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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 ... surgeon calculate the correct IOL power. Medications and cataract surgery If you are having cataract surgery, be ...

2

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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Femtosecond laser-assisted cataract surgery: a current review.  

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To evaluate the safety, efficacy, advantages, and limitations of femtosecond laser-assisted cataract surgery through a review of the literature. A PubMed search was conducted using topic-appropriate keywords to screen and select articles. Initial research has shown appropriate safety and efficacy of femtosecond laser-assisted cataract surgery, with improvements in anterior capsulotomy, phacofragmentation, and corneal incision. Limitations of these studies include small sample size and short-term follow-up. Cost-benefit analysis has not yet been addressed. Preliminary data for femtosecond laser-assisted cataract surgery shows appropriate safety and efficacy, and possible advantage over conventional cataract surgery. Questions to eventually be answered include comparisons of long-term postoperative complication rates-including infection and visual outcomes-and analysis of contraindications and financial feasibility. PMID:22224016

Moshirfar, Majid; Churgin, Daniel S; Hsu, Maylon

2011-10-01

5

Cataract Surgery  

Medline Plus

Full Text Available ... truck driver from Chandler, Arizona, is having cataract surgery today on his left eye. A month ago ... anesthesia to numb the eye area. With microscopic surgery the surgeon can make a very small incision, ...

6

Femtosecond-laser assisted cataract surgery: a review.  

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Introduced in 2008, the femtosecond laser is a promising new technological advance which plays an ever increasing role in cataract surgery where it automates the three main surgical steps: corneal incision, capsulotomy and lens fragmentation. The proven advantages over manual surgery are: a better quality of incision with reduced induced astigmatism; increased reliability and reproducibility of the capsulotomy with increased stability of the implanted lens; a reduction in the use of ultrasound. Regarding refractive results or safety, however, no prospective randomized study to date has shown significant superiority compared with standard manual technique. The significant extra cost generated by this laser, undertaken by the patient, is a limiting factor for both its use and study. This review outlines the potential benefits of femtosecond-laser-assisted cataract surgery due to the automation of key steps and the safety of this new technology. PMID:24835818

Abouzeid, Hana; Ferrini, Walter

2014-11-01

7

[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

2003-01-01

8

Cataract Surgery  

Medline Plus

Full Text Available ... right eye -- Announcer: Fifty-four year old Paul Wood, a former truck driver from Chandler, Arizona, is ... a cataract removed from his right eye. Paul Wood: I guess they go from a scale of ...

9

Cataract Surgery  

Medline Plus

Full Text Available ... symptoms include blurred images and problems with color perception. A cataract is the clouding of the transparent ... feel fine. Announcer: It's amazing. Paul Wood: No pain, no nothing. Announcer: Yes, and has the drug ...

10

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

2013-06-01

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Cataract surgery to lower intraocular pressure  

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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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Cataract surgery in uveitis  

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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...

Hazari Ajit; Sangwan Virender

2002-01-01

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Surgery for Congenital Cataract  

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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 Tool  

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The NASA-McGannon cataract surgery tool is a tiny cutter-pump which liquefies and pumps the cataract lens material from the eye. Inserted through a small incision in the cornea, the tool can be used on the hardest cataract lens. The cutter is driven by a turbine which operates at about 200,000 revolutions per minute. Incorporated in the mechanism are two passages for saline solutions, one to maintain constant pressure within the eye, the other for removal of the fragmented lens material and fluids. Three years of effort have produced a design, now being clinically evaluated, with excellent potential for improved cataract surgery. The use of this tool is expected to reduce the patient's hospital stay and recovery period significantly.

1977-01-01

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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

2002-01-01

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First postoperative day review after uneventful phacoemulsification cataract surgery: Is it necessary?  

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Full Text Available Abstract Background Our purpose was to examine the value of the first postoperative day review after uneventful phacoemulsification cataract surgery. Methods 291 patients who underwent uneventful phacoemulsification were randomized into two groups (ClinicalTrials.gov Identifier: NCT01247155: i Next day review (NDR group, n?=?146 and ii No next day review (NNDR group, n?=?145. The rate of complications, percentage of patients seeking non-scheduled medical consultation up to postoperative day 14, presence of any inflammation-related sign and best corrected visual acuity (BCVA on postoperative day 28 were analyzed. Results In the NDR group, 5.5% of patients developed a postoperative complication, whereas the respective rate was 6.2% in the NNDR group. The difference was not statistically significant (p?=?0.791. The most frequent complications were: elevated intraocular pressure, allergy to postoperative treatment, corneal abrasion, punctuate epitheliopathy, iris prolapse and postoperative hyphema, whose rates did not differ between the two groups. The rate of patients seeking non-scheduled medical consultation up to postoperative day 14, presence of any inflammation-related sign, as well as BCVA on day 28 did not exhibit any significant differences between the study groups. Conclusions First postoperative day review could be omitted in cases of uneventful cataract surgery.

Chatziralli Irini P

2012-06-01

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Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness.  

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Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral cefuroxime showed the best cost-effectiveness ratio. Both the observational studies and the economic evaluation have methodological limits that reduce their validity. This review confirmed that cefuroxime can prevent endophthalmitis after cataract surgery. Further randomized controlled trials, with large sample sizes, are required to compare different antibiotic prophylaxis regimens. PMID:25152613

Linertová, Renata; Abreu-González, Rodrigo; García-Pérez, Lidia; Alonso-Plasencia, Marta; Cordovés-Dorta, Luis Mateo; Abreu-Reyes, José Augusto; Serrano-Aguilar, Pedro

2014-01-01

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IOL Implants: Lens Replacement and Cataract Surgery (Intraocular Lenses)  

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... with cataract lens replacement, several types of IOL implants are available to help people enjoy improved vision. ... Causes Cataract Diagnosis Cataract Treatment Cataract Surgery IOL Implants: Lens Replacement Cataract Vision Simulator Cataract lens replacement: ...

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Strabismus presenting after cataract surgery.  

Science.gov (United States)

Strabismus presenting after cataract surgery is etiologically related to a heterogenous group of disorders. Clinical data from 63 patients so affected revealed four broad etiologic categories: 1) pre-existing disorders that preceded the cataract surgery, but were rendered asymptomatic by the occluding cataract (e.g., thyroid eye disease, cranial nerve palsy, myasthenia); 2) disorders precipitated by prolonged occlusion by a cataract (e.g., sensory deviations, decompensation of heterophorias, and central disruption of binocular vision); 3) disorders resulting from surgical trauma to extraocular muscles and orbital soft tissues. Traumatic injury to the inferior rectus muscle secondary to retrobulbar anesthesia injection, a specific subset, is postulated to result from a Volkmann's type ischemic contracture, a well-known osseofascial compartment syndrome occurring in peripheral skeletal muscles. 4) Disorders related to resulting aphakia/pseudophakia and associated optical aberrations (e.g.; anisophoria, ocular dominance reversal, and color/brightness disparity). The diagnostic and therapeutic implications of these findings are discussed. PMID:2008285

Hamed, L M

1991-02-01

20

Cataracts  

Medline Plus

Full Text Available ... Last reviewed: 01/09/2013 3 There are two main ways to remove a cataract. The doctor ... your anesthesiologist. Other risks are associated with any type of surgery, such as infection. Infection can occur ...

 
 
 
 
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Cataract surgery and its complications in diabetic patients.  

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Abstract Diabetic patients are known to have an increased risk of cataract development and cataract surgery is a common surgical procedure for diabetic individuals. Cataract extraction (CE) in diabetic patients as compared to non-diabetic patients is associated with higher risks of reported complications such as capsular contraction and opacification as well as post-surgical worsening of macular edema (ME) and diabetic retinopathy (DR). In this paper, we review the pathogenesis of diabetic cataract, the risk factors contributing to cataract complications as well as DR progression, and assess preventive measures and treatment options for DR and ME following CE. PMID:25325858

Haddad, Nour Maya N; Sun, Jennifer K; Abujaber, Samer; Schlossman, Deborah K; Silva, Paolo S

2014-11-01

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Patient satisfaction with cataract surgery  

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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

2008-10-01

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Management of mydriasis and pain in cataract and intraocular lens surgery: review of current medications and future directions.  

Science.gov (United States)

The maintenance of mydriasis and the control of postoperative pain and inflammation are critical to the safety and success of cataract and intraocular lens replacement surgery. Appropriate mydriasis is usually achieved by topical and/or intracameral administration of anticholinergic agents, sympathomimetic agents, or both, with the most commonly used being cyclopentolate, tropicamide, and phenylephrine. Ocular inflammation is common after cataract surgery. Topical steroids and nonsteroidal anti-inflammatory drugs are widely used because they have been proved effective to control postsurgical inflammation and decrease pain. Topical nonsteroidal anti-inflammatory drugs have also been shown to help maintain dilation. However, use of multiple preoperative drops for pupil dilation, inflammation, and pain control have been shown to be time consuming, resulting in delays to the operating room, and they cause dissatisfaction among perioperative personnel; their use can also be associated with systemic side effects. Therefore, ophthalmologists have been in search of new options to streamline this process. This article will review the current medications commonly used for intraoperative mydriasis, as well as pain and inflammation control. In addition, a new combination of ketorolac, an anti-inflammatory agent, and phenylephrine, a mydriatic agent has recently been designed to maintain intraoperative mydriasis and to reduce postoperative pain and irritation from intraocular lens replacement surgery. Two Phase III clinical trials evaluating this combination have demonstrated statistically significant differences when compared to placebo in maintaining intraoperative mydriasis (P<0.00001) and in reducing pain in the early postoperative period (P=0.0002). This medication may be of benefit for use in cataract and lens replacement surgery in the near future. PMID:25061276

Grob, Seanna R; Gonzalez-Gonzalez, Luis A; Daly, Mary K

2014-01-01

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The Impact of Cataract Surgery on AMD Development and Progression.  

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Abstract Age-related macular degeneration (AMD) and cataract are two leading causes of visual impairment worldwide which often occur concurrently in the same patient. With more than 1.6 million cataract operations performed per year in the United States, many of which occur in the nearly 1.75 million individuals diagnosed with AMD, there is ample incentive to further explore the interaction between these two conditions. Notably, the role of cataract surgery on AMD development and progression is of particular interest. This review summarizes the major findings from literature focusing on the effect of cataract surgery on AMD. PMID:25325855

Qian, Cynthia X; Young, Lucy H

2014-11-01

25

Cataracts  

Medline Plus

Full Text Available Cataract Surgery Introduction A cataract is a clouding of the eye’s lens. Cataracts are a common eye ... which translates these signals into images we see. Cataracts The lens of the eye is made of ...

