NS) causes a myopic shift. This change in refractive status can predispose to the development of monovision in presbyopic individuals. Recognition of adaptation to monovision is important when undertaking sequential cataract surgery. Our case describes a patient whose adaptation to monovision was only recognised after its reversal. Predisposing factors are discussed and lessons highlighted. PMID:22878623

Carrim, Zia I; Hickley, Nicholas M; Bishop, Fiona

2012-08-10

132

METHOD FOR PREVENTION OF CHOROIDAL NEOVASCULARISATION FOLLOWING CATARACT PHACOEMULSIFICATION SURGERY  

UK PubMed Central (United Kingdom)

FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, namely ophthalmology, and can be used for prevention of choroidal neovascularisation following cataract phacoemulsification. After sampling the patients to be involved in the offered therapy, the cataract phacoemulsification surgery follows by a standard technique. A flexible intraocular lens is implanted. After the intraocular lens implanted, lucentis is injected intravitreally. ^ EFFECT: method provides prevention of choroidal neovascularisation and thereby a macular oedema following the cataract phacoemulsification surgery in the patients with age-related macular dystrophy and confluent drusen of Bruch's membranes. ^ 1 ex

BORISKINA LJUDMILA NIKOLAEVNA; ISAKOVA IRINA ALEKSANDROVNA; DZHASHI BENTA GAJOZOVNA

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Modelling of changes in the corneal endothelium after cataract surgery and penetrating keratoplasty.  

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Long term changes in endothelial cell density were monitored in three groups of patients after surgery. One group underwent uncomplicated cataract surgery, one group complicated cataract surgery which eventually progressed to corneal decompensation, and one group penetrating keratoplasty. A mathemat...

Bates, A K; Hiorns, R W; Cheng, H

134

Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients  

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Full Text Available Background: The aim of this study was to evaluate the indications, safety, benefits, disadvantagesand advantages, and the visual outcomes for simultaneous bilateralcataract surgery (SBCS) under general anesthesia.Methods: This retrospective case review pertained to a period spanning from June1998 through June 2005 inclusively, and comprised of 27 consecutivepatients (54 eyes) that underwent simultaneous bilateral cataract surgeryunder general anesthesia at the Kaohsiung Chang Gung Memorial Hospital,Taiwan. Surgery modalities included phacoemulsification, extracapsularcataract extraction, lens aspiration and intraocular lens implantation.Outcome measures included postoperative best correct visual acuity (BCVA)as well as intraoperative and postoperative complication rates. Due to thebipolas distribution of the age, we arbitrarily divided our cases into youngergroup (Group Y, younger than 20 years old) and older group (Group O, equalto or older than 20 years old).Results: Thirty-eight of the 54 eyes (60% in the younger group and 76.5% in theolder group), featuring measured preoperative and postoperative BSCVA,achieved improved visual acuity following SBCS. Two eyes (5.9% in theolder group) demonstrated poorer visual acuity postoperatively than preoperatively.Seven patients (40% in the younger group and 17.6% in the oldergroup) were not able to express VA due to their particular medical conditionssuch as mental disease and young age. Intraoperative and postoperative complicationrates were similar to those cited in previous reports of analogousbut unilateral extracapsular surgery and simultaneous bilateral cataractsurgery. Endophthalmitis did not arise in any of the eyes operated upon andreported on herein, and no examples of bilateral complications that resultedin visual loss occurred in our patients.Conclusion: SBCS could be a good choice when cataract surgery needs to be performedunder general anesthesia. The relative benefits of SBCS under general anesthesiacould eclipse the associated enhanced risks of this surgery.

Tien-En Huang; Hsi-Kung Kuo; Sue-Ann Lin; Po-Chiung Fang; Pei-Chang Wu; Yi-Hao Chen; Yung-Jen Chen

2007-01-01

135

The incidence of retinal detachment after cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To estimate the cumulative risk of retinal detachment (RD) after routine cataract surgery by phacoemulsification. SETTING: Department of Ophthalmology, Aarhus University Hospital, Denmark METHODS: Retrospective cohort study based on 12.222 consecutive cataract surgeries in 7.856 patients using phacoemulsification over a 6 year period from 2000 to 2005. Cases with a diagnosis of RD were identified through the procedure-coding database at the Medical Registry of Aarhus University Hospital, which is based on Diagnosis Related Groups (DRG) and used to report to the Danish Patients Registry (LPR). For each case the age of the patient, gender, axial length, surgical complications, postoperative Nd:YAG capsulotomy and time interval between cataract surgery and RD were recorded. RESULTS: The mean follow-up time was 64.8 months (range 26.2-97.6 months). Forty-eight (48) cases of RD were identified making an overall cumulative risk of 0.39%. As compared to the normal incidence of RD reported in the Scandinavian literature, the relative risk of RD following cataract surgery was about 2.3 times that of the natural incidence. As compared to the average cataract group, the group of RD following cataract surgery was characterized by a younger mean age (60.5 vs. 73.7 years), male gender (58.3% vs 34.8%), longer axial lengths (24.56 vs 23.25 mm) and a higher frequency of surgical complications (10.4% vs 1.8%) (p<0.001) but not a higher frequency of Nd:YAG capsulotomy (p>0.05), CONCLUSIONS: The cumulative risk of RD after lens surgery was about 2.3 times the natural incidence but seems to be lower than that of older reports. SYNOPSIS: Retinal detachment following cataract surgery is associated with young age, male gender, long axial lengths and surgical complications. The cumulative risk of RD after lens surgery was about 2.3 times the natural.

Olsen T; Jeppesen P

2012-01-01

136

Comparison of the efficacy of manual nuclear small incision cataract surgery and phacoemulsification cataract surgery in the treatment of hard nuclear cataract  

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Full Text Available AIM: To compare the efficacy of broken nuclear small incision cataract surgery and phacoemulsification cataract surgery in the treatment of hard nuclear cataract.METHODS: Totally 42 patients with hard nuclear cataract were divided into observation group and control group, the observation group patients chosen broken nuclear small incision cataract surgery, the control group chosen phacoemulsification cataract surgery. Vision correction, corneal astigmatism effect after 1 day, 1 week, 1 month and 3 months and postoperative complications of two groups were observed and compared.RESULTS: After 1 day, 1 week, 1 month and 3 months, the difference of the proportion of patients corrected visual acuity 0.5-1.0 had no significant significance(P>0.05). Postoperative 1 day and 1 week, the observation group patients with corneal astigmatism higher than that in the control group, the difference was significant(PP>0.05). Sac membrane rupture in the control group was significantly higher than the observation group, the ratio of postoperative corneal edema in the control group were significantly higher than the observation group, the differences were statistically significant(PCONCLUSION: Broken nuclear small incision cataract surgery has good effect and few complications.

Jian-Zhi Chen; Chun-Yan Fu; Ze-Yi Li; Kang-Keng Zheng

2013-01-01

137

Cataract surgery in Knobloch syndrome: a case report  

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Full Text Available Carmen Sílvia Bongiovanni1, Carla Cristina Serra Ferreira1, Ana Paula Silvério Rodrigues1, João Borges Fortes Filho2, Márcia Beatriz Tartarella11Department of Ophthalmology, Congenital Cataract Section, Medical School, Federal University of São Paulo, São Paulo; 2Department of Ophthalmology, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, BrazilAbstract: Knobloch syndrome is an autosomal recessive disorder associated with early-onset ocular abnormalities and central nervous system malformations. Ocular abnormalities are usually severe, and include high myopia, vitreoretinal degeneration, retinal detachment, macular abnormalities, and cataract. The most frequent systemic changes are midline malformations of the brain, ventricular dilation, and occipital encephalocele. Cognitive delay may occur. We report a case of cataract in a child with Knobloch syndrome. Cataract surgery and follow-up are described.Keywords: Knobloch syndrome, cataract, phacoemulsification, vitreous, right eye, left eye, genetic

Bongiovanni CS; Ferreira CCS; Rodrigues APS; Fortes Filho JB; Tartarella MB

2011-01-01

138

Visual outcome following cataract surgery in rural punjab.  

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Full Text Available In a cluster sample survey in rural areas of Punjab visual outcome after cataract surgery was assessed. Three hundred patients (428 cataract operated eyes) were included in the study from 24 sampled villages. The mean age at cataract extraction was 61.70 +/- 9.82 years. The average interval since the cataract surgery was 7.05 +/- 5.86 years (range 0.11-32 years). Of the 428 operated eyes, 72 (16.82%) were blind (VA < 3/60), 162 (37.85%) had low visual acuity (VA 3/60-< 6/18) and 194 (45.33%) eyes gained good visual acuity (VA > or = 6/18). Cataract surgery related complications were the principal causes leading to blindness in 50 of 72 eyes; these included corneal oedema, (17/72;23.3%), retinal detachment (14/72;19.4%), and aphakic glaucoma (13/72;18.05%). This study emphasizes the need to improve the qualitative aspect of cataract surgery including long-term follow up in rural India.

Anand R; Gupta A; Ram J; Singh U; Kumar R

2000-01-01

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Nuclear management in manual small incision cataract surgery by snare technique  

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Manual small incision cataract surgery has evolved into a popular method of cataract surgery in India. However, in supra hard cataract, bringing out the whole nucleus through the sclerocorneal flap valve incision becomes difficult. A bigger incision required in such cataracts loses its value action,...

Bhattacharya Debasish

140

Laser-assisted cataract surgery and other emerging technologies for cataract removal  

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Full Text Available As we near the end of this century, refractive cataract surgery has become a reality through concerted contributions from ultrasonic phacoemulsification, foldable intraocular lens (IOL) implantation technology and keratorefractive surgery. As we enter the new millennium, our sights are set on realizing another dream: accommodative IOL surgery. Towards achieving this goal, many advances have been made in both techniques and technology of cataract removal. Lasers in particular have been under investigation for cataract removal for nearly two decades. The technology has now reached a stage where cataract can indeed be removed entirely with laser alone. Neodymium:YAG and erbium:YAG are the laser sources currently utilized by manufacturers of laser phaco systems. Initial clinical experience reported in the literature has served to highlight the capabilities of lasers and the need for further refinement. Despite the excitement associated with the availability of this alluring new technology for cataract removal, it is necessary to develop more effective laser systems and innovative surgical techniques that optimize its capabilities if laser phaco surgery is to be a genuine improvement over current techniques.

Aasuri Murali; Basti Surendra

1999-01-01

 
 
 
 
141

Evaluation of changes of macular thickness in diabetic retinopathy after cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To assess the macular thickness changes after cataract surgery in diabetic patients using optical coherence tomography (OCT). METHODS: We retrospectively reviewed the records of 104 diabetic patients who underwent cataract surgery. We examined the changes of macular thickness using OCT before cataract surgery and 1 week, 1-, 2- and 6-months after surgery. The central subfield mean thickness (CSMT) was used to evaluate macular edema which was defined as an increase of CSMT (?CSMT) > 30% from the baseline. The association between prior laser treatment or severity of diabetic retinopathy and macular thickness were also analyzed. RESULTS: Macular edema occurred in 19 eyes (18%) from the diabetic group and 63% of macular edema developed at 1 month after surgery. Thirteen (68%) out of 19 eyes with macular edema showed the resolution of macular edema by 6 months after surgery without treatment. ?CSMT of eyes without a history of laser treatment was statistically greater compared to eyes with a history of laser treatment in at 1- and 2-months after surgery, but was not different than eyes who had laser treatment at 6-months after surgery. The severity of diabetic retinopathy was not significantly correlated to macular edema, but there was statistical difference when patients who had a history of prior laser treatment were excluded. CONCLUSIONS: The incidence of macular edema after cataract surgery in diabetic patients was 18%. Its peak incidence was at 1 month post surgery and it resolved spontaneously in 68% of patients by 6 months post surgery. Prior laser treatment might prevent postoperative macular edema until 2 months after cataract surgery in diabetic patients. However, macular edema did not affect the severity of diabetic retinopathy.

Kwon SI; Hwang DJ; Seo JY; Park IW

2011-08-01

142

[Evolution of cataract surgery: smaller incision--less complications].  

UK PubMed Central (United Kingdom)

BACKGROUND/AIM: Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. METHODS: The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/forceps IOL implantation, phacoemulsification/injector IOL implantation, microincision cataract surgery (MICS). Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. RESULTS: Uncorrected visual aquity 30 days postoperatively was > or = 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS) there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. CONCLUSION: Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

Dragani? V; Vukosavljevi? M; Milivojevi? M; Resan M; Petrovi? N

2012-05-01

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[Clinical analysis of the occurrence of secondary glaucoma after pediatric congenital cataract surgery in the first 36 months of life].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To observe the rate of secondary glaucoma after pediatric congenital cataract surgery in the first 36 months of life. METHODS: Retrospective case series. The records of children who underwent surgery for congenital cataract within the first 36 months of life between July 1995 and July 2005 at Qingdao Eye Hospital were reviewed. Children with preoperative conditions associated with glaucoma were excluded. Age at surgery, unilateral or bilateral cataract, type of congenital cataract, primary intraocular lens (IOL) insertion, duration of follow-up, postoperative best corrected visual acuity, development of aphakic glaucoma, and development of glaucoma after secondary IOL implantation were evaluated. RESULTS: A total of 115 patients (204 eyes) with an average surgery age of (12.5 ± 9.2) months were included; the mean follow-up time was (83.7 ± 43.8) months. 15 eyes (11 patients) (7.4%) had subsequent development of glaucoma, 7 of which (4 patients) developed late-onset open-angle glaucoma. Of the 15 eyes, 13 eyes had surgery within 9 months, and 12 eyes developed nuclear or total cataract. None of the primarily pseudophakia eyes developed glaucoma in our study. Of 86 eyes that received implantation of secondary intraocular lens in the ciliary sulcus, 13 eyes (15.1%) developed pseudophakia glaucoma. CONCLUSIONS: Secondary glaucoma occurred after pediatric bilateral cataract surgery. As late-onset glaucoma usually occurred several years after primary surgery, long-time follow-up after pediatric cataract surgery needs to be emphasized.

Zhang H; Xie LX

2013-02-01

144

Visual Rehabilitation Following Manual Small Incision Cataract Surgery  

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Full Text Available Recent technological advances in cataract surgery with small incision ensure less surgically inducedastigmatism and faster visual rehabilitation .Manual small incision non phaco surgery has addedadvantage of low cost and less machine dependence. We present a series of 115 patients whowere operated upon using manual small incision cataract surgery and studied for visual recovery.95.65% of patients achieved a best corrected visual acuity of 6/12 or better and the mean surgicallyinduced astigmatism at 3 months was 0.69 Diopters .

Imtiyaz Ahmad, Abdul Wahab, Sheikh Sajjad, Reyaz A Untoo

2005-01-01

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Extracapsular cataract surgery compared with manual small incision cataract surgery in community eye care setting in western India: a randomised controlled trial  

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Aim: To study “manual small incision cataract surgery (MSICS)” for the rehabilitation of cataract visually impaired and blind patients in community based, high volume, eye hospital setting; to compare the safety and effectiveness of MSICS with conventional extracapsular cataract surgery (ECCE).

Gogate, P M; Deshpande, M; Wormald, R P; Deshpande, R; Kulkarni, S R

146

Focussing both eyes on health outcomes: revisiting cataract surgery  

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Abstract Background The appropriateness of cataract surgery procedures has been questioned, the suggestion being that the surgery is sometimes undertaken too early in the disease progression. Our three study questions were: What is the level of visual impairment in patients schedule...

Davis Jennifer C; McNeill Heather; Wasdell Michael; Chunick Susan; Bryan Stirling

147

Long-term outcome after cataract surgery : a longitudinal study  

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Background Cataract surgery is the most common surgical procedure carried out in the developed world and surgery volumes have increased considerably during the last decades. Various aspects of the surgical procedure, including surgical incision size and intraocular lens materials, have changed subst...

Lundqvist, Britta

148

Primary posterior capsular opacification in Indian rural population undergoing cataract surgery for hypermature senile cataract  

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Full Text Available Rajesh Subhash JoshiDepartment of Ophthalmology, Vasatrao Naik Government Medical College, Yavatmal, IndiaAim: To find out the incidence of primary posterior capsular opacification (PCO) in rural patients with a hypermature senile cataract undergoing cataract surgery.Settings: Tertiary eye care center in central India.Design: Prospective, observational, noncomparative study.Materials and methods: Two-hundred eyes of 200 patients presenting with a hypermature cataract underwent manual small incision cataract surgery. A single surgeon performed all surgeries under peribulbar anesthesia. After cortical clean-up, the capsular bag was inflated with viscoelastic. The presence or absence of opacity on the posterior lens capsule and location was noted. Postoperative follow-up was done for visual acuity and need for neodymium-doped yttrium aluminum garnet (ND:YAG) laser capsulotomy.Results: Primary PCO occurred in 76 eyes (incidence of 38%). It was peripheral in 58 eyes (76.3%) and central in 18 eyes (23.7%). At 6 weeks postoperatively, best corrected visual acuity for eyes with central primary PCO (n = 18) was 0.2–0.3 logMAR and 0–0.2 logMAR for eyes with peripheral primary PCO (n = 58). Best corrected visual acuity at the 6- and 12-month follow-up was 0–0.2 logMAR in both groups. Fibrotic primary PCO was seen in four patients. No predilection for the development of primary PCO to a particular quadrant of posterior capsule was observed. At 1 year postoperatively, eleven (14.5%) patients required ND:YAG laser capsulotomy, six (7.90%) of whom underwent ND:YAG laser capsulotomy at the 6-month follow-up. Seven patients with central primary PCO and four patients with peripheral primary PCO required ND:YAG laser capsulotomy.Conclusion: A high incidence of primary PCO was noted in rural patients with a hypermature senile cataract undergoing cataract surgery. No serious intraoperative complications were noted. Visual outcome at 1-year follow-up was satisfactory. Need for early ND:YAG laser posterior capsulotomy should be explained to these patients before cataract surgery. No post ND:YAG capsulotomy complications were noted in any patient.Keywords: posterior capsular opacification, hypermature cataract, manual small incision cataract surgery

Joshi RS

2013-01-01

149

The pattern of cataract surgery in India: 1992  

Directory of Open Access Journals (Sweden)

Full Text Available Surgery for cataract blindness, a major health problem, is undergoing a rapid transition. This study characterizes cataract surgery in India in terms of practice setting and surgical procedure. A survey questionnaire was mailed in December 1992 to 4356 members of the All India Ophthalmological Society, resident in India, requesting data on cataract surgery cases within the past 12 months. Two thousand one hundred thirty-four (49%) ophthalmologists responded to the survey. Of the 1,023,070 cataract cases reported, two-thirds were private patients. Among private patients, 26.0% received extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation and 20.7% received ECCE without an IOL. Among patients operated under government auspices, 9.1% received ECCE with IOL and 22.4% received ECCE without IOL. Overall, 82.8% of active surgeons reported experience with the ECCE procedure. The cataract case load in the private sector and the frequency of ECCE, with or without IOL implantation, among both private and government-operated cases is greater than previously recognized.

Gupta A; Ellwein Leon

1995-01-01

150

[Amblyopia after surgery for congenital unilateral cataract  

UK PubMed Central (United Kingdom)

Long-term functional results of the eyes with unilateral, congenital cataract operated in the years 1981-1983 are presented. It was found that 88% of the eyes had visual acuity below 5/50. The authors discussed these poor results and considered that they are associated with the lack of effective treatment of amblyopia. On account of this, the authors in their Ophthalmological Department operated only selected cases with unilateral cataract, mostly for cosmetic reasons.

Kornacki B; Goryszewska-Macioch H

1993-07-01

151

[Amblyopia after surgery for congenital unilateral cataract].  

Science.gov (United States)

Long-term functional results of the eyes with unilateral, congenital cataract operated in the years 1981-1983 are presented. It was found that 88% of the eyes had visual acuity below 5/50. The authors discussed these poor results and considered that they are associated with the lack of effective treatment of amblyopia. On account of this, the authors in their Ophthalmological Department operated only selected cases with unilateral cataract, mostly for cosmetic reasons. PMID:8121150

Kornacki, B; Goryszewska-Macioch, H

1993-07-01

152

Sutureless Non-phaco Cataract Surgery: A Solution to Reduce Worldwide Cataract Blindness?  

Directory of Open Access Journals (Sweden)

Full Text Available The Search for Appropriate Sutureless Cataract Surgery. During the last decade, in industrialised countries phacoemulsification has largely replaced ab-externo extracapsular cataract extraction with posterior chamber intraocular lenses (ECCE/PC IOL) with sutures. The small self-sealing phaco incision provides rapid visual rehabilitation, and the surgery is increasingly done on an outpatient basis. However, in developing countries phacoemulsification is performed only on selected patients, usually those able to pay high treatment charges. The reasons for this include the cost of a phaco machine and consumables such as foldable IOLs. Until now, phacoemulsification has played a very limited role in the reduction of cataract blindness in low income countries. Therefore, eye surgeons in developing countries are searching for alternatives to phacoemulsification. We need a surgical technique which is easy to learn, provides an immediate good uncorrected visual outcome, and is affordable to most cataract patients. Such a technique would advance cataract surgery in low income countries and contribute to reaching the goal of VISION 2020: The Right to Sight.

Albrecht Hennig

2003-01-01

153

Prevalence of myopic shifts among patients seeking cataract surgery.  

UK PubMed Central (United Kingdom)

Modern cataract surgery by phacoemulsification is a widely accepted procedure with a rapid recovery time. The prescription of specific intraocular lens, implanted during surgery, makes it possible to anticipate whether the patient will need reading glasses after the procedure. The present study analyses a sample of cataract surgery patients to show the frequency of myopic shifts related to nuclear opacity, which can result in clear near vision before surgery. A non-selected sample of consecutive patients who underwent elective cataract surgery in a private clinic was studied retrospectively. The myopic shift in refraction was assessed by comparing the old prescription with the spectacle correction at the time of interviewing.The mean age of the 229 subjects studied was 71.5 ± 10.4 years (109, 47.6%, males). A myopic shift in refraction, defined as at least - 0.5 diopters, was present in 37.1% of subjects (95% CI: 30.8%-43.4%). The mean change in refraction in these subjects was -2.52 ± 1.52 diopters. The percentage of subjects who had developed a myopic shift was significantly greater in those who presented greater nuclear opalescence. There were also differences in the mean myopic shift by refractive group, with the emmetropes having the greatest myopic shift. In this study of patients seeking cataract surgery in a clinical setting, more than one third had myopic shifts in refraction. This must be taken into account in order that patients maintain the benefit of clear near vision after surgery.

Iribarren R; Iribarren G

2013-01-01

154

Cataracts  

Medline Plus

Full Text Available ... X-Plain.com] ot020103 Last reviewed: 4/19/2009 1 The cornea is the front, transparent part ... X-Plain.com] ot020103 Last reviewed: 4/19/2009 2 If the doctor determines you have cataracts, ...

155

Subjective quality of vision before and after cataract surgery.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the effect of cataract surgery on subjective quality of vision. METHODS: The Quality of Vision (QoV) questionnaire (Italian translation) was completed before and 3 months after cataract surgery in 4 groups of patients recruited from September through December 2010: first eye with ocular comorbidity, first eye without ocular comorbidity, second eye with ocular comorbidity, and second eye without ocular comorbidity. The questionnaire measures 3 aspects of quality of vision: frequency, severity, and bothersome nature of symptoms. The Lens Opacities Classification System (LOCS) III was used for cataract grading. Friedman and Kruskal-Wallis H tests were performed to compare QoV scores within and between groups. Spearman rank correlations (rs) were calculated to investigate the correlation between LOCS III and QoV symptoms. RESULTS: Two hundred twelve patients (mean [SD] age, 74.2 [8.7] years) were recruited, and 212 eyes were included in the study. Improvements in QoV scores were found in all 4 groups (P < .05). There were no statistically significant (P > .05) differences among the 4 groups in the improvement in QoV scores or in the preoperative or postoperative scores. Blurred vision was correlated with posterior subcapsular cataract (rs = 0.420, P = .04). CONCLUSIONS: Cataract in one or both eyes causes a similar loss in subjective quality of vision, which is also irrespective of the presence of ocular comorbidity. Posterior subcapsular cataract causes the specific symptom "blurred vision." Cataract surgery resulted in a large and comparable improvement in subjective quality of vision, regardless of ocular comorbidity and first or second eye surgery.

Skiadaresi E; McAlinden C; Pesudovs K; Polizzi S; Khadka J; Ravalico G

2012-11-01

156

Biaxial microincision cataract surgery versus conventional coaxial cataract surgery: metaanalysis of randomized controlled trials.  

UK PubMed Central (United Kingdom)

A comprehensive literature search of Cochrane Library, PubMed, and Embase was performed to identify relevant prospective randomized controlled trials (RCTs) comparing biaxial microincision cataract surgery (MICS) and conventional coaxial phacoemulsification. A metaanalysis was performed on the following outcome measures: effective phacoemulsification time (EPT), phacoemulsification power (%), corrected distance visual acuity (CDVA), surgically induced astigmatism (SIA), laser flare photometry value, percentage of endothelial cell loss, change in central corneal thickness (CCT), and complications. Eleven RCTs describing a total of 1064 eyes were identified. There were no significant differences between the techniques in CDVA, mean percentage of endothelial cell loss, laser flare photometry value, CCT change, and intraoperative and postoperative complications. However, EPT was statistically significantly shorter and the mean phaco power was statistically significantly lower in the biaxial group than in the coaxial group, and biaxial MICS induced less SIA. Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Yu JG; Zhao YE; Shi JL; Ye T; Jin N; Wang QM; Feng YF

2012-05-01

157

Biaxial microincision cataract surgery versus conventional coaxial cataract surgery: metaanalysis of randomized controlled trials.  

Science.gov (United States)

A comprehensive literature search of Cochrane Library, PubMed, and Embase was performed to identify relevant prospective randomized controlled trials (RCTs) comparing biaxial microincision cataract surgery (MICS) and conventional coaxial phacoemulsification. A metaanalysis was performed on the following outcome measures: effective phacoemulsification time (EPT), phacoemulsification power (%), corrected distance visual acuity (CDVA), surgically induced astigmatism (SIA), laser flare photometry value, percentage of endothelial cell loss, change in central corneal thickness (CCT), and complications. Eleven RCTs describing a total of 1064 eyes were identified. There were no significant differences between the techniques in CDVA, mean percentage of endothelial cell loss, laser flare photometry value, CCT change, and intraoperative and postoperative complications. However, EPT was statistically significantly shorter and the mean phaco power was statistically significantly lower in the biaxial group than in the coaxial group, and biaxial MICS induced less SIA. Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned. PMID:22424804

Yu, Ji-guo; Zhao, Yun-e; Shi, Jie-liang; Ye, Ting; Jin, Nan; Wang, Qin-mei; Feng, Yi-fan

2012-03-16

158

Cost-effectiveness analysis of cataract surgery: a global and regional analysis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVE: To estimate the population health effects, costs and cost effectiveness of selected cataract surgery interventions in areas of the world with different epidemiological profiles. METHODS: Effectiveness estimates are based on a review of the literature taking into account factors such as op...

Baltussen, Rob; Sylla, Mariame; Mariotti, Silvio P.

159

Refractive stabilization and corneal swelling after cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To determine the earliest time after cataract surgery when corneal swelling and automated refraction are stabilized sufficiently to allow reliable refractive prescription. METHODS: This was a prospective, nonrandomized, case series study of 124 consecutive eyes undergoing uneventful cataract surgery. Automated refraction and central corneal thickness (CCT) measurements were made at baseline before cataract surgery and on follow-up visits 1 day and weekly for 4 weeks afterward. Corneal swelling was determined as the percentage change in CCT after surgery. To determine the validity of automated refraction, it was compared with subjective refraction at the final visit. RESULTS: Corneal swelling decreased between the first postsurgical day and the first week and again between postsurgical weeks 1 and 2 (p < 0.01 each). Although thinning continued through the fourth postsurgical week, the changes were not significant. Both spherical and cylindrical refraction were stable 1 week after surgery, with the greatest change between the first postsurgical day and 1 week (p < 0.01). In replicate measurements of automated spherical refraction taken on the last visit, the intraclass correlation coefficient was 0.93. For automated cylindrical refraction, it was 0.81. CONCLUSIONS: Automated refraction is highly repeatable and can be used to monitor postsurgical refractive changes. Whereas corneal swelling becomes stable 2 weeks after cataract surgery, automated refraction becomes stable after 1 week and can be used to accurately prescribe corrective lenses at that time.

de Juan V; Herreras JM; Pérez I; Morejón Á; Río-Cristóbal A; Cristóbal AR; Martín R; Fernández I; Rodríguez G

2013-01-01

160

A prospective study on postoperative pain after cataract surgery  

Science.gov (United States)

Purpose To evaluate postoperative pain and early recovery in cataract patients. Patients and methods A total of 201 patients who underwent elective first eye cataract extraction surgery were enrolled, and 196 were included in the final analysis. The study design was a single-center, prospective, follow-up study in a tertiary hospital in eastern Finland. Postoperative pain was evaluated with the Brief Pain Inventory at four time points: at baseline, and at 24 hours, 1 week, and 6 weeks postsurgery. Results Postoperative pain was relatively common during the first hours after surgery, as it was reported by 67 (34%) patients. After hospital discharge, the prevalence decreased; at 24 hours, 1 week, and 6 weeks, 18 (10%), 15 (9%) and 12 (7%) patients reported having ocular pain, respectively. Most patients with eye pain reported significant pain, with a score of ?4 on a pain scale of 0–10, but few had taken analgesics for eye pain. Those who had used analgesics rated the analgesic efficacy of paracetamol and ibuprofen as good or excellent. Other ocular irritation symptoms were common after surgery; as a new postoperative symptom, foreign-body sensation was reported by 40 patients (22%), light sensitivity by 29 (16%), burning by 15 (8%), and itching by 15 (8%). Conclusion Moderate or severe postoperative pain was relatively common after cataract surgery. Thus, all patients undergoing cataract surgery should be provided appropriate counseling on pain and pain management after surgery.

Porela-Tiihonen, Susanna; Kaarniranta, Kai; Kokki, Merja; Purhonen, Sinikka; Kokki, Hannu

2013-01-01

 
 
 
 
161

Visual outcome of cataract surgery; study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To analyze the visual outcome after cataract surgery. SETTING: Cataract surgery clinics in 15 European countries. DESIGN: Database study. METHODS: Data were drawn from case series of cataract extractions reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery database. These data were entered into the database via the Web by surgeons or by transfer from existing national registries or electronic medical record systems. The database contains individual anonymous data on preoperative, intraoperative, and postoperative measurements. RESULTS: Data on 368,256 cataract extractions were available for analysis. The best visual outcome was achieved in age groups 40 to 74 years, and men showed a higher percentage of excellent vision (1.0 [20/20] or better) than women. A corrected distance visual acuity (CDVA) of 0.5 (20/40) or better and of 1.0 (20/20) or better was achieved in 94.3% and 61.3% of cases, respectively. Ocular comorbidity and postoperative complications were the strongest influences on the visual outcome; however, surgical complications and ocular changes requiring complex surgery also had a negative influence. Deterioration of visual acuity after the surgery (n= 6112 [1.7% of all cases]) was most common in patients with a good preoperative visual acuity. CONCLUSIONS: The visual outcomes of cataract surgery were excellent, with 61.3% of patients achieving a corrected distance visual acuity of 1.0 (20/20) or better. Age and sex influenced the visual outcomes, but the greatest influences were short-term postoperative complications, ocular comorbidity, surgical complications, and complex surgery. A weakness of the study could be that some of the data is self-reported to the registry.

Lundström M; Barry P; Henry Y; Rosen P; Stenevi U

2013-05-01

162

Impact of cataract surgery on self-reported visual difficulties: comparison with a no-surgery reference group.  

UK PubMed Central (United Kingdom)

PURPOSE: To examine the impact of cataract surgery on older adults' self-reported visual difficulties and compare them with those of patients with cataract who declined surgery over the same period. SETTING: Twelve area practices. METHODS: This was a consecutive chart review over a 6-month period. Primary inclusion criteria were 55 years or older, cataract in 1 or both eyes with 20/40 visual acuity or worse (best corrected, distance), and no previous cataract surgery in either eye. The Activities of Daily Vision Scale (ADVS) and visual acuity, contrast sensitivity, and disability glare tests were administered at baseline and at a 1-year follow-up visit. RESULTS: This study comprised 245 patients, 156 of whom elected to have cataract surgery and 89 of whom declined. Those electing surgery were more likely to be white, female, and have worse visual acuity and no ocular comorbidities. At baseline, ADVS subscale scores ranged from 53 to 76 in the surgery group and from 72 to 89 in the no-surgery group. In the surgery group, subscale scores improved by 15 to 21 points on average at the 1-year follow-up; scores were unchanged or worse in the no-surgery group over this period. This difference between the groups remained statistically significant after adjustment for group baseline differences in demographics, vision, and ADVS score. In the surgery group, visual acuity improvement in the first eye was an independent predictor of increases in the ADVS overall score and night driving and glare disability subscales; contrast sensitivity was an independent predictor of improvement in the night driving subscale. A reduction in disability glare in the second eye was independently linked to increases in the overall ADVS score and the night driving, near vision, and glare disability subscales. CONCLUSIONS: Baseline findings suggest that cataract patients who have surgery have more difficulty in visual tasks than those who decline surgery. After surgery, patients reported less difficulty with visual tasks. In the no-surgery group, no change was reported. Improvements in visual acuity and contrast sensitivity and reductions in disability glare after surgery were independently linked to improvements in ADVS scores.

McGwin G Jr; Scilley K; Brown J; Owsley C

2003-05-01

163

Femtosecond laser-assisted cataract surgery in infants.  

UK PubMed Central (United Kingdom)

We describe a technique for performing cataract surgery with a femtosecond laser in infants. Anterior capsulotomy and lens division are performed by the laser. A fluid-filled interface makes it possible to re-dock the laser to the eye for posterior capsulotomy after the eye has been opened for lens aspiration without complications. The integrated 3-dimensional optical coherence tomography also visualizes the posterior capsule, allowing a centered central posterior capsulotomy followed by mechanical anterior vitrectomy. The anterior and the posterior capsule disks are removed without capsule tears. The technique has been performed in 4 infants (ages 2, 4, 7, and 9 months) with congenital cataract. It can enhance the quality of pediatric cataract surgery.

Dick HB; Schultz T

2013-05-01

164

Vitrectorhexis versus forceps posterior capsulorhexis in pediatric cataract surgery  

Science.gov (United States)

This study was done to compare the results of posterior continuous curvilinear capsulorhexis created using forceps with those created using vitrector in eyes suffering from congenital cataract. Vitrectorhexis term was first used by Wilson et al in 1999.[1] Fifty eyes with congenital and developmental cataract were included in this study. The posterior capsulorhexis was created using utrata forceps in 17 eyes or through a vitrector in 33 eyes. Forceps capsulorhexis was performed before IOL implantation, while vitrectorhexis was performed after IOL implantation in the bag. The results of both the surgery were compared using the following criteria: incidence of extension of rhexis, ability to achieve posterior rhexis of appropriate size, ability to implant the IOL in the bag, the surgical time, and learning curve. Vitrectorhexis after IOL implantation was an easy to learn alternative to manual posterior continuous curvilinear capsulorhexis in pediatric cataract surgery. It was more predictable and reproducible, with a short learning curve and lesser surgical time.

Kochgaway, Lav; Biswas, Partha; Paul, Ajoy; Sinha, Sourav; Biswas, Rupak; Maity, Puspen; Banerjee, Sumita

2013-01-01

165

Vitrectorhexis versus forceps posterior capsulorhexis in pediatric cataract surgery.  