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Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness  

Directory of Open Access Journals (Sweden)

Full Text Available Renata Linertová,1,2 Rodrigo Abreu-González,3 Lidia García-Pérez,1,2 Marta Alonso-Plasencia,3 Luis Mateo Cordovés-Dorta,4 José Augusto Abreu-Reyes,4 Pedro Serrano-Aguilar2,5 1Fundación Canaria de Investigación y Salud (FUNCIS, Santa Cruz de Tenerife, Spain; 2Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC, Madrid, Spain; 3Ophthalmology Service, University Hospital Ntra Sra de La Candelaria, Santa Cruz de Tenerife, Spain; 4Ophthalmology Service, University Hospital of Canary Islands, La Laguna, Spain; 5HTA Unit, Canary Health Service, Santa Cruz de Tenerife, Spain Abstract: Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral cefuroxime showed the best cost-effectiveness ratio. Both the observational studies and the economic evaluation have methodological limits that reduce their validity. This review confirmed that cefuroxime can prevent endophthalmitis after cataract surgery. Further randomized controlled trials, with large sample sizes, are required to compare different antibiotic prophylaxis regimens. Keywords: cefuroxime, moxifloxacin, intracameral, systematic review, endophthalmitis, prophylaxis, antibiotics

Linertová R

2014-08-01

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Management of mydriasis and pain in cataract and intraocular lens surgery: review of current medications and future directions  

Directory of Open Access Journals (Sweden)

Full Text Available Seanna R Grob,1–3 Luis A Gonzalez-Gonzalez,1–3 Mary K Daly1,2,4 1Department of Ophthalmology, Veterans Administration Boston Healthcare System, Boston, MA, USA; 2Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; 3Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA; 4Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA Abstract: The maintenance of mydriasis and the control of postoperative pain and ­inflammation are critical to the safety and success of cataract and intraocular lens replacement surgery. Appropriate mydriasis is usually achieved by topical and/or intracameral administration of anticholinergic agents, sympathomimetic agents, or both, with the most commonly used being cyclopentolate, tropicamide, and phenylephrine. Ocular inflammation is common after cataract surgery. Topical steroids and nonsteroidal anti-inflammatory drugs are widely used because they have been proved effective to control postsurgical inflammation and decrease pain. Topical nonsteroidal anti-inflammatory drugs have also been shown to help maintain dilation. However, use of multiple preoperative drops for pupil dilation, inflammation, and pain control have been shown to be time consuming, resulting in delays to the operating room, and they cause dissatisfaction among perioperative personnel; their use can also be associated with systemic side effects. Therefore, ophthalmologists have been in search of new options to streamline this process. This article will review the current medications commonly used for intraoperative mydriasis, as well as pain and inflammation control. In addition, a new combination of ketorolac, an anti-inflammatory agent, and phenylephrine, a mydriatic agent has recently been designed to maintain intraoperative mydriasis and to reduce postoperative pain and irritation from intraocular lens replacement surgery. Two Phase III clinical trials evaluating this combination have demonstrated statistically significant differences when compared to placebo in maintaining intraoperative mydriasis (P<0.00001 and in reducing pain in the early postoperative period (P=0.0002. This medication may be of benefit for use in cataract and lens replacement surgery in the near future. Keywords: ketorolac, phenylephrine, intraocular lens replacement surgery, mydriasis

Grob SR

2014-07-01

28

Are Entry Criteria for Cataract Surgery Justified?  

Science.gov (United States)

Purpose The German Ophthalmological Society (GOS) recently proposed surgical entry criteria, i.e. 300 cataract surgeries. We herein correlate the surgical hands-on experience with the risk of posterior capsule ruptures in order to assess whether this number is appropriate. Methods We identified all cataract operations that had been performed at the University Eye Hospital Freiburg since 1995. For each surgeon, we assigned a running number to his/her procedures in the order they had been performed. Thereafter, we excluded all combined procedures and the second eyes. We then selected the 5475 surgical reports between November 2008 and November 2012 for detailed review. We additionally classified each surgery into low- vs. high- à priori risk for posterior capsule ruptures. We fitted a multifactorial logistic regression model to assess the GOS recommendation of 300 surgeries under supervision. In the low-risk group, we additionally visualized the 'typical' learning curve by plotting the posterior capsule ruptures against the respective rank numbers. Results The odds ratio for posterior capsule ruptures of 'learning-mode' (one of the respective surgeon's 300 first procedures) vs. the non-learning-mode was 3.8 (pGOS entry criterion of 300 cataract procedures is therefore most likely justified. Careful selection of low-risk patients for the training surgeons may help in reducing the rate of posterior capsule ruptures during training. PMID:25401738

Böhringer, Daniel; Vach, Werner; Hagenlocher, Kai; Eberwein, Philipp; Maier, Philip; Reinhard, Thomas

2014-01-01

29

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 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

2012-01-01

30

Endothelial trauma in the surgery of cataract  

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Cataract surgery is most common in human surgery and comprises 80% of eye surgery programs. Owing to sophisticated technologies, it has become a routine surgery with lowered complications rate; hence, the functional outcome is more conditioned by operative trauma. The aim of this study was to demonstrate the significance of specular microscopy in the evaluation of operative trauma during extra-capsular cataract extraction (ECCE) and phacoemulsification (P), in a controlled environment. The st...

?urovi? Branislav M.

2004-01-01

31

Impairment of lacrimal drainage after cataract surgery  

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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

2007-05-01

32

Cataracts  

Medline Plus

Full Text Available Cataract Surgery Introduction A cataract is a clouding of the eye’s lens. Cataracts are a common eye condition that ... and what strength of replacement lens to use. Surgery Cataract surgery is a very safe and successful ...

33

Benign prostatic hyperplasia: clinical treatment can complicate cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available 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 hyperplasia", "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.

Fernando Facio

2010-10-01

34

Benign prostatic hyperplasia: clinical treatment can complicate cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English 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 hyperplasia", "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.

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

35

[Femtosecond laser-assisted cataract surgery].  

Science.gov (United States)

Employing a femtosecond laser as an initial step in cataract surgery has the clear potential to provide more precise capsulotomies and full lens fragmentation in cases of pre-existing astigmatism in conjunction with relaxing corneal incisions. In the long run femtosecond laser-assisted cataract surgery might replace phacoemulsification which has been the standard in cataract surgery over the last 20 years. Besides precision and predictability, the low rate of complications impresses surgeons working with the technology, particularly those employing a laser with a fluid-filled interface which seems to prevent major complications including increases in intraocular pressure. PMID:24961173

Dick, H B; Schultz, T

2014-07-01

36

Sir Harold Ridley: innovator of cataract surgery.  

Science.gov (United States)

Cataract surgery has evolved greatly over the years, from the ancient practice of 'couching' where the lens is dislodged, to the modern surgical techniques of today. Sir Harold Ridley's invention of the intraocular lens (IOL) has altered the approach towards cataract surgery, benefitting individuals worldwide. This has been his most notable contribution, it is therefore interesting to explore the build up to this event and gain an understanding of the issues faced by Sir Ridley. This paper explores the significant events and key developments that influenced one of the most valuable innovations in the context of cataract surgery--the intraocular lens. PMID:25326942

Sarwar, H; Modi, N

2014-09-01

37

Cataract  

Science.gov (United States)

A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age ... than half of all Americans either have a cataract or have had cataract surgery. A cataract can ...

38

Secondary glaucoma after pediatric cataract surgery  

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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.

Yasin Çinar

2013-04-01

39

Role of mannitol in cataract surgery  

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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

1978-01-01

40

Intraocular lens employed for cataract surgery  

Science.gov (United States)

The aim of this paper is to illustrate the techniques of cataract surgery with implantation of intraocular lenses and some physical properties of the used materials. The new technology, coupled with extensive experience and the studied cases, permits to increase the standardization and accuracy of the engravings, by reducing the use and handling of surgical instruments inside the eye. At present it is possible to replace the cataract with crystalline lenses based on biopolymers such as PMMA, silicone, acrylic hydrophilic and hydrophobic acrylic. These materials are increasingly able to replace the natural lens and to ensure the fully functional of the eye. The role of femtosecond lasers in cataract surgery, to assist or replace several aspects of the manual cataract surgery, are discussed.

Roszkowska, A. M.; Torrisi, L.

2014-04-01

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

Science.gov (United States)

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. PMID:23837247

Synek, Svatopluk

2013-04-01

42

Simultaneous pterygium and cataract surgery.  

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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

1995-01-01

43

Recent advances in the surgery of silicone oil filling complicated cataract  

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Full Text Available Because silicone oil's special physical and chemical properties, they are widely used in the vitreous retinal surgery, but the complications have aroused the concern of eye doctors, particularly, the complicated cataract. Nowadays, there are different kinds of surgery for silicone oil filling complicated cataract, but our aim is to choose a method which can be safe, effective and economical. This article reviews the progress in the research of silicone oil filling complicated cataract surgery.

Ruo-Fang Wang

2014-04-01

44

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

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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

2013-09-01

45

MRSA and cataract surgery – reflections for practice  

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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

2010-10-01

46

Post-cataract surgery diplopia: aetiology, management and prevention.  

Science.gov (United States)

Diplopia is an infrequent but distressing adverse outcome after uncomplicated cataract surgery. Many factors may contribute to the occurrence of this problem, including prolonged sensory deprivation resulting in disruption of sensory fusion, paresis of one or more extraocular muscles, myotoxic effects of local anaesthesia, optical aberrations (for example, aniseikonia) and pre-existing disorders (for example, thyroid orbitopathy). The purpose of this review is to present the aetiology and clinical features of diplopia after cataract surgery and to discuss the possible modalities for the prevention and treatment of this frustrating complication. PMID:25138745

Kalantzis, George; Papaconstantinou, Dimitris; Karagiannis, Dimitris; Koutsandrea, Chryssanthi; Stavropoulou, Dora; Georgalas, Ilias

2014-09-01

47

[Modern methods of astigmatism correction in cataract surgery].  

Science.gov (United States)

Modern methods of astigmatism correction in lens surgery are reviewed in the article. Keratorefractive, including laser-assisted, and intraocular techniques employing different models of toric intraocular lenses (IOL) are described. Current state of the problem is analyzed. Implantation of toric IOLs enables precise correction of corneal astigmatism simultaneously with cataract phacoemulsification. PMID:24684073

Iusef, Iu N; Iusef, S N; Ivanov, M N; Ryzhkova, E G; Shkoliarenko, N Iu

2014-01-01

48

Cost-effectiveness analysis of cataract surgery with intraocular lens implantation: extracapsular cataract extraction versus phacoemulsification  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A randomized single blinded clinical trial to compare the cost-effectiveness of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) from March 2000 until August 2001. The cost of a cataract surgery incurred by hospital, patients and households were calculated preoperatively, one week, two months (for both techniques) and six months (for ECCE only). Effectiveness of cataract surgery w...

Manaf, Mohd R. A.; Aljunid, Syed M.; Annuar, Faridah H.; Leong, Chuah K.; Normalina Mansor

2007-01-01

49

New technology update: femtosecond laser in cataract surgery  

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Full Text Available Zoltan Z NagyDepartment of Ophthalmology, Semmelweis University, Budapest, HungaryAbstract: Femtosecond lasers represent a new frontier in cataract surgery. Since their ­introduction and first human treatment in 2008, a lot of new developments have been achieved. In this review article, the physical principle of femtolasers is discussed, together with the indications and side effects of the method in cataract surgery. The most important clinical results are also presented regarding capsulotomy, fragmentation of the crystalline lens, corneal wound creation, and refractive results. Safety issues such as endothelial and macular changes are also discussed. The most important advantage of femtolaser cataract technology at present is that all the important surgical steps of cataract surgery can be planned and customized, delivering unparalleled accuracy, repeatability, and consistency in surgical results. The advantages of premium lenses can be maximally used in visual and presbyopia restoration as well. The advantages of ­premium lenses can be maximally used, not only in visual, but in presbyopia restoration as well. Quality of vision can be improved with less posterior chamber lens (PCL tilt, more centralized position of the PCL, possibly less endothelial damage, less macular edema, and less posterior capsule opacification (PCO formation. This technological achievement should be followed by other technical developments in the lens industry. Hopefully this review article will help us to understand the technology and the results to ­demonstrate the differences between the use of femtolasers and phacoemulsification-based cataract surgery. The most important data of the literature are summarized to show ophthalmologists the benefits of the technology in order to provide the best refractive results to the patient.Keywords: femtosecond laser-assisted cataract surgery, capsulotomy, lens fragmentation, corneal wound, arcuate keratotomy, safety, consistency of results

Nagy ZZ

2014-06-01

50

Cataracts  

Medline Plus

Full Text Available ... to decide what type and what strength of replacement lens to use. Surgery Cataract surgery is a very safe and successful ... has healed. Cataract surgery is usually an outpatient surgery, where the patient goes home the same day. However, you should ...

51

Cost-utility of routine cataract surgery  

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Full Text Available Abstract Background If decisions on health care spending are to be as rational and objective as possible, knowledge on cost-effectiveness of routine care is essential. Our aim, therefore, was to evaluate the cost-utility of routine cataract surgery in a real-world setting. Methods Prospective assessment of health-related quality of life (HRQoL of patients undergoing cataract surgery. 219 patients (mean (SD age 71 (11 years entering cataract surgery (in 87 only first eye operated, in 73 both eyes operated, in 59 first eye had been operated earlier filled in the 15D HRQoL questionnaire before and six months after operation. Direct hospital costs were obtained from a clinical patient administration database and cost-utility analysis performed from the perspective of the secondary care provider extrapolating benefits of surgery to the remaining statistical life-expectancy of the patients. Results Mean (SD utility score (on a 0–1 scale increased statistically insignificantly from 0.82 (0.13 to 0.83 (0.14. Of the 15 dimensions of the HRQoL instrument, only seeing improved significantly after operation. Mean utility score improved statistically significantly only in patients reporting significant or major preoperative seeing problems. Of the subgroups, only those whose both eyes were operated during follow-up showed a statistically significant (p Conclusion Mean utility gain after routine cataract surgery in a real-world setting was relatively small and confined mostly to patients whose both eyes were operated. The cost of cataract surgery per quality-adjusted life year gained was much higher than previously reported and associated with considerable uncertainty.

Ryynänen Olli-Pekka

2006-09-01

52

Corneal astigmatism after cataract surgery.  

Science.gov (United States)

206 Consecutive cataract patients were at random divided into three groups according to the way the cataract incision was closed: virgin silk 8-0, interrupted nylon 9-0, and double running nylon 9-0. The nylon, whether interrupted or continuous, yielded in the majority of cases a postoperative astigmatism with the rule, whereas virgin silk caused in nearly all patients a postoperative astigmatism against the rule and therefore behaved like an absorbable suture. Silk is chemically non-absorbable, but in virgin silk a natural worm-produced polymer is still present, which provokes a tissue reaction. Softening of tissue diminishes the tensile strength of the suture. With respect to the postoperative astigmatism, the suture material (nylon or virgin silk) seems a more important factor than the way in which it is used (interrupted or continuous). PMID:2696627

Dekkers, N W; Buijs, J

1989-08-01

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Cataract surgery in patients with ocular surface disease: An update in clinical diagnosis and treatment  

Science.gov (United States)

In this article we review essentials of diagnosis and management of ocular surface disease in patients who undergo cataract surgery. It is clearly shown that dry eye disease worsens following the cataract surgery in patients with prior history of ocular surface disease, Also new cases of dry eye might appear. Current strategies for the timely diagnosis and proper management of dry eye syndrome in the face of cataract surgery patients are mainly emphasized. To achieve the best outcome in cataract surgery, a healthy ocular surface is crucial. While ocular surface preparation is indispensable in patients with established ocular surface disease, it is also helpful in those with minimal signs or symptoms of surface disease. The current approach begins with early diagnosis and drastic management of ocular surface disease before cataract surgery using a stepwise regimen customized to each patient and disease severity. These measures are continued throughout and after the surgery.

Afsharkhamseh, Neda; Movahedan, Asadolah; Motahari, Hooman; Djalilian, Ali R.

2014-01-01

54

Small incision cataract surgery: tips for avoiding surgical complications  

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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

2008-03-01

55

Cataract surgery following KAMRA presbyopic implant  

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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

2013-09-01

56

[Appropriate cataract surgery training can promote work of blindness prevention].  

Science.gov (United States)

Cataract is the first blinding eye disease in the world and China. However, due to various reasons, cataract surgery rate (CSR) in China is much lower than in developed countries and even some developing countries. Properly and standardized training of cataract surgery for ophthalmologists from primary hospital and young eye doctors is one of the key point to improve CSR. For above, we had explored actively to establish an appropriate and suitable training model of cataract surgery. Ophthalmologist in primary hospital can provide high quality medical services to cataract patients in accordance with their own conditions after training and promote the sustainable development of blindness prevention work. PMID:24841809

Zhang, Mingzhi

2014-03-01

57

How to prevent endophthalmitis in cataract surgeries?  

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Full Text Available Postoperative endophthalmitis is a very devastating complication and every step should be taken to reduce its occurrence. Unattended air conditioning filter systems are often the culprits and regular maintenance of the filters is of paramount importance. Shedders of pathogenic organisms amongst the theater personnel should be identified by regular screening and should be promptly treated. In addition to the use of Povidone iodine 5% solution in the conjunctival sac few minutes prior to surgery, proper construction of wound, injectable intraocular lenses, use of prophylactic intracameral antibiotics or prophylactic subconjunctival antibiotic injection at the conclusion of cataract surgery, placing a patch after the surgery for at least 4 h and initiating topical antibiotics from the same day of surgery helps to lower the frequency of postoperative endophthalmitis. Intraoperative posterior capsule rupture and anterior vitrectomy are risk factors for acute endophthalmitis, and utmost care to prevent posterior capsular rent should be taken while performing cataract surgery. Also, in case of such complication, these patients should be closely monitored for early signs of endophthalmitis in the postoperative period. In the unfortunate event of endophthalmitis the diagnosis should be prompt and treatment must be initiated as early as possible.

Kelkar Aditya

2008-01-01

58

Endothelial trauma in the surgery of cataract  

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Full Text Available Cataract surgery is most common in human surgery and comprises 80% of eye surgery programs. Owing to sophisticated technologies, it has become a routine surgery with lowered complications rate; hence, the functional outcome is more conditioned by operative trauma. The aim of this study was to demonstrate the significance of specular microscopy in the evaluation of operative trauma during extra-capsular cataract extraction (ECCE and phacoemulsification (P, in a controlled environment. The study included 100 consecutive patients who met the established criteria, and groups were formed according to the type of surgery by the assignment of successive numbers from a random number table. Examination and photographs of the corneal endothelium, as well as pachymetry were performed on Keeler-Konan Poclington Specular Microscope (KSP. The obtained results revealed significant dissimilarity in endothelial cell reduction (9.17% in group E, and 4.72% in group P, which generated statistically significant correlation of pre-operative and post-operative pachymetry in the group E (p=0.0004. On the basis of the results obtained by specular microscopy, it was concluded that under the same conditions phacoemulsification caused reduced operative trauma of the corneal endothelium.

?urovi? Branislav M.

2004-01-01

59

Intracameral vancomycin following cataract surgery: An eleven-year study  

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Full Text Available Deepa R Anijeet, Prasad Palimar, Clive O PeckarDepartment of Ophthalmology, Warrington and Halton NHS Trust, UKAim: To compare the incidences of endophthalmitis after cataract operations before and after introduction of intracameral vancomycin at the end of surgery.Methods: A retrospective analysis was performed of presumed infectious endophthalmitis after cataract surgery from January 1, 1998 to December 31, 2008. From January 2001, the practice of using intracameral vancomycin at the end of cataract surgery was introduced. The period before introduction of intracameral vancomycin is considered as period A and that after as period B. The incidences of presumed or culture-proven endophthalmitis during periods A and B were compared.Results: A total of 16,606 cataract surgeries were performed during the study period. The incidence of endophthalmitis per 1000 cataract surgeries was 3.0 during period A and 0.08 during period B. This reduction was statistically significantly (Chi-squared test 36.6, P value < 0.0001. The relative risk of developing endophthalmitis without intracameral vancomycin prophylaxis was 38. The absolute risk reduction was 292 cases of endophthalmitis per 100,000 cataract surgeries.Conclusions: Intracameral vancomycin significantly reduced the incidence of postoperative endophthalmitis after cataract surgery. There is a universal need to adopt this mode of microbial prophylaxis to reduce the burden of endophthalmitis after cataract surgery.Keywords: endophthalmitis, intracameral vancomycin, cataract surgery

Deepa R Anijeet

2010-04-01

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42 CFR 1001.1701 - Billing for services of assistant at surgery during cataract operations.  

Science.gov (United States)

...services of assistant at surgery during cataract operations. 1001.1701 Section...services of assistant at surgery during cataract operations. (a) Circumstance for...Services of an assistant at surgery during a cataract operation, or (ii) Charges...

2010-10-01

 
 
 
 
61

Spontaneous corneal perforation post cataract surgery.  

Science.gov (United States)

A 69-year-old female was referred for bilateral cataracts. Best-corrected visual acuity was 6/12 oculus dexter (OD) and 6/18 oculus sinister (OS). On examination, tear film breakup time was 8 s, signifying mild dry eyes; otherwise was unremarkable. The patient underwent uneventful left cataract surgery. At a 1 month postoperative examination vision was 6/9. The left cornea was dry with extensive punctuate epithelial erosions. There was no lagophthalmos. Lubricants were started to both eyes. The authors proceeded with right cataract surgery. Postoperative preservative free drops were given. She failed to attend an earlier than routine 2 week postoperative examination. Four weeks postoperatively, the vision was 2/60. She was incompliant with the lubricant drops. Biomicroscopic examination showed a sterile painless paracentral corneal perforation with iris plugging, Seidel's negative. She was started on steroid drops and lubricants. A lower lid punctual plug was inserted. The best corrected vision at 4 months was 6/18 OD and 6/6 OS. PMID:22669966

Chaudhary, Rishika; Mushtaq, Bushra

2011-01-01

62

Recent status on femtosecond laser-assisted cataract surgery  

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Full Text Available Femtosecond laser-assisted cataract surgery performs the anterior capsulotomy, lens fragmentation, corneal incisions making and astigmatic limbal relaxing incision with femtosecond laser, which effectively reduces the complications of conventional phacoemulsification surgery and improves the postoperative visual quality of patients. It further improves the technology and effect of cataract surgery and has broad clinical application prospects. This paper compares pros and cons as well as the clinical values of femtosecond laser-assisted cataract surgery with conventional phacoemulsification surgery based on the overview of published articles.

Xiao-Ming Wang

2014-05-01

63

A Cochrane Systematic Review finds no significant difference in outcome or risk of postoperative complications between day care and in-patient cataract surgery.  

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This review was conducted to determine reliable evidence regarding the safety, feasibility, effectiveness, and cost-effectiveness of cataract extraction performed as a day care versus in-patient procedure. The search to identify randomized controlled trials comparing day care and in-patient surgery for age-related cataract included the Cochrane Eyes and Vision Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and LILACS Latin American and Caribbean Literature on Health Sciences. Assessment of methodological quality was based on criteria defined by the Cochrane Collaboration. The primary outcome was the achievement of a satisfactory visual acuity 6 weeks after operation. Two trials, involving a total of 1284 people, are included. One trial reported statistically significant differences in early postoperative complication rates in the day care group, which had no clinical relevance to visual outcomes 4 months postoperatively. Mean change in visual acuity Snellen lines of the operated eye 4 months postoperatively was 4.1 standard deviation SD 2.3 for the day care group and 4.1 SD 2.2 for the in-patient group. Costs were 20% more for the in-patient group attributable to higher costs for overnight stay.

Zbigniew Fedorowicz

2006-09-01

64

Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results  

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Full Text Available Jonathan S Chang, Harry W Flynn Jr, Darlene Miller, William E Smiddy Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA 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. Keywords: endophthalmitis, Stenotrophomonas maltophilia, cataract

Chang JS

2013-04-01

65

Recent advances in femtosecond laser-assisted cataract surgery  

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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

2013-07-01

66

Pediatric cataract and surgery outcomes in Central India: A hospital based study  

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Full Text Available Background : A review of pediatric cataract cases operated between January 2003 and March 2005 in the tribal belt of central India was carried out. Aim : We present the profile of cataract cases in children ?18 years and postoperative visual status in the eyes operated upon. Settings and design : This was a retrospective medical record retrieval type of cohort study in a hospital setting. materials and Methods : Pediatric ophthalmologists examined children and operated eyes with cataract. The personal profile, preoperative, intraoperative and postoperative details were noted. The surgical procedures included cataract extraction, intraocular lens implantation, posterior capsulorrhaxis and anterior vitrectomy in most of the cases. We evaluated the visual status of eyes with cataract before and 6 weeks after surgery. Statistical analysis: We used univariate type of parametric type of statistical analysis. Results: A total of 575 eyes of 502 children had cataract. Cataract in 65 children was bilateral and in 437 cases it was unilateral. Congenital cataracts were in 88 (17.5% eyes. Traumatic cataracts were noted in 170 (33.9% eyes. The proportion of cataract was higher in males than in females. Variation in ?number of cataracts? among different age groups was noted. Vision following surgery was more than 6/18 in 84 (16.4% eyes. The vision could not be assessed in 256 (44% eyes. Conclusion: Improvement of child health care is needed for early detection of cataract in children. Role of rubella and trauma in childhood cataract should be investigated and addressed. Visual assessment and postoperative care should be further improved.