UK PubMed Central (United Kingdom)

This study was done to compare the results of posterior continuous curvilinear capsulorhexis created using forceps with those created using vitrector in eyes suffering from congenital cataract. Vitrectorhexis term was first used by Wilson et al in 1999. [1] Fifty eyes with congenital and developmental cataract were included in this study. The posterior capsulorhexis was created using utrata forceps in 17 eyes or through a vitrector in 33 eyes. Forceps capsulorhexis was performed before IOL implantation, while vitrectorhexis was performed after IOL implantation in the bag. The results of both the surgery were compared using the following criteria: incidence of extension of rhexis, ability to achieve posterior rhexis of appropriate size, ability to implant the IOL in the bag, the surgical time, and learning curve. Vitrectorhexis after IOL implantation was an easy to learn alternative to manual posterior continuous curvilinear capsulorhexis in pediatric cataract surgery. It was more predictable and reproducible, with a short learning curve and lesser surgical time.

Kochgaway L; Biswas P; Paul A; Sinha S; Biswas R; Maity P; Banerjee S

2013-07-01

166

Cataract surgical coverage and barriers to uptake of cataract surgery in leprosy villages of north eastern Nigeria.  

UK PubMed Central (United Kingdom)

AIMS: To determine the coverage, outcome, and barriers to uptake of cataract surgery in leprosy villages of north eastern Nigeria. METHODS: People 30 years and above resident in eight leprosy villages were examined. Cataract blind people were questioned about the reasons they had not been treated. Subjects who had received an operation for cataract were examined to determine the outcome and, where applicable, the causes of poor outcome. RESULTS: 480 people were examined. Cataract was the commonest cause of blindness. The cataract surgical coverage (people) was 39.2% for orthodox surgery and 29.7% for couching. After surgery, visual acuity > or =3/60 had been restored to 82.1% of eyes that had had orthodox surgery, but only 58.6% of eyes that had been couched. Cost was the commonest reason given for not seeking treatment for cataract. CONCLUSIONS: Cataract is the major cause of blindness in this population but cataract surgical needs are currently not being met. There is a need for better collaboration between leprosy control and ophthalmic services, improved education of people affected by leprosy, a commitment to improving orthodox cataract surgery outcomes, and consideration of a possible role for traditional healers as sources of referral for orthodox surgical services.

Mpyet C; Dineen BP; Solomon AW

2005-08-01

167

Results of cataract surgery in the very elderly population.  

UK PubMed Central (United Kingdom)

AIM: The aim of our study was to retrospectively evaluate the effectiveness and safety of cataract surgery and intraocular lens implantation (IOL) for patients aged 90 years or older, whom we define as "very elderly." METHODS: The study involved a total number of 122 patients (122 eyes) with senile cataracts. The mean age of patients was 91.2 ± 2.3 years (range 90-100 years old). Phacoemulsification (phaco) was done on 113 of 122 eyes, and 9 of 122 eyes had extracapsular cataract extraction (ECCE). Postoperative visual acuity and intraocular pressure (IOP) were analyzed on the first postoperative day, 3 months after surgery, and 6 months after surgery. RESULTS: Best corrected visual acuity (BCVA) improved in 100 of 122 eyes (82.0%). BCVA remained the same in 20 of 122 eyes (16.4%) and decreased in 2 of 122 eyes (1.6%), mainly because of coexisting age-related macular degeneration (AMD). The BCVA 3 months after surgery was ?0.8 in 23 of 122 eyes (18.9%), between 0.5 and 0.7 in 28 of 122 eyes (22.3%), and between 0.2 and 0.4 in 33 of 122 eyes (27.1%). We found significant implications of cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma compared to the patients without glaucoma. CONCLUSION: Advanced age is not a contraindication for cataract surgery. The results of the study showed that when systemic conditions are stable, both phaco and ECCE with IOL for very elderly patients are effective and safe.

Michalska-Ma?ecka K; Nowak M; Go?ciniewicz P; Karpe J; S?owi?ska-?o?y?ska L; Lypaczewska A; Romaniuk D

2013-01-01

168

Results of cataract surgery in the very elderly population  

Science.gov (United States)

Aim The aim of our study was to retrospectively evaluate the effectiveness and safety of cataract surgery and intraocular lens implantation (IOL) for patients aged 90 years or older, whom we define as “very elderly.” Methods The study involved a total number of 122 patients (122 eyes) with senile cataracts. The mean age of patients was 91.2 ± 2.3 years (range 90–100 years old). Phacoemulsification (phaco) was done on 113 of 122 eyes, and 9 of 122 eyes had extracapsular cataract extraction (ECCE). Postoperative visual acuity and intraocular pressure (IOP) were analyzed on the first postoperative day, 3 months after surgery, and 6 months after surgery. Results Best corrected visual acuity (BCVA) improved in 100 of 122 eyes (82.0%). BCVA remained the same in 20 of 122 eyes (16.4%) and decreased in 2 of 122 eyes (1.6%), mainly because of coexisting age-related macular degeneration (AMD). The BCVA 3 months after surgery was ?0.8 in 23 of 122 eyes (18.9%), between 0.5 and 0.7 in 28 of 122 eyes (22.3%), and between 0.2 and 0.4 in 33 of 122 eyes (27.1%). We found significant implications of cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma compared to the patients without glaucoma. Conclusion Advanced age is not a contraindication for cataract surgery. The results of the study showed that when systemic conditions are stable, both phaco and ECCE with IOL for very elderly patients are effective and safe.

Michalska-Malecka, Katarzyna; Nowak, Mariusz; Gosciniewicz, Piotr; Karpe, Jacek; Slowinska-Lozynska, Ludmila; Lypaczewska, Agnieszka; Romaniuk, Dorota

2013-01-01

169

Outcomes of Cataract Surgery in Ocular Cicatricial Pemphigoid.  

UK PubMed Central (United Kingdom)

Abstract Purpose: To report the outcomes of cataract surgery in ocular cicatricial pemphigoid (OCP). Setting: L. V. Prasad Eye Institute, Hyderabad, India. Design: Retrospective, interventional case series. Methods: Patients diagnosed with OCP who had undergone cataract surgery were included. Staging of disease, type of surgery, pre- and postoperative best-corrected visual acuity (BCVA), and number and duration of topical and systemic medications were recorded. Complications and any exacerbation or worsening of disease were noted. Results: Nine eyes of 7 patients (3 male, 4 female) were included in the study, with mean age of 60.44?±?2.6 years (range 56-64 years). Follow-up ranged from 6 months to 10 years (mean 52.9?±?46.25 months). Surgery performed was extracapsular cataract extraction with posterior chamber intraocular lens implantation (n?=?5) or phacoemulsification with posterior chamber intraocular lens implantation (n?=?4). Best-corrected visual acuity improved by more than 2 lines in 6 of 9 (66.67%) eyes, which remained stable till the last follow-up. Three eyes had no visual improvement due to corneal scar in 2 patients and preexisting posterior staphyloma in 1 eye. Disease progression was noted in 2 of 9 operated eyes by one stage at the end of 1 year. Conclusion: In this series, cataract surgery could be safely performed with no major intra- or postoperative complications. While the surgical intervention itself was not associated with acute exacerbations of inflammation, progression of disease was noted in some cases over time. In spite of ongoing disease, cataract surgery in OCP was associated with stable visual outcomes.

Puranik CJ; Murthy SI; Taneja M; Sangwan VS

2013-08-01

170

Primary posterior capsular opacification in Indian rural population undergoing cataract surgery for hypermature senile cataract  

Science.gov (United States)

Aim To find out the incidence of primary posterior capsular opacification (PCO) in rural patients with a hypermature senile cataract undergoing cataract surgery. Settings Tertiary eye care center in central India. Design Prospective, observational, noncomparative study. Materials and methods Two-hundred eyes of 200 patients presenting with a hypermature cataract underwent manual small incision cataract surgery. A single surgeon performed all surgeries under peribulbar anesthesia. After cortical clean-up, the capsular bag was inflated with viscoelastic. The presence or absence of opacity on the posterior lens capsule and location was noted. Postoperative follow-up was done for visual acuity and need for neodymium-doped yttrium aluminum garnet (ND:YAG) laser capsulotomy. Results Primary PCO occurred in 76 eyes (incidence of 38%). It was peripheral in 58 eyes (76.3%) and central in 18 eyes (23.7%). At 6 weeks postoperatively, best corrected visual acuity for eyes with central primary PCO (n = 18) was 0.2–0.3 logMAR and 0–0.2 logMAR for eyes with peripheral primary PCO (n = 58). Best corrected visual acuity at the 6- and 12-month follow-up was 0–0.2 logMAR in both groups. Fibrotic primary PCO was seen in four patients. No predilection for the development of primary PCO to a particular quadrant of posterior capsule was observed. At 1 year postoperatively, eleven (14.5%) patients required ND:YAG laser capsulotomy, six (7.90%) of whom underwent ND:YAG laser capsulotomy at the 6-month follow-up. Seven patients with central primary PCO and four patients with peripheral primary PCO required ND:YAG laser capsulotomy. Conclusion A high incidence of primary PCO was noted in rural patients with a hypermature senile cataract undergoing cataract surgery. No serious intraoperative complications were noted. Visual outcome at 1-year follow-up was satisfactory. Need for early ND:YAG laser posterior capsulotomy should be explained to these patients before cataract surgery. No post ND:YAG capsulotomy complications were noted in any patient.

Joshi, Rajesh Subhash

2013-01-01

171

Primary posterior capsular opacification in Indian rural population undergoing cataract surgery for hypermature senile cataract.  

UK PubMed Central (United Kingdom)

AIM: To find out the incidence of primary posterior capsular opacification (PCO) in rural patients with a hypermature senile cataract undergoing cataract surgery. SETTINGS: Tertiary eye care center in central India. DESIGN: Prospective, observational, noncomparative study. MATERIALS AND METHODS: Two-hundred eyes of 200 patients presenting with a hypermature cataract underwent manual small incision cataract surgery. A single surgeon performed all surgeries under peribulbar anesthesia. After cortical clean-up, the capsular bag was inflated with viscoelastic. The presence or absence of opacity on the posterior lens capsule and location was noted. Postoperative follow-up was done for visual acuity and need for neodymium-doped yttrium aluminum garnet (ND:YAG) laser capsulotomy. RESULTS: Primary PCO occurred in 76 eyes (incidence of 38%). It was peripheral in 58 eyes (76.3%) and central in 18 eyes (23.7%). At 6 weeks postoperatively, best corrected visual acuity for eyes with central primary PCO (n = 18) was 0.2-0.3 logMAR and 0-0.2 logMAR for eyes with peripheral primary PCO (n = 58). Best corrected visual acuity at the 6- and 12-month follow-up was 0-0.2 logMAR in both groups. Fibrotic primary PCO was seen in four patients. No predilection for the development of primary PCO to a particular quadrant of posterior capsule was observed. At 1 year postoperatively, eleven (14.5%) patients required ND:YAG laser capsulotomy, six (7.90%) of whom underwent ND:YAG laser capsulotomy at the 6-month follow-up. Seven patients with central primary PCO and four patients with peripheral primary PCO required ND:YAG laser capsulotomy. CONCLUSION: A high incidence of primary PCO was noted in rural patients with a hypermature senile cataract undergoing cataract surgery. No serious intraoperative complications were noted. Visual outcome at 1-year follow-up was satisfactory. Need for early ND:YAG laser posterior capsulotomy should be explained to these patients before cataract surgery. No post ND:YAG capsulotomy complications were noted in any patient.

Joshi RS

2013-01-01

172

Bilateral Pseudomonas aeruginosa endophthalmitis following bilateral simultaneous cataract surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A bilateral simultaneous cataract surgery (BSCS) was performed on a 67-year-old man. The surgeon had not changed the surgical settings in between the two procedures for the two eyes. The patient developed fulminant bilateral endophthalmitis a day following the BSCS. Intravitreal culture grew Pseudo...

Kashkouli, Mohsen Bahmani; Salimi, Shabnam; Aghaee, Hossein; Naseripour, Masood

173

Viscoexpression technique in manual small incision cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Viscoexpression method of nucleus delivery in manual small incision cataract surgery is described in this article. The practical modifications to the conventional technique in special situations are presented. Intraoperative and postoperative problems likely to be encountered and the steps to avoid them and tackle them effectively are discussed.

Gokhale Nikhil

2009-01-01

174

Corneal endothelial cell characteristics after pediatric cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe the corneal endothelial cell characteristics after pediatric cataract surgery. METHODS: Retrospective case series of 29 study eyes and 26 controls were evaluable. Specular microscopy was performed and endothelial cell features were correlated with clinical and surgical features. RESULTS: Mean age at testing was 106 months in the study group and 116 months in the control group with a mean interval of 78 months after cataract surgery. Mean endothelial cell density in study eyes was 2,668 cells/mm(2) (control eyes, 3,002 cells/mm(2), P < .01). Mean coefficient of variation was 35% (control eyes, 31%, P < .01), and mean percentage of hexagonal cells was 40% (control eyes, 51%, P < .01). There was no significant difference based on age, duration since cataract surgery, contact lens use, glaucoma, number of intraocular procedures, or presence of intraocular lens. CONCLUSIONS: This study demonstrates endothelial cell loss with polymegathism and pleomorphism in children undergoing cataract surgery. This poses a risk of developing long-term corneal complications and hence close monitoring of the endothelial cell count is advisable.

Ramasubramanian A; Mantagos I; Vanderveen DK

2013-07-01

175

Nucleus management in manual small incision cataract surgery by phacosection  

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Nucleus management is critical in manual small incision cataract surgery (MSICS), as the integrity of the tunnel, endothelium and posterior capsule needs to be respected. Several techniques of nucleus management are in vogue, depending upon the specific technique of MSICS. Nucleus can be removed in ...

Ravindra M

176

Viscoexpression technique in manual small incision cataract surgery  

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Viscoexpression method of nucleus delivery in manual small incision cataract surgery is described in this article. The practical modifications to the conventional technique in special situations are presented. Intraoperative and postoperative problems likely to be encountered and the steps to avoid ...

Gokhale Nikhil

177

Wound construction in manual small incision cataract surgery  

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The basis of manual small incision cataract surgery is the tunnel construction for entry to the anterior chamber. The parameters important for the structural integrity of the tunnel are the self-sealing property of the tunnel, the location of the wound on the sclera with respect to the limbus, and t...

Haldipurkar S; Shikari Hasanain; Gokhale Vishwanath

178

[Must an eye after unilateral congenital cataract surgery by amblyopic?  

UK PubMed Central (United Kingdom)

Based on the data from literature, opinions concerning amblyopia after unilateral, congenital cataract surgery are presented. Problems of visual deprivation syndrome and possibilities of prevention and therapy of amblyopia in unilateral aphakia are discussed. The authors concluded that even the eyes operated very early, in newborns aged a few days, remained often amblyopic.

Kornacki B; Goryszewska-Macioch H; Sadowska E

1993-07-01

179

[Must an eye after unilateral congenital cataract surgery by amblyopic?].  

Science.gov (United States)

Based on the data from literature, opinions concerning amblyopia after unilateral, congenital cataract surgery are presented. Problems of visual deprivation syndrome and possibilities of prevention and therapy of amblyopia in unilateral aphakia are discussed. The authors concluded that even the eyes operated very early, in newborns aged a few days, remained often amblyopic. PMID:8121149

Kornacki, B; Goryszewska-Macioch, H; Sadowska, E

1993-07-01

180

Maximal mydriasis evaluation in cataract surgery  

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Full Text Available We propose the Maximal Mydriasis Test (MMT) as a simple and safe means to provide the cataract surgeon with objective and dependable pre-operative information on the idiosyncratic mydriatic response of the pupil. The MMT results of a consecutive series of 165 eyes from 100 adults referred for cataract evaluation are presented to illustrate its practical applications and value. The results of the MMT allows the surgeon to anticipate problem eyes pre-operatively so that he can plan his surgical strategy more appropriately and effectively. Conversely, the surgeon can also appropriately and confidently plan surgical procedures where wide pupillary dilation is important. The MMT has also helped improve our cost-effectiveness by cutting down unnecessary delays in the operating room and enabling better utilisation of restricted costly resources.

Ho Tony; Fan Richard; Hong Wong; Khian Khoo

1992-01-01

 
 
 
 
181

Instruments for cataract surgery: results from our survey  

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Full Text Available For any operation, including cataract surgery, the appropriate instruments must be available and in good working order. If instruments are not available, or are blunt, or do not function properly, it may be necessary to delay or postpone surgery. Using such instruments in an operation can result in a poor outcome, or even pose a risk to surgeons and their assistants.The impact is therefore considerable, and can damage the reputation of the hospital in the community.

Daksha Patel; Phil Hoare

2011-01-01

182

Hormone replacement therapy, reproductive factors, and the incidence of cataract and cataract surgery: the Blue Mountains Eye Study.  

UK PubMed Central (United Kingdom)

The authors aimed to assess the relation between endogenous and exogenous female hormones and the incidence of age-related cataract and cataract surgery. The Blue Mountains Eye Study examined 2,072 women aged 49 years or older during 1992-1994, of whom 1,343 (74.0% of survivors) were reexamined after 5 years, during 1997-1999. Information on reproductive factors and use of hormone replacement therapy was collected using an interviewer-administered questionnaire. Lens photographs were graded for the presence of cortical, nuclear, and posterior subcapsular cataract at baseline and follow-up. Women who had ever used hormone replacement therapy had a decreased incidence of cortical cataract affecting any eye compared with never users (odds ratio = 0.7, 95% confidence interval: 0.4, 1.0). However, this was not statistically significant (odds ratio = 0.7, 95% confidence interval: 0.4, 1.1) when using the first affected eye. Older age at menarche was associated with an increased incidence of cataract surgery (odds ratio = 2.6, 95% confidence interval: 1.2, 5.7) and a significant trend for increasing incidence of nuclear cataract (p = 0.04). There was also a significant trend for decreasing incidence of cataract surgery with increasing duration of reproductive years (p = 0.009). These epidemiologic data provide some evidence that estrogen may play a protective role in reducing the incidence of age-related cataract and cataract surgery.

Younan C; Mitchell P; Cumming RG; Panchapakesan J; Rochtchina E; Hales AM

2002-06-01

183

Hormone replacement therapy, reproductive factors, and the incidence of cataract and cataract surgery: the Blue Mountains Eye Study.  

Science.gov (United States)

The authors aimed to assess the relation between endogenous and exogenous female hormones and the incidence of age-related cataract and cataract surgery. The Blue Mountains Eye Study examined 2,072 women aged 49 years or older during 1992-1994, of whom 1,343 (74.0% of survivors) were reexamined after 5 years, during 1997-1999. Information on reproductive factors and use of hormone replacement therapy was collected using an interviewer-administered questionnaire. Lens photographs were graded for the presence of cortical, nuclear, and posterior subcapsular cataract at baseline and follow-up. Women who had ever used hormone replacement therapy had a decreased incidence of cortical cataract affecting any eye compared with never users (odds ratio = 0.7, 95% confidence interval: 0.4, 1.0). However, this was not statistically significant (odds ratio = 0.7, 95% confidence interval: 0.4, 1.1) when using the first affected eye. Older age at menarche was associated with an increased incidence of cataract surgery (odds ratio = 2.6, 95% confidence interval: 1.2, 5.7) and a significant trend for increasing incidence of nuclear cataract (p = 0.04). There was also a significant trend for decreasing incidence of cataract surgery with increasing duration of reproductive years (p = 0.009). These epidemiologic data provide some evidence that estrogen may play a protective role in reducing the incidence of age-related cataract and cataract surgery. PMID:12034578

Younan, Christine; Mitchell, Paul; Cumming, Robert G; Panchapakesan, Jai; Rochtchina, Elena; Hales, Angela M

2002-06-01

184

Cataract surgery: ensuring equal access for boys and girls  

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Full Text Available In Tanzania, many children are not brought for surgery in a timely fashion and follow up is often poor. Research at Kilimanjaro Christian Medical Centre (KCMC) has shown that girls are more likely than boys to be negatively affected: * Only half as many girls as boys received cataract surgery. * Girls tended to be brought for surgery later than boys. * Girls who did receive surgery were less likely than boys to be brought for the appropriate two-week follow-up visit (36 per cent of girls vs 64 per cent of boys).

Annie Bronsard; Sylvia Shirima

2009-01-01

185

Conjunctival inclusion cysts following small incision cataract surgery  

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Full Text Available The occurrence of acquired conjunctival inclusion cysts following various ophthalmic surgeries such as strabismus surgery, scleral buckling, pars plana vitrectomy, ptosis surgery and phacoemulsification has been reported. We report two cases of conjunctival inclusion cysts following manual Small Incision Cataract Surgery (SICS) in two male patients aged 65 and 67 years. The cysts originated from the scleral tunnel used for manual SICS. Both were treated by excision and confirmed histopathologically. No recurrence was noted at three months follow-up. To our knowledge, conjunctival inclusion cysts following SICS have not been reported previously. Careful reflection of conjunctiva during tunnel construction and posterior chamber intraocular lens implantation may prevent their occurrence.

Narayanappa Shylaja; Dayananda S; Dakshayini M; Gangasagara Suresh; Prabhakaran Venkatesh

2010-01-01

186

Pseudoexfoliation syndrome and the long-term incidence of cataract and cataract surgery: the blue mountains eye study.  

UK PubMed Central (United Kingdom)

PURPOSE: To assess whether the pseudoexfoliation syndrome (PXS) is associated with the long-term incidence of cataract or cataract surgery. DESIGN: Population-based cohort study. METHODS: The Blue Mountains Eye Study examined 3654 persons 49 years of age and older at baseline; 2564 were re-examined after 5 or 10 years, or both. PXS was recorded at the baseline eye examination by an ophthalmologist. Masked graders assessed lens photographs using the Wisconsin Cataract Grading System. Generalized estimating equation regression models were used to examine the association between PXS and cataract by eye. RESULTS: Eyes with PXS had a significantly greater prevalence of cortical cataract (P=.02) and nuclear cataract (P < .0001) than eyes without PXS. The association between PXS and cortical cataract, however, did not persist after further adjustment for age, gender, smoking, diabetes, steroid use, myopia, socioeconomic status, and open-angle glaucoma (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.53 to 1.46), whereas the association between PXS and nuclear cataract persisted after adjustment for the above confounders (OR, 1.90; 95% CI, 1.04 to 3.48). In addition, significant associations were found between the presence of PXS at baseline and the 10-year incidence of either nuclear cataract (P < .0001) or cataract surgery (P < .0001). These associations persisted after adjustment for the potential confounders listed above (OR, 3.25; 95% CI, 1.38 to 7.65; and OR, 4.09; 95% CI, 2.25 to 7.44; respectively). No significant cross-sectional or longitudinal associations were found between PXS and posterior subcapsular cataract. CONCLUSIONS: Long-term follow-up data from this population-based older cohort suggest that the presence of PXS is associated with an increased risk of nuclear cataract and cataract surgery.

Kanthan GL; Mitchell P; Burlutsky G; Rochtchina E; Wang JJ

2013-01-01

187

Cost-effectiveness of cataract surgery in a public health eye care programme in Nepal.  

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Presented is an assessment of the cost-effectiveness of cataract surgery using cost and services data from the Lumbini Zonal Eye Care Programme in Nepal. The analysis suggests that cataract surgery may be even more cost-effective than previously reported. Under a "best estimate" scenario, cataract s...

Marseille, E.

188

Long-Term Effects of Cataract Surgery on Tear Film Parameters  

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Purpose. To examine the differences in tear film parameters more than 3 months postsurgery in eyes with cataract surgery (surgical eyes) versus eyes without cataract surgery (nonsurgical eyes). Methods. 29 patients were seen at the Miami Veterans Affairs Medical Center (VAMC) who had cataract surge...

Venincasa, Vincent D.; Galor, Anat; Feuer, William; Lee, David J.; Florez, Hermes; Venincasa, Michael J.

189

Sudden visual loss after uneventful cataract surgery: Snuff syndrome.  

Science.gov (United States)

We describe a case in which the patient had routine, uneventful cataract surgery and developed snuff syndrome on day 1 postoperatively. The patient had pseudoexfoliation syndrome and normal intraocular pressure that was well controlled by timolol and previous laser trabeculoplasty. Although the visual result had been good after surgery in the first (right) eye with a best corrected visual acuity (BCVA) of 6/5, this adverse event, which decreased the BCVA in the left eye from 6/24 preoperatively to hand movements postoperatively, was unexpected. Systemic evaluation failed to identify a specific cause. Data were collected prospectively on 1000 subsequent, consecutive cases of cataract surgery, but we were unable to find pathogenetic data on this occurrence. PMID:15519103

Sharma, Neil; Ooi, Ju-Lee; Francis, Ian C; Sharma, Shanel; Papalkar, Daya; Kim, Peter; Alexander, Stella L; Schumacher, R Steve

2004-11-01

190

Results of cataract surgery in the very elderly population  

Directory of Open Access Journals (Sweden)

Full Text Available Katarzyna Michalska-Ma?ecka,1 Mariusz Nowak,2 Piotr Go?ciniewicz,1 Jacek Karpe,3 Ludmi?a S?owi?ska-?o?y?ska,4 Agnieszka ?ypaczewska,1 Dorota Romaniuk11Department of Ophthalmology, University Hospital No 5, Medical University of Silesia, Katowice, 2Pathophysiology Division, Department of Pathophysiology and Endocrinology, Medical University of Silesia, Zabrze, 3Department of Anesthesiology and Intensive Therapy, Medical University of Silesia, Zabrze, 4Department of Biophysics, Faculty of Medicine in Zabrze, Medical University of Silesia, Katowice, Silesia, PolandAim: The aim of our study was to retrospectively evaluate the effectiveness and safety of cataract surgery and intraocular lens implantation (IOL) for patients aged 90 years or older, whom we define as “very elderly.”Methods: The study involved a total number of 122 patients (122 eyes) with senile cataracts. The mean age of patients was 91.2 ± 2.3 years (range 90–100 years old). Phacoemulsification (phaco) was done on 113 of 122 eyes, and 9 of 122 eyes had extracapsular cataract extraction (ECCE). Postoperative visual acuity and intraocular pressure (IOP) were analyzed on the first postoperative day, 3 months after surgery, and 6 months after surgery.Results: Best corrected visual acuity (BCVA) improved in 100 of 122 eyes (82.0%). BCVA remained the same in 20 of 122 eyes (16.4%) and decreased in 2 of 122 eyes (1.6%), mainly because of coexisting age-related macular degeneration (AMD). The BCVA 3 months after surgery was ?0.8 in 23 of 122 eyes (18.9%), between 0.5 and 0.7 in 28 of 122 eyes (22.3%), and between 0.2 and 0.4 in 33 of 122 eyes (27.1%). We found significant implications of cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma compared to the patients without glaucoma.Conclusion: Advanced age is not a contraindication for cataract surgery. The results of the study showed that when systemic conditions are stable, both phaco and ECCE with IOL for very elderly patients are effective and safe.Keywords: very elderly patients, cataract surgery, postoperative best corrected visual acuity, intraocular pressure

Michalska-Ma?ecka K; Nowak M; Go?ciniewicz P; Karpe J; S?owi?ska-?o?y?ska L; ?ypaczewska A; Romaniuk D

2013-01-01

191

Visual outcome of cataract surgery with pupillary sphincterotomy in eyes with coexisting corneal opacity  

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Abstract Background To evaluate the visual outcome following cataract surgery with pupillary sphincterotomy in eyes with coexisting corneal opacity. Methods Patients with leucomatous corneal opacity with significant cataract were enrolled for the study. The uncorrected...

Sinha Rajesh; Sharma Namrata; Vajpayee Rasik B

192

Household Preferences for Cataract Surgery in Rural India: A Population-based Stated Preference Survey.  

UK PubMed Central (United Kingdom)

Abstract Purpose: Cataract surgery is provided both by the private and public sector in India. Free cataract surgery (with minimal amenities) funded through subsidies/reimbursements by government and non-governmental organizations is provided for underprivileged and poor patients, especially in rural areas. However, no evidence exists whether this free surgery is used by those who could afford to pay and are willing to pay for cataract surgery. So, understanding willingness to pay and preferences for cataract surgery in the population can have important policy implications. Methods: A cross-sectional survey of 1272 households from four randomly drawn rural household clusters in Theni district, Tamilnadu state, India was conducted. Respondents from households were presented with scenarios (with and without free surgery availability) to elicit their willingness to pay and preferences for cataract surgery. Results: Of those willing to undergo surgery; 696 (57%) were willing to undergo paid surgery, 148 (12%) only free surgery, and 378 (31%) paid surgery if no free surgery was available. In a multinomial logit model, household wealth measures, income variables and family history of cataract surgery largely distinguished the preferences. Good understanding of cataract and its intervention only marginally influenced preference for paid surgery. Conclusion: A larger number of people were willing to pay when free surgery was not available. Free surgery may be crowding out surgery for which costs can be recovered. With non-cataract causes of blindness in the Indian population also requiring attention, this has implications for allocation of scarce resources.

Radhakrishnan M; Venkatesh R; Valaguru V; Frick KD

2013-09-01

193

Cataracts  

Science.gov (United States)

X-Plain Cataracts Reference Summary Introduction A cataract is a clouding of the eye’s lens. Cataracts are a ... a summary of what appears on screen in X-Plain™ . It is for informational purposes and is not ...

194

Evaluation of the role of syringing prior to cataract surgery  

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Full Text Available Patients for cataract surgery in India routinely undergo preoperative syringing to rule out chronic dacryocystitis. We determined the sensitivity and specificity of the clinical test of regurgitation on pressure over the lacrimal sac (ROPLAS) as a screening test for chronic dacryocystitis and compared it to syringing. 621 consecutive outpatients who needed syringing for various reasons (including 318 who had routine syringing prior to cataract surgery) were examined in a masked manner for regurgitation on pressure over the lacrimal sac. They then underwent syringing by a trained (masked) observer. The sensitivity and specificity of ROPLAS were 93.2% and 99.3%, respectively. Using a 6.6% prevalence of chronic dacryocystitis (the prevalence in our cataract population), the negative predictive value of the test was 99.5%. In the presence of regurgitation of pressure over the sac, the high specificity of ROPLAS confirms chronic dacryocystitis. In view of the opportunity costs, when ROPLAS is negative, preoperative syringing in cataract is perhaps unnecessary, unless the findings are equivocal or the index of suspicion for chronic dacryocystitis is very high.

Thomas Ravi; Thomas Saju; Braganza Andrew; Muliyil Jayaprakash

1997-01-01

195

The effects of blunt trauma and cataract surgery on corneal endothelial cell density  

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Full Text Available Purpose: This study was designed to investigate the effects of trauma and cataract surgery on corneal endothelial cell density (ECD) in patients with a traumatic cataract due to blunt trauma without globe laceration. Materials and Methods: In this prospective study, 31 subjects with traumatic cataract (traumatic cataract group) and 30 subjects with a senile cataract (control group) were enrolled. The subjects with traumatic cataract were subdivided into two groups: uncomplicated surgery subgroup (n = 19) in which subjects underwent standard phacoemulsification with intraocular lens implantation and complicated surgery subgroup (n = 12) in which subjects underwent cataract surgery other than standard phacoemulsification. The ECD of the traumatic cataract group and the control group was compared preoperatively and at 3 months or later postoperatively. A P value less than 0.05 was considered statistically significant. Results: The ECD in the eyes with traumatic cataract was 13.1% lower than that for healthy eyes preoperatively (P = 0.043). Postsurgical ECD decreased by 16.7% in complicated surgery subgroup and 11.9% in uncomplicated surgery subgroup (P = 0.049) after 3 months postoperatively. The ECD decreased by 10.8% in the control group (P = 0.489). Conclusions: Patients with cataracts due to blunt trauma had a decreased endothelial cell count, which was significantly aggravated by cataract surgery. The loss of corneal endothelium cells due to surgery depends on the surgical approach.

Yeniad Baris; Corum Isik; Ozgun Cahit

2010-01-01

196

Safety and efficacy of manual small incision cataract surgery for brunescent and black cataracts.  

UK PubMed Central (United Kingdom)

AIMS: To evaluate the safety, visual outcome and complications of manual small incision cataract surgery (MSICS) in the treatment of patients with brunescent and black cataract (BBC). MetHODS: In a non-randomised interventional case series, 102 consecutive patients with BBC underwent cataract extraction by MSICS, with staining of the anterior capsule by trypan blue. RESULTS: Of the 102 eyes with BBC, MSICS was performed through superior scleral tunnel (SST) in 31 eyes (30.4%) and through temporal scleral tunnel (TST) in 71 eyes (69.6%). The main intraoperative complication was posterior capsule rupture in two patients (2.0%). Postoperatively, 20 eyes (19.6%) developed corneal oedema. Mild iritis was seen in six eyes (5.9%) and moderate iritis with fibrin membrane formation occurred in three eyes (2.9%). On the 40th postoperative day, 80 patients (78.4%) achieved uncorrected visual acuity of 6/18 or better, and 99 (97.1%) had best-corrected visual acuity of 6/18 or better. Patients in the SST group had significantly higher postoperative astigmatism compared to those in the TST group (-1.08 D vs -0.72 D, P=0.017). CONCLUSION: MSICS with trypan blue staining of the anterior capsule is a safe and effective method of cataract extraction for patients with BBC.

Venkatesh R; Tan CS; Singh GP; Veena K; Krishnan KT; Ravindran RD

2009-05-01

197

Retinal safety of near-infrared lasers in cataract surgery.  

UK PubMed Central (United Kingdom)

Femtosecond lasers have added unprecedented precision and reproducibility to cataract surgery. However, retinal safety limits for the near-infrared lasers employed in surgery are not well quantified. We determined retinal injury thresholds for scanning patterns while considering the effects of reduced blood perfusion from rising intraocular pressure and retinal protection from light scattering on bubbles and tissue fragments produced by laser cutting. We measured retinal damage thresholds of a stationary, 1030-nm, continuous-wave laser with 2.6-mm retinal spot size for 10- and 100-s exposures in rabbits to be 1.35 W (1.26 to 1.42) and 0.78 W (0.73 to 0.83), respectively, and 1.08 W (0.96 to 1.11) and 0.36 W (0.33 to 0.41) when retinal perfusion is blocked. These thresholds were input into a computational model of ocular heating to calculate damage threshold temperatures. By requiring the tissue temperature to remain below the damage threshold temperatures determined in stationary beam experiments, one can calculate conservative damage thresholds for cataract surgery patterns. Light scattering on microbubbles and tissue fragments decreased the transmitted power by 88% within a 12 deg angle, adding a significant margin for retinal safety. These results can be used for assessment of the maximum permissible exposure during laser cataract surgery under various assumptions of blood perfusion, treatment duration, and scanning patterns.

Wang J; Sramek C; Paulus YM; Lavinsky D; Schuele G; Anderson D; Dewey D; Palanker D

2012-09-01

198

Retinal safety of near-infrared lasers in cataract surgery  

Science.gov (United States)

Femtosecond lasers have added unprecedented precision and reproducibility to cataract surgery. However, retinal safety limits for the near-infrared lasers employed in surgery are not well quantified. We determined retinal injury thresholds for scanning patterns while considering the effects of reduced blood perfusion from rising intraocular pressure and retinal protection from light scattering on bubbles and tissue fragments produced by laser cutting. We measured retinal damage thresholds of a stationary, 1030-nm, continuous-wave laser with 2.6-mm retinal spot size for 10- and 100-s exposures in rabbits to be 1.35 W (1.26 to 1.42) and 0.78 W (0.73 to 0.83), respectively, and 1.08 W (0.96 to 1.11) and 0.36 W (0.33 to 0.41) when retinal perfusion is blocked. These thresholds were input into a computational model of ocular heating to calculate damage threshold temperatures. By requiring the tissue temperature to remain below the damage threshold temperatures determined in stationary beam experiments, one can calculate conservative damage thresholds for cataract surgery patterns. Light scattering on microbubbles and tissue fragments decreased the transmitted power by 88% within a 12 deg angle, adding a significant margin for retinal safety. These results can be used for assessment of the maximum permissible exposure during laser cataract surgery under various assumptions of blood perfusion, treatment duration, and scanning patterns.

Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel

2012-09-01

199

Toxic anterior segment syndrome subsequent to pediatric cataract surgery.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The aim of this study was to investigate possible risk factors and treatment outcomes for the development of toxic anterior segment syndrome (TASS) subsequent to pediatric cataract surgery. MATERIALS AND METHODS: Totally 893 eyes of 534 patients who underwent pediatric cataract surgery were evaluated retrospectively from the point of TASS development between 2006 and 2011. TASS was observed in 19 eyes of 13 patients. Properties of surgical materials used for these patients, postoperative symptoms and their initiation time, therapeutic approaches and results were evaluated. RESULTS: Lens aspiration, posterior capsulotomy and anterior vitrectomy was performed for 480 eyes and TASS developed in 12 eyes. However, TASS was observed in seven eyes of 413 eyes that underwent lens aspiration, posterior capsulotomy, anterior vitrectomy and intraocular lens (IOL) implantation. The factors that may cause TASS were evaluated. Materials used in surgery (intraocular irrigation fluids, viscoelastic materials, intracameral medications etc.) were the same, in all cases. But in all TASS cases, it has been noticed that ethylene oxide-sterilized vitrectomy packs were used for anterior vitrectomy. After the abolition of use of this material, we didn't see new TASS cases. Clinical improvement was achieved by treatment with 0.1% dexamethasone, 0.3% ofloxasin and 5% NaCl in 18 eyes with TASS at mean duration of 6.4?±?4.7 (range, 2-16) weeks. Penetrating keratoplasty was performed to one eye of a patient with bilateral TASS due to unresponsiveness to medical management. CONCLUSION: Use of ethylene oxide-sterilized vitrectomy packs in pediatric cataract surgery is an important risk factor for the development of TASS. Although the majority of the patients with TASS after pediatric cataract surgery recover with medical therapy, a few cases may need penetrating keratoplasty due to irreversible corneal decompensation.

Ari S; Caca I; Sahin A; Cingü AK

2012-03-01

200

Femtosecond laser-assisted cataract surgery in pediatric Marfan syndrome.  

UK PubMed Central (United Kingdom)

PURPOSE: To report femtosecond laser-assisted cataract surgery in pediatric Marfan syndrome. METHODS: Case report. RESULTS: A 10-year-old boy with ectopia lentis due to Marfan syndrome underwent femtosecond laser-assisted cataract surgery (Catalys Precision Laser System; OptiMedica, Sunnyvale, CA) under general anesthesia. Anterior capsulotomy was performed on the decentered lens. Routine irrigation/aspiration devices were used for lens and cortex removal. Centration of the capsular bag was achieved using a Cionni scleral fixation ring. A foldable intraocular lens was implanted. A free-positioned and precise sized capsulotomy was cut by the femtosecond laser. No intraoperative or postoperative complications were observed within the 10 weeks of follow-up. CONCLUSIONS: The use of a femtosecond laser has potential to perform a circular, well-centered capsulotomy for subsequent capsular tension ring and intraocular lens implantation without decentration in patients with Marfan syndrome.

Schultz T; Ezeanosike E; Dick HB

2013-09-01

 
 
 
 
201

Persistent vertical diplopia after cataract surgery: a case report.  

UK PubMed Central (United Kingdom)

Diplopia is an event that can occur following cataract surgery, although its rate of occurrence is limited and ranges from 0.67% to 0.85%. The authors present a case of vertical diplopia arising after peribulbar anaesthesia for cataract surgery in a 78-year-old woman. Diplopia appeared at distance in primary position, while at near there was binocular single vision. Stereopsis was present at the Lang I - II Test, but the Wirth Test was incomplete. Although in the literature the frequency of these "accidents" is very limited, we think it is relevant to emphasize the need to perform pre-operative routine using a careful orthoptic examination along with a thorough medical, especially strabological, history.

Migliorini R; Fratipietro M; Segnalini A; Arrico L

2013-01-01

202

Cardiovascular disease, vascular risk factors and the incidence of cataract and cataract surgery: the Blue Mountains Eye Study.  

UK PubMed Central (United Kingdom)

PURPOSE: To assess whether an association exists between cardiovascular disease, vascular risk factors and incident cataract and cataract surgery. METHODS: The Blue Mountains Eye Study examined 3654 participants > or = 49 years of age during 1992-4, then 2335 survivors (75.1%) after five years. Trained interviewers administered a vascular history questionnaire; height, weight and blood pressure were measured. Lens photographs from both examinations were graded for presence of cortical, nuclear or posterior subcapsular cataract. RESULTS: Obesity (body mass index > or = 30 kg/m2) was significantly associated with increased incidence of both cortical [odds ratio (OR) 1.6, 95% confidence interval (CI) 1.2-2.2] and posterior subcapsular cataract (OR 2.1, CI 1.2-3.7). Hypertensive participants using medication and aged less than 65 years at baseline had a higher incidence of posterior subcapsular cataract (OR 3.4, 95% CI 1.3-8.4) than normotensive subjects. A history of angina was associated with higher cataract surgery incidence (OR 2.1, 95% CI 1.3-3-5). CONCLUSIONS: These longitudinal data provide some evidence supporting a relationship between cardiovascular disease, vascular risk factors and incident cataract and cataract surgery. The findings confirm a number of associations previously documented in cross-sectional data.

Younan C; Mitchell P; Cumming R; Rochtchina E; Panchapakesan J; Tumuluri K

2003-10-01

203

Manual small incision cataract surgery for subluxated cataract with lens coloboma.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The lens coloboma results from a segmental defective or absent development of the zonules. It is usually unilateral and bilateral cases are rare. These eyes are at greater risk of complications during cataract surgery due to ocular malformations. In addition the capsular bag requires stabilization using modified capsule tension ring, capsular tension segment or capsular anchor. METHODS: Lens extraction is indicated for cataract or subluxation if visual function is sufficiently compromised. We report our surgical experience in a patient with bilateral isolated lens coloboma by performing manual small incision cataract surgery (MSICS) in left eye and phacoemulsification in right eye. RESULTS: The nuclear rotation was hampered because of the lack of zonules and presence of lens coloboma. MSICS was converted to the intracapsular technique in left eye, though breaking the nucleus into pieces during phacoemulsification in right eye enabled its mobilization and successful completion with implantation of modified capsule tension ring. CONCLUSIONS: A patient with lens subluxation and lens coloboma is better managed by phacoemulsification as compared to the MSICS.

Goel R; Kamal S; Khurana B; Kumar S; Malik KP; Bodh SA; Singh M

2012-04-01

204

Sequential intrastromal corneal ring implantation and cataract surgery in a severe keratoconus patient with cataract.  

Science.gov (United States)

A 49-year-old man with an uncorrected visual acuity (UCVA) of 20 / 1000, a best spectacle-corrected visual acuity (BSCVA) of 20 / 400, keratometric readings of K1 = 59.88 × 82° / K2 = 45.88 × 172°, and an inferior steepening that was consistent with keratoconus in his left eye was treated with clear-cornea phacoemulsification and an intraocular lens (IOL) implantation after insertion of keraring intrastromal corneal ring segments for severe keratoconus and cataract. An asymmetrical pair of kerarings was implanted with the assistance of a femtosecond laser in September 2008; the one segment was 250 µm and the other was 150 µm and both were placed at 70°. Three months after the kerarings were implanted, clear-cornea phacoemulsification and IOL implantation were performed on the left eye. After surgery, both the UCVA and the BSCVA of the left eye improved by eight lines. Postoperative central keratometry showed a decrease of 7.35 diopters in the left eye. Both the postoperative refraction (-0.75 -0.75 × 60°) and the keratometric reading (K1 = 50.05 × 93° / K2 = 48.83 × 3°) remained stable one month following the procedures. Thus, the sequential order of intrastromal corneal rings implantation and cataract surgery can be considered as a treatment option in patients with severe keratoconus and cataract. PMID:22670082

Lee, Seung Jae; Kwon, Hyun Suk; Koh, Il Hwan

2012-05-22

205

Sequential intrastromal corneal ring implantation and cataract surgery in a severe keratoconus patient with cataract.  

UK PubMed Central (United Kingdom)

A 49-year-old man with an uncorrected visual acuity (UCVA) of 20 / 1000, a best spectacle-corrected visual acuity (BSCVA) of 20 / 400, keratometric readings of K1 = 59.88 × 82° / K2 = 45.88 × 172°, and an inferior steepening that was consistent with keratoconus in his left eye was treated with clear-cornea phacoemulsification and an intraocular lens (IOL) implantation after insertion of keraring intrastromal corneal ring segments for severe keratoconus and cataract. An asymmetrical pair of kerarings was implanted with the assistance of a femtosecond laser in September 2008; the one segment was 250 µm and the other was 150 µm and both were placed at 70°. Three months after the kerarings were implanted, clear-cornea phacoemulsification and IOL implantation were performed on the left eye. After surgery, both the UCVA and the BSCVA of the left eye improved by eight lines. Postoperative central keratometry showed a decrease of 7.35 diopters in the left eye. Both the postoperative refraction (-0.75 -0.75 × 60°) and the keratometric reading (K1 = 50.05 × 93° / K2 = 48.83 × 3°) remained stable one month following the procedures. Thus, the sequential order of intrastromal corneal rings implantation and cataract surgery can be considered as a treatment option in patients with severe keratoconus and cataract.

Lee SJ; Kwon HS; Koh IH

2012-06-01

206

Cataract surgery in eyes with filtered primary angle closure glaucoma.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the effect of cataract surgery on intraocular pressure (IOP) in filtered eyes with primary angle closure glaucoma (PACG). METHODS: In this prospective interventional case series, 37 previously filtered eyes from 37 PACG patients with mean age of 62.1±10.4 years were consecutively enrolled. All patients had visually significant cataracts and phacoemulsification was performed at least 12 months after trabeculectomy. Visual acuity, IOP and the number of glaucoma medications were recorded preoperatively, and 1, 3, 6 and 12 months after surgery. Anterior chamber (AC) depth was measured preoperatively and 3 months after cataract surgery with A-scan ultrasonography. The main outcome measure was IOP at 12 months. RESULTS: IOP was decreased significantly from 18.16±5.91 mmHg at baseline to 15.37±2.90 mmHg at final follow-up (P<0.01). The mean number of glaucoma medications was significantly decreased from 1.81±0.24 to 0.86±1.00 (P=0.001) at 1 year postoperatively. At final follow up, 36 (97.2%) eyes and 32 (86.4%) eyes had IOP?21 and IOP?18 mmHg, respectively; 14 (37.8%) eyes and 9 (24.3%) eyes had IOP?21 and IOP?18 mmHg without medications, respectively. The magnitude of IOP reduction was correlated with higher preoperative IOP (r=0.85, P<0.001), shallower preoperative AC depth (r=-0.38, P=0.01) and greater changes in AC depth (r=-0.39, P=0.01). CONCLUSION: Cataract surgery reduces IOP and the number of glaucoma medications in previously filtered PACG eyes. This reduction seems to be greater in patients with higher preoperative IOP and shallower anterior chambers.

Moghimi S; Latifi G; Amini H; Mohammadi M; Fakhraie G; Eslami Y; Nassiri N; Caprioli J

2013-01-01

207

Bilateral Pseudomonas aeruginosa endophthalmitis following bilateral simultaneous cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available A bilateral simultaneous cataract surgery (BSCS) was performed on a 67-year-old man. The surgeon had not changed the surgical settings in between the two procedures for the two eyes. The patient developed fulminant bilateral endophthalmitis a day following the BSCS. Intravitreal culture grew Pseudomonas aeruginosa . The source of infection was not found. Immediate bilateral vitrectomy and intravitreal, subconjunctival, topical and systemic antibiotic did not save the eyes. Patient ended up with bilateral visual loss.

Kashkouli Mohsen; Salimi Shabnam; Aghaee Hossein; Naseripour Masood

2007-01-01

208

Argon laser photocoagulation of cyclodialysis clefts after cataract surgery  

Energy Technology Data Exchange (ETDEWEB)

Three patients with cyclodialysis clefts, hypotony and hypotonic retinopathy subsequent to cataract surgery were treated with argon laser photocoagulation. The hypotony was reversed in each patient and their visual acuity was normalized. Laser photocoagulation is a noninvasive treatment that can be repeated easily and safely. The complications of the treatment are minor. A hypertensive episode commonly occurs in the early postoperative period. (au) 8 refs.

Bauer, B. [Univ. of Lund, Dept. of Ophthalmology, Lund (Sweden)

1995-06-01

209

Argon laser photocoagulation of cyclodialysis clefts after cataract surgery  

International Nuclear Information System (INIS)

[en] Three patients with cyclodialysis clefts, hypotony and hypotonic retinopathy subsequent to cataract surgery were treated with argon laser photocoagulation. The hypotony was reversed in each patient and their visual acuity was normalized. Laser photocoagulation is a noninvasive treatment that can be repeated easily and safely. The complications of the treatment are minor. A hypertensive episode commonly occurs in the early postoperative period. (au) 8 refs

1995-01-01

210

Myopia and the Long-term Incidence of Cataract and Cataract Surgery: The Blue Mountains Eye Study.  

UK PubMed Central (United Kingdom)

BACKGROUND: To assess the association between refractive errors and the 10-year incidence of cataract and cataract surgery. DESIGN: Population based prospective cohort study PARTICIPANTS: 3654 persons aged 49+ years living in a well-defined geographical region were examined at baseline; 2564 were re-examined after 5 and/or 10 years. METHODS: Baseline refractive error was measured using autorefraction with subjective refinement. Lens photographs were taken at each visit and assessed using the Wisconsin Cataract Grading System. MAIN OUTCOME MEASURES: Long-term incidence of cataract and cataract surgery. RESULTS: Comparing to emmetropia, high myopia was associated with increased incidence of nuclear cataract (adjusted odds ratio [OR] 3.01, 95% confidence intervals [CI] 1.35 - 6.71). Low (OR 1.86, CI 1.03 - 3.35) and high myopia (OR 7.80, CI 3.51 - 17.35) were significantly associated with higher incidence of posterior subcapsular (PSC) cataract. Low, moderate and high myopia were associated with increased incidence of cataract surgery (OR 2.54, CI 1.76 - 3.68; OR 2.61, CI 1.45 - 4.69 and OR 4.81, CI 2.33 - 9.93, respectively). Either any (OR 1.35, CI 1.08 - 1.69) or moderate hyperopia (OR 1.76, CI 1.32 - 2.34) was associated with increased incidence of nuclear cataract. CONCLUSION: Our longitudinal study confirms the association between myopia and an increased risk of nuclear and PSC cataract. It also suggests that hyperopia may increase the risk of nuclear cataract.

Kanthan GL; Mitchell P; Rochtchina E; Cumming RG; Wang JJ

2013-09-01

211

Incidence of and factors associated with glaucoma after surgery for congenital cataract: findings from the British Congenital Cataract Study.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the incidence of and factors associated with postoperative open-angle glaucoma in a nationally representative group of children undergoing surgery for congenital or infantile cataract. DESIGN: Noncomparative interventional cohort study. PARTICIPANTS: All children in the United Kingdom who were newly diagnosed with congenital or infantile cataract in a 12-month period in 1995 and 1996 (the British Congenital/Infantile Cataract Study) were eligible for this study. One hundred sixty-five children with congenital or infantile cataract underwent cataract surgery. METHODS: All the children were traced through their managing ophthalmologists. Standardized outcome data were collected at least 6 years after diagnosis. For children undergoing cataract extraction, Cox regression analysis was performed to determine incidence of postoperative open-angle glaucoma and the effect of key factors considered, a priori, potentially to be associated with it (i.e., age at detection and surgery, type of cataract surgery, primary intraocular lens implantation, severe postoperative uveitis, and microphthalmia). MAIN OUTCOME MEASURES: Development of open-angle glaucoma after cataract surgery. RESULTS: Postoperative glaucoma developed in 27 of 275 eyes of 165 children who underwent cataract surgery. The overall annual incidence of postoperative glaucoma was 5.25 per 100 cataract operations. The median time to development of postoperative glaucoma was 1.34 years (range, 0.39 months-6.73 years). Younger age at detection of cataract was the only factor independently associated with the development of glaucoma when all other factors of interest (which were all statistically associated with age at detection) were accounted for. A 10-fold increase in the age at detection (for example, 30 days compared with 3 days) was associated with a 64% decrease in the hazard ratio (95% confidence interval, 41%-79%; P<0.001). CONCLUSIONS: Median time to development of postoperative open-angle glaucoma in the present study was lower than that reported previously, emphasizing the need for vigilance from the early postoperative period. Earlier detection of cataract was the only significant factor associated with the development of glaucoma after surgery for congenital cataract.

Chak M; Rahi JS

2008-06-01

212

Abdominal Pain after Cataract Surgery with Remifentanil Based Anesthesia  

Directory of Open Access Journals (Sweden)

Full Text Available Remifentanil is an ultra short acting opioid that is suitable for many operations and is wildly used for induction and maintenance of anesthesia. In this article we have reported the incidence of abdominal pain after cataract surgery in patients with remifentanil based anesthesia. This study is a randomized single blind clinical trial on 300 patients who were candidates for elective cataract surgery under general anesthesia. Patients were randomly divided into two groups. In the control group (N=150) after routine monitoring, general anesthesia was induced by fentanyl, propofol and atracurium. Anesthesia was maintained by propofol infusion and 60% N2O inhalation. In remifentanil group, general anesthesia was induced by remifentanil, propofol and atracurium. Anesthesia was maintained by remifentanil infusion and 60% N2O inhalation. Abdominal pain was observed in 79 patients (52.6%) of the remifentanil group. Abdominal pain was severe in 10 cases (6.7%), which indicated a therapeutic intervention. Abdominal pain was observed in 3 cases (2%) of control group patients. Abdominal pain incidence was significantly higher in remifentanil group (pP=0.0001). Postoperative nausea and vomiting (PNOV) was reported in 7 patients (4.7%) in remifentanil group and in 10 cases (6.7%) of the control group (0.454). Briefly, remifentanil based anesthesia caused high incidence of abdominal pain in cataract surgery patients.

Alireza Bameshki; Saeid Jahanbakhsh

2009-01-01

213

Cataracts  

Medline Plus

Full Text Available X-Plain Cataracts Reference Summary Introduction A cataract is a clouding of the eye’s lens. Cataracts are a common eye condition that affects ... reached by you and your doctor together. This reference summary will help you understand what cataracts are ...

214

Clinical observation of macular grid photocoagulation before cataract surgery for diabetes patients with diffuse macular edema  

Directory of Open Access Journals (Sweden)

Full Text Available AIM: To explore the effects and reliability of macular grid photocoagulation before cataract surgery for diabetes patients with diffuse macular edema.METHODS: A total of 30 patients(40 eyes)were enrolled in the study. All the patients were randomly divided into two groups: group A: 20 eyes were treated with macular grid photocoagulation before cataract surgery; group B: 20 eyes were treated with cataract surgery only. RESULTS: The patients treated with macular grid photocoagulation before cataract surgery. Postoperative visual acuity was improved, the edema of macular decreased. The patients treated with cataract surgery only, visual acuity showed no evident change and macular edema remained stable or creased. CONCLUSION: Macular grid photocoagulation before cataract surgery for diabetes patients can improve the outcome and vision of the patients.

Jun-Yan Li; Juan Shao; Yan Wang; Chun-Mei Wang; Qing-Xin Jin; Juan Liu

2013-01-01

215

Cirurgia da catarata infantil unilateral/ Unilateral pediatric cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Analisar os resultados visuais de uma série de crianças operadas de catarata unilateral. MÉTODOS: Um estudo retrospectivo foi realizado através da análise de 35 prontuários médicos do Serviço de Catarata Congênita da UNIFESP/EPM. RESULTADOS: Quanto à etiologia, a primeira causa de catarata foi idiopática, a segunda causa foi o trauma e a terceira foi a rubéola congênita. Em 51,4% dos olhos tinham acuidade visual pré-operatória de ausência de fixa (more) ção. E em 42,8% dos casos operados a acuidade visual final foi igual ou melhor que 20/200. DISCUSSÃO: Embora a cirurgia em catarata unilateral seja motivo de controvérsias entre os oftalmologistas, obteve-se melhora de acuidade visual em número significativo de casos. Abstract in english PURPOSE: To analyze the results in a series of children submitted to unilateral cataract surgery. METHODS: A retrospective study was conducted through the analysis of 35 patient files from the Congenital Cataract Service of UNIFESP/EPM. RESULTS: The main cause of unilateral cataract was idiopathic, the second cause was ocular trauma and the third cause was congenital rubella. Initial visual acuity was very poor in 51.4% of the cases (did not fix or follow), and the best c (more) orrected final visual acuity was better than 20/200 in 42.8% of the eyes. DISCUSSION: Although controversial, the surgical treatment of unilateral cataract, in this study, showed improvement in many cases.

Brandão, Adriana Maria Drummond; Tartarella, Márcia Beatriz

2008-04-01

216

Cirurgia da catarata infantil unilateral Unilateral pediatric cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Analisar os resultados visuais de uma série de crianças operadas de catarata unilateral. MÉTODOS: Um estudo retrospectivo foi realizado através da análise de 35 prontuários médicos do Serviço de Catarata Congênita da UNIFESP/EPM. RESULTADOS: Quanto à etiologia, a primeira causa de catarata foi idiopática, a segunda causa foi o trauma e a terceira foi a rubéola congênita. Em 51,4% dos olhos tinham acuidade visual pré-operatória de ausência de fixação. E em 42,8% dos casos operados a acuidade visual final foi igual ou melhor que 20/200. DISCUSSÃO: Embora a cirurgia em catarata unilateral seja motivo de controvérsias entre os oftalmologistas, obteve-se melhora de acuidade visual em número significativo de casos.PURPOSE: To analyze the results in a series of children submitted to unilateral cataract surgery. METHODS: A retrospective study was conducted through the analysis of 35 patient files from the Congenital Cataract Service of UNIFESP/EPM. RESULTS: The main cause of unilateral cataract was idiopathic, the second cause was ocular trauma and the third cause was congenital rubella. Initial visual acuity was very poor in 51.4% of the cases (did not fix or follow), and the best corrected final visual acuity was better than 20/200 in 42.8% of the eyes. DISCUSSION: Although controversial, the surgical treatment of unilateral cataract, in this study, showed improvement in many cases.

Adriana Maria Drummond Brandão; Márcia Beatriz Tartarella

2008-01-01

217

Changes in central corneal thickness after congenital cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate central corneal thickness (CCT) changes after congenital cataract surgery with or without intraocular lens (IOL) implantation. SETTING: Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. DESIGN: Comparative case series. METHODS: Anterior lensectomy and anterior vitrectomy were performed in eyes with congenital cataract. Eyes had IOL implantation (pseudophakic group) or remained aphakic (aphakic group). The CCT and intraocular pressure were measured in all cases preoperatively and 1 and 6 months postoperatively. Age-matched normal eyes served as a control group. RESULTS: The study evaluated 47 eyes (30 patients), 32 pseudophakic and 15 aphakic. The mean preoperative CCT was 540 ?m ± 34 (SD) in the pseudophakic group, 548 ± 61 ?m in the aphakic group, and 558 ± 36 ?m in the control group (P = .207). The mean CCT in the aphakic group was significantly greater than in the pseudophakic group (587 ± 65 ?m versus 539 ± 37 ?m) 1 month postoperatively (P = .018) and at 6 months (602 ± 65 ?m versus 540 ± 36 ?m) (P = .012). Although the CCT values in the pseudophakic group at 1 month and 6 months were similar to preoperative values (P = .463 and P = 1.00, respectively), both postoperative CCT values in the aphakic group were significantly greater than preoperatively (P<.001). CONCLUSIONS: The CCT in eyes with congenital cataract was similar to that in normal age-matched eyes. However, shortly after cataract removal, the CCT was significantly greater in aphakic eyes than in pseudophakic eyes.

Faramarzi A; Javadi MA; Jabbarpoor Bonyadi MH; Yaseri M

2010-12-01

218

Congenital cataract surgery with intraocular lens implantation in microphthalmic eyes: visual outcomes and complications.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the visual outcomes and complications of congenital cataract surgery with primary intraocular lens implantation in microphthalmic eyes of children younger than 4 years of age. METHODS: This retrospective interventional case series included 14 microphthalmic eyes from 10 children who underwent congenital cataract surgery with primary intraocular lens implantation younger than 4 years of age. Seven patients had bilateral cataracts (11 eyes met the study's inclusion criteria) and 3 patients had unilateral cataract. Patients' medical charts were reviewed to obtain information regarding the preoperative and postoperative ophthalmological examination. Main outcome measures were intraocular pressure (IOP), best-corrected visual acuity, and intraoperative and postoperative complications. RESULTS: Mean age at the time of surgery was 21.7 ± 2.9 months. Mean ocular axial length was 19.2 ± 0.9 mm. Mean preoperative IOP was 9.7 ± 1.7 mmHg and 10.3 ± 3.1 mmHg on final follow-up (P=0.18). There were no intraoperative complications. Two (15.4%) eyes developed secondary visual axis opacification, of which only one needed to be reoperated due to significantly decreased vision (0.5 logMAR). Preoperative and postoperative best-corrected visual acuity was 2.09 ± 0.97 logMAR and 0.38 ± 0.08 logMAR in bilateral cases and 1.83 ± 1.04 logMAR and 0.42 ± 0.13 logMAR in unilateral cases, respectively. CONCLUSION: Primary intraocular lens implantation in congenital cataract surgery in microphthalmic eyes resulted in a significant best-corrected visual acuity improvement with no intraoperative complications and minimal postoperative complications.

Ventura MC; Sampaio VV; Ventura BV; Ventura LO; Nosé W

2013-08-01

219

Five year incidence of cataract surgery: the Blue Mountains Eye Study.  

UK PubMed Central (United Kingdom)

AIMS: To assess the 5 year incidence of cataract surgery in an older population based prospective cohort. METHODS: 5 Year prospective follow up of the population based Blue Mountains Eye Study (BMES) performed in 1992. The follow up study examined 2335 survivors (75.1%) of the 3654 baseline participants. Baseline and 5 year slit lamp and retroillumination lens photographs were graded for presence of cortical, nuclear, or posterior subcapsular cataract using the Wisconsin cataract grading method and cataract surgery was documented from the history and the clinical examination. RESULTS: An overall cataract surgery rate of 5.7% in first or both eyes was documented. The incidence was 0.3% in people aged 49-54 years at baseline, 1.7% for ages 55-64 years, 7.9% for ages 65 to 74 years, and 17.4% in people aged 75 years or older. The rate of surgery in first or both eyes was 6.0% in women and 5.2% in men, age adjusted p = 0.66. Bilateral cataract surgery was performed during follow up on 2.7% of participants, while 43.1% of unilateral phakic cases had second eye surgery. Presence of any posterior subcapsular (PSC) cataract, either alone or in combination with other cataract types, was the most likely type of cataract at baseline to be associated with incident cataract surgery. Baseline age was the most important non-ocular variable predicting incident cataract surgery. CONCLUSIONS: This study has documented age specific rates for 5 year incident cataract surgery in an older community. The finding of relatively similar incidence rates and ocular predictors of cataract surgery to those reported by the Beaver Dam Eye Study, Wisconsin, United States, is of interest, given previous documented similarities between these two populations.

Panchapakesan J; Mitchell P; Tumuluri K; Rochtchina E; Foran S; Cumming RG

2003-02-01

220

Cataract surgery and quality of life in patients with age related macular degeneration  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: The coexistence of cataract and age related macular degeneration (AMD) is not unusual, especially in the very elderly. The outcome of cataract surgery in these cases depends on the effect of AMD on vision. In this study the authors have compared the outcome of cataract patients with AMD ...

Lundström, M; Brege, K G; Florén, I; Lundh, B; Stenevi, U; Thorburn, W

 
 
 
 
221

The deficit in cataract surgery in England and Wales and the escalating problem of visual impairment: epidemiological modelling of the population dynamics of cataract  

Digital Repository Infrastructure Vision for European Research (DRIVER)

BACKGROUND—The pool of old cases of cataract, the expected new cases, and the shortfall in cataract surgery and consequently the numbers dying with poor vision without the benefit of cataract surgery are regarded as escalating problems worldwide. Successive governments and the professional ophthalmi...

Minassian, D; Reidy, A; Desai, P; Farrow, S; Vafidis, G; Minassian, A

222

Post-Cataract Surgery Visual Disturbance in a Retinitis Pigmentosa Patient with Asteroid Hyalosis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A patient with retinitis pigmentosa showed visual disturbances following successful cataract surgery. He had a dense asteroid hyalosis in the eye before cataract surgery. After the surgery he noticed that his vision became worse. The visual disturbance was explained as being caused by the progressio...

Jingami, Yoko; Otani, Atsushi; Kojima, Hiroshi; Makiyama, Yukiko; Yoshimura, Nagahisa

223

Cataract Surgery in Behcet's Disease Patients One Week after Infliximab Administration.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe two patients with Behçet's disease who underwent cataract surgery one week after infliximab administration. METHODS: Patients received preoperative antibiotic therapy with 0.5% levofloxacin eye drops and 500 mg levofloxacin oral tablets, followed by cataract surgery one week after infliximab administration. We observed ocular findings following cataract surgery, phacoemulsification-aspiration, and posterior chamber intraocular lens implantation. RESULTS: There were no intraoperative complications. Neither ocular inflammatory attacks nor infectious complications were found in the operated eyes of both patients during follow-up. CONCLUSION: Administration of infliximab one week before cataract surgery is safe and effective for patients with Behçet's disease.

Handa T; Tsunekawa H; Zako M

2011-05-01

224

[Progresses in antiinflamatory treatment in cataract surgery].  

UK PubMed Central (United Kingdom)

Anti-inflamatory medication is commonly used to reduce inflammation, edema and symptoms associated with allergies, trauma and infections diseases. Topical nonsteroidial anti-inflammatory (NSAIDs) and topical corticosteroids are overview of the role of topical NSAIDs and the progress of their use in eye surgery

Stefan C; Pop A; Cojocaru I

2011-01-01

225

[Proptosis and ophthalmoplegia after cataract surgery].  

Science.gov (United States)

We report a case of a 57 years old female presenting with proptosis, periorbital swelling and ophthalmoplegia, 4 days after an uneventful phacoemucification surgery. Visual acuity was 20/200, biomicroscopy showed mild corneal edema and anterior chamber cells with normal posterior segment. The patient was febrile with leukocytosis and elevated Levels of C-reactive protein. A head computed tomography venography scan showed left eye proptosis, bilateral paranasal sinus hyper-density with massive sinus vein thrombosis extending from the left ophthalmic vein to the left cavernous, transversal and sigmoidal sinuses, the right cavernous and sigmoidal sinuses and internal jugular veins bilaterally. Very mild infiltration was seen around the Left ophthalmic vein, with no other signs of orbital inflammation. Emergency endoscopic sinus surgery was performed followed by anticoagulation and antibiotic treatment, blood and sinus culture later grew streptococci. The therapeutic measures resulted in complete resolution of the ocular and systemic findings. PMID:23885454

Shahar, Jonathan; Leibovitch, Igal; Amit, Sharon; Zitser, Jennifer; Neuderfer, Meira; Landsberg, Roee

2013-05-01

226

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?  

Science.gov (United States)

Femtosecond laser-assisted cataract surgery (FLACS) represents a potential paradigm shift in cataract surgery, but it is not without controversy. Advocates of the technology herald FLACS as a revolution that promises superior outcomes and an improved safety profile for patients. Conversely, detractors point to the large financial costs involved and claim that similar results are achievable with conventional small-incision phacoemulsification. This review provides a balanced and comprehensive account of the development of FLACS since its inception. It explains the physiology and mechanics underlying the technology, and critically reviews the outcomes and implications of initial studies. The benefits and limitations of using femtosecond laser accuracy to create corneal incisions, anterior capsulotomy, and lens fragmentation are explored, with reference to the main platforms, which currently offer FLACS. Economic considerations are discussed, in addition to the practicalities associated with the implementation of FLACS in a healthcare setting. The influence on surgical training and skills is considered and possible future applications of the technology introduced. While in its infancy, FLACS sets out the exciting possibility of a new level of precision in cataract surgery. However, further work in the form of large scale, phase 3 randomised controlled trials are required to demonstrate whether its theoretical benefits are significant in practice and worthy of the necessary huge financial investment and system overhaul. Whether it gains widespread acceptance is likely to be influenced by a complex interplay of scientific and socio-economic factors in years to come. PMID:23370418

Trikha, S; Turnbull, A M J; Morris, R J; Anderson, D F; Hossain, P

2013-02-01

227

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?  

UK PubMed Central (United Kingdom)

Femtosecond laser-assisted cataract surgery (FLACS) represents a potential paradigm shift in cataract surgery, but it is not without controversy. Advocates of the technology herald FLACS as a revolution that promises superior outcomes and an improved safety profile for patients. Conversely, detractors point to the large financial costs involved and claim that similar results are achievable with conventional small-incision phacoemulsification. This review provides a balanced and comprehensive account of the development of FLACS since its inception. It explains the physiology and mechanics underlying the technology, and critically reviews the outcomes and implications of initial studies. The benefits and limitations of using femtosecond laser accuracy to create corneal incisions, anterior capsulotomy, and lens fragmentation are explored, with reference to the main platforms, which currently offer FLACS. Economic considerations are discussed, in addition to the practicalities associated with the implementation of FLACS in a healthcare setting. The influence on surgical training and skills is considered and possible future applications of the technology introduced. While in its infancy, FLACS sets out the exciting possibility of a new level of precision in cataract surgery. However, further work in the form of large scale, phase 3 randomised controlled trials are required to demonstrate whether its theoretical benefits are significant in practice and worthy of the necessary huge financial investment and system overhaul. Whether it gains widespread acceptance is likely to be influenced by a complex interplay of scientific and socio-economic factors in years to come.

Trikha S; Turnbull AM; Morris RJ; Anderson DF; Hossain P

2013-04-01

228

Iris recognition as a biometric method after cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Biometric methods are security technologies, which use human characteristics for personal identification. Iris recognition systems use iris textures as unique identifiers. This paper presents an analysis of the verification of iris identities after intra-ocular procedures, when individuals were enrolled before the surgery. Methods Fifty-five eyes from fifty-five patients had their irises enrolled before a cataract surgery was performed. They had their irises verified three times before and three times after the procedure, and the Hamming (mathematical) distance of each identification trial was determined, in a controlled ideal biometric environment. The mathematical difference between the iris code before and after the surgery was also compared to a subjective evaluation of the iris anatomy alteration by an experienced surgeon. Results A correlation between visible subjective iris texture alteration and mathematical difference was verified. We found only six cases in which the eye was no more recognizable, but these eyes were later reenrolled. The main anatomical changes that were found in the new impostor eyes are described. Conclusions Cataract surgeries change iris textures in such a way that iris recognition systems, which perform mathematical comparisons of textural biometric features, are able to detect these changes and sometimes even discard a pre-enrolled iris considering it an impostor. In our study, re-enrollment proved to be a feasible procedure.

Roizenblatt Roberto; Schor Paulo; Dante Fabio; Roizenblatt Jaime; Belfort Rubens

2004-01-01

229

Incidence of posterior vitreous detachment after cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the incidence of posterior vitreous detachment (PVD) after uneventful state-of-the-art small-incision phacoemulsification with implantation of a posterior chamber intraocular lens (PC IOL). SETTING: Department of Ophthalmology, Ludwigshafen Hospital, Ludwigshafen, Germany. METHODS: This prospective study evaluated the vitreous status of eyes by biomicroscopic examination, indirect binocular ophthalmoscopy, and B-scan ultrasonography before planned cataract surgery. Patients with the posterior vitreous attached were included for follow-up and examined 1 week, 1 month, and 1 year after uneventful phacoemulsification with PC IOL implantation. The preoperative prevalence and postoperative incidence of PVD were determined by ultrasonography. RESULTS: The study included 188 eyes of 188 patients (131 women, 57 men) with a mean age of 77.2 years. The mean spherical equivalent was -0.78 diopter (D) (range -8.75 to +6.25 D) and the mean axial length (AL), 23.22 mm (range 20.50 to 26.04 mm). Preoperatively, 130 eyes (69.1%) had PVD and 58 eyes (30.9%) had no PVD. Postoperatively, 12 eyes (20.7%) developed PVD at 1 week, 18 eyes (31%) at 1 month, and 4 eyes (6.9%) at 1 year. The vitreous body remained attached to the retina in 24 eyes (41.4%) 1 year after surgery. No preoperatively measured parameter (eg, age, refraction, AL, effective phacoemulsification time) was predictive of the occurrence of PVD after cataract surgery. CONCLUSION: The occurrence of PVD after modern cataract surgery was frequent in cases in which the posterior hyaloid was attached to the retinal surface preoperatively.