Khandekar Rajiv

2007-01-01

67

Cataracts  

Medline Plus

Full Text Available ... occur during or after cataract surgery. This may lead to scarring and deteriorating vision. Antibiotics can be ... inflammation in the eye can occur, which can lead to reduced vision. In some cases, depending on ...

68

Cataracts  

Medline Plus

Full Text Available ... the back of the eye, the light rays travel through a transparent substance called the vitreous. The ... resting for a while in a recovery area. Risks and Complications Cataract surgery is a very safe ...

69

Cataract surgery in Knobloch syndrome: a case report.  

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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. PMID:21691582

Bongiovanni, Carmen Sílvia; Ferreira, Carla Cristina Serra; Rodrigues, Ana Paula Silvério; Fortes Filho, João Borges; Tartarella, Márcia Beatriz

2011-01-01

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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.

Bunce Catey

2007-09-01

71

Observation on the efficacy of complicated small pupil cataract surgeries  

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Full Text Available AIM: To investigate the techniques and clinical results of complicated small pupil cataract surgeries. METHODS: In the various 58 cases(69 eyesof complicated small pupil cataract surgeries, pupillary margin radial cuts, situ phacoemulsification of cataract and intraocular lens implantation were used to replace assistive devices and mechanical pupil dilation. RESULTS: The postoperative patients' visions were improved: 1.0 to 0.6 of 21(30.4%, 0.5 to 0.3 of 28(40.6%, 0.25 to 0.1 of 16(23.2%, CONCLUSION: Complicated small pupil cataract surgeries with the radial pupillary margin cuts and cataract situ phacoemulsification can realize visual recovery, and physiological pupils also can be obtained. Surgical methods are safe and effective.

Zhi Lei

2013-07-01

72

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

73

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

2004-01-01

74

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

1998-01-01

75

Cataract surgery during active methicillin-resistant Staphylococcus aureus infection  

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Full Text Available Ahmad M Mansour,1,2 Haytham I Salti11Department of Ophthalmology, American University of Beirut, 2Rafic Hariri University Hospital, Beirut, LebanonAbstract: We present two patients with active, foul-smelling, methicillin-resistant ­Staphylococcus aureus (MRSA wounds of the forehead and sternum following craniotomy or open heart surgery. Both had debilitating cataracts and were told by the infectious diseases team that cataract surgery is very risky. Both underwent sequential bilateral phacoemulsification with no sign of infection. Patients with active MRSA wound infections may safely undergo cataract surgery with additional precautions observed intraoperatively (good wound construction and postoperatively (topical antibiotics and close observation. Banning such surgeries can unnecessarily jeopardize the lifestyles of such patients.Keywords: cataract, infection, methicillin-resistant Staphylococcus aureus, phacoe­mulsification

Mansour AM

2014-04-01

76

Research Shows Cataract Surgery Can Reduce Hip Fracture Risk  

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... sponsored Research Shows Cataract Surgery Can Reduce Hip Fracture Risk 08/01/2012 09:00:00 AM ... Medicare beneficiaries shows that the risk of hip fractures was significantly reduced in patients who had had ...

77

Reducing older driver motor vehicle collisions via earlier cataract surgery.  

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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. PMID:23369786

Mennemeyer, Stephen T; Owsley, Cynthia; McGwin, Gerald

2013-12-01

78

Evaluation of an improved suture for cataract surgery.  

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An improved synthetic absorbable suture for ophthalmic surgery, 8-0 Dexon "S" polyglycolic acid, was evaluated in 25 cataract extractions and, in 5 cases, compared with 8-0 Vicryl polyglactin sutures. Dexon "S" sutures caused less tissue drag than Vicryl sutures; Vicryl was more easily knotted. With respect to handling, knotting, tissue drag, absorption, and postoperative complications, the improved Dexon suture was found to be well suited for use in cataract surgery. PMID:434745

Sherman, S E

1979-02-01

79

Excimer Laser Application For Cataract Surgery  

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The ablation threshold of bovine lenses was determined for excimer laser radiatiF at 308 nanreters. The ablation th5eshold for bovine lenses was approximately 0.6J/cm +/-0.1J/cm , for cortex and 1J/cm for nucleus. The threshold for bovine nucleus was higher than the threshold for cortex and difference was statistically significant at the 0.05 level. The relatively low ablation threshold for bovine lenses demonstrates the potential effectiveness of excimer laser radiation at 308 nm for cataract surgery. An experimental prototype has been developed and results of its application demonstrated. Further experiments to demonstrate safety for the retina and adjacent ocular structures are necessary because of the well known hazards of ultraviolet radiation. The potential of theleymir laser for keratorefractive surgery is currently under intensive investigation. In preliminary studies the ablation behavior of bovine lenses was investigated. The objective of this study was to quantify ablation rates as the first step in determining the specification for a laser system which would be practical in the clinical setting. Although excimer laser systems are available at 193 nm (ArF), 248 (KrF) and 351 (xeF) we selected 308 nm because of the availability of fiberoptics for the transmission of 308 nm as well as the known absorbance of human lenses in the 280 nm region.

Bath, Patricia E.; Mueller, Gerhard; Apple, David J.; Stolzenburg, Norbert M.

1988-06-01

80

The temerloh hospital cataract complications study: factors associated with, types and outcomes of cataract surgery complications  

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Full Text Available AIM: To study the prevalence of complications of cataract surgery and any association between the occurrence of complications and experience of surgeon, type of surgery, type of anaesthesia and visual outcome.METHODS: This was a retrospective study of patients who underwent cataract surgery over a period of two years in a district hospital in Malaysia. The demographic details of patients, type of surgery done, as well as type of anaesthesia used and experience of the surgeon were noted. The types of intraoperative and postoperative complications were recorded. The final best corrected visual outcome was recorded.RESULTS: Complications occurred in 11.1% of the total 1007 patients operated. Posterior capsule rupture(3.6%was the most common complication. The experience of the surgeon and the type of anaesthesia used did not affect complications during surgery. Intracapsular cataract extraction(ICCEand phacoemulsification converted to extracapsular cataract extraction(ECCEwere significantly associated with more complications(PPCONCLUSION: The occurrence of complications during cataract surgery significantly affected the visual outcome. The type of surgery done was associated by the occurrence of complications. However, the experience of the surgeon and the type of anaesthesia used did not affect the occurrence of complications. We recommend that particular attention be given to ICCE and phacoemulsification converted to ECCE to minimise the complications and thereby reducing the chances of poor vision postoperatively.

Thevi Thanigasalam

2014-08-01

 
 
 
 
81

Quality of vision in refractive and cataract surgery, indirect measurers: review article / Qualidade visual em cirurgia refrativa e catarata, medidores indiretos: artigo de revisão  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Qualidade Visual é a medida da capacidade individual de reconhecer detalhes de um objeto no espaço. Medições de função visual na clínica oftalmológica são limitadas por vários fatores, tal como máximo contraste e assim podem não refletir adequadamente as condições visuais reais, bem como os aspectos [...] subjetivos da percepção do mundo pelo paciente. O sucesso em uma cirurgia está não apenas em restaurar linhas de visão, mas sim qualidade visual. Portanto, as cirurgias refrativas e de catarata têm a responsabilidade de alcançar resultados de qualidade. É difícil definir qualidade visual por um único parâmetro, sendo os principais testes de função visual: sensibilidade ao contraste; glare; dispersão intraocular da luz e aberrometria. Nesta revisão os diferentes componentes da função visual são explicados e os diversos métodos disponíveis para se avaliar a qualidade de visão são descritos. Abstract in english Visual acuity is the measurement of an individual's ability to recognize details of an object in a space. Visual function measurements in clinical ophthalmology are limited by factors such as maximum contrast and so it might not adequately reflect the real vision conditions at that moment as well as [...] the subjective aspects of the world perception by the patient. The objective of a successful vision-restoring surgery lies not only in gaining visual acuity lines, but also in vision quality. Therefore, refractive and cataract surgeries have the responsibility of achieving quality results. It is difficult to define quality of vision by a single parameter, and the main functional-vision tests are: contrast sensitivity, disability glare, intraocular stray light and aberrometry. In the current review the different components of the visual function are explained and the several available methods to assess the vision quality are described.

Taís Renata Ribeira, Parede; André Augusto Miranda, Torricelli; Adriana, Mukai; Marcelo, Vieira Netto; Samir Jacob, Bechara.

82

Investigation of cataract surgery in Leshan, Sichuan Province  

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Full Text Available AIM: To comprehensively investigate the current status of cataract surgery in Leshan city, and find the existing problems according to the survey results as a guide to cataract prevention and treatment in future. METHODS: We surveyed the status of cataract surgery containing equipments, surgeons and surgery conditions in 17 ophthalmology departments of general hospitals from Leshan including 6 counties, 1 county-level city and 4 districts during 2012. Cataract surgery methods, according to various surgery financial resources, surgical performances and surgical incision, were divided into phacoemulsification and intraocular lens implantation(Phaco+IOL, extracapsular cataract extraction and intraocular lens implantation(ECCE+IOL, and each method contained 2 groups. We analyzed the outcomes following preoperative examination, surgeons, surgical methods, surgical equipments, types of IOL, surgical quantity, surgical results, and intraoperative complication. RESULTS: In whole city there were 16 operating microscopes, 43 slit lamp microscopes, 12 non-contact tonometers, 1 intraocular lens Master, 8 optical A/B type ultrasonic examination systems, 4 YAG lasers and 12 phacoemulsification instruments. There 15 doctors could complete cataract surgery independently, and 5 of them were phacoemulsification surgeons. The total number of completed cataract surgeries reached 6 211 eyes, containing 3 564 eyes for Phaco+IOL(57%(preoperative visual acuity ?0.3 in Phaco+IOL1 were 1 520 eyes, 24%and 2 647 eyes for ECCE+IOL(43%(1 533 eyes in ECCE+IOL1, 25%. In various groups, off-blindness rate was 94.80%-100%, off-disability rate was 90.41%-100%, and 94.96%-100% received intraocular lens implantation, intraoperative complication rate was 1.00%-15.10%. CONCLUSION: The distribution of surgeons and equipments in the whole city is unbalanced, and the utilization rate of phaco equipment is low. The levels are different in various hospitals on surgical technique, surgical quantity and surgical results. Phacoemulsification and intraocular lens implantation is considered as the main therapy for cataract, and as a transition to dioptric and personalized cataract surgery. The surgical condition of the city is good, but the proportion of cataract surgery for prevention of blindness in Leshan city is low, and the surgical technique remains to be further improved.

Yu Han

2014-08-01

83

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

2013-06-01

84

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

2011-06-01

85

Cost-effectiveness analysis of cataract surgery with intraocular lens implantation: extracapsular cataract extraction versus phacoemulsification  

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Full Text Available A randomized single blinded clinical trial to compare the cost-effectiveness of cataract surgery between extracapsular cataract extraction (ECCE and phacoemulsification (PEA was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM from March 2000 until August 2001. The cost of a cataract surgery incurred by hospital, patients and households were calculated preoperatively, one week, two months (for both techniques and six months (for ECCE only. Effectiveness of cataract surgery was assessed using Visual Function 14 (VF-14, quality of life measurement specifically for vision. The cost analysis results from each 50 subjects of ECCE and PEA group showed that average cost for one ECCE after six months post-operation is USD 458 (± USD 72 and for PEA is USD 528 (± USD 125. VF-14 score showed a significant increased after a week, two months and six months post-operation compared to the score before operation for both techniques (p<0.001. However, there was no significant difference between them (p = 0.225. This study indicated that ECCE is more cost effective compared to PEA with cost per one unit increment of VF-14 score of USD 14 compared to USD 20 for PEA. (Med J Indones 2007; 16:25-31 Keywords: cataract, cost-effectiveness, extracapsular cataract extraction, phacoemulsification, visual function 14

Mohd R.A. Manaf

2007-02-01

86

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

2000-01-01

87

Clinical observation of complicated cataract after glaucoma surgery  

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Full Text Available AIM: To observe the complicated cataract after glaucoma surgery, analyze the causes and summarize the treatments, in order to provide the basis for clinical treatment.METHODS: Forty-five patients(50 eyeswith complicated cataract after glaucoma surgery treated in our hospital from October 2012 to September 2013 were selected. All patients were treated by 3.2mm tunnel incision phacoemulsification cataract operation. The postoperative complications, intraocular pressure, and visual acuity were observed. RESULTS: After treatment, visual acuity of all patients were improved, without obvious complications, the intraocular pressure was normal.CONCLUSION: 3.2mm tunnel incision phacoemulsification cataract operation can effectively improve the intraocular pressure and promote the recovery of visual acuity.

Xue-Yan Wang

2014-09-01

88

Evolution of cataract surgery: Smaller incision - less complications  

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Full Text Available 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 ? 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? Vladimir

2012-01-01

89

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

1999-01-01

90

Sutureless Cataract Surgery: Principles and Steps  

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Full Text Available Introduction. Cataracts cause about 50% of world blindness. There is little likelihood of effective prevention becoming available in the next few years and so the only treatment will remain surgical. For many of the other major causes of world blindness, like trachoma, xerophthalmia and onchocerciasis, the remedy is community-based, not hospital-based, and requires prevention rather than treatment. The prevalence of blinding cataract will only increase as people live longer, so cataract will continue to be, by far, the most important treatable cause of blindness.

John Sandford-Smith

2003-01-01

91

VITREOUS LOSS IN CATARACT SURGERY: GENERAL ANESTHESIA VS LOCAL ANESTHESIA  

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Full Text Available Introduction. Vitreous loss (VL is one of the most serious ocular complications during cataract surgery without correct management may causes other serious complications and sometimes visual loss. By selecting the correct method of anesthesia (general or local anesthesia it is possible to reduce the incidence of this complication and consequent events. The aim of this research is to determine the incidence of VL in cataract surgery with local and general anesthesia and comparing them with each other. Methods. This survey was conducted in 210 patients over 40 years old who had been operated for cataract surgery. Subjects were randomized in two groups (general vs local anesthesia. There is no premeditations in anyone. Findings. The incidence of VL in general and local anesthesia was 3.6 and 9.1 percent, respectively (P<0.05. The groups were similar with respect to demographic data and potential confounding variables. Conclusion. The incidence of vitreous loss during cataract surgery under local anesthesia is more than general anesthesia. If general anesthesia is contraindicated, it is better to use sedative drugs during local anesthesia for cataract surgery to prevent vitreous loss.

A.A MORTAZAVI

2000-03-01

92

The pattern of cataract surgery in India: 1992  

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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

1995-01-01

93

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

2013-08-01

94

Critical appraisal of ophthalmic ketorolac in treatment of pain and inflammation following cataract surgery  

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Full Text Available Rahul Reddy, Stephen Jae KimDepartment of Ophthalmology, Vanderbilt University, Nashville, TN, USABackground: The purpose of this review was to provide a critical appraisal of the literature supporting the efficacy of ophthalmic ketorolac (Acuvail® in the treatment of pain and inflammation after cataract surgery.Methods: Literature search and expert opinion of the authors.Results: Recent studies indicate greater intraocular drug levels in the anterior chamber and iris-ciliary body after topical application of Acuvail in comparison with older formulations of ketorolac. A large randomized, multicenter, placebo-controlled study demonstrated significantly less inflammation and pain after cataract surgery using Acuvail.Conclusion: Acuvail appears to be effective in reducing post-cataract surgery pain and inflammation.Keywords: ketorolac tromethamine, Acuvail®, postsurgical, cystoid macular edema, nonsteroidal anti-inflammatory drugs

Reddy RK

2011-06-01

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

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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

96

Simultaneous Penetrating Keratoplasty and Cataract Surgery  

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Purpose To determine the clinical outcomes of simultaneous penetrating keratoplasty (PK), cataract removal and intraocular lens implantation (triple procedure), and to compare the safety and efficacy of two different cataract extraction techniques during the course of PK. Methods This retrospective comparative study was conducted on patients who had undergone a triple procedure. The technique of cataract extraction was either open- sky extracapsular cataract extraction (ECCE) or phacoemulsification (PE). In the ECCE group, the posterior chamber intraocular lens (PCIOL) was implanted in the ciliary sulcus, while in the PE group PCIOLs were fixated within the capsular bag. Outcome measures included best spectacle corrected visual acuity (BSCVA), refractive results, graft clarity and complications. Results Seventy-six eyes of 69 consecutive patients with mean age of 61.4±14.2 years were enrolled. Mean follow-up period was 61.4±37.2 months over which mean BSCVA was significantly improved from 1.40±0.68 to 0.44±0.33 LogMAR (P<0.001). Mean postoperative spherical equivalent refractive error was -2.13±3.02 D, which significantly differed from the target refraction (-0.73±0.29 D, P=0.004). At final follow-up, 89.5% of the corneal grafts remained clear. Conclusion The triple procedure is a safe and effective approach to restore vision in patients with coexisting corneal pathologies and cataracts. However, unacceptable postoperative refractive error can be anticipated. PMID:23825711

Javadi, Mohammad-Ali; Feizi, Sepehr; Moein, Hamid-Reza

2013-01-01

97

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

2011-12-01

98

Topical use of indomethacin on the day of cataract surgery.  

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The use of topical indomethacin in the prevention of surgically induced miosis has been documented. However, in these previous prospective trials this prostaglandin synthetase inhibitor was administered the day before surgery. With the frequency of 'day case' cataract surgery increasing, an efficient preoperative mydriatic regimen is important. In this study we considered the use of topical indomethacin as an addition to a regimen already implemented. One hundred and fourteen eyes underwent i...

Searle, A. E.; Pearce, J. L.; Shaw, D. E.

1990-01-01

99

Iris recognition as a biometric method after cataract surgery  

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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 ...

Roizenblatt Jaime; Schor Paulo; Roizenblatt Roberto; Belfort Rubens

2004-01-01

100

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.

Sylvia Shirima

2009-06-01

 
 
 
 
101

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

1992-01-01

102

DEPLOYMENT OF SIX SIGMA METHODOLOGY IN PHACOEMULSIFICATION CATARACT SURGERY  

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Full Text Available The purpose of this study is to show how a public eye care center in Turkey initiated Six Sigma principles to reduce the number of complications encountered during and after phacoemulsification cataract surgeries. To analyze the 3-year data, main tools of Six Sigma’s Define-Measure-Analyze-Improve-Control (DMAIC improvement cycle such as SIPOC table, Fishbone Diagram and, Failure, Mode and Effect Analysis were implemented. Experience of the ophthalmic surgeon, patient’s anatomy, cooperation of patient during the surgery, sterilization and hygiene, attention of assistant surgeon, calibration of equipment and quality/chemical composition of intraocular material were identified to be Critical-to-Quality (CTQ factors for a successful phacoemulsification cataract surgery. The most frequently occurring complication was found to be iris atrophy. The process sigma level for the process was found to be 3.958.

Ibrahim SAHBAZ

2014-04-01

103

A prospective study of the rate of falls before and after cataract surgery  

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Background: There has been considerable interest in the development of intervention programmes aimed at reducing the risk of falls. The primary objective was to ascertain whether cataract surgery reduced the risk of falls in elderly patients with age related cataract.

Brannan, S.; Dewar, C.; Sen, J.; Clarke, D.; Marshall, T.; Murray, P. I.

2003-01-01

104

Results of cataract surgery in the very elderly population  

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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

2013-08-01

105

Pediatric traumatic cataract and surgery outcomes in eastern China:a hospital-based study  

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Full Text Available AIM: To evaluate the etiologies, management, and outcomes of pediatric traumatic cataract in eastern China. METHODS:Pediatric traumatic cataract were reviewed for demographic information, type of injury, mode of injury, time of injury, interval between injury and first visiting doctors, hospital of first visiting, surgeries, complications and prognosis. RESULTS:A total of 117 eyes of 117 patients (96 boys and 21 girls with unilateral injuries (66 right and 51 left eyes were included in the study. The mean (SEM age at diagnosis was (6.6±3.2 years (range, 1.3-13.8 years. Each cataract was categorized according to the type of trauma:closed-globe (n=26 or open-globe (n=91 injuries. The most common injuring objects were sharp metal objects (37.61%. The most common complication in open-globe injuries was corneal laceration, whereas traumatic mydriasis was most common in closed-globe injuries. Of 68 eyes in patients with open-globe injuries who received cataract extraction, intraocular lens (IOLs were primarily implanted in 47 eyes (68.12%, whereas 18 eyes with closed-globe injuries received cataract extraction, and IOLs were primarily implanted in 17 eyes (94.4%. The surgical procedures included reconstruction of the anterior segment, synechiolysis, excision of the membrane, lensectomy, vitrectomy and related techniques. Postoperative vision was significantly improved compared with preoperative vision. CONCLUSION: Pediatric traumatic cataract should be treated in time to attenuate the complications, and education on pediatric traumatic cataract and improvements in pediatric health care are needed for the early detection of cataract in children.

Yu-Sen Huang

2013-04-01

106

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

2010-01-01

107

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

1997-01-01

108

Clinical study of phacoemulsification with complicated cataract after vitrectomy surgery  

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Full Text Available AIM: To evaluate the characteristics, safety and effectiveness of phacoemulsification with complicated cataract after vitrectomy surgery.METHODS:Thirty-nine patients(39 eyeswith complicated cataract after vitrectomy were operated by phacoemulsification, among which 23 eyes after silicon oil tamponade were combined with silicon oil removal. Preoperative and postoperative best corrected visual acuity(BCVAand complications were recorded. The mean follow-up period was 10 months, with the range from 3 to 24 months. RESULTS:There were no serious surgical complications. Postoperatively, BCVA improved in 37 eyes(95%, and did not change in 2 eyes(5%. No decreased visual acuity was observed on the patients. One case had recurrent retinal detachment at two weeks after silicon oil removal, and one case had vitreous hemorrhage at one month. Both eyes were treated with vitrectomy and silicon oil tamponade and were cured. Postoperative complications, such as choroidal hemorrhage, ocular hypotension and so on were not observed.CONCLUSION: Cataract is complicated and surgery can be much more challenging after vitrectomy. Phacoemulsification is safe and effective for complicated cataract in vitrectomized eyes.

Jian Li

2013-12-01

109

Retinal safety of near-infrared lasers in cataract surgery  

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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

110

Impact of tamsulosin exposure on late complications following cataract surgery: retrospective cohort study.  