Mirshahi A; Hoehn F; Lorenz K; Hattenbach LO

2009-06-01

230

Ocular pulse amplitude before and after cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To investigate the impact of cataract surgery on the association of the ocular pulse amplitude (OPA) and intraocular pressure (IOP) with respect to the interpretation of OPA as an estimate of ocular blood flow. METHODS: Twenty-four patients with cataract were included in a clinical study. OPA was measured using dynamic contour tonometry (DCT, Pascal(®), SMT Swiss Microtechnology AG, Switzerland). IOP was measured by means of Goldmann applanation tonometry (IOP GAT) and DCT (IOP DCT). All measurements were performed before and one day after cataract surgery. RESULTS: At baseline, OPA was correlated to IOP GAT (r?=?0.67, P?=?0.0002) and IOP DCT (r?=?0.82, P?surgery (IOP DCT n?=?14), whereas an increase was apparent in seven patients (IOP DCT n?=?10). The mean absolute deviation of IOP GAT pre- to post-surgery was 4.54 mmHg ± 2.47 (range 1-10 mmHg) and 5.4 mmHg ± 3.2 (range 1.1-13.1 mmHg) for IOP DCT. The changes of OPA were significantly correlated to changes in IOP GAT (r?=?0.48, P?=?0.017) and IOP DCT (r?=?0.60, P?=?0.001). IOP GAT and IOP DCT changes were not correlated to changes in corneal thickness. CONCLUSIONS: The OPA measured with the Pascal(®) device seems to be dependent on IOP changes. Particular caution should be taken in the interpretation of OPA in estimating pulsatile ocular blood flow.

Plange N; Rennings C; Herr A; Weber A; Roessler GF; Mazinani BE; Kaup M; Remky A

2012-02-01

231

Cataracts  

Medline Plus

Full Text Available X-Plain Cataracts Reference Summary Introduction A cataract is a clouding of the eye’s lens. Cataracts are a ... a summary of what appears on screen in X-Plain™ . It is for informational purposes and is not ...

232

Selective suture cutting for control of astigmatism following cataract surgery  

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Full Text Available Use of 10-0 monofilament nylon in ECCE cataract surgery leads to high with the rule astigmatism. Many intraoperative and post operative methods have been used to minimise post operative astigmatism. We did selective suture cutting in 38 consecutive patients. Mean keratometric astigmatism at three and six weeks post operative was 5.76 and 5.42 dioptres (D) respectively. 77.5% of eyes had astigmatism above 2 D. Selective suture cutting along the axis of the plus high cylinder was done after six weeks of surgery. Mean post suture cutting keratometric astigmatism was 3.3 D and 70% of the eyes had astigmatism below 2 D. After 3 months of surgery mean keratometric astigmatism was reduced to 1.84 D. Axis of the astigmatism also changed following suture cutting. 40% of the eyes showed improvement in their Snellen acuity following reduction in the cylindrical power.

Bansal R; Gupta Amod; Grewal SPS

1992-01-01

233

Microbiological profile of anterior chamber aspirates following uncomplicated cataract surgery  

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Full Text Available Anterior chamber aspirate cultures were done for 66 patients who underwent either an uncomplicated intracapsular cataract extraction, extracapsular cataract extraction with posterior-chamber intraocular lens implantation, or phacoemulsification with posterior-chamber intraocular lens implantation. The aspirate was obtained at the time of wound closure. The aspirates were immediately transferred to the microbiology laboratory where one drop of the aspirate was placed on a glass slide for gram stain, and the remainder was unequally divided and inoculated into blood agar, chocolate agar and thioglycolate broth. The cultures were incubated at 37° C with 5% CO2 and held for 5 days. Of 66 patients 4 (6%), had smear-positive anterior chamber aspirates. None of the aspirates showed any growth on any of the 3 culture media used. None of the eyes in the study developed endophthalmitis. This study concludes that there is no contamination of the anterior chamber by viable bacteria after cataract surgery, irrespective of the mode of intervention.

Prajna N; Sathish S; Rajalakshmi P; George Celine

1998-01-01

234

Results at seven years after the use of intracamerular cefazolin as an endophthalmitis prophylaxis in cataract surgery  

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Abstract Background To evaluate results after seven years using prophylactic intracameral cefazolin for the prevention of endophthalmitis in cataract surgery. Methods A prospective, observational study of all patients submitted to cataract surgery over the period Janua...

Romero-Aroca Pedro; Méndez-Marin Isabel; Salvat-Serra Merce; Fernández-Ballart Juan; Almena-Garcia Matias; Reyes-Torres Javier

235

Clinical value of microsurgical cataract surgery in dogs by cryoextraction method.  

UK PubMed Central (United Kingdom)

The results of 64 operations of cataract in dogs applying the operating microscope are presented in the paper. The dogs were divided into 4 groups according to the type of cataract: senile, symptomatic, diabetic and toxic. The lenses were removed with a ++cryo-extractor , Dexon and Vicryl were used for suturing. The evaluation of dogs' ability to see after cataract surgery was made on the basis of clinical examinations of vision, ophthalmoscopy and clinical tests. The results of microsurgical cryoextraction in dogs were positive as far as senile and symptomatic cataracts were concerned. No positive results were obtained in the case of diabetic cataract because of existing retinopathy and in toxic cataract where retinal atrophy caused by intoxication occurred. Cataract surgery does not lead to a complete return of vision since the eye is aphakic and hypermetropic. However, it permits the dog to use its sense of vision for orientation in the environment.

Kie?bowicz Z

1990-01-01

236

Suture-related corneal infections after clear corneal cataract surgery.  

UK PubMed Central (United Kingdom)

Three patients at our institution developed corneal infections associated with sutures placed after clear corneal incision cataract surgery. The time to infection was 9 weeks, 22 months, and 33 months. One patient required injection of intravitreal antibiotic agents for presumed endophthalmitis associated with the corneal infection. Two patients were treated with topical fortified antibiotic eyedrops only. Although there was no significant change in visual acuity after resolution of the infection, morbidity from suture-related corneal infections can be significant. Routine suture removal in the early postoperative period may be warranted to prevent such infections.

Lee BJ; Smith SD; Jeng BH

2009-05-01

237

"PRIMARY VITRECTOMY VERSUS SCLERAL BUCKLING IN PATIENTS WITH RETINAL DETACHMENT AFTER CATARACT SURGERY"  

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The purpose of this study was to compare the anatomic and visual outcome of primary vitrectomy with scleral buckling in patients with retinal detachment following cataract surgery. Fifty-six consecutive patients with retinal detachment after cataract surgery were randomly assigned to two treatment g...

"H. Faghihi; A Lashay; H. Ghazi; A. Tabatabaee; MR. Mansouri; A. Javadian; R. Karkhaneh; M. Riazi; A. Mirshahi; Z. Alami

238

A Case of Decreased Visual Field after Uneventful Cataract Surgery: Nonarteritic Anterior Ischemic Optic Neuropathy  

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The purpose of this article is to report a case of nonarteritic anterior ischemic optic neuropathy (NAION) after uneventful cataract surgery. A 53-year-old Filipina underwent cataract surgery. She had a small optic disc with cup-to-disc ratio of 0.2 in the left eye and 0.3 in the right eye. On the f...

Lee, Hun; Kim, Chan Yun; Seong, Gong Je; Ma, Kyoung Tak

239

An Unexpected Delayed Complication of Cataract Surgery: Retinal Detachment Secondary to Capsular Tension Ring Dislocation  

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We aim to present a case of retinal detachment secondary to capsular tension ring dislocation following cataract surgery. A 45-year-old man who underwent cataract surgery 2 years previously presented with decreased vision in his left eye. The patient's posterior capsule was intact with a well-locate...

?ekero?lu, Hande Taylan; Erdem, Elif; Yar, Kemal; Demircan, Nihal

240

Cataract surgery under topical anesthesia using 2% lignocaine jelly and intracameral lignocaine: Is manual small incision cataract surgery comparable to clear corneal phacoemulsification?  

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A prospective comparative study was undertaken to compare the patients? pain experience, surgical outcome and surgeon?s experience in phacoemulsification and manual small incision cataract surgery (MSICS) under topical anesthesia supplemented with intracameral lignocaine (TASIL). In Gr...

Gupta Sanjiv; Kumar Ajai; Agarwal Swati

 
 
 
 
241

Small eyes big problems: is cataract surgery the best option for the nanophthalmic eyes?  

UK PubMed Central (United Kingdom)

Nanophthalmos refers to an eyeball of short axial length, usually less than 20 mm which leads to angle closure glaucoma due to relatively large lens. Intra-ocular lens extraction relieves the angle closure in nanophthalmos. Cataract surgery in a nanophthalmic eye is technically difficult with high risk of complications such as posterior capsular rupture, uveal effusion, choroidal haemorrhage, vitreous haemorrhage, malignant glaucoma, retinal detachment and aqueous misdirection. Various options are explained in the literature to perform cataract surgery in nanophthalmos, like extracapsular cataract extraction with or without sclerostomy; small-incision cataract extraction by phacoemulsification which not only helps maintain the anterior chamber during surgery but also reduces the incidence of complications due to less fluctuation of intraocular pressure (IOP) during the surgery. Cataract surgery deepens and widens the anterior chamber angle in nanophthalmic eyes and has beneficial effects on IOP in eyes with nanophthalmos but is associated with a high incidence of complications.

Khan Utman SA

2013-09-01

242

A case of Creutzfeldt-Jakob disease following cataract surgery: sporadic versus iatrogenic cause.  

UK PubMed Central (United Kingdom)

Creutzfeldt-Jakob Disease (CJD) is a fatal neurologic disorder caused by an infectious agent called a human prion protein. CJD can be classified as sporadic CJD, familial CJD, variant CJD, and iatrogenic CJD. We report a 64-year-old man diagnosed with CJD three months after cataract surgery. Although sporadic CJD is the most common type, the patient's cataract surgery elicited the possibility of an iatrogenic transmission. It is important to consider whether visual symptoms are a manifestation of sporadic CJD, rather than cataract surgery resulting in iatrogenic CJD. Preceding cataract surgeries have been reported with CJD, but there is no proven causality. This case highlights consideration of sporadic versus iatrogenic cause when seen in association with cataract surgery.

Gnanajothy R; Umashanker D; Vega MC; Wu BJ

2013-06-01

243

Profile of cataract surgery in Varamin Iran: a population based study.  

UK PubMed Central (United Kingdom)

PURPOSE: To identify cataract surgical coverage (CSC), barriers and outcomes of cataract surgery in a representative sample of Iranian population. METHODS: This cross-sectional study was performed on 3000 adults over 50 in Varamin district. CSC was defined as the proportion of (pseudo) aphakic eyes of all operable and operated eyes with cataract. If there was obvious lens opacity in either or both eyes in combination with best corrected VA less than 6/18, the person was asked why the operation for cataract was not done to find out about barriers of cataract surgery. Outcomes of cataract surgery were categorized as good, intermediate and poor using presenting visual acuity (VA) which were defined as VA?6/18, 6/60? VA <6/18 and VA < 6/60, respectively. RESULTS: Out of 5638 examined eyes, 526 eyes (9.3 %) had history of cataract surgery. 156 subjects (45.7%) had a unilateral and 185 subjects (54.2%) had bilateral operated eyes. CSC was 66.4% in visually impaired eyes (VA < 6/18), 90.4% in blind eyes (VA < 3/60), 80.5% in visually impaired persons (VA< 6/18 in the better eye) and 97.6% in blind persons (VA< 3/60 in the better eye). Cataract surgery in the majority of eyes (71.9%) had a good visual outcome. The main barrier of cataract surgery was unawareness of treatment. CONCLUSION: Cataract surgery was performed for two thirds of the eyes with an indication of this surgery. Overall, the cataract services in the studied population were acceptable, although it should be improved, to achieve vision 2020 objectives.

Katibeh M; Ziaei H; Rajavi Z; Hosseini S; Javadi MA

2013-08-01

244

Predicting the necessity of LASIK enhancement after cataract surgery in patients with multifocal IOL implantation  

Directory of Open Access Journals (Sweden)

Full Text Available Pinakin Gunvant1,2, Anna Ablamowicz2, Subba Gollamudi31Western University of Health Sciences, College of Optometry, Pomona, CA, 2Southern College of Optometry, Memphis, TN, 3Eye Specialty Group, Memphis, TN, USAPurpose: To investigate if the parameters measured routinely prior to cataract surgery with multifocal intraocular lens (IOL) implantation can predict the necessity of additional laser in situ keratomileusis (LASIK) to improve visual outcome.Methods: Records of patients undergoing cataract surgery between January 2008 and December 2009 were reviewed. Individuals satisfied with visual outcome of cataract surgery and not satisfied were grouped (group 1 and 2, respectively). Preoperative data of refractive error, axial length, corneal astigmatism, intraocular pressure, and postoperative uncorrected visual acuity were recorded. Data was available for 62 patients (104 eyes), of which LASIK enhancement was deemed necessary in 21 eyes (20%; group 2). The receiver operator characteristic curves were used to discriminate between the groups and linear regression analysis was performed to predict the postoperative visual outcome.Results: The astigmatism measured preoperatively using manifest refraction had an accuracy of 64% in discriminating between the groups. Age, spherical component of refraction, axial length, corneal astigmatism, and intraocular pressure were very close to chance prediction 59%, 57%, 56%, 51%, and 51%, respectively. The postoperative uncorrected visual acuity had an accuracy of 79% in discriminating the groups. Individuals with uncorrected visual acuity worse than 20/40 after cataract surgery were most likely to undergo LASIK enhancement; however, approximately 20% of group 2 underwent LASIK enhancement despite having visual acuity of 20/30 or better. When combined, preoperative visual acuity accounted for just 7% of variance in postoperative uncorrected visual acuity.Conclusion: Requirement of LASIK enhancement after cataract surgery with multifocal IOL implant is complex in nature, and parameters routinely measured before surgery cannot successfully identify the group requiring LASIK enhancement or predict postoperative uncorrected visual acuity.Keywords: refractive error, axial length, corneal astigmatism, intraocular pressure, uncorrected visual acuity, visual outcome, multivariate analysis, LASIK enhancement

Gunvant P; Ablamowicz A; Gollamudi S

2011-01-01

245

Recognising ‘high-risk’ eyes before cataract surgery  

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Full Text Available Certain eyes are at a higher risk of complication during cataract surgery. Operations on such ‘high-risk’ eyes are also more likely to yield a poor visual outcome (defined as best corrected vision less than 6/60 after surgery).1Learning to recognise when eyes are at greater risk, and acting accordingly, will help you to avoid complications. Even so, before the operation takes place, it is good practice to explain to such patients that a poor outcome is a possibility. This makes these patients’ expectations more realistic and improves postoperative compliance and follow-up. In most cases, patients who are blind with complicated cataract will be happy with even a modest improvement of their vision.It is also important to have available all the equipment you may need to manage a possible complication, for example a vitrectomy machine in the case of capsular rupture and vitreous loss.Depending on where you are in the world, certain ‘high-risk’ eyes will be more common: for example, pseudoexfoliation in Somalia and India, onchocerciasis in Sudan, and angle-closure glaucoma in Asia. You will get to know your local problems as you perform more operations.

Parikshit Gogate; Mark Wood

2008-01-01

246

[Waste of medical tests in preoperative evaluation for cataract surgery].  

UK PubMed Central (United Kingdom)

The objective of this clinical trial was to determine the frequency of medical tests considered unnecessary in routine preoperative evaluation for cataract surgery. Unnecessary costs with these tests were also evaluated. For patients assigned to the selective testing group, it was requested that no preoperative testing be performed unless the patient presented a new or worsening medical problem warranting medical evaluation with testing. For patients assigned to the routine testing group, three tests were requested: a 12-lead electrocardiogram, complete blood count, and serum glucose level. The costs of tests considered unnecessary were calculated. The sample of 1,025 patients consisted of 512 assigned to the routine testing group and 513 to the selective testing group. Cumulative rate of medical events was similar in the two groups (p=0.923). The selective group underwent 60.7% fewer tests. The results suggest that selective preoperative testing in cataract surgery does not harm patients in terms of peri-operative clinical complications and also represents a significant cost reduction compared to routine testing.

Arieta CE; Nascimento MA; Lira RP; Kara-José N

2004-01-01

247

Anterior segment OCT imaging after femtosecond laser cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the anterior segment imaging characteristics after femtosecond laser assisted cataract surgery. METHODS: Cataract surgery was performed with the LenSx femtosecond laser (Alcon-LenSx Inc., Aliso Viejo, CA) in 40 eyes of 40 patients. The laser was programmed to perform a 4.5-mm capsulorhexis, a cross-pattern fragmentation of the nucleus, a 2.8-mm main incision, and a 1.0-mm side-port incision. The anterior segment was then analyzed using the Visante OCT anterior segment program (Zeiss-Meditec AG, Jena, Germany). RESULTS: The preoperatively set treatment parameters correlated well with the achieved results. For the capsulorhexis, the femtosecond laser cut was programmed to start 350 ?m behind the anterior lens capsule and OCT measured 377 ± 55.3 ?m. Nucleus fragmentation was programmed to start 750 ?m in front of the posterior capsule and end 550 ?m behind the anterior capsule, and OCT measured 794 ± 111 and 568 ± 147 ?m, respectively. The diameter of the capsulorhexis measured by OCT was 4.54 ± 0.2 mm, compared to the 4.5 mm programmed. CONCLUSIONS: Anterior segment OCT imaging was able to detect the tissue changes within the lens after femtosecond laser capsulorhexis and nucleus fragmentation. The measured values correlated well with the planned treatment parameters.

Nagy ZZ; Filkorn T; Takács AI; Kránitz K; Juhasz T; Donnenfeld E; Knorz MC; Alio JL

2013-02-01

248

Which visual measures affect change in driving difficulty after first eye cataract surgery?  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate self-reported driving difficulty before and after first eye cataract surgery and determine which visual measures are associated with changes in self-reported driving difficulty after surgery. METHODS: A cohort of 99 older drivers with bilateral cataract were assessed the week before and 12 weeks after first eye cataract surgery. Visual measures including visual acuity, contrast sensitivity, stereopsis and useful field of view were assessed. Self-reported driving difficulty was measured via the Driving Habits Questionnaire. Cognitive status was assessed using the Mini Mental State Examination. Regression analysis was undertaken to determine the association between changes in visual measures and self-reported driving difficulty after first eye cataract surgery. RESULTS: Overall, self-reported driving difficulty improved after first eye cataract surgery. However, 16% of participants did not improve and driving difficulty worsened in 11% following surgery. Improvement in driving difficulty score after first eye cataract surgery was associated with improved contrast sensitivity in the operated eye (p<0.001), new glasses after surgery (p<0.001), and fewer chronic health conditions (p=0.016). CONCLUSION: Contrast sensitivity rather than visual acuity was a significant factor affecting change in self-reported driving difficulty after first eye cataract surgery for bilateral patients. This has implications for driver licensing authorities worldwide that rely heavily on visual acuity as a measure of visual fitness to drive.

Fraser ML; Meuleners LB; Lee AH; Ng JQ; Morlet N

2013-09-01

249

Functional improvement after one- and two-eye cataract surgery in the Salisbury Eye Evaluation.  

UK PubMed Central (United Kingdom)

PURPOSE: To determine the impact that cataract and cataract surgery have on clinical measurements of vision, reading speed, objective mobility performance, and subjective visual functioning. DESIGN: Prospective, population-based study. PARTICIPANTS: A total of 1739 Salisbury Eye Evaluation (SEE) participants without previous cataract surgery with bilateral baseline best-corrected visual acuity (BCVA) of logarithm of the minimum angle of resolution (logMAR) ? 0.3 (? 20/40) or cataract surgery between rounds 1 and 2. METHODS: Participants were categorized on the basis of cataract surgery by round 2 into no surgery, unilateral surgery, or bilateral surgery. Visual performance, mobility-based tasks, and the Activities of Daily Vision Scale (ADVS) were measured at baseline and 2 years. Mobility score was converted into a z score by subtracting the participant's time from the population baseline average and then dividing by the standard deviation. Comparisons were made between the no surgery and surgery groups using multivariate linear regression. MAIN OUTCOME MEASURES: Change in bilateral BCVA in logMAR, contrast sensitivity, reading speed in words per minute (wpm), mobility score, and ADVS. RESULTS: During the study period, 29 participants had cataract surgery on both eyes, 90 participants had unilateral surgery, and 1620 participants had no surgery. After adjusting for baseline value, demographics, depression, and mental status, the unilateral surgery group's BCVA improved 0.04 logMAR (P = 0.001) and the bilateral group's BCVA improved 0.13 compared with no surgery (P<0.001). Overall mobility declined in all groups. The unilateral group's z score decreased 0.18 more than that of the no surgery group (P = 0.02), whereas the bilateral group showed a 0.18 z score improvement compared with no surgery (P = 0.19). Change in reading speed significantly improved in the unilateral and bilateral groups compared with no surgery (12 and 31 wpm, respectively). The bilateral surgery group showed significant positive change in ADVS compared with no surgery (5 points of relative improvement; P = 0.01), whereas the unilateral group showed a 5-point relative decline (P<0.001). CONCLUSIONS: Cataract negatively affects both subjective quality of life and objective performance measures. Unilateral cataract surgery improves visual functioning, but the largest gains are found in patients who undergo second-eye cataract surgery. This finding supports second-eye cataract surgery for patients with visual or functional symptoms even after successful first-eye surgery. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Lee BS; Munoz BE; West SK; Gower EW

2013-05-01

250

Do ophthalmology training programs affect corrective procedure rates after cataract surgery?  

UK PubMed Central (United Kingdom)

The Veterans Health Administration (VHA) plays a major role in training surgeons in the United States. This study examined the rates of corrective procedures after routine cataract surgery stratified for VHA institutions according to the presence or absence of ophthalmology training programs. There was a wide range of rates of corrective surgeries in the 111 centers that performed cataract surgery. VHA medical centers affiliated with training programs had nearly twice the rates of corrective surgery after cataract extraction than those institutions without such programs. Variation in secondary procedure rates has implications for the development of quality improvement in ophthalmology.

French DD; Margo CE; Campbell RR

2013-05-01

251

Conjunctival sac bacterial flora isolated prior to cataract surgery  

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Full Text Available Chikako Suto1,2, Masahiro Morinaga1,2, Tomoko Yagi1,2, Chieko Tsuji3, Hiroshi Toshida41Department of Ophthalmology, Saiseikai Kurihashi Hospital, Saitama; 2Department of Ophthalmology, Tokyo Women's Medical University, Tokyo; 3Department of Clinical Laboratory, Saiseikai Kurihashi Hospital, Saitama; 4Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, JapanObjective: To determine the trends of conjunctival sac bacterial flora isolated from patients prior to cataract surgery.Subjects and methods: The study comprised 579 patients (579 eyes) who underwent cataract surgery. Specimens were collected by lightly rubbing the inferior palpebral conjunctival sac with a sterile cotton swab 2 weeks before surgery, and then cultured for isolation of bacteria and antimicrobial sensitivity testing. The bacterial isolates and percentage of drug-resistant isolates were compared among age groups and according to whether or not patients had diabetes mellitus, hyperlipidemia, dialysis therapy, oral steroid use, dry eye syndrome, or allergic conjunctivitis.Results: The bacterial isolation rate was 39.2%. There were 191 strains of Gram-positive cocci, accounting for the majority of all isolates (67.0%), among which methicillin-sensitive coagulase-negative staphylococci was the most frequent (127 strains, 44.5%), followed by methicillin-resistant coagulase-negative staphylococci (37 strains, 12.7%). All 76 Gram-positive bacillary isolates (26.7%) were from the genus Corynebacterium. Among the 16 Gram-negative bacillary isolates (5.9%), the most frequent was Escherichia coli (1.0%). The bacterial isolation rate was higher in patients >60 years old, and was lower in patients with dry eye syndrome, patients under topical treatment for other ocular disorders, and patients with hyperlipidemia. There was no significant difference in bacterial isolation rate with respect to the presence/absence of diabetes mellitus, steroid therapy, dialysis, or a history of allergic conjunctivitis. Methicillin-resistant coagulase-negative staphylococci showed a significantly higher detection rate in diabetic patients than nondiabetic patients (20.3% versus 7.0%, P < 0.05). The percentage of all isolates resistant to levofloxacin, cefmenoxime, and tobramycin was 14.0%, 15.2%, and 17.9%, respectively, with no significant differences among these drugs.Conclusion: The high bacterial isolation rate in patients >60 years old and the high methicillin-resistant coagulase-negative staphylococci isolation rate in patients with diabetes are important to consider for prevention of perioperative infections.Keywords: endophthalmitis, cataract surgery, conjunctival sac, bacterial flora, diabetes mellitus

Suto C; Morinaga M; Yagi T; Tsuji C; Toshida H

2012-01-01

252

Virtual reality cataract surgery training: learning curves and concurrent validity.  

UK PubMed Central (United Kingdom)

PURPOSE: To investigate initial learning curves on a virtual reality (VR) eye surgery simulator and whether achieved skills are transferable between tasks. METHODS: Thirty-five medical students were randomized to complete ten iterations on either the VR Caspulorhexis module (group A) or the Cataract navigation training module (group B) and then two iterations on the other module. Learning curves were compared between groups. The second Capsulorhexis video was saved and evaluated with the performance rating tool Objective Structured Assessment of Cataract Surgical Skill (OSACSS). The students' stereoacuity was examined. RESULTS: Both groups demonstrated significant improvements in performance over the 10 iterations: group A for all parameters analysed including score (p < 0.0001), time (p < 0.0001) and corneal damage (p = 0.0003), group B for time (p < 0.0001), corneal damage (p < 0.0001) but not for score (p = 0.752). Training on one module did not improve performance on the other. Capsulorhexis score correlated significantly with evaluation of the videos using the OSACSS performance rating tool. For stereoacuity < and ?120 seconds of arc, sum of both modules' second iteration score was 73.5 and 41.0, respectively (p = 0.062). CONCLUSION: An initial rapid improvement in performance on a simulator with repeated practice was shown. For capsulorhexis, 10 iterations with only simulator feedback are not enough to reach a plateau for overall score. Skills transfer between modules was not found suggesting benefits from training on both modules. Stereoacuity may be of importance in the recruitment and training of new cataract surgeons. Additional studies are needed to investigate this further. Concurrent validity was found for Capsulorhexis module.

Selvander M; Åman P

2012-08-01

253

Cataracts  

Medline Plus

Full Text Available ... Introduction A cataract is a clouding of the eye’s lens. Cataracts are a common eye condition that affects more than half of the ... how they can be treated surgically. Anatomy Our eyes are very sophisticated optical organs that collect light ...

254

Impact of simulator training on resident cataract surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: Virtual reality surgery simulation training improves resident performance as measured by the simulator itself and wet-lab performance. This study aims to determine whether virtual surgery simulator training improves actual resident cataract surgery performance. METHODS: The first 50 phacoemulsification cases of 20 residents, at a single residency program (Henry Ford Hospital), were retrospectively compared as two groups: before (2007-8) and after (2009-10) introduction of the Eyesi virtual surgery simulator to the surgical training program. Primary outcomes were the incidence of posterior capsule tears and operation duration. All residents received traditional didactic and wet-lab training. Instructor surgeons were surveyed for their impression of the simulator's contribution to resident surgical training. RESULTS: The nonsimulator and simulator groups each comprised 500 cases with 40 and 35 posterior capsule tears respectively. Capsular tear rates for the nonsimulator and simulator groups were 8.8 % and 10 % respectively for the first 25 cases, and 7.2 % and 3.6 % (P = 0.11) respectively for cases 26 through 50 . The percentage of long cases (defined as >40 min) for cases 10 through 50 was 42.3 % and 32.4 % (P = 0.005) for the nonsimulator and simulator groups respectively. CONCLUSIONS: Virtual reality surgical simulator training mildly shortens the learning curve for the first 50 phacoemulsification cases. The less adept residents appear to benefit most.

Pokroy R; Du E; Alzaga A; Khodadadeh S; Steen D; Bachynski B; Edwards P

2013-03-01

255

Full OCT anterior segment biometry: an application in cataract surgery  

Science.gov (United States)

In vivo three-dimensional (3-D) anterior segment biometry before and after cataract surgery was analyzed by using custom high-resolution high-speed anterior segment spectral domain Optical Coherence Tomography (OCT). The system was provided with custom algorithms for denoising, segmentation, full distortion correction (fan and optical) and merging of the anterior segment volumes (cornea, iris, and crystalline lens or IOL), to provide fully quantitative data of the anterior segment of the eye. The method was tested on an in vitro artificial eye with known surfaces geometry at different orientations and demonstrated on an aging cataract patient in vivo. Biometric parameters CCT, ACD/ILP, CLT/ILT Tilt and decentration are retrieved with a very high degree of accuracy. IOL was placed 400 ?m behind the natural crystalline lens, The IOL was aligned with a similar orientation of the natural lens (2.47 deg superiorly), but slightly lower amounts (0.77 deg superiorly). The IOL was decentered superiorly (0.39 mm) and nasally (0.26 mm).

Ortiz, Sergio; Perez-Merino, Pablo; Duran, Sonia; Velasco-Ocana, Miriam; Birkenfeld, Judith; de Castro, Alberto; Jimenez-Alfaro, Ignacio; Marcos, Susana

2013-01-01

256

Analyses of cataract surgery performed by the Unified Health System in Brazil, 2006-2007.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Estimate cataract surgical rates (CSR) for Brazil and each federal unit in 2006 and 2007 based on the number of surgeries performed by the Unified Health System to help plan a comprehensive ophthalmology network in order to eliminate cataract blindness in compliance with the target set by the World Health Organization (WHO) of 3,000 cataract surgeries per million inhabitants per year. METHODS: This descriptive study calculates CSR by using the number of cataract surgeries carried out by the Brazilian Unified Health System for each federal unit and estimates the need for cataract surgery in Brazil for 2006-2007, with official population data provided by the Brazilian Institute of Geography and Statistics. The number of cataract surgeries was compared with the WHO target. RESULTS: To reach the WHO goal for eliminating age-related cataract blindness in Brazil, 560,312 cataract surgeries in 2006 and 568,006 surgeries in 2007 needed to be done. In 2006, 179,121 cataract surgeries were done by the Unified Health System, corresponding to a CSR of 959 per million population; in 2007, 223,317 were performed, with a CSR of 1,179. With the Brazilian Council of Ophthalmology estimation of 165,000 surgeries each year by the non-public services, the CSR for Brazil would be 1,842 for 2006 and 2,051 for 2007. The proportions needed to achieve the proposed target were 38.6% in 2006 and 31.6% in 2007. CONCLUSIONS: Human resources, technical expertise, and equipment are crucial to reach the WHO goal. Brazil has enough ophthalmologists but needs improved planning and infrastructure in order to eliminate the problem, aspects that require greater financial investment and stronger political commitment.

Caligaris LS; Medina NH; Lansingh VC; Waldman EA; Yaacov-Peña F

2011-06-01

257

Application of Intra-ocular Lenses in Cataract Surgery and the Factors Influencing Visual Acuity after Surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: With the growing and rapid development of refractive surgery, researches focus increasingly on improvement of visual quality after cataract surgery. Intraocular lenses (IOLs) were a successful effort in the field of cataract surgery. Despite significant advances in cataract surgery, several complications related to surgical technique and IOL design after surgery can cause vision changes and reduce accuracy. Improvements in IOL design and surgical technique have a significant impact on the rate and extent of Tilt and Decentration effects. Because of small movement in modern intraocular lenses (aspheric), its performance can be significantly reduced, therefore aberration correction in the eye with an artificial lens requires to be more careful on IOL centration and location. Methods: In this paper, the characteristics of intraocular lenses and devices used in the measurement and design of this lens are also taken into consideration. In addition, factors affecting the optical and visual acuity in cataract surgery such as Tilt and Decentration are presented. Additionally, materials in regard to computer simulation of optical models of the eye in research as well as optical computations in clinical situations are provided. Conclusion: Finally, the findings revealed that obtaining optimal vision in cataract surgery requires precise measurement and computational techniques as well as an awareness of aberrations that may be created during or after surgery. Moreover, further research and improvement in the process of measurement and calculation will enhance the visual acuity in cataract surgery.

A Asgari; K keshavarzi; AA Parach

2013-01-01

258

Evaluating the benefits of second-eye cataract surgery among the elderly.  

UK PubMed Central (United Kingdom)

UNLABELLED: The aim of this systematic review was to synthesize and appraise the evidence of benefits of second-eye cataract extraction for visual function, patient-reported quality of life, falls, and driving ability among the elderly. We conducted a comprehensive search in MEDLINE using "surgery," "cataract extraction," "second eye," and "bilateral." Ten studies met the inclusion and quality criteria. We found "moderate" evidence supporting improvement in stereopsis, stereoacuity, and anisometropia over and above the benefits of first-eye surgery. We also found "moderate" evidence supporting improvement in visual acuity, contrast sensitivity, and self-reported visual functioning. Studies included in the review do not provide definitive evidence of second-eye surgery benefits on health-related quality of life, visual fields, falls prevention, and driving performance. However, the heterogeneity of outcome measures and the limited number of studies likely contributed to our findings. The findings have implications for clinicians and policymakers in the health-care industry and emphasize the need for additional trials examining this important and widely performed clinical procedure. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Ishikawa T; Desapriya E; Puri M; Kerr JM; Hewapathirane DS; Pike I

2013-10-01

259

Severe unilateral corneal melting after uneventful phacoemulsification cataract surgery.  

UK PubMed Central (United Kingdom)

We present a rare case of severe unilateral corneal melt after uneventful phacoemulsification. A 38-year-old woman presented one week after uneventful phacoemulsification cataract surgery complaining of pain and blurred vision in her operated eye. Our differential diagnosis included peripheral ulcerative keratitis, Mooren's ulcer and herpetic keratitis. The patient was started on oral acyclovir and topical steroids. An extensive blood work-up was done to rule out autoimmune diseases. Purified protein derivative test demonstrated 15 mm of erythema. Because the clinical picture was progressing, the patient was started on triple anti-tuberculosis therapy. Despite treatment, the patient was complaining of excruciating eye pain that was relieved only with intramuscular prednisone injections. The corneal melt healed after approximately three months without any other intervention, leaving a 90 per cent thickness loss in its central area. Idiopathic corneal melt after uneventful phacoemulsification is a rare complication, which must be managed in a multidirectional treatment approach to prevent devastating corneal perforation.

Praidou A; Brazitikos P; Dastiridou A; Androudi S

2013-01-01

260

Prevalence of corneal astigmatism before cataract surgery in Chinese patients.  

UK PubMed Central (United Kingdom)

PURPOSE: To assess the demographics and distribution of corneal astigmatism before cataract surgery in Chinese patients. SETTING: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN: Clinic-based cross-sectional study. METHODS: From July 2009 to May 2011, preoperative bilateral partial coherence interferometry (IOLMaster) was performed in consecutive patients having cataract surgery. Patient demographics and keratometric data were recorded. RESULTS: The mean age of the 2849 patients (4831 eyes) was 70.56 years ± 9.55 (SD); there was a predominance of women patients (64.0%). The mean axial length was 23.58 ± 1.13 mm. The mean corneal astigmatism in this cohort was 1.01 D (range 0.05 to 6.59 D). Corneal astigmatism was between 0.25 D and 1.25 D in 67.7% of eyes, 1.25 D or higher in 27.5% eyes, and less than 0.25 D in 4.8% of eyes. Astigmatism was with the rule in 25.1% of eyes, against the rule (ATR) in 58.2% of eyes, and oblique in 16.7% of eyes. The mean steep keratometry measurement was 44.76 ± 1.56 D. Against-the-rule astigmatism increased significantly with older age. CONCLUSIONS: Corneal astigmatism largely fell between 0.25 D and 1.25 D in these predominantly elderly female Chinese patients, and ATR astigmatism increased with age. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Chen W; Zuo C; Chen C; Su J; Luo L; Congdon N; Liu Y

2013-02-01

 
 
 
 
261

The Association between Cataract Surgery and Atypical Antipsychotic Use: A Nested Case-Control Study.  

UK PubMed Central (United Kingdom)

PURPOSE: To investigate cataract risk associated with the use of atypical antipsychotics. DESIGN: Retrospective, nested case-control study. METHODS: A large health claims database (The British Columbia Ministry of Health Databases) from British Columbia, Canada, was used from January 2000 through December 2007. Cases were defined as clinically significant cataracts requiring surgery and were identified using cataract surgery procedure codes. For each case, 4 to 10 controls were selected randomly using a density-based sampling approach and were matched to cases by age and calendar time. Rate ratios were calculated for users of atypical and typical antipsychotics adjusting for known cataractogenic factors. RESULTS: One hundred sixty-two thousand five hundred one cases of cataract surgery and 650 004 controls were included. The adjusted rate ratio for current users of atypical antipsychotics was 0.84 (95% confidence interval, 0.80 to 0.89) compared with nonusers. A greater number of prescriptions filled in the year before cataract surgery compared with the median number of filled prescriptions was associated with a lower cataract surgery rate (adjusted rate ratio, 0.70; 95% confidence interval, 0.65 to 0.75) than those with fewer prescriptions filled (adjusted rate ratio, 0.85; 95% confidence interval, 0.79 to 0.91). CONCLUSIONS: A protective association between the use of atypical antipsychotics and risk of clinically significant cataracts requiring surgery was established. Potential biochemical and neurochemical mechanisms for this protective effect are discussed.

Pakzad-Vaezi KL; Etminan M; Mikelberg FS

2013-09-01

262

Post-cataract surgery visual disturbance in a retinitis pigmentosa patient with asteroid hyalosis.  

Science.gov (United States)

A patient with retinitis pigmentosa showed visual disturbances following successful cataract surgery. He had a dense asteroid hyalosis in the eye before cataract surgery. After the surgery he noticed that his vision became worse. The visual disturbance was explained as being caused by the progression of retinal degeneration. Although the electroretinogram was non-recordable, the degeneration of macular area appeared relatively small. We considered that dense asteroid hyalosis was responsible for his visual disturbances, and pars plana vitrectomy (PPV) was performed to remove the asteroid hyalosis. After the PPV, rapid improvement of his visual acuity was observed. Cataract surgery may affect the status of asteroid hyalosis and cause rapid visual loss. PPV should be considered for retinitis pigmentosa patients with dense asteroid hyalosis, especially when a large decrease in visual acuity is noted shortly after cataract surgery. PMID:21941506

Jingami, Yoko; Otani, Atsushi; Kojima, Hiroshi; Makiyama, Yukiko; Yoshimura, Nagahisa

2011-08-18

263

Post-cataract surgery visual disturbance in a retinitis pigmentosa patient with asteroid hyalosis.  

UK PubMed Central (United Kingdom)

A patient with retinitis pigmentosa showed visual disturbances following successful cataract surgery. He had a dense asteroid hyalosis in the eye before cataract surgery. After the surgery he noticed that his vision became worse. The visual disturbance was explained as being caused by the progression of retinal degeneration. Although the electroretinogram was non-recordable, the degeneration of macular area appeared relatively small. We considered that dense asteroid hyalosis was responsible for his visual disturbances, and pars plana vitrectomy (PPV) was performed to remove the asteroid hyalosis. After the PPV, rapid improvement of his visual acuity was observed. Cataract surgery may affect the status of asteroid hyalosis and cause rapid visual loss. PPV should be considered for retinitis pigmentosa patients with dense asteroid hyalosis, especially when a large decrease in visual acuity is noted shortly after cataract surgery.

Jingami Y; Otani A; Kojima H; Makiyama Y; Yoshimura N

2011-05-01

264

Long-term effects of cataract surgery on tear film parameters.  

UK PubMed Central (United Kingdom)

PURPOSE: To examine the differences in tear film parameters more than 3 months postsurgery in eyes with cataract surgery (surgical eyes) versus eyes without cataract surgery (nonsurgical eyes). METHODS: 29 patients were seen at the Miami Veterans Affairs Medical Center (VAMC) who had cataract surgery by phacoemulsification in one eye more than 3 months prior to the study date and had no history of surgical intervention in their fellow eye. Tear film parameters were measured in both eyes and compared using McNemar tests for dichotomous variables and paired and single sample t-tests for continuous variables. RESULTS: Mean patient age was 73 (standard deviation (SD): 11); 26 patients (90%) identified themselves as White and 7 (24%) as Hispanic. The mean number of days between surgery and this study was 952 (SD: 1109). There were no statistical differences between the surgical eye and the nonsurgical eye with respect to any of the measured tear film parameters. Confidence intervals around these differences were narrow enough to exclude a substantial effect of cataract surgery. The elapsed time between cataract surgery and measurement of the tear parameters did not appear to affect the difference in parameters between the two eyes. CONCLUSION: We found that eyes that had cataract surgery more than 3 months prior to testing had no differences in their tear film parameters compared to eyes without a history of surgery.

Venincasa VD; Galor A; Feuer W; Lee DJ; Florez H; Venincasa MJ

2013-01-01

265

Cataracts  

Medline Plus

Full Text Available ... to the brain, which translates these signals into images we see. Cataracts The lens of the eye ... can reduce vision to the extent that sharp images can no longer be formed. In cases such ...

266

Cataracts  

Medline Plus

Full Text Available ... is called the retina. The retina changes light signals into electric signals. These electric signals are sent through the optic nerve to the brain, which translates these signals into images we see. Cataracts The lens of ...

267

Cataract surgery following cobalt-60 plaque radiotherapy for posterior uveal malignant melanoma  

International Nuclear Information System (INIS)

[en] The authors reviewed the records of thirteen patients with posterior uveal malignant melanoma who had developed a mature radiation cataract following cobalt-60 plaque radiotherapy. Cataract extraction had been performed in seven of these patients as of the survey date of this investigation. The authors attempted to determine if cataract extraction increased the risk of metastatic melanoma, improved or worsened visual function, or resulted in any consistent intraoperative or postoperative complications that did not occur if the cataract was retained. This analysis showed that removing the cataract did not appear to increase the risk of death from metastatic melanoma, but it also indicated that cataract extraction did not seem to improve the visual function of the irradiated eye. On the basis of this experience to date, the authors offer suggested guidelines for the management of patients who develop a mature cataract following cobalt-60 plaque radiotherapy of a posterior uveal malignant melanoma

1985-01-01

268

Barriers to the uptake of cataract surgery in patients presenting to a hospital  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: To assess the barriers for the acceptance of surgery among patients with cataract and visual disability. Materials and Methods: A short-term descriptive study was conducted in patients with cataract presenting to a hospital. Socio-demographic data were entered in a proforma. An interviewer-assisted questionnaire, surveying knowledge about cataract and barriers to cataract surgery, was administered by one of the authors (SKG) in the local language (Hindi). Results: There were 100 patients (53 men and 47 women); 14 were bilaterally blind (vision < 10/200 in the better eye). Attitudinal barriers included: could manage daily work (71%), cataract not mature (68%), could see clearly with the other eye (64%), too busy (57%), female gender (37%), fear of surgery (34%), fear of surgery causing blindness (33%) or death (13%), old age (33%), it is God?s will (29%) and worry about cost of surgery (27%). The barriers relating to service delivery, cost, and affordability included: insufficient family income (76%), not knowing another person who had undergone cataract surgery (26%), no one to accompany (20%), distance from hospital (20%) or from a main road (9%) and lack of transport (7%). Conclusions: Attitudinal barriers were reported more often, rather than issues of accessibility or cost. Eye care providers should address the identified barriers for increasing acceptance of surgery in the study area.

Dhaliwal Upreet; Gupta Sunil

2007-01-01

269

Vision, quality of life and depressive symptoms after first eye cataract surgery.  

UK PubMed Central (United Kingdom)

CONCLUSIONS: Contrast sensitivity and stereopsis, but not visual acuity, were significant factors affecting improvement in vision-related quality of life or depressive symptoms after first eye cataract surgery.

Fraser ML; Meuleners LB; Lee AH; Ng JQ; Morlet N

2013-10-01

270

Visual prognosis, intraocular pressure control and complications in phacomorphic glaucoma following manual small incision cataract surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Aims: To evaluate intraocular pressure (IOP) control, visual prognosis and complications following manual small incision cataract surgery among eyes with phacomorphic glaucoma. Materials and Methods: This prospective, non-randomized interventional consecutive case series included al...

Ramakrishanan R; Maheshwari Devendra; Kader Mohideen; Singh Rita; Pawar Neelam; Bharathi M

271

Feasibility and Complications between Phacoemulsification and Manual Small Incision Surgery in Subluxated Cataract  

Science.gov (United States)

Purpose. To compare the feasibility of cataract surgery with implantation of endocapsular supporting devices and intraocular lens (IOL) in subluxated cataract in phacoemulsification and manual small incision cataract surgery (MSICS). Design. Prospective randomized intervention case series consisting of 60 eyes with visually significant subluxated cataract. Method. The patients were randomly distributed between the two groups equally. The main outcome measure was implantation of in-the-bag IOL, requirement of additional procedure and complications, if any. Results. Capsular bag retention in subluxated lenses is possible in 90% cases in phacoemulsification versus 76.67% cases in MSICS (P = 0.16). Both groups, achieved similar best corrected visual acuity (P = 0.73), although additional procedures, intraoperative, and postoperative complications were more common in MSICS. Conclusions. Achieving intact capsulorhexis and nuclear rotation in MSICS may be difficult in cases with large nucleus size and severe subluxation, but subluxated cataracts can be effectively managed by both phacoemuslification and MSICS.

Goel, Ruchi; Kamal, Saurabh; Kumar, Sushil; Kishore, Jugal; Malik, K. P. S.; Angmo Bodh, Sonam; Bansal, Smriti; Singh, Madhu

2012-01-01

272

Feasibility and Complications between Phacoemulsification and Manual Small Incision Surgery in Subluxated Cataract.  

UK PubMed Central (United Kingdom)

Purpose. To compare the feasibility of cataract surgery with implantation of endocapsular supporting devices and intraocular lens (IOL) in subluxated cataract in phacoemulsification and manual small incision cataract surgery (MSICS). Design. Prospective randomized intervention case series consisting of 60 eyes with visually significant subluxated cataract. Method. The patients were randomly distributed between the two groups equally. The main outcome measure was implantation of in-the-bag IOL, requirement of additional procedure and complications, if any. Results. Capsular bag retention in subluxated lenses is possible in 90% cases in phacoemulsification versus 76.67% cases in MSICS (P = 0.16). Both groups, achieved similar best corrected visual acuity (P = 0.73), although additional procedures, intraoperative, and postoperative complications were more common in MSICS. Conclusions. Achieving intact capsulorhexis and nuclear rotation in MSICS may be difficult in cases with large nucleus size and severe subluxation, but subluxated cataracts can be effectively managed by both phacoemuslification and MSICS.

Goel R; Kamal S; Kumar S; Kishore J; Malik KP; Angmo Bodh S; Bansal S; Singh M

2012-01-01

273

Virtual reality phacoemulsification: a comparison between skilled surgeons and students naive to cataract surgery  

Science.gov (United States)

We have developed a simulator for virtual phacoemulsification surgery. In the current study, the performance of one experienced cataract surgeon was compared to the performance of four subjects naive to cataract surgery. They all operated on the same virtual patient and a number of different response variables were measured. It was found that the experienced subject performed better than the naive subjects on almost all response variables. This indicates that the simulator developed by us is authentic for phaco emulsification surgery. The lack of negative effects in case of complications during virtual phacoemulsification surgery makes the phaco simulator that we developed a very attractive tool for learning phacoemulsification surgery.

Soderberg, Per; Laurell, Carl-Gustaf; Simawi, Wamidh; Nordqvist, Per; Skarman, Eva; Nordh, Leif

2005-04-01

274

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To compare change of macular thickness after uneventful cataract surgery and after cataract surgery complicated with vitreous loss, using optic coherence tomography (OCT). METHODS: Twenty eyes of 20 patients who underwent cataract surgery complicated with posterior capsular tear participated in this retrospective study (Group 2). The fellow eyes of those patients who underwent uneventful cataract surgery served as the control group (Group 1). Best spectacle-corrected visual acuity (BCVA), refraction, keratometry, axial length measurement, intraocular lens power calculation, intraocular pressure, and biomicroscopic and posterior segment examinations were done preoperatively. BCVA was evaluated at the postoperative 1st day, 1st week, 1st month, and 3rd month. Macular thickness and volumetric measurements with OCT with MM5 protocol were conducted at the postoperative 3rd month. RESULTS: Logarithm of the minimum angle of resolution BCVA of Group 1 was significantly better than Group 2 at all intervals (P < 0.05). Foveal, parafoveal (superior and temporal), and perifoveal (superior and temporal) macular thickness measurements were significantly higher in Group 2 at month 3 (P < 0.05). Foveal volume was also significantly higher in Group 2 when compared with Group 1 (P < 0.05). In Group 2, two eyes (10%) were diagnosed with clinically significant cystoid macular edema at the 1-month visit. CONCLUSION: Macular thickness was found to be significantly high in eyes undergoing complicated cataract surgery (with posterior capsular tear) when compared with uneventful cataract surgeries of fellow eyes.

Akçay B?; Bozkurt TK; Güney E; Unlü C; Erdogan G; Akcali G; Bayramlar H

2012-01-01

275

[Impact of cataract surgery on central macular thickness in diabetic patients without diabetic retinopathy].  

UK PubMed Central (United Kingdom)

PURPOSE: To determine whether cataract surgery increases macular thickness in diabetic patients without preoperative retinopathy or macular edema. PATIENTS AND METHODS: In a prospective, non-controlled study, we compared preoperative macular thickness as measured by OCT to that measured 3 and 6 months after cataract surgery. RESULTS: Thirty-six eyes of 21 patients (ten men and 11 women) were included in the study from November 2008 to May 2009. Mean foveolar thickness measured preoperatively was 198 ?m (± 18.5 ?m) compared with 202 ?m (±17.2 ?m) 3 months postoperatively and 212 ?m (± 18.9 ?m) 6 months postoperatively. DISCUSSION: In our study, we do not show a significant increase in central foveolar thickness 3 months after cataract surgery; however, we do measure a significant increase at 6 months. This increase in thickness is similar to that found in the literature after cataract surgery in a non-diabetic population. CONCLUSION: Cataract surgery in diabetic patients without preoperative retinopathy does not appear to induce significant macular thickening compared to non-diabetic patients. The period prior to any diabetic retinopathy or maculopathy seems to be the most amenable to cataract surgery when necessary.

Giocanti-Aurégan A; Grenet T; Fajnkuchen F; Chaine G

2013-01-01

276

Cataract surgery complications as a cause of visual impairment in a population aged 50 and over.  

UK PubMed Central (United Kingdom)

The purpose of this study was to measure the extent to which complications relating to cataract surgery are a cause of visual impairment in a population aged 50 and over from the city of Campinas, São Paulo State, Brazil. An assessment of cataract surgery services was conducted using random cluster sampling, with the sample composed of 60 clusters of 40 people aged 50 years or older. Of the selected sample of 2,400 subjects, 92.67% were examined. Of these 2,224 examined subjects, 75 (3.37%) presented bilateral visual impairment and 164 unilateral, while a total of 314 (7.06%) eyes presented visual impairment. 352 eyes had undergone cataract surgery. The causes of visual impairment after surgery were concurrent eye disease (56%), surgical complications (28.8%) and refractive errors (15.2%). Cataract surgery complications represented the 5th most important cause of visual impairment. The other main causes were cataract, posterior segment disorders, diabetic retinopathy and glaucoma. These results suggest cataract surgery complications are a major cause of visual impairment in this population. Their prevention and treatment must be part of public health care policies.

Oliveira DF; Lira RP; Lupinacci AP; Paccola M; Arieta CE

2008-10-01

277

Effect of cataract surgery and pupil dilation on iris pattern recognition for personal authentication.  

UK PubMed Central (United Kingdom)

PURPOSE: The purpose of this study was to investigate the effect of cataract surgery and pupil dilation on iris pattern recognition for personal authentication. METHODS: Prospective non-comparative cohort study. Images of 15 subjects were captured before (enrolment), and 5, 10, and 15 min after instillation of mydriatics before routine cataract surgery. After cataract surgery, images were captured 2 weeks thereafter. Enrolled and test images (after pupillary dilation and after cataract surgery) were segmented to extract the iris. This was then unwrapped onto a rectangular format for normalization and a novel method using the Discrete Cosine Transform was applied to encode the image into binary bits. The numerical difference between two iris codes (Hamming distance, HD) was calculated. The HD between identification and enrolment codes was used as a score and was compared with a confidence threshold for specific equipment, giving a match or non-match result. The Correct Recognition Rate (CRR) and Equal Error Rates (EERs) were calculated to analyse overall system performance. RESULTS: After cataract surgery, perfect identification and verification was achieved, with zero false acceptance rate, zero false rejection rate, and zero EER. After pupillary dilation, non-elastic deformation occurs and a CRR of 86.67% and EER of 9.33% were obtained. CONCLUSIONS: Conventional circle-based localization methods are inadequate. Matching reliability decreases considerably with increase in pupillary dilation. Cataract surgery has no effect on iris pattern recognition, whereas pupil dilation may be used to defeat an iris-based authentication system.

Dhir L; Habib NE; Monro DM; Rakshit S

2010-06-01

278

Combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery in cases with cataract and posterior segment diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. Aim: To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery. Settings and Design: A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital. Materials and Methods: In this study, 28 eyes of 28 patients underwent combined 23-gauge transconjunctival sutureless vitrectomy and phacoemulsification and IOL implantation for cataract and various posterior segment diseases. The outcome measures included, visual acuity, intraocular pressure changes, and anatomical success were evaluated. Results: The mean follow-up was 4.8 months (range, 3-15 months). Mean overall preoperative visual acuity was 20/333, and final acuity was 20/95 (P P > 0.05). Three eyes (10.7%) had postoperative hypotony (Conclusion: Combined transconjunctival sutureless vitrectomy and phacoemulsification was effective and safe in patients with significant lens opacities and vitreoretinal pathology. Although the anatomic and visual outcomes were satisfactory, the outcomes depended mainly on underlying vitreoretinal pathology.

Yazici Ahmet; Kara Necip; Bozkurt Ercument; Cakir Mehmet; Goker Hasan; Demirok Ahmet; Yilmaz Omer

2010-01-01

279

Nuevas tecnologías en cirugía de catarata por facoemulsificación/ New technologies in phacoemulsification cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Actualmente la cirugía de catarata es considerada una de las más frecuentes de toda la medicina. Es un procedimiento seguro que se efectúa anualmente a millones de pacientes a lo largo y ancho del mundo. Por otro lado, en los últimos años además de lograr la recuperación de la transparencia, ha adquirido el compromiso de brindar mayor satisfacción a los pacientes y se ha convertido en un procedimiento refractivo. En la cirugía moderna del cristalino, todos los ci (more) rujanos coinciden en que la técnica más adecuada para la extracción de la catarata es la facoemulsificación. Se realizó una revisión bibliográfica con el objetivo de describir su surgimiento y evolución, técnicas quirúrgicas, así como las nuevas innovaciones en dicho proceder. Abstract in english The cataract surgery is currently considered one of the most frequent procedures in medicine. It is a safe procedure that is performed on millions of patients throughout the world. On the other hand, in the last few years, it has managed to recover the crystalline transparency in addition to providing greater satisfaction to the patients by becoming a refractive method. In the modern surgery of the crystalline, all the surgeons agree that the most suitable technology for (more) the cataract extraction is phacoemulsificación. A literature review was made to describe emergence and evolution, surgical technologies, as well as new innovations in this surgical procedure.

Rodriguez Rivero, Darlen; Martín Perera, Yoanner; Pérez Candelaria, Eneida de la Caridad; Veitía Rovirosa, Zucell Ana; Méndez Duque de Estrada, Ana María; Vidal Castillo, Malvys

2013-04-01

280

Síndrome pseudoexfoliativo y cirugía de catarata/ Pseudoexfoliative syndrome and the cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Se realizó una revisión bibliográfica con el objetivo de exponer los principales aspectos relacionados con la cirugía de catarata en los pacientes con pseudoexfoliación. Se efectuó una búsqueda de los principales artículos científicos de los últimos 10 años y fueron seleccionados los contenidos más relevantes para la confección del informe final. El síndrome de pseudoexfoliación es una patología sistémica asociada a un alto riesgo de complicaciones durant (more) e la cirugía de catarata debido principalmente a la debilidad del soporte zonular y la dilatación insuficiente de la pupila. Mediante un cuidadoso examen preoperatorio y una adecuada técnica quirúrgica correctamente valorada por el cirujano, el índice de complicaciones durante el proceder y en el posoperatorio puede reducirse significativamente. Abstract in english A literature review was made to present the main aspects of the cataract surgery in patients with pseudoexfoliative syndrome. The main scientific articles of the past ten years related to the topic were searched, and the most relevant contents were selected for the preparation of the final report. It was found that the pseudoexfoliation syndrome is a systemic pathology associated with high risk of complications during the cataract surgery mainly due to the weakness of the (more) zonular support and the pupilar insufficient dilation. By means of a careful preoperative exam and an appropriate surgical technique, adequately assessed by the surgeon, the rate of complications during and after the surgical procedure may be significantly reduced.

Pérez González, Henry; García Concha, Yanet; Zozaya Aldana, Beatriz

2012-12-01

 
 
 
 
281

Impact of bilateral cataract surgery on vision-related activity limitations.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate patients' vision-related activity limitation before and after bilateral cataract surgery using the German version of the Catquest-9SF questionnaire. SETTING: Hanusch Hospital, Vienna, Austria, and Ophthalmic Clinic, Minden, Germany. DESIGN: Questionnaire development. METHODS: This prospective 2-center study included patients who were scheduled for bilateral cataract surgery and attended their preassessment appointment approximately 1 week before cataract surgery. All patients self-administered the Catquest-9SF at the preassessment session and a second time 3 months after cataract surgery. The questionnaire includes 9 items and is a revised short form of the Catquest, scored using Rasch analysis. The Catquest-9SF includes questions concerning vision-associated problems in everyday life, general satisfaction with vision, and difficulties performing activities. RESULTS: The study comprised 210 patients, 120 in Austria and 90 in Germany. The mean age of all patients was 74.1 years (range 41 to 92 years). Patients mostly had difficulties doing handwork (42%) or recognizing uneven surfaces (30%). Sixty percent of the patients in Austria and approximately 50% in Germany were very unsatisfied with their vision preoperatively. Postoperatively, all patients recognized a subjective improvement in their vision. CONCLUSIONS: Patients having bilateral cataract surgery achieved marked improvements in vision-related activity limitation and satisfaction with vision. A subset of patients with less vision-related activity limitation before surgery was satisfied with first-eye surgery only.

Harrer A; Gerstmeyer K; Hirnschall N; Pesudovs K; Lundström M; Findl O

2013-05-01

282

Cataract and refractive surgery in ; a survey of KSCRS members from 1995~2006.  

UK PubMed Central (United Kingdom)

PURPOSE: This purpose of this report was to study trends in cataract and refractive surgeries conducted during the past twelve years and to compare results to previous reports from the ASCRS and New Zealand (NZ) in order to forecast future medical services. METHODS: We surveyed members of the Korean Society of Cataract and Refractive Surgery (KSCRS) every year from 1995 to 2006, and studied changes in cataract and refractive surgeries (RS). RESULTS: The duration of hospitalization has been gradually decreasing to the point that a one day hospitalization following surgery has become common. The rate of topical anesthesia use has significantly increased since 1998. Sutureless incision methods are now commonly practiced. The use of acryl IOL as an optic material has been gradually increasing for cataract surgeries. KSCRS members showed an interest in the special intraocular lenses as multifocal IOL. While Excimer laser PRK was the most popular refractive surgery during the first stage, KSCRS members increasingly prefer LASIK to the Excimer laser PRK. Regression of the corrected visual acuity, dry eye, night halo, and flashes were the most common complications following refractive surgeries. Medical disputes related to PRK and LASIK have been gradually increasing throughout the study period. CONCLUSIONS: We confirm that the KSCRS practice styles for cataract and RS are similar to those of the ASCRS and NZ. We infer a world-wide trend from the comparison of these three societies.

Yoon SC; Jung JW; Sohn HJ; Shyn KH

2009-09-01

283

Endophthalmitis: controlling infection before and after cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Endophthalmitis is a rare, but serious, postoperative complication of cataract surgery. It can have a devastating consequence on a patient’s vision: some patients may lose all light perception.The incidence of endophthalmitis has been reported to be between 0.13% and 0.7%.1 The primary source of this intraocular infection is considered to be bacteria from the patient’s ocular surface (cornea, conjunctiva) or adnexa (lacrimal glands, eyelids, and extraocular muscles). The bacteria most frequently isolated are gram-positive coagulase-negative cocci (mainly Staphylococcus epidermidis) which account for 70% of culture-positive cases. Staphylococcus aureus is isolated in 10% of culture-positive cases, Streptococcus species in 9%, Enterococcus species in 2%, and other gram-positive species in 3% of cases. Gram-negative bacteria account for just 6% of culture-positive cases; however, an infection with these bacteria, particularly with Pseudomonas aeruginosa, can lead to a devastating visual outcome.

Nuwan Niyadurupola; Nick Astbury

2008-01-01

284

Histopathologic correlation of Aspergillus endophthalmitis following uncomplicated cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Luis J Haddock,1 Harry W Flynn Jr,1 Sander R Dubovy,1 Rahul N Khurana,2 Peter R Egbert31Department of Ophthalmology, Bascom Palmer Eye Institute, Miami Miller School of Medicine, Miami, FL, 2Northern California Retina Vitreous Associates, Mountain View, CA, 3Department of Ophthalmology, The Byers Eye Institute at Stanford, Stanford University, Palo Alto, CA, USAAbstract: A clinicopathologic correlation between two patients with acute-onset Aspergillus endophthalmitis undergoing enucleation is reported. These two patients presented with pain, redness, and decreased vision following uncomplicated cataract surgery. In both patients, vitreous aspiration and intravitreal injections were the initial treatment followed later by pars plana vitrectomy for clinical worsening. Despite repeated surgical and medical interventions, the clinical course of both patients was prolonged, unsuccessful, and resulted in enucleation for a blind painful eye. Histologic examination of the enucleated specimens showed that, in spite of prolonged local and systemic therapy, there was persistent diffuse infiltration of the anterior chamber and ciliary body by a filamentous mold.Keywords: mold, enucleation, voriconazole, amphotericin B

Haddock LJ; Flynn HW Jr; Dubovy SR; Khurana RN; Egbert PR

2012-01-01

285

[Pseudoexfoliation syndrome and cataract surgery. Avoidance and treatment of complications].  

UK PubMed Central (United Kingdom)

Eyes with pseudoexfoliation syndrome often exhibit insufficient mydriasis, zonular weakness and pronounced fibrotic capsular shrinkage. This may make cataract surgery as such difficult but also leads to postoperative complications, such as rhexis ovalization or phimosis (capsule contraction syndrome) or progressive zonular weakening with final spontaneous dislocation of the capsule-implant complex (CIC). To avoid or correct for this special techniques and implants may be used: as prophylaxis, intracameral adrenalin and retroiridal capsulorhexis, iris retractors or dilators, various models of capsular tension and bending rings, bimanual capsule ring implantation, capsular bag stabilization with iris retractors or segments and secondary capsulorhexis may be used. Rhexis phimosis may be excised by a special diathermic probe, a subluxated CIC may be sutured to the sclera either in toto or the lens only after removal from the capsule bag, the latter also to the posterior iris surface. When luxated into the vitreous cavity, the CIC may be lifted to the iris plane and refixed as described or exchanged for a new lens sutured into the sulcus or an angle or iris-supported anterior chamber lens.

Menapace R

2012-10-01

286

[Pseudoexfoliation syndrome and cataract surgery. Avoidance and treatment of complications].  

Science.gov (United States)

Eyes with pseudoexfoliation syndrome often exhibit insufficient mydriasis, zonular weakness and pronounced fibrotic capsular shrinkage. This may make cataract surgery as such difficult but also leads to postoperative complications, such as rhexis ovalization or phimosis (capsule contraction syndrome) or progressive zonular weakening with final spontaneous dislocation of the capsule-implant complex (CIC). To avoid or correct for this special techniques and implants may be used: as prophylaxis, intracameral adrenalin and retroiridal capsulorhexis, iris retractors or dilators, various models of capsular tension and bending rings, bimanual capsule ring implantation, capsular bag stabilization with iris retractors or segments and secondary capsulorhexis may be used. Rhexis phimosis may be excised by a special diathermic probe, a subluxated CIC may be sutured to the sclera either in toto or the lens only after removal from the capsule bag, the latter also to the posterior iris surface. When luxated into the vitreous cavity, the CIC may be lifted to the iris plane and refixed as described or exchanged for a new lens sutured into the sulcus or an angle or iris-supported anterior chamber lens. PMID:23053332

Menapace, R

2012-10-01

287

Cataract surgery under topical anesthesia using 2% lignocaine jelly and intracameral lignocaine: Is manual small incision cataract surgery comparable to clear corneal phacoemulsification?  

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A prospective comparative study was undertaken to compare the patients’ pain experience, surgical outcome and surgeon’s experience in phacoemulsification and manual small incision cataract surgery (MSICS) under topical anesthesia supplemented with intracameral lignocaine (TASIL). In Group 1 (n=88) p...

Gupta, Sanjiv K; Kumar, Ajai; Agarwal, Swati

288

Risk factors for acute endophthalmitis after cataract surgery: a population-based study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To identify risk factors for suspected acute endophthalmitis after cataract surgery. DESIGN: Population-based retrospective cohort. PARTICIPANTS: Administrative data from more than 440,000 consecutive cataract surgeries in Ontario, Canada, from April 1, 2002, to March 31, 2006. METHODS: Consecutive physician billing claims for cataract surgery and specific intraoperative and postoperative procedures related to complications of cataract surgery were identified. Acute endophthalmitis was defined using surrogate markers for intraocular infection, including vitrectomy, vitreous injection, or aspiration procedures not in combination with air/fluid exchange or dislocated lens extraction, performed 1 to 14 days after cataract surgery. Anterior vitrectomy performed on the day of surgery was used as a surrogate marker for capsular rupture. MAIN OUTCOME MEASURES: Overall rates of endophthalmitis were calculated and grouped by patient demographics, surgical facility, season, year, and association with capsular rupture. RESULTS: There were 617 suspected acute endophthalmitis cases of 442,177 cataract surgeries over the 4 years. The overall unadjusted and adjusted rates of suspected acute endophthalmitis were both 1.4 per 1000 cataract surgeries. Men had higher rates than women (1.70 vs. 1.19/1000 surgeries, P<0.0001) with an adjusted odds ratio of 1.40 (95% confidence interval, 1.19-1.64).The oldest age group (>or= 85 years) had the highest rate (2.18/1000), and the youngest group (20-64) had the second highest rate (1.76/1000). The endophthalmitis rates for these age groups were significantly different from those aged 65 to 84 years. The endophthalmitis rate was approximately 10-fold higher in those with capsular rupture compared with those without (13.11 vs. 1.34/1000, P<0.0001), with an adjusted odds ratio of 9.56 (95% confidence interval, 6.43-14.2). CONCLUSIONS: The overall rates of suspected acute endophthalmitis are low but significantly higher in certain patient groups. Our population-based analysis can be used as a benchmark for quality-improvement initiatives and can assist clinicians in educating their patients regarding the risks associated with cataract surgery. Future work is required to address the higher rate of endophthalmitis in men, those with capsular rupture, and the oldest patients undergoing cataract surgery.

Hatch WV; Cernat G; Wong D; Devenyi R; Bell CM

2009-03-01

289

Changes of corneal endothelium in diabetes patients after cataract phacoemulsification surgery by confocal microscopy  

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Full Text Available AIM: To observe the changes of corneal endothelium in diabetes patients before and after cataract phacoemulsification surgery with confocal microscopy for exploring the variation and influencing factors. METHODS: Phacoemulsification were randomly divided into 50 aged-related cataract patients with diabetes mellitus(56 eyes, diabetes group)and 50 patients with senile cataract(60 eyes, control group). Cataract phacoemulsification and intraocular lens implantation were performed, central corneal thickness, the corneal endothelial cell density, coefficient of variation and percentage of hexagonal cell were measured before surgery, 1 week, 1 month and 3 months after surgery by confocal microscopy. RESULTS: Before surgery, there was no statistical difference between the two groups of central corneal thickness, corneal endothelial cell density, coefficient of variation and percentage of hexagonal cell(P>0.05). Compared with pre-operation, the central corneal thickness and coefficient of variation were increased post-operation, but the corneal endothelial cell density and percentage of hexagonal cell decreased gradually. The central corneal thickness of diabetes group was more significantly than control group 1 week, 3 months after surgery(P<0.05), and the corneal endothelial cell density was less significantly than control group(P<0.05). One week, 3 months after surgery, the percentage of hexagonal cell was less than control group(P<0.01). The coefficient of variation was significantly higher than control group(P<0.01). CONCLUSION: Aged-related cataract patients with diabetes mellitus were much more poor tolerability on cataract phacoemulsification surgery. Compared with senile cataract patients, the corneal endothelium injury was more serious and the velocity and validity of recovery were lower comparatively.

Chao Zhao; Gui - Qiu Zhao; Cheng - Ye Che; Ang Gao; Qiang Xu; Qian Wang

2013-01-01

290

The effect of health insurance reform on the number of cataract surgeries in Chongqing, China  

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Full Text Available Abstract Background Cataracts are the leading cause of blindness in China, and poverty is a major barrier to having cataract surgery. In 2003, the Chinese government began a series of new national health insurance reforms, including the New Cooperative Medical Scheme (NCMS) and the Urban Resident Basic Health Insurance scheme (URBMI). These two programs, combined with the previously existing Urban Employee Basic Health Insurance (UEBMI) program, aimed to make it easier for individuals to receive medical treatment. This study reports cataract surgery numbers in rural and urban populations and the proportion of these who had health insurance in Chongqing, China from 2003 to 2008. Methods The medical records of a consecutive case series, including 14,700 eyes of 13,262 patients who underwent age-related cataract surgery in eight hospitals in Chongqing from January 1, 2003, to December 31, 2008, were analysed retrospectively via multi-stage cluster sampling. Results In the past six years, the total number of cataract surgeries had increased each year as had the number of patients with insurance. Both the number of surgeries and the number of insured patients were much higher in the urban group than in the rural group. The rate of increase in the rural group however was much higher than in the urban group, especially in 2007 and 2008. The odds ratios of having health insurance for urban vs. rural individuals were relatively stable from 2003 to 2006, but it decreased in 2007 and was significantly lower in 2008. Conclusions Health insurance appears to be an important factor associated with increased cataract surgery in Chongqing, China. With the implementation of health insurance, the number of Chongqing's cataract surgeries was increased year by year.