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The purpose of this study is to measure the impact of tamsulosin intake on five postoperative cataract surgery complications (toxic anterior segment syndrome, rebound uveitis, retinal detachment, macular edema, and postoperative endophthalmitis). This retrospective cohort study was conducted at University Hospital of Henares. The study included 660-eyes of 660 patients submitted to cataract surgery at the ophthalmology unit of Hospital del Henares (Madrid) between 2 March 2009 and 28 February 2010. Extracapsular cataract extraction, combined glaucoma and cataract surgery phacovitrectomy, posterior capsule rupture and zonular damage were considered exclusion criteria. Clinical charts were reviewed during July 2012. Patients were divided in two groups (exposed and non-exposed to tamsulosin). Cumulative incidence of toxic anterior segment syndrome, rebound uveitis, retinal detachment, macular edema and postoperative endophthalmitis were compared in both groups. Rebound uveitis (relative risk [RR] 3.39; confidence interval [CI] 1.63-7.08) and macular edema (RR 4.15; CI 1.06-16.22) were more common in the tamsulosin-exposed group. Retinal detachment had a similar incidence in both groups. We observed no cases of endophthalmitis or toxic anterior segment syndrome in either of the two groups. Tamsulosin exposure in this cohort was associated with a higher risk of rebound uveitis and macular edema but the other three studied postoperative complications had a similar incidence in both groups. PMID:24158613

González-Martín-Moro, Julio; González-López, Julio José; Gómez-Sanz, Fernando; Zarallo-Gallardo, Jesús; Cobo-Soriano, Rosario

2014-08-01

111

Bilateral Pseudomonas aeruginosa endophthalmitis following bilateral simultaneous cataract surgery  

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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 w...

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

2007-01-01

112

Bilateral Pseudomonas aeruginosa endophthalmitis following bilateral simultaneous cataract surgery  

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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

2007-01-01

113

Safety and efficacy of intracameral mydriatics in cataract surgery  

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Background: In order to perform cataract surgery, adequate dilatation of the pupil is essential. This is traditionally achieved by preoperative topical mydriatic eye-drops, commonly cyclopentolate and phenylephrine. This routine has several disadvantages. First, the slow penetration through the cornea delays the onset of mydriasis. Second, the limited bioavailability of topically administered substances with significant systemic absorption may increase the risk for systemic side effects. Thir...

Lundberg, Bjo?rn

2008-01-01

114

Cataract Surgery in Eyes with Filtered Primary Angle Closure Glaucoma  

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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. PMID:23825710

Moghimi, Sasan; Latifi, Golshan; Amini, Heydar; Mohammadi, Masood; Fakhraie, Ghasem; Eslami, Yadollah; Nassiri, Nariman; Caprioli, Joseph

2013-01-01

115

Suppurative keratitis caused by Streptococcus pneumoniae after cataract surgery.  

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Six elderly patients are described (age range 76-86 years) in whom a characteristic peripheral suppurative keratitis developed 1-36 months after uncomplicated cataract surgery. A corneal section had been used in all patients and four or five interrupted nylon sutures were present at the time of onset. Streptococcus pneumoniae was cultured from a corneal scrape in all cases. Treatment with appropriate antibiotics resulted in slow resolution though supplementary topical steroids were necessary ...

Charteris, D. G.; Batterbury, M.; Armstrong, M.; Tullo, A. B.

1994-01-01

116

Clinical evaluation on the coaxial microincision cataract surgery in hard nuclear cataracts  

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Full Text Available AIM: To assess and compare the results of 2.2mm microincision coaxial cataract surgery(MCCSphacoemulsification with the conventional 3.0mm MCCS in hard nuclear cataracts. METHODS: Totally 132 eyes with hard cataract(? level and abovewere randomized to two groups: 2.2mm MCCS(group 1:60 eyesand 3.0mm MCCS(group 2:72 eyes. All patients underwent standard phacoemulsification and intraocular lens implantation surgery by one experienced surgeon. The average ultrasound power(AVEwas recorded during the operation. The incidences of capsule rupture and postoperative corneal edema were compared.Visual acuity, surgically induced astigmatism(SIAand the descent rate of endothelial cell density were compared at intervals of 1 day, 1 month and 3 months after surgery. Statistic analysis was taken by Student's t test and Chi square test. RESULTS: There was no significant difference on the incidences of capsule rupture, postoperative corneal edema and AVE(P> 0.05between the two groups(3.3%, 10.0%, 65.09±20.15and(4.2%, 11.1%, 69.13±15.44. One day after the surgery, the 2.2mm MCCS group showed better uncorrected visual acuity as compared to the 3.0mm MCCS group(P < 0.05. There were no significant differences on best-corrected visual acuity on 1 month and 3 months after the surgery. There was no significant difference on the descent rate of endothelial cell density(16.54%±10.20%, 17.69%±10.65%3 months after the surgery. One day, 1 month and 3 months after the surgery, SIA was 0.77±0.31,0.66±0.29, 0.52±0.25D in the 2.2mm MCCS group, and 1.41±0.73,0.98±0.61D,0.82±0.35D in the 3.0mm MCCS group, respectively. The differences were statistically significant. CONCLUSION: The operative safety of the 2.2mm MCCS group were the same as 3.0mm MCCS group with the hard nuclear cataracts. The 2.2mm MCCS phacoemulsification could significantly reduce SIA and get better earlier visual rehabilitation.

Qing-Cheng Shi

2013-05-01

117

Abdominal Pain after Cataract Surgery with Remifentanil Based Anesthesia  

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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

2009-01-01

118

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

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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 eyeswere 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

2013-09-01

119

Cirurgia da catarata infantil unilateral / Unilateral pediatric cataract surgery  

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Full Text Available SciELO Brazil | Language: Portuguese 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 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. 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 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.

120

Bilateral photic maculopathy after extracapsular cataract surgery: a case report  

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A 42 year old Caucasian female underwent uncomplicated extracapsular cataract extraction with posterior chamber lens implantation in the left eye, using a Zeiss model OpMi-6 operating microscope. Her postoperative course was unremarkable and she achieved a corrected visual acuity of 20/15+3. A lesion consistent with a photoretinal injury was noted inferior to the fovea. Seven months later the patient underwent cataract extraction in the right eye. Special care was taken to minimize light exposure during the procedure, including reducing the microscope illumination, minimizing operating time, intraoperative pharmacologic miosis, and using a corneal light shield. Despite these precautions, the patient developed a photoretinal injury almost identical to that in the contralateral eye. Postoperative corrected visual acuity was 20/15+3. Recent studies have reported incidences of retinal photic injuries from operating microscopes between 0 and 28 percent of patients. Several risk factors have been identified, including light intensity, intensity of the blue light component, and exposure time. The occurrence of a retinal photic injury in this patient despite precautions, development of bilateral cataracts at a young age, and a strong family history of early cataracts may indicate an inherited susceptibility to light induced damage. The American National Standards Institute is developing a product performance standard which will be applicable to operating microscopes used in ophthalmic surgery. The as yet undetermined role of individual susceptibility to retinal photic injury should be considered in the formulation of this standard.

Chalfin, Steven

1997-05-01

 
 
 
 
121

Comparative efficacy of topical tetracaine solution versus lidocaine gel in cataract surgery  

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Full Text Available Roberto Bellucci1, Francesco Bellucci21Ophthalmic Unit, Department of Neurosciences, Hospital and University of Verona, Verona, Italy; 2Faculty of Psychology, University of Parma, Parma, ItalyBackground: Cataract surgery is mainly performed under topical anesthesia achieved either by tetracaine solution (0.5%–1.0% or gel (0.5%, or by 2% lidocaine gel. This paper reviews the current knowledge about these two drugs, with special emphasis on a published prospective comparison between them.Methods: The main pharmacological aspects of topical anesthetic agents are summarized, explaining the difference between the ester (tetracaine and the amide (lidocaine compounds. Tetracaine is available as single-use eye drops, or as a multidose gel containing benzalkonium chloride, a preservative not contained in the multidose lidocaine gel. A literature search was performed, using “tetracaine”, “tetracaine gel”, “lidocaine”, “lidocaine gel”, “lidocaine jelly”, and “cataract surgery” as keywords, and compiling cross-references. A total of 25 studies were identified and included in this review. Of them, seven were uncontrolled studies describing different experiences with the drugs of interest, and 18 were controlled studies. Six studies directly compared tetracaine eye drops or gel with lidocaine gel before cataract surgery.Results: Both tetracaine solution and gel and lidocaine gel proved to be effective in providing analgesia before cataract surgery. Both drugs were comparable with needle injection anesthesia when intracameral lidocaine was added to topical treatment. Direct comparisons indicate better activity for tetracaine when used at the 1% concentration in single-dose units, or in the gel form at a 0.5% concentration. Patients showed a slight preference for the agent that caused the least discomfort when administered (lidocaine, while the surgical complication rate and the surgeon satisfaction were the same with either drug.Conclusion: Tetracaine solution and lidocaine gel were equally effective in providing topical anesthesia for cataract surgery in the published studies. Tetracaine was found to be better than lidocaine only if augmented by either increasing the concentration to 1% (solution or by increasing the penetration by adding benzalkonium chloride (gel.Keywords: tetracaine, tetracaine gel, lidocaine, lidocaine gel, cataract surgery

Bellucci R

2012-02-01

122

[Proptosis and ophthalmoplegia after cataract surgery].  

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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

123

Cataracts  

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Full Text Available ... occur after birth or after an eye injury. Diabetes and smoking can also predispose patients to have cataracts. A personal or family history of cataracts can also increase the chances of developing cataracts. Symptoms In their earliest stages, cataracts may not be ...

124

Iris recognition as a biometric method after cataract surgery  

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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 Jaime

2004-01-01

125

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

1992-01-01

126

Preemptive analgesia in elective cataract surgery (Phacoemulcification  

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Full Text Available Background: Preemptive analgesia is based on the idea that analgesia which initiates before a nociceptive even will be more effective than the analgesia commenced afterwards. This clinical trial compared postoperative analgesia and comfort in patients with general anesthesia combined with preoperative or postoperative local anesthesia. Methods: 90 patients who had been scheduled for phacoemulcification in Farabi Eye Hospital, 2002-3, were enrolled in the study. Sixty patients received general anesthesia: 15 received preoperative local anesthesia (GA+LA+OP, 15 received postoperative local anesthesia (GA+OP+LA, and 30 did not get local anesthesia (only GA. Thirty patients only received local anesthesia (LA. Subjective postoperative pain was determined by a visual analogue scale. Frequency of oculocardiac reflex, postoperative nausea and vomiting (PONV, and patient's comfort were assessed. Results: Postoperative pain was less in local anesthesia (LA compared to general anesthesia (GA (p < 0.0001. Additional preoperative application of local anesthesia (GA+LA+OP resulted in less pain than additional postoperative application (GA+OP+LA (p <0.05. Additional postoperative peribulbar block did not differ from general anesthesia (Only GA. The incidence of intraoperative oculocardiac reflex and postoperative nausea and vomiting was significantly less in patients with peribulbar block (P = .0001 and in GA+LA+OP group, as compared with others (P= 0.001. Conclusion: We conclude that preoperative local anesthesia (Only LA or in combination with general anesthesia provides the best comfort for the patient in eye surgery. Keywords: preemptive analgesia, analgesia, peribulbar block, postoperative pain, phacoemulcification, ocular surgery

H Zahedi

2005-03-01

127

Peritopic anesthesia: a new alternative in cataract surgery  

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Full Text Available José A Abreu,1 Rodrigo Abreu,2 Luis M Cordovés,1 José J Aguilar11Ophthalmology Department, University Hospital of the Canary Islands, Tenerife, Canary Islands, Spain; 2Ophthalmology Department, University Hospital of La Candelaria, Tenerife, Canary Islands, Spain We read with interest the recently published article "Superior subconjunctival anesthesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training program: a randomized controlled trial" by Pipat Kongsap,1 where the author studied possible differences in the clinical outcomes of superior subconjunctival anesthesia and retrobulbar anesthesia, in a residency training program.View original paper by Kongsap.