Chen Xiaofan; Chen Chunlin; Zhang Yao; Yuan Rongdi; YE Jian

2011-01-01

291

Regular provision of outreach increases acceptance of cataract surgery in South India.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The prevalence of visual loss and blindness from cataract remains high in India. Marginalized communities are frequently reached through outreach clinics. The aim of this study was to explore the hypothesis that regular outreach, held in the same location by the same provider, leads to greater acceptance of cataract surgery than outreach clinics that are irregular in terms of timing and location. METHODS: The study was integrated into outreach clinics run in two districts by Sankara Eye Centre, Coimbatore, Southern India. A semi-structured questionnaire was administered to patients who had attended outreach eye clinics and either accepted or not accepted the offer of cataract surgery. RESULTS: Overall acceptance of surgery was high (91.7%), being higher in the district with regular outreach (94.6%vs. 82.3%, P < 0.001). A total of 398 participants (240, 60% acceptors) were interviewed. Acceptors were more likely to live in smaller households and in supportive families than non-acceptors who lived in larger families which could not provide support and where transport and distance were also barriers (P .001). Attending regular outreach and having had first eye cataract surgery were independent predictors of acceptance in a logistic regression model. CONCLUSION: The findings indicate the importance of providers building trust by organizing regular outreach in the same location. Previous eye surgery was also a strong predictor of accepting cataract surgery. To promote universal access to health care, marginalized rural communities will continue to need outreach for some time to come.

Finger RP; Kupitz DG; Holz FG; Chandrasekhar S; Balasubramaniam B; Ramani RV; Gilbert CE

2011-10-01

292

'Phaco-ECP': combined endoscopic cyclophotocoagulation and cataract surgery to augment medical control of glaucoma.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Does phaco-ECP reduce intraocular pressure? Is phaco-ECP safe? DESIGN: Retrospective case note review of all patients undergoing phaco-ECP between June 2008 and June 2009. All glaucoma subtypes were included. SETTING: Single District General Hospital Ophthalmology Department within the UK. PARTICIPANTS: 58 participants case notes reviewed. Mean age 79.0 years (SD ±9.8). INTERVENTIONS: All patients received combined cataract surgery and endoscopic cyclophotocoagulation. OUTCOME MEASURES: Follow-up was 1 day, 1 week, 1, 3, 6, 12, 18 and 24 months for intraocular pressure (IOP) measurement. Number of medications, visual acuity and presence of complications were also assessed. RESULTS: Of the 58 cases performed, 56 case notes (97%) were available for analysis. Mean age 79.0 years (SD ±9.8). Mean pre-procedural IOP was 21.54 mm?Hg (95% CI 19.86 to 23.22, n=56). Mean IOP was 14.43 mm?Hg (95% CI 13.65 to 15.21, n=53) at 18 months and 14.44 mm?Hg (95% CI 13.63 to 15.25, n=41) at 24 months. The mean drop from baseline to 18 and 24 months was 7.1 mm?Hg. Statistically significant decrease in IOP was demonstrated at all time points (p<0.001). Mean medication usage was 1.97 agents (95% CI 1.69 to 2.25) at baseline, 1.96 agents (95% CI 1.70 to 2.22) at 18 months and 2.07 agents (95% CI 1.76 to 2.38) at 24 months. No statistically significant change throughout. CONCLUSIONS: This study confirms the safety of phaco-ECP. In this case series, the IOP-lowering effect was significant at all time points; however, the effect of cataract surgery alone was not controlled. A randomised controlled trial is required to draw efficacy conclusions. The authors proposed endoscopic cyclophotocoagulation's main role is to optimise control of low-risk glaucoma of low-risk patients at the time of cataract surgery. However, the authors do not propose that phaco-ECP is a substitute for filtration surgery in high-risk eyes or when low target pressures (<14 mm?Hg) are indicated.

Lindfield D; Ritchie RW; Griffiths MF

2012-01-01

293

A cost-benefit analysis of cataract surgery based on the English Longitudinal Survey of Ageing.  

UK PubMed Central (United Kingdom)

This paper uses the English Longitudinal Survey of Ageing to explore the self-reported effect of cataract operations on eye-sight. A non-parametric analysis shows clearly that most cataract patients report improved eye-sight after surgery and a parametric analysis provides further information: it shows that the beneficial effect is larger the worse was self-reported eye-sight preceding surgery so that those with very good or excellent eye-sight do not derive immediate benefit. Nevertheless, the long-run effect is suggested to be beneficial. Calibrating the results to existing studies of the effect of imperfect eye-sight on quality of life, the impact of cataract operations on Quality Adjusted Life Years is found to be similar to that established in previous studies and well above the costs of cataract operations in most circumstances.

Weale M

2011-07-01

294

Cataract surgery under topical anesthesia: Gender-based study of pain experience  

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Full Text Available Background : Pain perception, expression, tolerance, and the healthcare provider?s evaluation and management of pain are affected by the gender of the patient. To the best of our knowledge, there is lack of gender-based evaluation of pain during cataract surgery under topical anesthesia. Aims : This study has been initiated to evaluate and determine pain experience during cataract surgery under topical anesthesia and to study the gender-based differences of the same. Settings and Design : Hospital-based study involving cataract surgery under topical anesthesia using standard cataract surgery. It was an interventional comparative case series. Materials and Methods : One hundred and sixty patients were included in four groups, according to the gender and choice of surgery. Patients underwent either phacoemulsification with foldable intra ocular lens (IOL) or manual small incision cataract surgery with rigid IOL under topical anesthesia. Patients ranked their pain experience on VAS scale after the surgery and the surgeon recorded the ease/difficulty accordingly using a questionnaire. Statistical Analysis Used : MedCalc version 10.2.0.0 ( www.medcalc.be ) for windows was used to analyze the results. Analysis of variance (ANOVA) test and Kruskal-Walis test were used to analyze the data. Results : The overall visual analog scale (VAS) score was 0.8 (SD 1.3 range 0-8), with no statistical difference among the groups (P=0.5). The average surgeon?s score was 3.3 (SD 0.71 range 3-7), with no statistical difference between the groups (P=0.37).There were no sight threatening complications during the surgery in any group. Conclusions : The outcome of the study demonstrates that the patients undergoing cataract surgery under topical anesthesia perceive comparable pain and discomfort irrespective of their gender.

Gupta Sanjiv; Kumar Ajay; Agarwal Swati

2010-01-01

295

Macular morphology after cataract surgery with primary posterior capsulorhexis and posterior optic buttonholing.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate possible changes in macular morphology after cataract surgery with combined primary posterior capsulorhexis and posterior optic buttonholing in comparison to conventional in-the-bag intraocular lens (IOL) implantation. DESIGN: Prospective randomized study. METHODS: Fifty consecutive age-related cataract patients with normal macular morphology and function waiting for bilateral cataract surgery were enrolled. Cataract surgery with combined primary posterior capsulorhexis and posterior optic buttonholing was performed in one eye; in the fellow eye cataract surgery was performed with in-the-bag IOL implantation, leaving the posterior lens capsule untouched. Optical coherence tomography measurements were performed one week and one month postoperatively. RESULTS: During follow-up, no statistically significant changes of macular morphology could be observed in any of the tested patients. Mean central retinal thickness, minimum and maximum retinal thickness, and central retinal volume were all statistically comparable between the eyes with combined primary posterior capsulorhexis and posterior optic buttonholing and the control eyes (P > .05). Best-corrected visual acuity was full in all patients (Snellen 20/25 and better). No cases of subclinical macular edema were observed. CONCLUSION: Cataract surgery with combined primary posterior capsulorhexis and posterior optic buttonholing apparently does not increase the risk for postoperative macular edema in patients with a normal macula, since no cases of biomicroscopically noticeable macular edema with visual loss were observed in the first 1,000 eyes with primary posterior capsulorhexis/posterior optic buttonholing cataract surgery and no case of subclinical macular edema was found in this prospective randomized study.

Stifter E; Menapace R; Neumayer T; Luksch A

2008-07-01

296

Chandelier retroillumination-assisted torsional oscillation for cataract surgery in patients with severe corneal opacity.  

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We describe a technique that uses 25-gauge transconjunctival chandelier endoillumination in combination with a torsional oscillation system for cataract surgery in cases with severe bullous keratopathy. Because of the hands-free and self-retaining nature of the chandelier fiber, continuous curvilinear capsulorhexis and subsequent bimanual intraocular manipulation can be performed easily. Torsional oscillation efficiently emulsifies lens particles along with the fluidics, preventing posterior capsule rupture and endothelial cell damage. After the chandelier fiber is removed at the end of surgery, the 25-gauge incision self-seals. This technique is safe and provides excellent visualization during cataract surgery in patients with severe corneal opacities. PMID:18053897

Oshima, Yusuke; Shima, Chiharu; Maeda, Naoyuki; Tano, Yasuo

2007-12-01

297

EFFECT OF COMBINED CATARACT SURGERY AND RANIBIZUMAB INJECTION IN POSTOPERATIVE MACULAR EDEMA IN NONPROLIFERATIVE DIABETIC RETINOPATHY.  

UK PubMed Central (United Kingdom)

PURPOSE:: To evaluate whether intravitreal ranibizumab injection at cataract surgery prevents postoperative diabetic macular edema (PME) in patients with stable diabetic retinopathy without significant macular edema. METHODS:: Eighty patients with cataract, stable diabetic retinopathy, and no significant macular edema were randomized to a sham group (cataract surgery only) or a group undergoing cataract surgery plus intraoperative ranibizumab injection. Best-corrected visual acuities, central subfield thickness, and total macular volume were assessed at baseline and 1 week, 1, 3, and 6 months postoperatively by spectral domain optical coherence tomography. Clinically meaningful PME (central subfield thickness increase >60 ?m relative to baseline) was computed. RESULTS:: The groups did not differ in baseline best-corrected visual acuity, central subfield thickness, and total macular volume. Compared with the ranibizumab injection group, the sham group had significantly larger central subfield thickness increases relative to baseline at 1 week and 1 month; larger total macular volume increases at all time points (P = 0.012, P = 0.005, P < 0.001, P < 0.001, P = 0.005, P = 0.017, respectively); higher PME frequency at 1 month (P = 0.019); and poorer best-corrected visual acuity improvement from baseline to 6 months after surgery (P = 0.046). CONCLUSION:: In patients with stable diabetic retinopathy without significant macular edema, intravitreal ranibizumab injection at cataract surgery may prevent the postoperative worsening of macular edema and may improve the final visual outcome without affecting safety.

Chae JB; Joe SG; Yang SJ; Lee JY; Sung KR; Kim JY; Kim JG; Yoon YH

2013-06-01

298

[Cost of phacoemulsification in the national campaign of elective cataract surgery in Itapolis, SP, Brazil].  

UK PubMed Central (United Kingdom)

PURPOSE: To determine the average cost of cataract surgery using the phacoemulsification technique with intraocular lens implant (IOL). This study was conducted during a national campaign to treat patients with cataracts promoted by the Brazilian Council of Ophthalmology (CBO) and the Health Ministry in the city of Itápolis-SP from March to December, 2000. METHODS: All expenses related to the surgery were collected (pre-, intra-, and postoperative data) and analyzed. Fifty-eight patients with senile cataracts and without any other ocular findings were submitted to the procedure in a prospective study. RESULTS: The average cost of the surgery in this study was R$ 485.03 or USD 248.05. This value represents the average cost of the surgery itself; in which some materials, equipment, taxes and other services were previously determined and used for this project. CONCLUSION: The phacoemulsification technique for cataract surgery has been used more and more, due to its effectiveness, being an excellent method to treat cataracts. Although this is an excellent technique, the economical aspect does not allow it to be used for part of the population.

Saad Filho R; Saad FG; Freitas LL

2005-01-01

299

Cataract surgery at Aravind Eye Hospitals: 1988–2008  

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Full Text Available In the 1980s, cataract was the major cause of blindness in India and was responsible for 80% of all blindness. This prompted the Indian government to launch a national cataract control programme, which succeeded in lowering the prevalence of blindness from 1.49% to 1.1%. In addition, by 2000, this programme had reduced the proportion of people blind due to cataract from 80% to 62%.Aravind Eye Hospitals contributed to a third of all cataract operations in the state of Tamil Nadu during the last two decades and played a major part in lowering the rate of blindness in that state. By 2000, the prevalence level of blindness was just 0.78%, compared to the national level of 1.11%.

G Natchiar; RD Thulasiraj; R Meenakshi Sundaram

2008-01-01

300

Predictors of attendance and barriers to cataract surgery in Kenya, Bangladesh and the Philippines.  

UK PubMed Central (United Kingdom)

PURPOSE: Cataract is the leading cause of blindness worldwide, and is particularly common in low- and middle-income countries. Our study aims to identify the predictors for and barriers to acceptance of cataract surgery in Kenya, Bangladesh and the Philippines. METHODS: Cases were individuals aged ?50 years and with best corrected VA of <6/24 in the better eye due to cataract who were identified through population-based surveys and community-based case detection. Cases were asked why they had not attended for surgery. They were offered free cataract surgery and followed-up at one year. Non-acceptors were interviewed to identify barriers to accepting surgery. RESULTS: Of all participants, 58.6% attended for cataract surgery in Kenya, 53.9% Bangladesh and 47.1% the Philippines. Younger age was a predictor for attendance for surgery in all three countries. In Bangladesh and Kenya, male gender and psychosocial score were predictors. At baseline "cost" and "unaware of cataract" were most frequently reported barriers to uptake of surgery in the three settings. At follow-up, "surgical services inaccessible" was one of the two most frequently reported barriers in Kenya and the Philippines while "fear" was most frequently reported in Bangladesh and the Philippines. There were no consistent predictors of the most frequently reported barriers across the different settings. CONCLUSIONS: Future services need to focus on increasing uptake among older people and women. Cost is often reported as a barrier but this may conceal more complicated underlying barriers which need to be explored through in-depth qualitative research. IMPLICATIONS FOR REHABILITATION: Cataract is the leading cause of blindness worldwide, and is particularly common in low- and middle-income countries. Evidence suggests that even when surgical services are available, there can be a lack of demand and low utilization resulting from barriers to uptake. Older cataract patients, females and especially older females are least likely to attend for surgery. Future cataract surgical programmes should put special emphasis on targeting and increasing uptake in these groups.

Syed A; Polack S; Eusebio C; Mathenge W; Wadud Z; Mamunur AK; Foster A; Kuper H

2013-09-01

 
 
 
 
301

Blindness and visual impairment due to age-related cataract in sub-Saharan Africa: a systematic review of recent population-based studies.  

UK PubMed Central (United Kingdom)

AIM: We aimed to evaluate age-related cataract as a contributor to blindness and visual impairment (VI) in sub-Saharan Africa (SSA). METHODS: A systematic review of population-based studies published between 2000 and October 2012. Prevalence and proportions of blindness and VI due to cataract, cataract surgical coverage (CSC), per cent intraocular lens (IOL) implantation and visual outcomes of surgery in accordance with WHO criteria were ascertained. RESULTS: Data from 17 surveys (subjects mostly aged ?50-years-old) from 15 different countries in SSA were included, comprising 96 402 people. Prevalence of blindness (presenting visual acuity <3/60 in better eye) ranged from 0.1% in Uganda to 9.0% in Eritrea, and the proportion of total blindness due to cataract ranged between 21% and 67%. Cataract was the principal cause of blindness and VI in 15 and 14 studies, respectively. There was a strong positive correlation between good visual outcomes and IOL use (R=0.69, p=0.027). Considerable inter-study heterogeneity was evident in CSC and visual outcomes following surgery, and between 40% and 100% of operations had used IOL. CONCLUSIONS: Cataract represents the principal cause of blindness and VI and should remain a priority objective for eye care in SSA. However, the prevalence of blindness and VI due to cataract was variable and may reflect differences in the availability of cataract surgical programmes and cataract incidence.

Bastawrous A; Dean WH; Sherwin JC

2013-10-01

302

Implementation of a free cataract surgery program in rural China: a community-based randomized interventional study.  

UK PubMed Central (United Kingdom)

PURPOSE: To identify effective methods to increase the number of cataract surgeries in a rural setting in Pucheng County of Shaanxi Province, northwestern China. DESIGN: Community-based randomized interventional study. PARTICIPANTS: Four hundred thirty-two patients 50 years of age or older with operable cataract who had not undergone surgery 3 months after participation in a cataract outreach screening program. METHODS: Three hundred fifty-five (82.2%) patients eligible for surgery, but not scheduling it on their own, were contacted and were assigned randomly into 4 groups. Participants in group 1 (n = 86) were given informative reminders by telephone or in person by a trained facilitator about undergoing low-cost cataract surgery. Group 2 (n = 86) was offered free cataract surgery. Group 3 (n = 90) was offered free surgery and reimbursement of transportation expenses. Group 4 (n = 93) was provided with free rides from home to hospital in addition to the reminder and free surgery. MAIN OUTCOME MEASURES: Number of participants undergoing cataract surgery after interventions. RESULTS: In total, 94 patients (26.5%) underwent cataract surgery after interventions. In group 1, 13 patients (14.4%) underwent surgery, which was significantly lower than the number in group 2 (n = 25 [27.8%]; P = 0.027), group 3 (n = 28 [31.1%]; P = 0.012), and group 4 (n = 26 [28%]; P = 0.038). There were no significant differences between groups 2 and 3 (P = 0.768) or between groups 2 and 4 (P = 0.869). CONCLUSIONS: Provision of free cataract surgery was twice as effective as giving patients an informative reminder when it came to increasing the uptake of cataract surgery. However, offering reimbursement of transportation expenses or provision of free rides had minimal added impact on the response rate of participants to undergo cataract surgery.

Zhang XJ; Liang YB; Liu YP; Jhanji V; Musch DC; Peng Y; Zheng CR; Zhang HX; Chen P; Tang X; Lam DS

2013-02-01

303

Factors influencing stereoacuity levels after surgery to correct unilateral developmental cataracts in children  

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AIM To evaluate factors influencing stereoacuity after surgery to correct unilateral developmental pediatric cataracts. METHODS We retrospectively surveyed 110 patients who had undergone removal of unilateral acquired developmental cataracts and primary posterior chamber intraocular lens implantation between February 1992 and December 2009. In all patients, stereoacuity was assessed using the Titmus test at the last follow-up period of minimum 2 years after surgery. Patients were divided into two groups according to the extent of stereoacuity: group 1 (n=42) had stereoacuity values?100sec/arc and group 2 (n=68) values >100sec/arc. The values of ten parameters associated with stereoacuity were measured in each group: Cataract types, preoperative best corrected visual acuity (BCVA) of the affected eyes, preoperative inter-ocular difference of BCVA, age at cataract surgery, operative method, secondary cataract, postoperative strabismus, postoperative BCVA of the affected eyes, postoperative inter-ocular difference of BCVA, and anisometropia. RESULTS The extent of stereoacuity was significantly associated with both operative method and secondary cataract (P=0.000 and P=0.016, respectively). All patients in whom the posterior capsule was preserved, had poor stereoacuity >100sec/arc. Significant correlations with the extent of stereoacuity were found with postoperative strabismus (P=0.048), postoperative BCVA of the affected eyes (P=0.002), anisometropia (P=0.034). CONCLUSION : Postoperative stereoacuity was better in patients who underwent either optic capture or anterior vitrectomy after posterior continuous curvilinear capsulorhexis, and who didn't develop secondary cataracts or strabismus postoperatively. Furthermore, postoperative BCVA of the affected eyes, and anisometropia influenced the stereoacuity of the patients surgically treated for unilateral developmental pediatric cataracts.

Lee, Soo-Jung; Kim, Wan-Soo

2013-01-01

304

Cataracts  

Science.gov (United States)

... medical conditions such as diabetes, trauma or past eye surgery. Long-term use of steroid medications, too, can ... pressure Obesity Previous eye injury or inflammation Previous eye surgery Prolonged use of corticosteroid medications Smoking Preparing for ...

305

Influence of prostaglandin analogue on outcome after combined cataract surgery and trabecular aspiration in pseudoexfoliative glaucoma.  

UK PubMed Central (United Kingdom)

Introduction: The aim of this study was to analyze the postoperative outcome and risk profile after combined clear cornea phacoemulsification and trabecular aspiration in the treatment of pseudoexfoliative glaucoma (PEX) associated with cataract. ?Methods: In this retrospective study, 69 eyes of 60 patients with visually significant cataract and PEX were treated with small-incision cataract surgery combined with trabecular aspiration. The intraocular pressure (IOP), number of antiglaucoma eyedrops before and after surgery, as well as complications were measured at all postoperative visits (1 day, 7 days, 6 weeks, 6 months, 12 months). ?Results: There was a statistically significant decrease in postoperative IOP during the follow-up ?period. There was no significant difference in the number of medications being used after 6 weeks follow-up. Six months and 12 months after surgery, the number of antiglaucoma eyedrops decreased significantly. Complications were fibrinotic iritis in 4 eyes (5.9%), cystoid macular edema in 3 eyes (4.4%), and hyphema in 1 eye (1.4%). Fibrinotic iritis and macular edema were present in only 37 of ?69 eyes that were treated with prostaglandin analogues.?Conclusions: Small-incision cataract surgery combined with trabecular aspiration in cases of PEX associated with cataract is effective in IOP reduction over a 1-year follow-up. Prostaglandin analogues may increase the risk of postoperative macular edema and fibrinotic iritis. Preoperative medication exchange may be considered.

Gonnermann J; Klamann MK; Maier AK; Torun N; Ruokonen PC; Bertelmann E

2013-05-01

306

Intracameral mydriatics in phacoemulsification cataract surgery -- a 6-year follow-up.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the long-term safety of intracameral mydriatics (ICM) in phacoemulsification cataract surgery compared with conventional topical mydriatics (TM). METHODS: A total of 45 patients were examined 6 years after phacoemulsification cataract surgery. The patients had previously participated in a prospective randomized double-blind study including 60 patients, operated with either ICM or TM. The follow-up included best-corrected visual acuity (BCVA), intraocular pressure (IOP), grade of posterior capsule opacification (PCO), YAG laser capsulotomy rate, pupil size, corneal thickness and endothelial morphology. RESULTS: No differences in postoperative BCVA, IOP, pupil size, PCO or YAG rate were observed between the groups. Endothelial cell loss, endothelial morphology and corneal thickness were also equivalent. CONCLUSIONS: Intracameral mydriatics is a safe alternative to topical mydriatics in phacoemulsification cataract surgery with no long-term disadvantages at 6-year follow-up.

Lundberg B; Behndig A

2013-05-01

307

Cataract and pterygium surgery results in Venezuelan patients treated in the Misión Milagro program  

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Full Text Available An intervention to address vision loss was carried out in 2008 in Táchira, Venezuela, by health teams of the joint Cuban-Venezuelan initiative known as Misión Milagro. It included active case identification of patients with ophthalmologic conditions and, where warranted, surgery, followup, rehabilitation and medical discharge. From a universe of 345 patients aged >18 years with ophthalmologic conditions found, 210 were selected for cataract or pterygium surgery. Of cataract patients, 55.2% recovered optimal vision within three months after surgery, as did 90.9% of those with pterygium; frequency of complications was 15.4% in cataract patients and 41.7% in pterygium patients. The intervention was considered successful, although many patients' low-income status required premature postoperative return to their jobs and other labors, a factor considered detrimental to optimal recovery.

Idalia Triana; Oaris de los Ángeles Socarrás; Nelsis Rondón

2012-01-01

308

Results at seven years after the use of intracamerular cefazolin as an endophthalmitis prophylaxis in cataract surgery  

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Full Text Available Abstract Background To evaluate results after seven years using prophylactic intracameral cefazolin for the prevention of endophthalmitis in cataract surgery. Methods A prospective, observational study of all patients submitted to cataract surgery over the period January 1996 to December 2009. All cases of postoperative endophthalmitis over that period were reviewed. The patients were classified in two groups: Group 1 (11,696 patients) operated on between January 1996 and December 2002, Group 2 (13,305 patients) between January 2003 and December 2009 (in whom a 1 mg/0.1 bolus of intracameral cefazolin was instilled). Results During the study period, 76 cases of endophthalmitis were observed in Group 1, and seven in Group 2. The rate of postoperative endophthalmitis reduced from 0.63% to 0.05% with a cefazolin injection. The relative risk (RR) for endophthalmitis in Group 1 against group 2 was 11.45 [95% CI 5.72-22.84, p . Conclusions An intracameral bolus injection of cefazolin (1 mg in 0.1 ml solution) at the conclusion of the cataract surgery significantly reduced the rate of postoperative endophthalmitis.

Romero-Aroca Pedro; Méndez-Marin Isabel; Salvat-Serra Merce; Fernández-Ballart Juan; Almena-Garcia Matias; Reyes-Torres Javier

2012-01-01

309

Prevalence of visual impairment, cataract surgery and awareness of cataract and glaucoma in Bhaktapur district of Nepal: The Bhaktapur Glaucoma Study  

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Full Text Available Abstract Background Cataract and glaucoma are the major causes of blindness in Nepal. Bhaktapur is one of the three districts of Kathmandu valley which represents a metropolitan city with a predominantly agrarian rural periphery. This study was undertaken to determine the prevalence of visual impairment, cataract surgery and awareness of cataract and glaucoma among subjects residing in this district of Nepal. Methods Subjects aged 40 years and above was selected using a cluster sampling methodology and a door to door enumeration was conducted for a population based cross sectional study. During the community field work, 11499 subjects underwent a structured interview regarding awareness (heard of) and knowledge (understanding of the disease) of cataract and glaucoma. At the base hospital 4003 out of 4800 (83.39%) subjects underwent a detailed ocular examination including log MAR visual acuity, refraction, applanation tonometry, cataract grading (LOCS??), retinal examination and SITA standard perimetry when indicated. Results The age-sex adjusted prevalence of blindness (best corrected Conclusion The low prevalence of visual impairment and the high cataract surgical coverage suggests that cataract intervention programs have been successful in Bhaktapur. Awareness and knowledge of cataract and glaucoma was very poor among this population. Eye care programs needs to be directed towards preventing visual impairment from refractive errors, screening for incurable chronic eye diseases and promoting health education in order to raise awareness on cataract and glaucoma among this population.

Thapa Suman S; Berg Rosa VD; Khanal Shankar; Paudyal Indira; Pandey Pooja; Maharjan Nhukesh; Twyana Shankha N; Paudyal Govinda; Gurung Reeta; Ruit Sanduk; Rens Ger HMBV

2011-01-01

310

Utility of EQ-5D to assess patients undergoing cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To assess the construct validity and responsiveness of the EuroQoL-5D (EQ-5D) instrument in Asian patients undergoing cataract surgery in Singapore. METHODS: In this prospective study, English- or Chinese-speaking patients (n = 216) completed the EQ-5D and the VF-14 questionnaires before and 3 months after they underwent cataract surgery. The impact of cataracts on patients was assessed using two standard gamble (SG) questions before surgery. Construct validity of the EQ-5D index and the visual analog scale (VAS) was assessed by examining their correlation with the VF-14 and SG scores. Responsiveness of the EQ-5D was compared with that of the VF-14 in terms of the magnitude of score change associated with cataract surgery. RESULTS: We found that the EQ-5D index correlated with VF-14, SG (death), and SG (blindness) (Pearson r = 0.30, 0.23 and 0.24, respectively; p < 0.01). In contrast, we found no correlation between the EQ-VAS, VF-14, and SG scores. The mean EQ-5D index (difference, 0.06; effect size, 0.35) and VF-14 score (difference, 1.75; effect size, 0.97) of patients improved after cataract surgery (p < 0.0001). CONCLUSIONS: Our study demonstrated that the EQ-5D utility index is a valid and responsive outcome measure for evaluating the impact of cataract surgery in our Asian population. However, the implications of using the generic EQ-5D instrument to assess the cost-effectiveness of surgical interventions for visual impairment require further investigation.

Ang M; Fenwick E; Wong TY; Lamoureux E; Luo N

2013-08-01

311

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery  

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Full Text Available Betül Ilkay Sezgin Akçay, Tahir Kansu Bozkurt, Esra Güney, Cihan Ünlü, Gürkan Erdogan, Gülünay Akcali, Huseyin BayramlarUmraniye Research and Training Hospital, Istanbul, TurkeyPurpose: To compare change of macular thickness after uneventful cataract surgery and after cataract surgery complicated with vitreous loss, using optic coherence tomography (OCT).Methods: Twenty eyes of 20 patients who underwent cataract surgery complicated with posterior capsular tear participated in this retrospective study (Group 2). The fellow eyes of those patients who underwent uneventful cataract surgery served as the control group (Group 1). Best spectacle-corrected visual acuity (BCVA), refraction, keratometry, axial length measurement, intraocular lens power calculation, intraocular pressure, and biomicroscopic and posterior segment examinations were done preoperatively. BCVA was evaluated at the postoperative 1st day, 1st week, 1st month, and 3rd month. Macular thickness and volumetric measurements with OCT with MM5 protocol were conducted at the postoperative 3rd month.Results: Logarithm of the minimum angle of resolution BCVA of Group 1 was significantly better than Group 2 at all intervals (P < 0.05). Foveal, parafoveal (superior and temporal), and perifoveal (superior and temporal) macular thickness measurements were significantly higher in Group 2 at month 3 (P < 0.05). Foveal volume was also significantly higher in Group 2 when compared with Group 1 (P < 0.05). In Group 2, two eyes (10%) were diagnosed with clinically significant cystoid macular edema at the 1-month visit.Conclusion: Macular thickness was found to be significantly high in eyes undergoing complicated cataract surgery (with posterior capsular tear) when compared with uneventful cataract surgeries of fellow eyes.Keywords: BCVA, posterior capsular tear, vitreous loss

Akçay B?; Bozkurt KT; Güney E; Ünlü C; Erdogan G; Akcali G; Bayramlar H

2012-01-01

312

Cataract surgery and postoperative complications in diabetic patients.  

UK PubMed Central (United Kingdom)

Diabetes mellitus influences the function and morphology of the eye lens. The cataract is the second most common complication of diabetes mellitus on the eye. A hundred patients with cataract were examined in the prospective study. The patients were divided into two groups. The first group consisted of 50 patients with cataract who had not suffered from a system or local disease. The second group consisted of 50 patients with cataract and diabetes mellitus that had lasted for at least five years. In both groups the patients underwent identical cataract extra capsular extraction with intraocular PMMA (polymethylmethacrylate) lens implantation in camera posterior. The objective of this study was to compare the two groups of patients in order to find out the most common intraoperative or postoperative complications in diabetics. The most common postoperative complications in patients suffering from diabetes were inflammatory reactions and bleeding: postoperative keratopathy, uveitis anterior serous and uveitis anterior fibrinous with posterior sinechia and opacity of the posterior lens capsule as results. Postoperative visual acuity was worse in the patients in group II on the seventh day and six months after operation. It was diabetic retinopathy and its progression that caused deterioration of visual acuity. Diabetic retinopathy and its progression, as well as maculopathy were found only in patients who were not treated with photocoagulation before the operation.

Ivanci? D; Mandi? Z; Bara? J; Kopi? M

2005-01-01

313

Sensitivity change in cornea and tear layer due to incision difference on cataract surgery with either manual small-incision cataract surgery or phacoemulsification.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe corneal sensitivity changes caused by different incision methods-manual small-incision cataract surgery (manual SICS) and phacoemulsification-and their influence on tear film quantity and quality. METHODS: This was a prospective observational study conducted in 30 subjects undergoing manual SICS or phacoemulsification. Corneal sensitivity was assessed before and 1, 7, and 15 days after surgery by Cochet-Bonnet esthesiometer. Tear meniscus, noninvasive breakup time, lipid pattern, and Schirmer test results were evaluated. Patient symptoms were reviewed based on the Ocular Surface Disease Index. RESULTS: In the group undergoing phacoemulsification, corneal sensitivity decreased at the incision site and at other sites on days 1, 7, and 15 after surgery, whereas in the group undergoing manual SICS, no change in corneal sensitivity was noted. Between-group difference in corneal sensitivity was significant on days 1, 7, and 15. Aqueous production significantly (P = 0.016) increased on the first day in both groups and returned to presurgery level on day 15. Tear film quality decreased on day 1 only in the group undergoing manual SICS (P = 0.035). Tear meniscus and tear lipid profile showed no change in either group. Patient symptoms significantly increased on day 1 in both groups, and the difference between the 2 groups was significant on day 15 (P = 0.044). CONCLUSIONS: Compared with manual SICS, temporal-side incision in phacoemulsification decreased corneal sensitivity in the incision site and other sites until day 15 and changes in tear film quantity and patient symptoms only on day 1.

Sitompul R; Sancoyo GS; Hutauruk JA; Gondhowiardjo TD

2008-09-01

314

[Retinal nerve fiber layer changes after cataract surgery measured by OCT: a pilot study  

UK PubMed Central (United Kingdom)

PURPOSE: To analyze changes in peripapillary retinal nerve fiber layer (RNFL) after cataract surgery. METHODS: The average RFNL thickness of patients who underwent cataract surgery was measured using the optical coherence tomography (OCT) III Stratus(R) before surgery, the day after and one month later. The data were analyzed using the SPSS 12.0 software. We used paired two tail student's t test for comparisons. RESULTS: The study group was composed by 74 eyes of 74 patients. The RNFL thickness average was 90.71 microm (SD: 19.93), 88.30 microm (SD: 20.59) and 97.45 microm (SD: 14.30), before cataract surgery (AVGT0), the day after surgery (AVGT1) and one month later (AVGT2) respectively. We did not find statistically significant difference between AVGT0 and AVGT1 (P=0.37); however, statistically significant difference between AVGT1 and AVGT2 (P= 0.002) as well as in the image signal quality between AVGT0 and AVGT2 (P= 0.0001). CONCLUSIONS: The RNFL average thickness measured by OCT III Stratus showed an increase one month after cataract surgery. This phenomenon is accompanied with an improvement in signal quality.

Pareja-Esteban J; Teus-Guezala MA; Drake-Casanova P; Dapena-Sevilla I

2009-06-01

315

Prevalence of Blindness and Outcomes of Cataract Surgery in Hainan Province in South China.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To define the prevalence of blindness and visual impairment (VI) in people in rural Hainan using the rapid assessment of avoidable blindness (RAAB) and to report the outcomes of cataract surgery among the residents. DESIGN: Population-based, cross-sectional survey. PARTICIPANTS: A total of 6482 rural residents of the Hainan province. METHODS: A total of 136 clusters, each of which consisted of 50 people aged ?50 years, were selected through probability-proportionate-to-size sampling. Door-to-door visits were performed by 2 outreach teams. Visual acuity (VA) was measured on site, and those with VA <6/18 in either eye were examined by an ophthalmologist. Causes of blindness and VI were determined. The causes of poor visual outcome after cataract surgery were evaluated. Information regarding barriers to receiving surgery was collected by trained interviewers. MAIN OUTCOME MEASURES: Prevalence and causes of blindness (VA <3/60), severe VI (SVI) (VA <6/60 but ?3/60), and VI (VA <6/18 but ?6/60) based on presenting VA (PVA) were assessed. Outcomes of cataract surgery performed in public and private hospitals and charitable organizations were compared. RESULTS: A total of 6482 subjects were examined (response rate, 95.3%). The sample prevalence of blindness was 4.4% (95% confidence interval [CI], 2.0-6.8). The prevalence of SVI and VI was 1.9% (95% CI, 0-4.3) and 9.9% (95% CI, 7.6-12.2), respectively. Age and sex were associated with increased prevalence of blindness, SVI, and VI. Overall, cataract accounted for approximately 60% of blindness and SVI. Of the 524 eyes that had received cataract surgery, 87.2% had intraocular lenses implanted, 21% had a poor visual outcome (PVA <6 /60), and 20% had a borderline visual outcome (PVA <6/18 but ?6/60). Eyes that received surgery in charitable organizations had a higher rate of intraocular lens implantation and good visual outcome (VA ?6/18) compared with eyes that were operated on elsewhere. CONCLUSIONS: The prevalence of blindness, SVI, and VI was high among rural residents in Hainan. Cataract remained the leading cause of avoidable blindness. Outcomes of cataract surgery performed in public hospitals were suboptimal. Quality-control initiatives should be introduced to improve cataract surgery outcomes. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Li EY; Liu Y; Zhan X; Liang YB; Zhang X; Zheng C; Jhanji V; Xu P; Chang DF; Lam DS

2013-05-01

316

The pain experience and cooperation of patients in consecutive cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: The aim of this study was to investigate the pain experience and the cooperation of patients during consecutive cataract surgery. METHODS: In this prospective, randomized study, 60 consecutive adult patients with bilateral senile cataracts were recruited. All operations were performed with clear corneal phacoemulsification (phaco) technique under topical and intracameral anesthesia without sedation. The first surgery was performed in the eye with high-grade cataract. The other eye was operated within 3 months. Every patient was graded using a visual analogue scale (VAS) from 0 (no pain) to 10 (unbearable pain) after the surgery. The cooperation of the patient was graded from 0 (no event) to 3 (marked eye and head movement and lid squeezing) by the surgeon. The VAS scores and cooperation of patients were the main outcome measurements. RESULTS: The mean VAS score was 1.50± 0.81 in the first surgery and 2.15±0.79 in the other eye surgery (p<0.001). The patient cooperation score was 1.50±0.81 in the first surgery and 2.18±0.77 in the other eye surgery (p<0.001). The VAS and patient cooperation scores were positively correlated (r=0.633, p<0.001) in the study group. The VAS and patient cooperation scores were similar based on sex and laterality. CONCLUSIONS: Patients who previously underwent phaco surgery in one eye experience more pain and have worse cooperation during the other eye phaco surgery.

Aslan L; Aslankurt M; Cekic O; Aksoy A; Yildiz H

2013-05-01

317

Incidence of Endophthalmitis after Corneal Transplant or Cataract Surgery in a Medicare Population.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To estimate the incidence of infectious endophthalmitis after corneal transplant or cataract surgery, to evaluate the trend of endophthalmitis during the study period, and to assess demographic risk factors for endophthalmitis after surgeries. DESIGN: A retrospective population-based cohort study. PARTICIPANTS AND CONTROLS: Study cohorts were derived from the Medicare claims databases, 2006 to 2011. Patients were continuously enrolled in Medicare Part A, Part B, and Part D. Patients undergoing corneal transplant or cataract surgery were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes. METHODS: Endophthalmitis was defined in 3 different ways: (1) using ICD-9-CM codes (sensitive definition), (2) combining ICD-9-CM codes with Current Procedural Terminology, Fourth Edition (CPT-4) codes (specific definition), or (3) combining ICD-9-CM codes with antifungal prescriptions for endophthalmitis caused by fungal infection. Demographic risk factors for endophthalmitis were examined using multivariate Cox models. MAIN OUTCOME MEASURES: Incidence rates of endophthalmitis were calculated and compared for each definition of endophthalmitis at 6-week and 6-month intervals after corneal transplant or cataract surgery. RESULTS: The infectious endophthalmitis incidence rates ranged from 0.11% to 1.05% in the corneal transplant cohort, 0.06% to 0.20% in the cataract surgery cohort, and 0.16% to 0.68% in the concurrent surgery cohort, depending on the definition and time interval after surgery. Compared with the cataract surgery cohort, the corneal transplant cohort had a higher adjusted hazard ratio (HR) of endophthalmitis within the 6-week postoperative interval (HR, 2.744; 95% confidence interval [CI], 1.544-4.880 in the sensitive definition and HR, 2.792; 95% CI, 1.146-6.802 in the specific definition) and within the 6-month postoperative interval (HR, 4.607; 95% CI, 3.144-6.752 for the sensitive definition and HR, 4.385; 95% CI, 2.245-8.566 for the specific definition). CONCLUSIONS: It is possible to monitor the trend of infectious endophthalmitis after corneal transplant or cataract surgery through examining Medicare claims databases as long as a consistent definition of endophthalmitis is used. The annual incidence of endophthalmitis was stable over time during the study period for both corneal transplant and cataract surgery procedures; however, there was a wider year-to-year variation for the corneal transplant cohort. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Du DT; Wagoner A; Barone SB; Zinderman CE; Kelman JA; Macurdy TE; Forshee RA; Worrall CM; Izurieta HS

2013-08-01

318

Cataract surgery in India: Results of a 1995 survey of ophthalmologists  

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Full Text Available The aim of this study was to investigate cataract surgery procedures and caseloads among Indian ophthalmologists in private and government practices. Members of the All India Ophthalmological Society and state ophthalmic societies were surveyed by mail questionnaire in December 1995. Out of 6,800 surveyed, 2,098 responses (31%) were received. Over 61% of the 990,249 reported cataract surgeries were carried out in private facilities with 24% of private patients receiving extracapsular cataract extraction (ECCE) and 41% ECCE with intraocular lens (IOL). Intracapsular cataract extraction remains more common in government facilities with 62% of cases. Over 85% of all surgeons reported some experience with ECCE/IOL. Surgeons operating in both private and government facilities carry an average annual caseload of 861 cataract surgeries, which is twice that of their colleagues operating exclusively in either private or government settings. Although the questionnaire response rate was low, the findings suggest that ECCE is more common in India than is generally recognized, and with the recent availability of low-cost IOLs, its popularity is rapidly expanding.

Gupta A; Tewari H; Ellwein Leon

1998-01-01

319

Baseline factors predictive of visual prognosis in acute postoperative bacterial endophthalmitis in patients undergoing cataract surgery.  

UK PubMed Central (United Kingdom)

IMPORTANCE Although rare, postoperative endophthalmitis in patients undergoing cataract surgery can lead to anatomical or functional loss of the eye. Therapeutic strategies such as antibiotic prophylaxis and microbiological diagnosis are more effective with a target patient population. New prospective data are needed to identify prognostic factors. OBJECTIVE To identify baseline factors of visual prognosis in patients with acute bacterial endophthalmitis after cataract surgery. DESIGN Prospective study of consecutive patients undergoing cataract surgery, enrolled from March 1, 2004, through December 31, 2005. We analyzed outcomes to determine the effect on the final visual outcome, defined as poor (visual acuity [VA] worse than 20/100) or good (VA 20/40 or better) using univariate and multivariate analysis. SETTING Four academic hospitals. PARTICIPANTS Ninety-nine consecutive patients with cataract. INTERVENTION Corneal phacoemulsification. MAIN OUTCOMES AND MEASURES Factors related to the cataract surgery (complications), initial clinical presentation, and microbiological diagnosis and the final VA. RESULTS The significant baseline factors (at presentation) for good visual outcome (45% of the series) were the winter season, absence of complications during cataract surgery, initial VA, microbiological investigations revealing no microorganism or a coagulase-negative Staphylococcus species (CNSP), and fundus visibility. Quantitative factors associated with a good clinical prognosis were shorter duration of cataract surgery, younger age, and a hypopyon no greater than 1.5 mm. Significant factors associated with poor visual outcome were infection of the right eye, initial VA, corneal edema, a hypopyon larger than 1.5 mm, detection of bacterial species other than a CNSP, and the absence of fundus visibility. Multiple logistic regression analysis showed that high bacterial virulence was the only independent factor (odds ratio, 14.0 [95% CI, 2.7-71.0]; P?=?.001) for poor visual outcome. On the other hand, low bacterial virulence (odds ratio, 0.2 [95% CI, 0.03-0.6]; P?=?.01) and the absence of complications during cataract surgery (0.1 [0.01-0.4]; P?=?.003) were independent factors for good VA. CONCLUSIONS AND RELEVANCE Most clinical outcome factors in acute postoperative endophthalmitis can be identified at presentation. The bacterial virulence level is the main factor predictive of the final visual prognosis.

Combey de Lambert A; Campolmi N; Cornut PL; Aptel F; Creuzot-Garcher C; Chiquet C

2013-09-01

320

Pain perception in sequential cataract surgery: comparison of first and second procedures.  

UK PubMed Central (United Kingdom)

PURPOSE: To compare pain and anxiety between first and second cataract extractions under topical anesthesia with monitored anesthesia care. SETTING: University ophthalmology clinic. DESIGN: Cohort study. METHODS: Consecutive adults having bilateral sequential clear corneal cataract extraction using phacoemulsification under topical anesthesia with monitored anesthesia care were recruited. Exclusion criteria included baseline eye pain, poor comprehension, and complicated cataract extraction. Patients completed 4 short perioperative surveys with each cataract extraction as follows: the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Scale (STAI) preoperatively and a 0-to-10 visual analog scale pain survey twice after surgery. Pain and difference in pain were the primary outcomes. RESULTS: Of the 65 patients who completed the study, 26 (40%) reported higher visual analog scale pain scores for the second cataract extraction. Overall, the median pain score was 0 (range 0 to 6) for the first cataract extraction and 1 (range 0 to 9) for the second (P = .004). By 1 day postoperatively, the pain scores were similar (median 0; range 0 to 9; P = .58). Both APAIS and STAI anxiety scores decreased between surgeries (P = .003 and P < .001, respectively). CONCLUSIONS: Although cataract extraction remained relatively painless under topical anesthesia with monitored anesthesia care, there was a subtle increase in pain in the second surgery relative to the first. This appears to be associated with decreased preoperative anxiety and may be related to the amnestic effects of intravenous sedation. These data may explain a common operative observation. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Ursea R; Feng MT; Zhou M; Lien V; Loeb R

2011-06-01

 
 
 
 
321

Causes of cataract surgery malpractice claims in England 1995-2008.  

UK PubMed Central (United Kingdom)

AIMS: To analyse the causes of malpractice claims related specifically to cataract surgery in the National Health Service in England from 1995 to 2008. METHODS: All the malpractice claims related to cataract surgery from 1995 to 2008 from the National Health Service Litigation Authority were analysed. Claims were classified according to causative problem. Total numbers of claims, total value of damages, mean level damages and paid:closed ratio (a measure of the likelihood of a claim resulting in payment of damages) were determined for each cause. RESULTS: Over the 14-year period, there were 324 cataract surgery claims with total damages of £ 1.97 million and mean damages for a paid claim of £ 19,900. Negligent surgery (including posterior capsule tear and dropped nucleus) was the most frequent cause for claims, while reduced vision accounted for the highest total and mean damages. Claims relating to biometry errors/wrong intraocular lens power were the second most frequent cause of claims and result in payment of damages in 62% of closed cases. The claims with the highest paid:closed ratio were inadequate anaesthetic (75%) and complications of anaesthetic injections including globe perforation (67%). CONCLUSIONS: Claims from cataract surgery in the NHS are extremely infrequent. Consent, though essential, may not prevent a claim arising or resulting in damages. Refractive accuracy has significant medicolegal impact. Endophthalmitis can lead to successful claims if there is delay in diagnosis. Claims relating to inadequate anaesthesia or anaesthetic injection complications are particularly hard to defend.

Ali N; Little BC

2011-04-01

322

Effect of air bubble on inflammation after cataract surgery in rabbit eyes.  

UK PubMed Central (United Kingdom)

PURPOSE: Intense inflammation after cataract surgery can cause cystoid macular edema, posterior synechia and posterior capsule opacification. This experimental study was performed to investigate the effect of air bubble on inflammation when given to anterior chamber of rabbit eyes after cataract surgery. MATERIALS AND METHODS: 30 eyes of 15 rabbits were enrolled in the study. One of the two eyes was in the study group and the other eye was in the control group. After surgery air bubble was given to the anterior chamber of the study group eye and balanced salt solution (BSS; Alcon) was left in the anterior chamber of control eye. RESULTS: On the first, second, fourth and fifth days, anterior chamber inflammations of the eyes were examined by biomicroscopy. On the sixth day anterior chamber fluid samples were taken for evaluation of nitric oxide levels as an inflammation marker. When the two groups were compared, in the air bubble group there was statistically less inflammation was seen. (1, 2, 4. days P = 0,001, and 5. day P = 0,009). CONCLUSIONS: These results have shown that when air bubble is left in anterior chamber of rabbits' eyes after cataract surgery, it reduced inflammation. We believe that, air bubble in the anterior chamber may be more beneficial in the cataract surgery of especially pediatric age group, uveitis patients and diabetics where we see higher inflammation. However, greater and long termed experimental and clinical studies are necessary for more accurate findings.

Demirci G; Karabas L; Maral H; Ozdek S; Gülkilik G

2013-07-01

323

A new drug delivery system inhibits uveitis in an animal model after cataract surgery.  

UK PubMed Central (United Kingdom)

Cataract surgery is a common ocular surgical procedure consisting in the implantation of an artificial intraocular lens (IOL) to replace the ageing, dystrophic or damaged natural one. The management of postoperative ocular inflammation is a major challenge especially in the context of pre-existing uveitis. The association of the implanted IOL with a drug delivery system (DDS) allows the prolonged intraocular release of anti-inflammatory agents after surgery. Thus IOL-DDS represents an "all in one" strategy that simultaneously addresses both cataract and inflammation issues. Polymeric DDS loaded with two model anti-inflammatory drugs (triamcinolone acetonide (TA) and cyclosporine A (CsA)) were manufactured in a novel way and tested regarding their efficiency for the management of intraocular inflammation during the 3 months following surgery. The study involved an experimentally induced uveitis in rabbits. Experimental results showed that medicated DDS efficiently reduced ocular inflammation (decrease of protein concentration in aqueous humour, inflammatory cells in aqueous humour and clinical score). Additionally, more than 60% of the loading dose remained in the DDS at the end of the experiment, suggesting that the system could potentially cover longer inflammatory episodes. Thus, IOL-DDS were demonstrated to inhibit intraocular inflammation for at least 3 months after cataract surgery, representing a potential novel approach to cataract surgery in eyes with pre-existing uveitis.

Eperon S; Rodriguez-Aller M; Balaskas K; Gurny R; Guex-Crosier Y

2013-02-01

324

Accuracy of intraocular lens power calculation in paediatric cataract surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

AIMS—To determine the accuracy of intraocular lens (IOL) power calculation in a group of pseudophakic children.?METHODS—A retrospective analysis of biometric and refractive data was performed on 52 eyes of 40 infants and children, who successfully underwent cataract extraction and IOL implantation. ...

Tromans, C; Haigh, P; Biswas, S; Lloyd, I

325

Anesthetic management of cardiac patient for cataract surgery  

International Nuclear Information System (INIS)

We are reporting the successful anesthetic management of a 6 years old child, who had cyanotic congenital heart disease and underwent an operation for cataract extraction. Ketamine was used for the induction and maintenance of anesthesia. Ventilation was assisted manually by using laryngeal masks. (author)

2003-01-01

326

Five-year change in visual acuity following cataract surgery in an older community: the Blue Mountains Eye Study.  

UK PubMed Central (United Kingdom)

AIMS: To assess the change in visual acuity following cataract surgery in the Blue Mountains Eye Study (BMES) population. Change in visual acuity was assessed by age, sex, baseline cataract type, and baseline visual acuity. METHODS: A 5-year prospective follow-up of the population-based BMES cohort, who were initially examined in 1992. After 5 years, 2335 survivors of 3654 (75.1%) baseline BMES participants were re-examined. Slit-lamp and retro-illumination lens photographs were graded for the presence of incident cataract and evidence of cataract surgery. Visual acuity was measured using a logMAR chart, read at 2.4 m. The main outcome measure was change in the number of logMAR letters correctly identified by eyes that underwent cataract surgery during the 5-year follow-up period. RESULTS: In a multiple linear regression model, age (P<0.0001) and early age-related maculopathy (ARM) at baseline (P<0.0001) were found to affect adversely the postoperative visual acuity following the cataract surgery. As expected, eyes with any baseline cataract showed the greatest improvement in visual acuity after cataract surgery (right eyes: mean +/- s.e. change of 3.75 +/- 1.34 letters; left eyes: mean change +/- s.e. of 6.7 +/- 0.99 letters). There was also a statistically significant improvement in vision after cataract surgery in eyes with no significant lens opacity graded as present at baseline (right eyes: mean +/- s.e. change of 3.78 +/- 1.85 letters; left eyes: mean change +/- s.e. of 2.68 +/- 1.33 letters). CONCLUSIONS: Age and baseline cataract or ARM status, and baseline visual acuity were determinants of the postoperative visual outcome in older persons who underwent cataract surgery in this community.

Panchapakesan J; Rochtchina E; Mitchell P

2004-03-01

327

Surgical checklist for cataract surgery: progress with the initiative by the Royal College of Ophthalmologists to improve patient safety.  

UK PubMed Central (United Kingdom)

PURPOSE: The World Health Organisation (WHO) identified patient safety in surgery as an important public health matter and advised the adoption of a universal peri-operative surgical checklist. An adapted version of the WHO checklist has been mandatory in the National Health Service since 2010. Wrong intraocular lens (IOL) implantation is a particular safety concern in ophthalmology. The Royal College of Ophthalmologists launched a bespoke checklist for cataract surgery in 2010 to reduce the likelihood of preventable errors. We sought to ascertain the use of checklists in cataract surgery in 2012. PATIENTS AND METHODS: A survey of members of the Royal College of Ophthalmologists seeking views on the use of checklists in cataract surgery. Four hundred and sixty-nine completed responses were received (18% response rate). RESULTS: Respondents worked in England (75%), Scotland (11%), Wales (5%), Northern Ireland (2%), the Republic of Ireland (1%), and overseas (6%). Ninety-four per cent of respondents support the use of a checklist for cataract surgery and 85% say that they always use a checklist before cataract surgery. Sixty-seven per cent of cataract surgeons stated they undertake a pre-operative team brief. Thirty-six per cent use a cataract surgery checklist developed locally, 18% use the college's bespoke cataract surgery checklist, 39% use a generic surgical checklist, and 4% reported that they do not use a checklist. CONCLUSION: Ninety-three per cent of cataract surgeons responding to the questionnaire report using a surgical checklist and 67% use a team brief. However, only 54% use a checklist, which addresses the selection of the correct intraocular implant. We recommend wider adoption of checklists, which address risks relevant to cataract surgery, in particular the possibility of selection of an incorrect IOL.

Kelly SP; Steeples LR; Smith R; Azuara-Blanco A

2013-07-01

328

Emergence of diplopia and oscillopsia due to Heimann-Bielschowsky phenomenon after cataract surgery.  

UK PubMed Central (United Kingdom)

The Heimann-Bielschowsky phenomenon (HBP) refers to coarse vertical oscillation of the eye with impaired vision. The ocular movements are strictly monocular, occurring only in the eye with amblyopia. The vertical oscillation is of equal velocity in both vertical directions, or may sometimes be greater in the downward than upward direction. HBP develops several years after loss of vision. It can be differentiated from dissociated nystagmus in spasmus nutans, congenital nystagmus and internuclear ophthalmoplegia based on the strict unilaterality, vertical direction and low frequency. Previously, only a few reports described the development of oscillopsia due to HBP after cataract surgery, which resolved spontaneously or responded to gabapentin. However, visual impairments due to diplopia or oscillopsia from HBP after cataract surgery have received little attention. We report a man who developed persistent vertical diplopia and oscillopsia due to HBP after a cataract operation, which markedly impaired his vision.

Jeong SH; Oh YM; Hwang JM; Kim JS

2008-10-01

329

Outcomes of cataract surgery in urban southern China: the Liwan Eye Study.  

UK PubMed Central (United Kingdom)

PURPOSE: The outcomes of cataract surgery have been well reported in rural China; however, the situation in the urban population remains unclear. This study assessed the outcomes of cataract surgery in urban southern China. METHODS: Data were gathered from the Liwan Eye Study, a population-based, cross-sectional study conducted in people aged 50 years or more in the Liwan District of Guangzhou. Presenting and best corrected visual acuity and a detailed eye examination were performed. For all aphakic and pseudophakic participants identified, information on the date, setting, type, and complications of cataract surgery were recorded. RESULTS: Of the 1405 participants, 62 people (90 eyes) had undergone cataract surgery. Of those, 54.4% underwent the phacoemulsification (Phaco) technique, 33.3% extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation, and 11.1% ECCE without IOL; 1 patient had intracapsular cataract extraction (ICCE). Presenting visual acuity (PVA) was >6/18 in 56 (62.2%) eyes, <6/18 to >6/60 in 20 (22.2%) eyes, <6/60 to >3/60 in 3 (3.3%) eyes, and <3/60 in 11(12.3%) eyes. Of the 34 eyes with PVA less than 6/18, the principal causes were 26.5% retinal abnormalities, 20.6% glaucoma, 35.3% uncorrected aphakia or refractive error, and 14.5% posterior capsule opacification (PCO). CONCLUSIONS: ECCE or Phaco with IOL are the major surgical techniques used in urban southern China. More than half of the eyes with poor outcomes due to uncorrected aphakia, refractive error, or PCO are potentially treatable. This result suggests a pressing need for improved surgical training and postoperative care.

Huang W; Huang G; Wang D; Yin Q; Foster PJ; He M

2011-01-01

330

Postoperative increase in grey matter volume in visual cortex after unilateral cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: The developing visual cortex has a strong potential to undergo plastic changes. Little is known about the potential of the ageing visual cortex to express plasticity. A pertinent question is whether therapeutic interventions can trigger plastic changes in the ageing visual cortex by restoring vision. METHODS: Twelve patients aged 50-85 years underwent structural high-resolution T1-weighted MRI of the whole brain 2 days and 6 weeks after unilateral cataract surgery. Voxel-based morphometry (VBM) based on T1-weighted magnetic resonance imaging (MRI) was employed to test whether cataract surgery induces a regional increase in grey matter in areas V1 and V2 of the visual cortex. RESULTS: In all patients, cataract surgery immediately improved visual acuity, contrast sensitivity and mean sensitivity in the visual field of the operated eye. The improvement in vision was stable throughout the 6 weeks after operation. VBM revealed a regional expansion of grey matter volume in area V2 contralateral to the operated eye during the 6-week period after surgery. Individual increases in grey matter were predicted by the symmetry in visual acuity between the operated eye and nonoperated eye. The more symmetrical visual acuity became after unilateral cataract surgery, the more pronounced was the grey matter increase in visual cortex. CONCLUSION: The data suggest that cataract surgery triggered a use-dependent structural plasticity in V2 presumably through improved binocular integration of visual input from both eyes. We conclude that activity-dependent cortical plasticity is preserved in the ageing visual cortex and may be triggered by restoring impaired vision.

Lou AR; Madsen KH; Julian HO; Toft PB; Kjaer TW; Paulson OB; Prause JU; Siebner HR

2013-02-01

331

Postoperative increase in grey matter volume in visual cortex after unilateral cataract surgery  

DEFF Research Database (Denmark)

Purpose: The developing visual cortex has a strong potential to undergo plastic changes. Little is known about the potential of the ageing visual cortex to express plasticity. A pertinent question is whether therapeutic interventions can trigger plastic changes in the ageing visual cortex by restoring vision. Methods: Twelve patients aged 50-85 years underwent structural high-resolution T1-weighted MRI of the whole brain 2 days and 6 weeks after unilateral cataract surgery. Voxel-based morphometry (VBM) based on T1-weighted magnetic resonance imaging (MRI) was employed to test whether cataract surgery induces a regional increase in grey matter in areas V1 and V2 of the visual cortex. Results: In all patients, cataract surgery immediately improved visual acuity, contrast sensitivity and mean sensitivity in the visual field of the operated eye. The improvement in vision was stable throughout the 6 weeks after operation. VBM revealed a regional expansion of grey matter volume in area V2 contralateral to the operated eye during the 6-week period after surgery. Individual increases in grey matter were predicted by the symmetry in visual acuity between the operated eye and nonoperated eye. The more symmetrical visual acuity became after unilateral cataract surgery, the more pronounced was the grey matter increase in visual cortex. Conclusion: The data suggest that cataract surgery triggered a use-dependent structural plasticity in V2 presumably through improved binocular integration of visual input from both eyes. We conclude that activity-dependent cortical plasticity is preserved in the ageing visual cortex and may be triggered by restoring impaired vision.

Lou, Astrid R; Madsen, Kristoffer H

2013-01-01

332

[Potentials and limitations of the planned compulsory quality assurance program for cataract surgery (Qesü)].  

Science.gov (United States)

Cataract surgery is scheduled for a federal program for quality improvement across the different sectors of care (outpatient care and hospitals). In case of implementation not only ophthalmic surgeons but all ophthalmologists would have to contribute to the documentation. Urgency, potential benefits and limitations of a compulsory compared to a voluntary quality assessment system are analyzed. PMID:23539300

Hahn, U; Bertram, B; Krummenauer, F; Reuscher, A; Fabian, E; Neuhann, T; Schmickler, S; Neuhann, I

2013-04-01

333

Application of ultrasound biomicro-scopy in the planning of cataract surgery in anterior megalophthalmos  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Anterior megalophthalmos, a rare hereditary disorder, is macrocornea (horizontal corneal diameter more than 13 mm) in association with enlarged lens-iris diaphragm and ciliary ring. One of the major challenging issues in the cataract surgery of these patients is preventing intraocular lens (IOL) mal...

Zare, Mohammad Ali; Eshraghi, Bahram; Kiarudi, Mohammad Yaser; Masoule, Ebrahim Azaripur

334

Incidence of preoperative high blood pressure in cataract surgery among hypertensive and normotensive patients.  

UK PubMed Central (United Kingdom)

UNLABELLED: Incidence of preoperative rise in blood pressure (BP) in cataract surgery among hypertensive and normotensive patients. OBJECTIVE: To study the incidence of preoperative rise in BP in cataract surgery among normotensive individuals and hypertensive patients with historic good BP control in a population without other major chronic diseases. Settings: Ophthalmology Service of a University Hospital. MATERIALS AND METHODS: A prospective study with 822 patients older than 40 years of age, with cataract surgery indication, and without major chronic diseases other than hypertension. The patients were divided in two groups: hypertensive and normotensive. Preoperative data, physical exams and medical adverse events were recorded in an evaluation questionnaire. RESULTS: The sample included 427 normotensive (52%) and 395 hypertensive patients (48%). The two groups had similar proportions of operations that were cancelled and not subsequently rescheduled, 2% (eight patients) in each group. The incidence of preoperative rise in BP was 3.7% in the normotensive group and 10.9% in the hypertensive group (P < 0.001). CONCLUSION: Hypertensive patients with historic good BP control and without other major co-morbidities present a larger incidence of preoperative rise in BP than normotensive individuals in cataract surgery.

Lira RP; Nascimento MA; Arieta CE; Duarte LE; Hirata FE; Nadruz W

2010-11-01

335

Cataract Surgery Complications: An in vitro Model of Toxic Effects of Ropivacaine and Lidocaine  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Intraoperative lidocaine is widely used in controlling discomfort during cataract surgery. However, recent studies have confirmed the toxic effect of lidocaine on ganglion cells. Ropivacaine is an anesthetic recently introduced in clinical practice that couples a long anesthetic effect w...

Pescosolido, Nicola; Scarsella, Gianfranco; Tafani, Marco; Nebbioso, Marcella

336

Outcomes of cataract surgery in a rural and urban south Indian population  

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Purpose: To assess the visual outcome after cataract surgery in a south Indian population. Materials and Methods: Population-based cross-sectional study of subjects aged 40 years or more. Three thousand nine hundred and twenty-four rural subjects from 27 contiguous villages and 3850...

Vijaya Lingam; George Ronnie; Rashima A; Raju Prema; Arvind Hemamalini; Baskaran Mani; Ve Ramesh

337

Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses  

Digital Repository Infrastructure Vision for European Research (DRIVER)

10 pages, 6 figures.-- PMID: 17276261 [PubMed]. , [Purpose] To study the effect of cataract surgery through 3.2 mm superior incisions on corneal aberrations with 2 types of monofocal intraocular lenses (IOLs) with an aspherical design. , [Setting] Instituto de Optica, Consejo Superior de Investigaciones C...

Marcos, Susana; Rosales, Patricia; Llorente, Lourdes; Jiménez-Alfaro, Ignacio

338

Comparison of surgically induced astigmatism between one-handed and two-handed cataract surgery techniques  

Science.gov (United States)

Background The purpose of this study was to compare surgically induced astigmatism (SIA) between one-handed and two-handed cataract surgery techniques. Methods Eighty-eight eyes of 44 patients with no ocular disease other than cataract, who underwent cataract surgery by a single surgeon, were selected for this study. Cataract surgery was performed by coaxial phacoemulsification and intraocular lens implantation via a 2.4 mm transconjunctival single-plane sclerocorneal incision at the 12 o’clock position. In each patient, one eye was subjected to coaxial phacoemulsification using a one-handed technique while the fellow eye was subjected to coaxial phacoemulsification using a two-handed technique. For the two-handed technique, a corneal side port was created at the 2 o’clock position. The appropriate incision meridian was identified by a preoperative axis mark. SIA was calculated using the Alpins method. Results Mean SIA was 0.40 ± 0.28 diopters (D) in the one-handed technique group and 0.39 ± 0.25 D in the two-handed technique group. No statistically significant difference was found in the mean SIA score. The mean torque value was ?0.05 ± 0.26 D in the one-handed technique group and 0.11 ± 0.37 D in the two-handed technique group. Mean torque was significantly lower (Pcataract surgery has a rotating effect on the axis of astigmatism.

Kawahara, Asushi; Kurosaka, Daijiro; Yoshida, Aktoshi

2013-01-01

339

PREOPERATIVE ORAL CODEINE EFFECT ON POSTOPERATIVE CAUGH CONTROL IN CATARACT SURGERY  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Introduction: cataract surgery is .one of the most common operation in ophthalmology. Post operative caught can lead to anterior chamber hemmorage and dehiscence of suture so we were going to finding a way to overcome to this problem. Method: This study is a clinical trial one which was done on...

H SOLTANI NEZHAD; K MONTAZERI; S ATAROD

340

Zonuloplasty, A Novel Surgical Treatment for Zonular Weakness in Patients Undergoing Cataract Surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Purpose: Patients with zonular weakness, undergoing cataract surgery, have a very high risk of the Intraocular Lens (IOL) dislocation during this operation. Strengthening the capsular bag is undeniably important in these patients. In this article, we suggest a novel surgical technique as a prospecti...

Alireza Ghaffariyeh; Tooraj Chamacham

 
 
 
 
341

Capsulotomy and hydroprocedures for nucleus prolapse in manual small incision cataract surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Manual small incision cataract surgery (MSICS) involves the manual removal of nucleus through a scleral tunnel. To achieve 100% success every time, one has to do a good capsulotomy and should master the technique to prolapse the nucleus into anterior chamber. During conversion from extracapsu...

Venkatesh Rengaraj; Veena Kannusamy; Ravindran Ravilla

342

[Potentials and limitations of the planned compulsory quality assurance program for cataract surgery (Qesu)].  

UK PubMed Central (United Kingdom)

Cataract surgery is scheduled for a federal program for quality improvement across the different sectors of care (outpatient care and hospitals). In case of implementation not only ophthalmic surgeons but all ophthalmologists would have to contribute to the documentation. Urgency, potential benefits and limitations of a compulsory compared to a voluntary quality assessment system are analyzed.

Hahn U; Bertram B; Krummenauer F; Reuscher A; Fabian E; Neuhann T; Schmickler S; Neuhann I

2013-04-01

343

Levobupivacaine 0.75% vs. lidocaine 4% for topical anaesthesia: a clinical comparison in cataract surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: The aim of this study was to compare the efficacy of topical levobupivacaine drops 0.75% vs. lidocaine drops 4% in cataract surgery. METHODS: We examined 203 patients undergoing cataract surgery by phacoemulsification. They were randomized into two groups: one received four drops of lidocaine 4% and the other received four drops of levobupivacaine 0.75%. The onset and offset times of sensory block were evaluated. Application, intraoperative and postoperative subjective pain was quantified by the patients using a verbal pain score. Complications, rates of supplemental anaesthesia, and the satisfaction of surgeon and patients were also recorded. RESULTS: The mean sensory onset and offset times were significantly higher for the levobupivacaine group (P < 0.01). Pain score was lower in the levobupivacaine group than in the lidocaine one and the difference was statistically significant at all stages (P < 0.01). The mean satisfaction scores of patients and surgeon were also statistically higher for levobupivacaine (P < 0.01). No significant differences for complications and rates of supplemental anaesthesia were found. CONCLUSIONS: Topical levobupivacaine 0.75% shows the same efficacy and safety as lidocaine 4% in cataract surgery by phacoemulsification. There was an adequate block with a good level of satisfaction of surgeon and patients. Levobupivacaine 0.75% offers a new and acceptable choice for topical anaesthesia in cataract surgery.

Di Donato A; Fontana C; Lancia F; Di Giorgio K; Reali S; Caricati A

2007-05-01

344

Microincision versus small-incision coaxial cataract surgery using different power modes for hard nuclear cataract.  

UK PubMed Central (United Kingdom)

PURPOSE: To compare the efficacy of microincision and small-incision coaxial phacoemulsification in treating hard cataracts using different ultrasound power modes. SETTING: Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea. DESIGN: Randomized clinical trial. METHODS: Eyes with hard cataract were randomized to have an initial incision of 1.80 mm, 2.20 mm, or 2.75 mm. The eyes in each group were equally randomized to treatment with burst, pulse, or continuous mode. Ultrasound time (UST), mean cumulative dissipated energy (CDE), corrected distance visual acuity (CDVA), surgically induced corneal astigmatism, incisional and central corneal thickness (CCT), and endothelial cell counts were evaluated. RESULTS: The study enrolled 180 eyes, 60 in each group. Two months postoperatively, there were no statistically significant differences in UST, CDE, CDVA, CCT, or percentage endothelial cell loss between the 3 incision groups. The 2.75 mm incision induced more astigmatism at 2 months and less incisional corneal edema at 1 week than the 1.80 mm or 2.20 mm incision (P<.05). The UST, CDE, incisional corneal thickness, and CCT at 1 week and the percentage endothelial cell loss at 2 months with continuous mode were statistically significantly higher than with pulse mode and burst mode in all 3 incision groups (P<.05). CONCLUSIONS: Phacoemulsification using microincisions may be as safe and effective as the conventional small incision for hard cataract. The intraoperative energy use and ocular damage was less with the pulse and burst modes than with the continuous mode. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Kim EC; Byun YS; Kim MS

2011-10-01

345

Cataract surgeons outperform medical students in Eyesi virtual reality cataract surgery: evidence for construct validity.  

UK PubMed Central (United Kingdom)

PURPOSE: To investigate construct validity for modules hydromaneuvers and phaco on the Eyesi surgical simulator. Methods: Seven cataract surgeons and 17 medical students performed capsulorhexis, hydromaneuvers, phaco, navigation, forceps, cracking and chopping modules in a standardized manner. Three trials were performed on each module (two on phaco) in the above order. Performance parameters as calculated by the simulator for each trial were saved. Video recordings of the second trial of the modules capsulorhexis, hydromaneuvers and phaco were evaluated with the modified Objective Structured Assessment of Surgical Skill (OSATS) and Objective Structured Assessment of Cataract Surgical Skill (OSACSS) tools. RESULTS: Cataract surgeons outperformed medical students with regard to overall score on capsulorhexis (p < 0.001, p = 0.035, p = 0.010 for the tree iterations, respectively), navigation (p = 0.024, p = 0.307, p = 0.007), forceps (p = 0.017, p = 0.03, p = 0.028). Less obvious differences in overall score were found for modules cracking and chopping (p = 0.266, p = 0.022, p = 0.324) and phaco (p = 0.011, p = 0.081 for the two iterations, respectively). No differences in overall score were found on hydromaneuvers (p = 0.588, p = 0.503, p = 0.773), but surgeons received better scores from the evaluations of the modified OSATS (p = 0.001) and OSACSS (capsulorhexis, p = 0.003; hydromaneuvers, p = 0.017; phaco, p = 0.001). CONCLUSIONS: Construct validity was found on several modules previously not investigated (phaco, hydromaneuvers, cracking and chopping, navigation), and our results confirm previously demonstrated construct validity for capsulorhexis and forceps modules. Interestingly, validation of the hydromaneuvers module required OSACSS video evaluation tool. A further development of the scoring system in the simulator for the hydromaneuvers module would be advantageous and make training and evaluation of progress more accessible and immediate.