Abreu JA

2013-03-01

128

Cost of cataract surgery after implantation of three intraocular lenses  

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Full Text Available Catherine Boureau1, Antoine Lafuma2, Viviane Jeanbat2, Andrew F Smith3, Gilles Berdeaux41Clinique Geoffroy St Hilaire, Paris, France; 2Cemka-Eval, Bourg la Reine, France; 3Alcon Laboratories Ltd, Hemel Hempstead, UK and Nuffield Laboratory of Ophthalmology, University of Oxford, UK; 4Alcon France, Rueil Malmaison, France; Conservatoire National des Arts et Métiers, Paris, FranceBackground: Posterior capsule opacification is one of the most frequent adverse events following cataract surgery. This manuscript reports the lifetime cost of complications linked to posterior capsule opacification using three types of intraocular lens with square edges.Methods: Costs were estimated from a retrospective study of patients who underwent cataract surgery and data from the literature. The lenses studied were hydrophobic acrylic (SA60AT and AR40E and hydrophilic acrylic (XL-Stabi lenses with square edges. The frequency of Nd-Yag laser capsulotomies after 4 years’ survival was estimated by two methods: the first involved linear adjustment of the rate at 5 and 6 years follow-up and then application of a constant rate after 6 years; the second involved linear adjustment after 5 years follow-up. The economic perspective was that of the French Sickness Fund.Results: After 3 years’ follow-up the percentage of patients who had not undergone laser Nd-Yag capsulotomy was 86.9% with SA60AT, 76.6% with AR40E and 54.6% with XL-Stabi lenses (p < 0.001. The total cost of capsulotomy and management of complications per patient lifetime was estimated to be €90.5 for SA60AT, €189.5 for AR40E and €288.0 for XL-Stabi lenses by the first extrapolation method. With the second method of extrapolation the costs were €94.8, €200.0 and €300.2, respectively.Interpretation: Lower costs for cataract surgery and management of related complications were observed with the two hydrophobic acrylic lenses; the lowest costs were observed with SA60AT lenses as they were associated with fewer Nd-Yag laser capsulotomies.Keywords: cataract surgery, Nd-Yag laser, capsulotomy, adverse event, cost, budget impact

Catherine Boureau

2009-03-01

129

Is ultrasonography essential before surgery in eyes with advanced cataracts?  

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Full Text Available Background: Ultrasonography is an important tool for evaluating the posterior segment in eyes with opaque media. Aim: To study the incidence of posterior segment pathology in eyes with advanced cataract and to see whether certain features could be used as predictors for an abnormal posterior segment on ultrasound. Setting: Tertiary care hospital in South India. Methods and Materials: In this prospective study conducted over a 6-month period, all eyes with dense cataracts precluding visualization of fundus underwent assessment with ultrasound. Presence of certain patient and ocular "risk" factors believed to be associated with a higher incidence of abnormal posterior segment on ultrasound were looked for and the odds ratio (OR for posterior segment pathology in these eyes was calculated. Results: Of the 418 eyes assessed, 36 eyes (8.6% had evidence of posterior segment pathology on ultrasound. Retinal detachment (17 eyes; 4.1% was the most frequent abnormality detected. Among patient features, diabetes mellitus (OR= 4.9, P=0.003 and age below 50 years (OR= 15.4, P=0.001 were associated with a high incidence of abnormal ultrasound scans. In ocular features, posterior synechiae (OR= 20.2, P=0.000, iris coloboma (OR= 34.6, P=0.000, inaccurate projection of rays (OR= 15.1, P=0.002, elevated intraocular pressure (OR= 15.1, P=0.004, and keratic precipitates (OR= 22.4, P=0.004 were associated with high incidence of posterior segment pathology. Only four eyes (1.5% without these features had abnormal posterior segment on ultrasonography. Conclusions: Certain patient and ocular features are indicative of a high risk for posterior segment pathology and such patients should be evaluated by ultrasonography prior to cataract surgery. In the absence of these risk factors, the likelihood of detecting abnormalities on preoperative ultrasonography in eyes with advanced cataracts is miniscule.

Salman Amjad

2006-01-01

130

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

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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. (author)

131

Cataracts  

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Full Text Available ... patients to have cataracts. A personal or family history of cataracts can also increase the chances of ... Options Your doctor will take a detailed medical history and do a thorough eye examination in order ...

132

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

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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

2011-09-01

133

Treatment experience of posterior capsular rupture in phaco-cataract surgery  

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Full Text Available AIM: To study the complications of phaco-cataract surgery.METHODS: Totally, 500 eyes underwent phaco-cataract surgery were retrospectively analysis from January 2008 to January 2011. RESULTS: In all 500 cases(500 eyeswith age-related cataract by phaco-cataract surgery, posterior capsular rupture were occurred in 45 eyes(9.0%. Of them, 33 eyes(6.6%were complicated by posterior capsular rupture among before 250 eyes, 12 eyes(2.4%arose posterior capsular rupture in after 250 eyes. CONCLUSION: Surgical treatment posterior capsular rupture must be according to different situation in phaco-cataract surgery. Choosing different modes of artificial lens implantation can achieve good treatment effect.

Xiao-Cheng Lin

2013-12-01

134

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

2012-01-01

135

Cirugía de catarata en pacientes vitrectomizados / Cataract surgery in vitrectomized patients  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish La vitrectomía pars plana en el desprendimiento de retina, así como la cirugía de patologías maculares y de la retinopatía diabética, entre otras, exacerba la progresión y el desarrollo de catarata en pacientes fáquicos, considerada una complicación frecuente de esta intervención. La extracción de c [...] atarata en ojos con cirugía vítrea previa se caracteriza por una serie de diferencias que particularizan a este tipo de pacientes. Esta particularidad motivó la siguiente revisión con el propósito de hacer referencia a algunos factores que influyen en el desarrollo o progresión de la catarata después de la vitrectomía pars plana, complicaciones de los sustitutos vítreos, opciones en la realización simultánea o secuencial de la cirugía de segmento anterior y posterior. Se aborda también algunas consideraciones pre y transoperatorias de la cirugía de catarata en ojos vitrectomizados, así como complicaciones trans y postoperatorias. La capacidad visual puede mejorar significativamente luego de la cirugía de catarata, sin embargo, la cuantía de la misma estará determinada por la extensión y severidad de la patología vítreo-retiniana de base. Abstract in english Pars plana vitrectomy in retinal detachment as well as in macular pathology and diabetic retinopathy surgeries, among others, exacerbated the progression and the development of cataract in phakic patients, which is considered a common complication of this intervention. Cataract extraction in eyes th [...] at underwent previous vitreous surgery is characterized by a series of differences that particularize this type of patients. This particularity encouraged the following review to mention some factors influencing the development or the progression of cataract after pars plana vitrectomy, complications of vitreous replacements, options in simultaneous or sequential performance of the anterior and posterior segment surgery. It also dealt with some preoperative and transoperative considerations of the cataract surgery in vitrectomized eyes as well as transoperative and postoperative complications. The visual capacity may significantly improve after the cataract surgery; however, the magnitude of such capacity will be determined by the extension and severity of the underlying vitreous-retinal pathology.

Ailen, Garcés Fernández; Suzel, Veitía Rovirosa; Iván, López Hernández.

2013-12-01

136

Cirugía de catarata en pacientes vitrectomizados / Cataract surgery in vitrectomized patients  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish La vitrectomía pars plana en el desprendimiento de retina, así como la cirugía de patologías maculares y de la retinopatía diabética, entre otras, exacerba la progresión y el desarrollo de catarata en pacientes fáquicos, considerada una complicación frecuente de esta intervención. La extracción de c [...] atarata en ojos con cirugía vítrea previa se caracteriza por una serie de diferencias que particularizan a este tipo de pacientes. Esta particularidad motivó la siguiente revisión con el propósito de hacer referencia a algunos factores que influyen en el desarrollo o progresión de la catarata después de la vitrectomía pars plana, complicaciones de los sustitutos vítreos, opciones en la realización simultánea o secuencial de la cirugía de segmento anterior y posterior. Se aborda también algunas consideraciones pre y transoperatorias de la cirugía de catarata en ojos vitrectomizados, así como complicaciones trans y postoperatorias. La capacidad visual puede mejorar significativamente luego de la cirugía de catarata, sin embargo, la cuantía de la misma estará determinada por la extensión y severidad de la patología vítreo-retiniana de base. Abstract in english Pars plana vitrectomy in retinal detachment as well as in macular pathology and diabetic retinopathy surgeries, among others, exacerbated the progression and the development of cataract in phakic patients, which is considered a common complication of this intervention. Cataract extraction in eyes th [...] at underwent previous vitreous surgery is characterized by a series of differences that particularize this type of patients. This particularity encouraged the following review to mention some factors influencing the development or the progression of cataract after pars plana vitrectomy, complications of vitreous replacements, options in simultaneous or sequential performance of the anterior and posterior segment surgery. It also dealt with some preoperative and transoperative considerations of the cataract surgery in vitrectomized eyes as well as transoperative and postoperative complications. The visual capacity may significantly improve after the cataract surgery; however, the magnitude of such capacity will be determined by the extension and severity of the underlying vitreous-retinal pathology.

Ailen, Garcés Fernández; Suzel, Veitía Rovirosa; Iván, López Hernández.

137

The incidence of vitreous loss and visual outcome in patients undergoing cataract surgery in a teaching hospital.  

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Full Text Available Purpose: To determine the incidence of vitreous loss in patients undergoing cataract surgery and the visual outcome in a tertiary teaching hospital. Methods: Hospital records of 2095 consecutive patients undergoing cataract surgery between July 1999 and June 2000 were reviewed in this non-concurrent cohort study. Incidence and visual outcome of vitreous loss managed using standard vitrectomy techniques were assessed for different cataract surgical techniques (extracapsular, Blumenthal technique and phacoemulsification as well as at different levels of surgical training. The outcome was compared with matched cases without vitreous loss (controls. Results: Vitreous loss occurred in 160 of 2095 eyes (7.63%; CI -7 to 9.3: 8.3% for ECCE, 8.1% for the Blumenthal technique and 5% with phacoemulsification. Vision ? 6/18 was achieved in 85% of cases and 95% of controls. For experienced surgeons, 95% of the cases and controls had vision ? 6/18. 5.8 % of cases and 0.7% of controls had vision < 6/60. One patient in each group was blind following cataract surgery; both had operable cataracts in the fellow eye. Conclusions: The vitreous loss rate in this tertiary teaching hospital is relatively high. This complication, managed with standard surgical techniques, is compatible with good visual outcome. In eyes with vitreous loss, the final visual acuity achieved by experienced surgeons was similar to that in uncomplicated cases.

Kothari Mihir

2003-01-01

138

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

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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

2013-10-01

139

Day care cataract surgery in Central and Southern Italy: a multicentric survey  

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Full Text Available Abstract Background Cataract day surgery has rapidly gained worldwide acceptance, because the new surgical techniques and costs are generally lower than those involved in ordinary hospitalization. Cataract surgery serves as a proxy indicator of the trend towards day surgery hospitalization in Italy and, therefore, of regional variability in health-care delivery and cost. The aim of this study was to update the diffusion of cataract day surgery through various surgical ophthalmological centers in central and southern Italy during 2005. Methods A two-stage stratified cluster sampling method was used to draw a sample of Cataract Surgery Unit from Ophthalmic Units of central and southern Italy. A questionnaire was sent to 25 cataract surgery centers in nine health districts that represented the range of establishments (public, private, accredited or otherwise in which cataract surgery is performed. Data were collected on numbers of procedures performed in 2005, hospital admission type, time from the onset of cataract day surgery, surgical procedure, and presence of other surgical centers. Results The response rate was 42% (10 surveys, resulting in at least one completed questionnaire for each of these 9 districts. There is a positive trend towards day surgery hospitalization in all surgical centers. The percentage of patients treated as outpatients during 2005 varied from 50–60% (Avellino, Naples, Campobasso, to 80–90% (Rome, Bari, up to 90–100% (Catania, Palermo, Siracusa and Trapani, with an increasing trend in all the centers studied. Few differences were found in surgical procedures, and these were statistically insignificant. Conclusion Our results confirm a positive trend towards day surgery in place of hospital inpatient admission for cataract surgery. This trend is expected to close the existing regional gap in Italy. Increased efficiency is an overriding need for the National Health Service in order to improve the rationalization of resources.