Selvander M; Asman P

2013-08-01

346

Six-year incidence of endophthalmitis after cataract surgery: Swedish national study.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the nationwide incidence and risk factors for endophthalmitis after cataract surgery in Sweden. SETTING: Swedish National Cataract Register containing reports on cataract operations from all Swedish ophthalmic surgical units. DESIGN: Prospective epidemiologic study. METHODS: Endophthalmitis case reports were collected from 2005 through 2010. Case and control parameters pertaining to patient characteristics and surgical technique were generated from the database. In addition, information from annual surveys regarding the topical prophylactic protocol was analyzed. RESULTS: The reports showed 135 endophthalmitis cases in 464,996 operations, equaling an incidence of 0.029%. Patient age over 85 years, perioperative communication with the vitreous and, above all, nonuse of intracameral cefuroxime showed a statistically significant association with endophthalmitis in the logistic regression. Short-term topical antibiotics given as add-on prophylaxis to the intracameral regimen before, after, or before and after the operation did not confer a clear-cut benefit. Groups with topical treatment were small, comprising 14% of the sample. CONCLUSIONS: The incidence of endophthalmitis after cataract surgery in Sweden is declining, which appears to be explained by a fall in the frequency of major risk factors. Operating earlier in the cataract course, avoiding capsule breakage, and giving intracameral antibiotics universally should further reduce the endophthalmitis rate.

Friling E; Lundström M; Stenevi U; Montan P

2013-01-01

347

Exudative Inflammatory Eye Response in Cataract Surgery: Current View on the Problem  

Directory of Open Access Journals (Sweden)

Full Text Available There has been analyzed one of the most frequent and serious complications of cataract surgery — exudative inflammatory response (EIR) of eye. There has been presented current view on etiopathogenesis of the condition, classifications and the description of clinical presentation of various EIR types have been given. Known techniques of prognosis and prevention of postoperative exudative uveites have been presented. There have been given present methods of complex treatment of eye EIR: drug treatment, laser therapy and surgery.

N.Y. Belousova

2011-01-01

348

Radiation dose and cataract surgery incidence in atomic bomb survivors, 1986-2005.  

UK PubMed Central (United Kingdom)

PURPOSE: To examine the incidence of clinically important cataracts in relation to lens radiation doses between 0 and approximately 3 Gy to address risks at relatively low brief doses. MATERIALS AND METHODS: Informed consent was obtained, and human subjects procedures were approved by the ethical committee at the Radiation Effects Research Foundation. Cataract surgery incidence was documented for 6066 atomic bomb survivors during 1986-2005. Sixteen risk factors for cataract, such as smoking, hypertension, and corticosteroid use, were not confounders of the radiation effect on the basis of Cox regression analysis. Radiation dose-response analyses were performed for cataract surgery incidence by using Poisson regression analysis, adjusting for demographic variables and diabetes mellitus, and results were expressed as the excess relative risk (ERR) and the excess absolute risk (EAR) (ie, measures of how much radiation multiplies [ERR] or adds to [EAR] the risk in the unexposed group). RESULTS: Of 6066 atomic bomb survivors, 1028 underwent a first cataract surgery during 1986-2005. The estimated threshold dose was 0.50 Gy (95% confidence interval [CI]: 0.10 Gy, 0.95 Gy) for the ERR model and 0.45 Gy (95% CI: 0.10 Gy, 1.05 Gy) for the EAR model. A linear-quadratic test for upward curvature did not show a significant quadratic effect for either the ERR or EAR model. The linear ERR model for a 70-year-old individual, exposed at age 20 years, showed a 0.32 (95% CI: 0.09, 0.53) [corrected] excess risk at 1 Gy. The ERR was highest for those who were young at exposure. CONCLUSION: These data indicate a radiation effect for vision-impairing cataracts at doses less than 1 Gy. The evidence suggests that dose standards for protection of the eye from brief radiation exposures should be 0.5 Gy or less.

Neriishi K; Nakashima E; Akahoshi M; Hida A; Grant EJ; Masunari N; Funamoto S; Minamoto A; Fujiwara S; Shore RE

2012-10-01

349

Moxifloxacin as postoperative prophylaxis for enterococcus faecalis-induced endophthalmitis after cataract surgery in aphakic rabbits.  

UK PubMed Central (United Kingdom)

PURPOSE: The development of endophthalmitis after cataract surgery often results in significant vision loss. Inhibition of bacterial proliferation in the anterior chamber using antibiotic eye drops is important to prevent endophthalmitis after cataract surgery. We aimed to determine the sensitivity of fluoroquinolones against Enterococcus faecalis ocular isolates and the efficacy of fluoroquinolones to prevent E. faecalis-induced endophthalmitis in aphakic rabbits. METHODS: The minimum inhibitory concentrations (MICs) of moxifloxacin (MFLX) and levofloxacin (LVFX) used in ophthalmic solutions for 13 E. faecalis isolates obtained from the conjunctival sac or endophthalmitis cases were determined. Eye drops containing MFLX (0.5%), LVFX (0.5%), or saline were administered to aphakic rabbits with endophthalmitis induced by E. faecalis. The eye drops were administered immediately after lensectomy and at 3 and 6?h after cataract surgery (early instillation group) or immediately after lensectomy and at 12 and 15?h after cataract surgery (delayed instillation group). Bacterial growth, electroretinography (ERG), and slit-lamp examination (SLE) were determined throughout the course of infection. RESULTS: In vitro susceptibility testing revealed that the MICs of MFLX for E. faecalis isolates were lower than those of LVFX. In the early ocular instillation groups, MFLX significantly improved SLE scores, ERG, and viable bacterial counts compared with LVFX and saline (all, P<0.05). There were no significant differences in any parameter between MFLX and saline in the delayed ocular instillation groups. CONCLUSIONS: Early ocular instillation of MFLX delays retinal damage compared with LVFX when used to treat E. faecalis-induced endophthalmitis after cataract surgery.

Tasaka Y; Suzuki T; Kawasaki S; Uda T; Mito T; Uno T; Ohashi Y

2013-05-01

350

Analysis of influence factors of free cataract surgery in suburban district of one city in middle China  

Directory of Open Access Journals (Sweden)

Full Text Available AIM:To investigate the reasons of the barriers to free cataract surgery in suburban area of one city in middle China. METHODS: From 2008 to 2009, in Sight Rehabilitation Programme of Cataract in suburban district of one city in middle China, all visually significant cataract patients screened were questioned about why he/she did not accept free cataract surgery. The answers were recorded and analyzed. RESULTS: Of 892 screened patients, only 387 patients(43.39%)wanted a free cataract surgery at first. At last 490 patients(54.93%)accepted free surgery. The main reasons for patients who did not accept free surgery include: be afraid of surgery and wanting other treatments(193, 21.64%), thinking the eyesight was enough for daily life(148, 16.59%), worrying about that the result would not be good as those paid for surgery(147, 16.48%), and other reasons(17, 1.91%).CONCLUSION: The reasons of the barriers to free cataract surgery include patients' ignorance, surgery outcome of patients around, and working mode of designated surgical hospital.

Jian-He Xiao; Shi-Yang Li; Hong-Li Ma; Ai-Hong Zhao; Xing Xing

2013-01-01

351

A review on cataract and its herbal treatments  

Directory of Open Access Journals (Sweden)

Full Text Available Cataract, called in Sanskrit as linganaasha or timira, is one of the leading causes for blindness today. Cataract is the opacification (light impenetrability) of the lens. In this condition, the lens of the eyes interferes with the eye vision. Since light cannot enter the opaque lens, therefore the eyes fail to give the representation of the objects seen. Plants used in Ayurvedic eye drops formulation are rich source of tannin and tannin like compounds. Antioxidant and antimicrobial properties of ayurvedic eye drops are attributed to the presence of tannins and tannin like compounds. Now-a-days, people increasingly prefer ayurvedic eye drops because it is safe and relatively free from side effect and adverse reactions. Ayurvedic eye drops are known to show antiinflammatory, antioxidant and antimicrobial activity due to their tannin content in aqueous extract. The anticataract efficacy of these preparations was mainly attributed to their antioxidant potential. Various herbal drugs such as Osmium sanctum, Emblica officinalis, Ginkgo biloba etc are used in cataract. The presented review summarizes the information concerning the new profile of anticataract drugs obtained from medicinal plants.

A K Meena1, Bhavana Pal2*, Brijendra Singh2, A K Yadav2, Uttam Singh2, Ramanjeet Kaur2, Ayushy Sachan2 and M.M.Rao1

2010-01-01

352

Topical diclofenac sodium for treatment of postoperative inflammation in cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: To study the effect of a topical non-steroidal anti-inflammatory drug as an alternative to topical steroids for postoperative control of inflammation in cataract surgery. Methods: The effect of diclofenac sodium 0.1% following cataract surgery was studied and compared to routine corticosteroid, dexamethasone phosphate 1% in a prospective, double-blind randomized study. Both groups were similar in baseline parameters. Postoperative inflammatory response, intraocular pressure and best-corrected visual acuity following standard extracapsular cataract extraction were assessed in both groups in the initial 21 days and the severity of these parameters was graded. The severity of postoperative inflammatory response to the two drugs was graded at 1, 3, 7, 14 and 21 days. Intraocular pressure and visual acuity at baseline and endpoint were compared and statistically analyzed. Results: The two groups did not differ statistically in treatment effect for any of the variables including aqueous cells, flare, ciliary congestion, Descemet?s folds, visual acuity and intraocular pressure (p< 0.001). However there seemed to be a trend towards quicker improvement with corticosteroid when cells in the anterior chamber were considered. There were no side effects from topical diclofenac, and it was well tolerated. Conclusion: Dicfofenac sodium is as effective as topical corticosteroid and can be used as an alternative in routine postoperative treatment following uncomplicated cataract surgery.

Reddy Manjoo; N Suneetha; Thomas Reji; Battu R

2000-01-01

353

Femtosecond laser-assisted cataract surgery in management of phacomorphic glaucoma.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the use of femtosecond laser-assisted cataract surgery in management of phacomorphic glaucoma. METHODS: An 89-year-old patient developed acute phacomorphic glaucoma in her right eye with elevated intraocular pressure (62 mm Hg), shallow anterior chamber, and mature cataract. After conservative antiglaucoma therapy and Nd:YAG iridotomy, femtosecond laser-assisted cataract surgery was performed. A Malyugin ring was implanted for mechanical pupil dilatation and a 4.8-mm capsulorrhexis and lens fragmentation was performed using a femtosecond laser system (Alcon LenSx Inc., Aliso Viejo, CA) followed by in-the-bag intraocular lens implantation. RESULTS: Intact 4.8-mm capsulorrhexis and successful lens fragmentation could be performed using femtosecond laser. After cataract surgery, the patient's visual acuity increased from hand motions to 0.4 (Snellen 4/10) and the intraocular pressure returned to normal range without antiglaucoma drop therapy. CONCLUSIONS: The results indicate that femtosecond laser can be successfully used in certain cases of phacomorphic glaucoma, even if mechanical pupil dilatation is needed.

Kránitz K; Takács AI; Gyenes A; Filkorn T; Gergely R; Kovács I; Nagy ZZ

2013-09-01

354

Intraoperative use of intravitreal triamcinolone in uveitic eyes having cataract surgery: pilot study.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the outcomes of cataract extraction with intraoperative intravitreal triamcinolone (IVTA) in eyes with a history of posterior uveitis. SETTING: Moorfields Eye Hospital Uveitis Service, London, United Kingdom. METHODS: Nineteen eyes of 17 patients with posterior uveitis thought to require systemic corticosteroid prophylaxis for cataract surgery were included. The use of systemic corticosteroids at the time of surgery would have been problematic in 7 of the patients, who had a history of systemic hypertension. Three of the 7 patients were also diabetic. All patients were not happy about using oral corticosteroids. RESULTS: Median visual acuity 1 day after surgery was 20/40 (range 20/20 to counting fingers). At final follow-up (mean 25.2 months; range 7 to 41 months), 17 eyes (89.5%) eyes achieved visual acuity of 20/40 or better; 2 eyes failed to achieve a final visual acuity of 20/40 or better, 1 as a result of optic atrophy and the other as a result of macular edema. No patient lost acuity and no eye developed macular edema within 4 months of surgery. Intraocular pressure elevation occurred after surgery in 3 eyes; all were controlled by topical medication that was discontinued after 3 months. One patient developed severe intraocular inflammation after surgery that resolved with intensive topical corticosteroid therapy within 1 week. CONCLUSIONS: Cataract extraction by phacoemulsification with concurrent IVTA appears a useful treatment option. Targeted delivery of corticosteroid is achieved without the risks of systemic corticosteroid prophylaxis. The incidence of postoperative macular edema was markedly reduced. Levels of visual acuity after cataract surgery, similar to those in eyes without uveitis, were achieved in eyes with posterior uveitis.

Okhravi N; Morris A; Kok HS; Menezo V; Dowler JG; Hykin PG; Lightman S

2007-07-01

355

Role of patient choice in influencing wait time for cataract surgery.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess the role of patient choice in influencing wait time for cataract surgery. DESIGN: Cross-sectional study. PARTICIPANTS: 496 patients aged ?40 years presenting to Kensington Eye Institute in Toronto for cataract surgery in 2010-2011. METHODS: Patients were invited to complete a self-administered questionnaire about their experience with wait time management, sociodemographics, and satisfaction with wait time. Differences in median wait time were statistically tested with the Wilcoxon test. Factors associated with declining the first available surgery date were analyzed with prevalence ratios (PR) and 95% confidence intervals (CIs). RESULTS: Overall, 90% of patients had surgery within 21 weeks; 16% experienced a wait longer than the pan-Canadian benchmark (16 weeks). The median wait time was 8 weeks. Altogether, 21% declined the first available surgery date. Major reasons included planned travel/holidays (35%), family responsibilities (14%), and earlier date became available (13%). Excluding those with "earlier date became available" and "cancellation by surgeon," the proportion declining the first available date decreased to 18%. In multivariate analysis, individuals with a college/university education were 60% more likely to decline (PR 1.6, 95% CI 1.0-2.5). Conversely, individuals living alone were 50% less likely to decline (PR 0.5, 95% CI 0.3-0.9). The median wait time was 2.5 weeks longer for those who declined than for those who accepted (8.5 vs 6 weeks; p = 0.02). CONCLUSIONS: One in 5 patients declined the first available date for cataract surgery in 2010-2011 in Toronto. As wait time for cataract surgery improves, patient choice seems to play a greater role in influencing the wait.

Leung V; Vanek J; Braga-Mele R; Punch D; Jin YP

2013-08-01

356

A Comparative Study of Surgically Induced Astigmatism in Superior and Temporal Scleral Incision in Manual Small Incision Cataract Surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Aim: To evaluate the amount and type of surgically induced astigmatism in superior and temporal scleral incision in Manual Small Incision Cataract Surgery (MSICS). Material and Methods: A prospective randomized comparative study was carried out in 100 cases of senile or pre-senile cataract. All the ...

Renu M Magdum; Abha Gahlot; Rupali D.Maheshgauri; Khevna Patel

357

Cost of intraocular lens versus contact lens treatment after unilateral congenital cataract surgery: retrospective analysis at age 1 year.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe the differences in treatment costs for infants randomized to contact lens correction versus primary intraocular lens (IOL) implantation after unilateral cataract surgery in the Infant Aphakia Treatment Study (IATS). DESIGN: Retrospective cost analysis of a prospective, randomized clinical trial based on Georgia Medicaid data and the actual costs of supplies used. PARTICIPANTS: The IATS is a randomized, multicenter (n=12) clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with unilateral congenital cataract. INTERVENTION: Infants underwent cataract surgery with or without placement of an IOL. MAIN OUTCOME MEASURES: The mean cost of cataract surgery and all additional surgeries, examinations, and supplies used up to 12 months of age. RESULTS: The mean cost of treatment for a unilateral congenital cataract with primary IOL implantation was $14 752 versus $10 726 with contact lens correction. The initial cataract surgery accounted for approximately 50% of the treatment costs for both groups. Contact lens costs accounted for 15% ($1600/patient) in the aphakic group, whereas glasses costs represented only 4% ($535/patient) in the IOL group. The increased costs in the IOL group were primarily due to the higher cost of cataract surgery in this group ($7302 vs. $5357) and the cost of additional operations. CONCLUSIONS: For IATS patients up to 12 months of age, cataract surgery coupled with IOL implantation and spectacle correction was 37.5% (?$4000) more expensive than cataract surgery coupled with contact lens correction. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Carrigan AK; DuBois LG; Becker ER; Lambert SR

2013-01-01

358

Patients' preoperative expectation and outcome of cataract surgery at jimma university specialized hospital -department of ophthalmology.  

UK PubMed Central (United Kingdom)

BACKGROUND: Patient's satisfaction for a given treatment is an important clinical outcome because a satisfied patient is more likely to comply with treatments, attend follow-ups and advocate the service to others. Therefore, knowing patients' expectations before a planned procedure or treatment and the actual level of satisfaction and fulfillment of their initial expectations thereafter is much helpful. As far as the knowledge and experience of the researchers is concerned, there has not been any study conducted in Ethiopia to find out about patients' preoperative expectations and postoperative level of satisfaction for actual outcomes. This study was therefore, conducted to describe and find out the relationship between preoperative expectations of cataract patients and the actual postoperative experience and their satisfaction level following the surgery at ophthalmology department in Jimma University Specialized Hospital. METHODS: A prospective cohort study of patients undergoing first eye cataract surgery was conducted from July 10 to Oct., 10, 2007 in the Ophthalmology department of Jimma University Specialized Hospital. Detailed interviews that included general and vision specific health status measures and patients' preoperative expectations for cataract surgery outcomes were performed followed by visual acuity testing. Postoperatively, visual acuity testing was taken again and patients' level of satisfaction with attained postoperative vision was assessed. Data were collected and filled in a separate questionnaire form for each patient, and entered into a computer and analyzed using SPSS for Windows version 12.0. RESULTS: Of the 200 patients operated for cataract, 179 (89.5%) were followed for the whole five weeks. The average expected preoperative Visual Function-15 score was 96.3, compared to an achieved (postoperative) Visual Function-15 score of just 96.2. However, the most unrealistic expectations observed were reading small prints and doing fine handiwork. The final pinhole visual acuity postoperatively was ? 6/18 in 126 (70.4%) patients. Of the 78 (39%) patients who were bilaterally blind preoperatively, 5 (2.5%) patients remained blind postoperatively. CONCLUSIONS: Significant improvements were obtained in clinical, functional, and perceived vision by cataract surgery involving extracapsular cataract extraction with posterior chamber intraocular lens implantations. Expectations regarding visual functioning after cataract surgery were very high, and in most cases and in most cases they were fulfilled.

Addisu Z; Solomon B

2011-03-01

359

Statin Use and Cataract Surgery: A Nationwide Retrospective Cohort Study in Elderly Ethnic Chinese Patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Since a report of lenticular opacities in dogs treated with high dosages of statins, the debate on the relationship between statin therapy and cataracts has not reached a conclusion. OBJECTIVE: The aim of this study was to evaluate the association between statin therapy and the risk of cataract surgery in an elderly ethnic Chinese population using time-dependent analysis to minimize immortal time bias. METHODS: A retrospective cohort study using the Longitudinal Health Insurance Database 2005 randomly sampled from the National Health Insurance Research Database, Taiwan, was conducted. A total of 50,165 adults aged between 65 and 90 years in 1998 without records of statin therapy or diagnosis of cataracts between July 1997 and December 1997 were included in the analysis. The first record of lens extraction within the follow-up period (1998-2009) was set as the study endpoint. A propensity score was derived using a logistic regression model to model the receipt of statin therapy as a function of the baseline characteristics for every subject. We used the time-dependent Cox regression model to test the relative hazard of undergoing cataract surgery between statin users and non-users, while use of statins was treated as a time-dependent variable, controlling for baseline age and individual propensity score. RESULTS: Of the 50,165 enrolled subjects, 17,670 individuals with an incident lens extraction were identified during a median follow-up of 10.7 years. The incidence of cataract surgery was 49.7/1,000 person-years in the statin-using period compared with 38.5/1,000 person-years in the statin-non-using period. The adjusted hazard ratio of cataract surgery was 1.20 (95 % CI 1.14-1.27; P < 0.001) in statin users compared with statin non-users. CONCLUSION: Statin therapy was associated with a modestly increased risk of cataract surgery. We suggest regular checks for lens opacity in statin users.

Lai CL; Shau WY; Chang CH; Chen MF; Lai MS

2013-06-01

360

Postcataract surgery endophthalmitis in the United States: analysis of the complete 2003 to 2004 Medicare database of cataract surgeries.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To estimate endophthalmitis incidence after cataract surgery nationally and at the state level in 2003 and 2004 and to explore risk factors. DESIGN: Analysis of Medicare beneficiary claims data. PARTICIPANTS: We evaluated billed claims for cataract surgery and endophthalmitis diagnosis and treatment for all Medicare fee-for-service beneficiaries in 2003-2004. METHODS: Cataract surgeries were identified by procedure codes and merged with demographic information. Cataract annual surgical volume was calculated for all surgeons. Presumed postoperative endophthalmitis cases were identified by International Classification of Diseases-9 Clinical Modification Codes on claims within 42 days after surgery. Endophthalmitis rates and 95% confidence intervals (CI) were calculated at state and national levels. Logistic regression was used to investigate the association between developing endophthalmitis and surgery location and surgeon factors. MAIN OUTCOME MEASURES: Endophthalmitis incidence and risk factors. RESULTS: We included 4006 cases of presumed endophthalmitis, which occurred after 3 280 966 cataract surgeries. The national rate in 2003 was 1.33 per 1000 surgeries (95% CI, 1.27-1.38) and decreased to 1.11 per 1000 (95% CI, 1.06-1.16) in 2004. Males (relative risk [RR], 1.23; 95% CI, 1.15-1.31), older individuals (RR, 1.53; 95% CI, 1.38-1.69; ?85 compared with 65-74 years), blacks (RR, 1.17; 95% CI, 1.03-1.33), and Native Americans (RR, 1.72; 95% CI, 1.07-2.77) had increased risk of disease. After adjustment, surgeries by surgeons with low annual volume (RR, 3.80; 95% CI, 3.13-4.61 for 1-50 compared with ?1001 annual surgeries) and less experience (RR, 1.41; 95% CI, 1.25-1.59 for 1-10 compared with ?30 years), and surgeries performed in 2003 (RR, 1.20; 95% CI, 1.13-1.28) had increased endophthalmitis risk. CONCLUSIONS: Endophthalmitis rates are lower than previous yearly US estimates, but remain higher than rates reported from a series of studies from Sweden; patient factors or methodologic differences may contribute to differences across countries. Patient age, gender, and race, and surgeon volume and years of experience are important risk factors.

Keay L; Gower EW; Cassard SD; Tielsch JM; Schein OD

2012-05-01

 
 
 
 
361

Two episodes of anaphylaxis following exposure to hydroxypropyl methylcellulose during cataract surgery.  

UK PubMed Central (United Kingdom)

UNLABELLED: We report a case of immediate severe anaphylaxis to hydroxypropyl methylcellulose (HPMC) on 2 separate occasions during cataract surgery in a 71-year-old patient. Skin prick tests were positive for HPMC, a constituent of Ocucoat and Xylocaine gel, which were administered intraocularly during surgery. Skin prick tests were also positive for methylcellulose. Based on symptoms and clinical signs of anaphylaxis following 2 separate cataract operations together with positive prick tests to HPMC, HPMC is the most plausible cause of the reactions. The patient has since had uneventful surgery for a detached retina avoiding HPMC. This case stresses the importance of considering all medication given to patients as possible causes of an anaphylactic reaction. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Munk SJ; Heegaard S; Mosbech H; Garvey LH

2013-06-01

362

[Would micro-incision phacoemulsification be a new trend of cataract surgery].  

Science.gov (United States)

Coaxial small-incision phacoemulsification has become the most performed and widely accepted cataract surgery in the world. With the development of phaco technique and advances in surgery skills, ophthalmologists pay more and more attention to micro-incision phacoemulsification. Clinically, there are a number of debates focusing on efficiency and safety of micro-incision phacoemulsification. By analyzing the clinical and laboratory studies at home and abroad, we believe that micro-incision phacoemulsification is safe, efficient and economic. Therefore, it will be a new trend of cataract surgery. In order to support our view and to improve ophthalmologists' understanding about micro-incision phacoemulsification and ultimately strengthen their clinical performance, we primarily introduce the history, features and effects of micro-incision phacoemulsification in this paper. PMID:22800447

Shentu, Xing-chao; Miao, Qi; Yao, Ke

2012-04-01

363

Comparative study of general, local and topical anesthesia for cataract surgery1  

Directory of Open Access Journals (Sweden)

Full Text Available Recently, small incision cataract extraction by phaco and implantation of a foldable intraocular lense with topical anesthesia has used in an attempt to decrease the complication of general anesthesia and peribulbar injection. To compare effects and complications of topical, local and general anesthesia, 92 patients admitted to Imam Hosein hospital for cataract surgery, were randomly assigned to three groups and surgery was done under different methods of anesthesia. During routine ECCE, lid and globe movements, miosis and viterous bulg were observed more in topical anesthesia than the other techniques, but serious complications such as posterior capsular rupture and viterous loss were not seen. Because of less systemic and local complications and rapid return of vision and possibility of outpatient surgery, topical anesthesia should be considered as an alternative to local and general methods.

Tarighat Monfared MH; Moezi H; Rajavi Zh

2000-01-01

364

Comparative study of general, local and topical anesthesia for cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Recently, small incision cataract extraction by phaco and implantation of a foldable intraocular lense with topical anesthesia has used in an attempt to decrease the complication of general anesthesia and peribulbar injection. To compare effects and complications of topical, local and general anesthesia, 92 patients admitted to Imam Hosein hospital for cataract surgery, were randomly assigned to three groups and surgery was done under different methods of anesthesia. During routine ECCE, lid and globe movements, miosis and viterous bulg were observed more in topical anesthesia than the other techniques, but serious complications such as posterior capsular rupture and viterous loss were not seen. Because of less systemic and local complications and rapid return of vision and possibility of outpatient surgery, topical anesthesia should be considered as an alternative to local and general methods.

Tarighat Monfared MH; Moezi H; Rajavi Zh

2001-01-01

365

[Would micro-incision phacoemulsification be a new trend of cataract surgery].  

UK PubMed Central (United Kingdom)

Coaxial small-incision phacoemulsification has become the most performed and widely accepted cataract surgery in the world. With the development of phaco technique and advances in surgery skills, ophthalmologists pay more and more attention to micro-incision phacoemulsification. Clinically, there are a number of debates focusing on efficiency and safety of micro-incision phacoemulsification. By analyzing the clinical and laboratory studies at home and abroad, we believe that micro-incision phacoemulsification is safe, efficient and economic. Therefore, it will be a new trend of cataract surgery. In order to support our view and to improve ophthalmologists' understanding about micro-incision phacoemulsification and ultimately strengthen their clinical performance, we primarily introduce the history, features and effects of micro-incision phacoemulsification in this paper.

Shentu XC; Miao Q; Yao K

2012-04-01

366

Cataract and pterygium surgery results in Venezuelan patients treated in the Misión Milagro program  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english An intervention to address vision loss was carried out in 2008 in Táchira, Venezuela, by health teams of the joint Cuban-Venezuelan initiative known as Misión Milagro. It included active case identification of patients with ophthalmologic conditions and, where warranted, surgery, followup, rehabilitation and medical discharge. From a universe of 345 patients aged >18 years with ophthalmologic conditions found, 210 were selected for cataract or pterygium surgery. Of cata (more) ract patients, 55.2% recovered optimal vision within three months after surgery, as did 90.9% of those with pterygium; frequency of complications was 15.4% in cataract patients and 41.7% in pterygium patients. The intervention was considered successful, although many patients' low-income status required premature postoperative return to their jobs and other labors, a factor considered detrimental to optimal recovery.

Triana, Idalia; Socarrás, Oaris de los Ángeles; Rondón, Nelsis

2012-07-01

367

[Visual results of extracapsular cataract surgery with posterior chamber lenses  

UK PubMed Central (United Kingdom)

In a total of 1663 consecutive patients best corrected visual acuity after extracapsular cataract extraction with implantation of a posterior chamber lens was determined. Average follow-up time was 21 months. Visual acuity improved from an average of 0.15 preoperatively to 0.6 postoperatively. In the absence of other ocular disorders postoperative vision averaged 0.7. The visual outcome was clearly related to the age of the patients and showed a continuous decline for operations performed after the age of 69 years.

Spitznas M; Werdermann D

1991-04-01

368

Influence of corneal biomechanical properties on surgically induced astigmatism in cataract surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: To perform an overall follow-up of the morphologic, optical, and biomechanical properties of the cornea to determine new parameters influencing the refractive outcomes of cataract surgery. DESIGN: Clinical study. METHODS: Patients scheduled for cataract surgery were assessed for surgically induced corneal astigmatism (SIA) and higher-order aberrations, (HOAs) using a Scheimpflug rotating camera (Pentacam) together with corneal imaging by optical coherence tomography (Spectralis) and biomechanical analysis by the Ocular Response Analyzer preoperatively and 1, 7, and 30 days postoperatively. The central and peripheral corneal thicknesses; incision width, length, and architecture; corneal hysteresis (CH); and corneal resistance factor (CRF) were computed to identify new parameters influencing corneal optical changes that determine the final refractive result. RESULTS: The study enrolled 40 patients (40 eyes). The SIA and HOAs were significantly lower after microincision surgery (? 2.2 mm) than after small-incision surgery (2.75 mm) (both P<.01). The CRF was significantly reduced with a direct corneal incision compared with a constructed incision (P<.01). Multivariate analysis showed that SIA was correlated not only with incision width (P<.05) but also with preoperative CH (P<.01). Corneal 3rd-order trefoil depended on incision width (P<.01). CONCLUSIONS: In addition to the well-known influence of incision size on SIA, CH also modulates optical changes. The biomechanical features of the cornea should be taken into account preoperatively to better predict the refractive outcomes of cataract surgery.

Denoyer A; Ricaud X; Van Went C; Labbé A; Baudouin C

2013-08-01

369

[Incidence and extent of postoperative macular edema following vitreoretinal surgery with and without combined cataract operation  

UK PubMed Central (United Kingdom)

PURPOSE: In the majority of patients with full-thickness macular hole, closure can be achieved with vitreoretinal surgery techniques. However, postoperative function is variable and the prognostic determinants for visual acuity are incompletely understood. We evaluated the incidence and extent of macular edema after macular foramen surgery with and without combined cataract-surgery. METHODS: Between October 1997 and March 2001 macular foramen surgery was performed in 125 eyes from 116 patients. Fluorescein angiograms with sufficient quality were obtained from 59 eyes using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph, HRA, Heidelberg Engineering, Heidelberg) and were evaluated by two independent observers. RESULTS: Angiographic macular edema was noted on average 4.2 months after the operation in 47 out of 59 (79.7%) eyes. The incidence of macular edema was 87% in eyes after a combined cataract operation compared to 66.7 % in eyes with no simultaneous operation ( p=0.735). Mean postoperative visual acuity was 0.4 (min 0.1-max 1.2) with no significant difference between eyes with (4.1 lines) and without macular edema (3.5 lines) with regard to visual improvement from baseline. CONCLUSIONS: The results indicate a high incidence of macular edema in eyes after macular hole surgery with subsequent anatomical success. Apparently, the presence of macular edema is not associated with short term visual impairment. Furthermore it seems that a combined cataract operation compared to a consecutive procedure is not associated with disadvantages regarding the functional outcome.

Staudt S; Miller DW; Unnebrink K; Holz FG

2003-09-01

370

Corneal endothelial cells 6-7 years following cataract surgery in patients with pseudoexfoliation syndrome.  

UK PubMed Central (United Kingdom)

PURPOSE: To assess the condition of the corneal endothelium an extended period after cataract surgery in eyes with and without pseudoexfoliation syndrome (PES). METHODS: Forty-six patients with PES who underwent cataract surgery in the Eye Department, Oslo University Hospital, in 2001 and 2002 were enrolled and compared to 101 matched controls without PES who had surgery in the same period. They were re-examined 6-7 years following surgery with measurements taken of corneal endothelial cell density (ECD), pleomorphism, polymegathism and corneal thickness. RESULTS: Mean ECD was 2024 ± 371 cells/mm(2) in eyes with PES and 2144 ± 365 cells/mm(2) in eyes without PES. The difference was not statistically significant. No significant difference in polymegathism and pleomorphism was noted. Mean corneal thickness was 543 and 547 ?m in eyes with and without PES, respectively (not statistically significant). The presence of glaucoma in pseudoexfoliative eyes was not associated with endothelial cell changes. CONCLUSION: Six to 7 years following cataract surgery, no statistically significant differences were established in ECD, pleomorphism, polymegathism and corneal thickness in eyes with and without PES. No clinical signs of corneal decompensation were noted amongst the participants.

Ostern AE; Drolsum L

2012-08-01

371

OUTCOMES AFTER COMBINED 1.8-MM MICROINCISION CATARACT SURGERY AND 23-GAUGE TRANSCONJUNCTIVAL VITRECTOMY FOR POSTERIOR SEGMENT DISEASE: A Retrospective Study.  

UK PubMed Central (United Kingdom)

PURPOSE:: The aim of the study was to retrospectively review indications, intraoperative and postoperative complications, and outcomes of combined coaxial microincision cataract surgery and 23-gauge vitrectomy for posterior segment disease. METHODS:: The outcomes and findings of surgery in 50 patients (50 eyes) who underwent coaxial microincision cataract surgery and foldable intraocular lens implantation combined with 23-gauge vitrectomy for a variety of indications between January 2010 and March 2012. RESULTS:: No posterior capsule tear was observed during surgery. Intraoperatively, a retinal break was found in 9 eyes (18%), which were successfully treated with laser and/or cryotherapy. Corneal suture was done in 6 eyes (12%), 5 of them left and 1 right. Sclerotomy was sutured in 2 left and 2 right eyes, respectively, a total of 4 eyes (8%). In 1 case, 23-gauge vitrectomy was converted to 20-gauge vitrectomy. The postoperative intraocular pressure (millimeters of mercury, mean ± standard deviation) was 16.7 ± 9.8. Hypotony (intraocular pressure < 9 mmHg) occurred in 9 eyes (18%). In 1 eye (2%) posterior iris synechia were observed 2 weeks after surgery, and intraocular pressure was >40 mmHg. Intraocular pressure was normalized after Nd:YAG laser iridotomy. Fibrin reaction in the anterior chamber was observed in 1 eye (2%) Day 1 after surgery. Posterior capsule opacification, which required Nd:YAG laser capsulotomy, was observed in 11 eyes (22%) during the follow-up. CONCLUSION:: Combined sutureless coaxial microincision cataract surgery and 23-gauge vitrectomy offers the advantages of both coaxial microincision cataract surgery (less wound leakage, good anterior chamber stability, and safety) and 23-gauge vitrectomy (decreased inflammation and faster rehabilitation after surgery).

Czajka MP; Frajdenberg A; Johansson B

2013-06-01

372

Efficacy and safety of mass cataract surgery campaign in a developing country.  

UK PubMed Central (United Kingdom)

PURPOSE: To determine the visual outcomes achieved in terms of efficacy and safety during a mass eye surgery campaign in a low-income developing country. METHODS: Three hundred fifteen eyes of 305 patients underwent extracapsular cataract extraction with intraocular lens implantation in a prospective, analytical, experimental, and nonrandomized study on patients who underwent cataract surgery during the campaign that two Spanish nongovernmental organizations conducted in December 2008 in a district hospital in Bobo-Dioulasso (Burkina Faso). RESULTS: Mean age was 61.97 ± 14.39 years. The mean uncorrected distance visual acuity before surgery was 2.17 ± 0.7 (20/3000), which improved to 0.86 ± 0.64 logMAR (20/150) 3 months after cataract surgery. The mean spherical equivalent at 3 months was -0.87 ± 1.90 diopters. The corrected distance visual acuity was 0.52 ± 0.44 logMAR (20/60) 3 months after surgery, 68.7% of the patients had good visual outcomes, and 9.16% had poor outcomes. A total of 41.4% of the operated eyes showed a spherical equivalent within ± 1.00 diopter of emmetropia. The most common intraoperative complication was posterior capsule rupture (incidence, 2.9%, 9 of 315), and the most serious complication was expulsive hemorrhage (incidence, 0.3%, 1 of 315). Three months after surgery, 2.9% (9 of 315) of the eyes was affected by posterior capsular opacity. CONCLUSIONS: A mass cataract campaign performed in a developing country with the proper technique and standardized protocols of act