Cillino Giovanni

2007-02-01

140

Frequency of retinal detachment after cataract surgery in highly myopic patients  

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Full Text Available Objectives: To determine the potential risk factors for retinal detachment after cataract surgery. Methods: In this retrospective cohort study, medical records of patients operated on between 2000 and 2010 at the Department of Ophthalmology, King  Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia were retrospectively reviewed for both demographic and clinical data. Cases were identified as having an ocular axial length ?25 mm, while a control group of 500 eyes (axial length range; 22-24 mm was sampled. Data were analyzed to compare both groups, and to assess potential risk factors for post-cataract retinal detachment. Results: We reviewed 852 eyes of 721 patients; 352 eyes with documented high myopia were compared with 500 control eyes. After a mean follow up of 45.1 ± 27.9 months, the postoperative mean LogMAR visual acuity significantly differed; 0.51 ± 0.48 for cases and 0.38 ± 0.41 for controls (ppp=0.007. High axial length was the only significant risk factor for retinal detachment (p=0.005 even after multivariate adjustment (p=0.019. Conclusion: High axial length among myopic cataract patients may increase the risk of postoperative retinal detachment. 

Sultan Al-Rashidy

2013-05-01

 
 
 
 
141

Subnormal Vision in Uneventful Cataract Surgery after 6 Weeks – Hospital Based Study  

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Full Text Available Background: With accurate estimation of power of intraocular lens (IOL, uncomplicated cataract surgery and uneventful post operative period, the implant is capable of providing a visual acuity of 6/6 and a normal field of vision. However, post operative results are not always according to the expectations. This study is an attempt to find out causes of subnormal vision post uneventful cataract surgery with posterior chamber intraocular lens by various surgical techniques in Krishna Institute of Medical Sciences, Karad, Maharashtra, India. Aims and Objectives: To study the incidence of subnormal vision in patients who have undergone uneventful cataract surgery with posterior chamber IOL implant and relation between the type of surgery and IOL used and its effect on the subnormal vision post operatively, in Krishna Hospital. Material and Methods: 185 patients among 1230 who underwent uneventful cataract surgery were diagnosed to have sub-normal vision in our study, over the period of 18 months. All pseudophakic patients, who have undergone uneventful cataract surgery, with normal pre-operative assessment were included in the study. Diabetic and hypertensive patients without any maculopathy were also included. Patients with intra operative complications, traumatic cataract, complicated cataract and pre existing pathology were excluded. Result: Prevalence of sub-normal vision in our study was approximately 14.18%. Among all the causes of sub-normal vision, incidence of posterior capsular opacification (PCO was maximum, (80.87%. Incidence of PCO was least in foldable IOLs as compared to square edge and non square edge.

V. H. Karambelkar

2014-07-01

142

A survey of potential and previous cataract-surgery patients: what the ophthalmologist should know  

Directory of Open Access Journals (Sweden)

Full Text Available Bonnie An Henderson,1 Kerry Solomon,2 Samuel Masket,3 Richard Potvin,4 Edward J Holland,5 Robert Cionni,6 Helga Sandoval2 1Ophthalmic Consultants of Boston, Boston, MA, 2Carolina Eyecare Research Institute, Carolina Eyecare Physicians, Mount Pleasant, SC, 3Advanced Vision Care, Los Angeles, CA, 4Science in Vision, Akron, NY, 5Cincinnati Eye Institute, Cincinnati, OH, 6Eye Institute of Utah, Salt Lake City, UT, USA Objective: This study utilized a phone survey to characterize patient perceptions of cataract surgery and the manner in which the ophthalmologist contributes to the patient’s understanding in electing cataract surgery.Patients and methods: Calls were made from a randomized membership list of the American Association of Retired Persons until 1,000 respondents 50 years of age or older had been recruited. Three groups were recruited: persons with no prior diagnosis of cataracts, persons diagnosed with cataracts but who had not had surgery, and persons who had had cataract surgery on both eyes within the past 5 years. A series of fixed-choice and open-ended questions was then presented to qualified participants. Questions related to vision, quality of life, and the understanding and perceptions of cataract surgery.Results: Two-thirds of respondents reported having frequent eye examinations. More than half indicated that they had discussed cataract surgery with an eye doctor, most often with an ophthalmologist. They reported that the benefits of surgery were most often mentioned (68%, but lens options were infrequently mentioned (39%. Of those who had had surgery, 81% elected to do so on the advice of their health care professional. About 85% of respondents who had had surgery felt well educated about the procedure, though only 75% felt they understood their lens and vision options. Three-quarters of those who had had cataract surgery wished they had had the surgery sooner, and reported that they were enjoying life more after surgery.Conclusion: The ophthalmologist plays an important role in preparing patients for cataract surgery. Discussing both the timing of the surgery and the patient’s lens options are critical for appropriate care; the survey results suggest room for improvement in this regard. Respondents reported they wished they had had surgery sooner, based primarily on their improved quality of life postoperatively. Keywords: cataract surgery, intraocular lens, perception, quality of life

Henderson BA

2014-08-01

143

Cataracts  

Science.gov (United States)

... U.S. Prevalent Cases of Cataract (in thousands) by Age, Gender, and Race/Ethnicity Female/Age White Black Hispanic ... U.S. Prevalent Cases of Cataract (in thousands) by Age, Gender, and Race/Ethnicity Female/Age White Black Hispanic ...

144

Cataracts  

Medline Plus

Full Text Available ... Introduction A cataract is a clouding of the eye’s lens. Cataracts are a common eye condition that affect many people aged 65 or ... how they can be treated surgically. Anatomy Our eyes are very sophisticated optical organs that collect light ...

145

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

2007-01-01

146

Cirurgia de catarata realizada por residentes: avaliação dos riscos Cataract surgery performed by residents: risk analysis  

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Full Text Available OBJETIVO: Avaliar a frequência de complicações nas cirurgias de catarata realizada por residentes de um hospital universitário (segundo e terceiro anos, comparado com as realizadas por cirurgiões experientes (assistentes. MÉTODOS: Análise retrospectiva dos prontuários de todos pacientes submetidos à cirurgia de catarata realizadas nas primeiras quinzenas de março (época do início do aprendizado da técnica cirúrgica e de novembro (meados do aprendizado da técnica. Foram analisados a época da realização da cirurgia; graduação do cirurgião (residente ou médico assistente; técnica cirúrgica empregada (extração extracapsular ou facoemulsificação e a ocorrência de complicações per-operatórias e pós-operatórias. RESULTADOS: Foram analisadas 481 cirurgias, destas, 194 (40% foram realizadas pelos residentes do terceiro ano, 165 (34% pelos residentes do segundo ano e 116 (26% pelos assistentes. A complicação mais frequentemente encontrada em todas as cirurgias foi a rotura de cápsula posterior (4,8%. Não houve diferença estatisticamente significativa de complicações entre as cirurgias realizadas em março e novembro (p=0,97, bem como entre os residentes sob supervisão e os assistentes (p=0,08. CONCLUSÃO: A rotura de cápsula posterior continua sendo a complicação mais frequentemente encontrada nas cirurgias de residentes em treinamento. Não houve diferença estatisticamente significativa entre as taxas de complicação destes residentes e os assistentes, o que demonstra o importante papel de uma supervisão adequada.PURPOSE: To evaluate the complication's rate of cataract surgery performed by ophthalmology residents (second and third-year and experienced surgeons at a public teaching hospital. METHODS: A retrospective chart review of all patients who had cataract surgery between March (begin of the technique practice and November (end of the technique practice was conducted. RESULTS: In 481 cataracts surgeries, 194 (40% was performed by third-year residents, 165 (34% by second-year residents and 116 (26% by experienced surgeons. The most frequent complication in all surgeries was the posterior capsule rupture (4,8%. No statistical diference was found between the residents and experienced surgeons complication's rates (p=0,08. CONCLUSION: The posterior capsule rupture remains the most frequent complication during the cataract surgery learning curve. In this study there was no statistical difference between residents and experienced surgeons, which demonstrates the important role of adequate supervision of the surgeires.

Jackson Barreto Junior

2010-10-01

147

Cirurgia de catarata realizada por residentes: avaliação dos riscos / Cataract surgery performed by residents: risk analysis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar a frequência de complicações nas cirurgias de catarata realizada por residentes de um hospital universitário (segundo e terceiro anos), comparado com as realizadas por cirurgiões experientes (assistentes). MÉTODOS: Análise retrospectiva dos prontuários de todos pacientes submetidos [...] à cirurgia de catarata realizadas nas primeiras quinzenas de março (época do início do aprendizado da técnica cirúrgica) e de novembro (meados do aprendizado da técnica). Foram analisados a época da realização da cirurgia; graduação do cirurgião (residente ou médico assistente); técnica cirúrgica empregada (extração extracapsular ou facoemulsificação) e a ocorrência de complicações per-operatórias e pós-operatórias. RESULTADOS: Foram analisadas 481 cirurgias, destas, 194 (40%) foram realizadas pelos residentes do terceiro ano, 165 (34%) pelos residentes do segundo ano e 116 (26%) pelos assistentes. A complicação mais frequentemente encontrada em todas as cirurgias foi a rotura de cápsula posterior (4,8%). Não houve diferença estatisticamente significativa de complicações entre as cirurgias realizadas em março e novembro (p=0,97), bem como entre os residentes sob supervisão e os assistentes (p=0,08). CONCLUSÃO: A rotura de cápsula posterior continua sendo a complicação mais frequentemente encontrada nas cirurgias de residentes em treinamento. Não houve diferença estatisticamente significativa entre as taxas de complicação destes residentes e os assistentes, o que demonstra o importante papel de uma supervisão adequada. Abstract in english PURPOSE: To evaluate the complication's rate of cataract surgery performed by ophthalmology residents (second and third-year) and experienced surgeons at a public teaching hospital. METHODS: A retrospective chart review of all patients who had cataract surgery between March (begin of the technique p [...] ractice) and November (end of the technique practice) was conducted. RESULTS: In 481 cataracts surgeries, 194 (40%) was performed by third-year residents, 165 (34%) by second-year residents and 116 (26%) by experienced surgeons. The most frequent complication in all surgeries was the posterior capsule rupture (4,8%). No statistical diference was found between the residents and experienced surgeons complication's rates (p=0,08). CONCLUSION: The posterior capsule rupture remains the most frequent complication during the cataract surgery learning curve. In this study there was no statistical difference between residents and experienced surgeons, which demonstrates the important role of adequate supervision of the surgeires.

Jackson, Barreto Junior; Helio, Primiano Junior; Rodrigo França de, Espíndola; Renato Antunes Schiave, Germano; Newton, Kara-Junior.

2010-10-01

148

Uncorrected visual acuity in the immediate postoperative period following uncomplicated cataract surgery: bimanual microincision cataract surgery versus standard coaxial phacoemulsification.  

LENUS (Irish Health Repository)

AIM: We compared bimanual microincision cataract surgery (MICS) and standard coaxial phacoemulsification (CAP) in terms of uncorrected visual acuity (UCVA) recorded 1 h and 2 weeks postoperatively. METHODS: This was a prospective, nonrandomised comparative study. All MICS procedures were performed by one surgeon (MGM), and all CAP procedures were performed by another surgeon (SB). Eyes with visually consequential ocular morbidity were excluded. The primary outcome measure was UCVA recorded 1 h postoperatively. RESULTS: One hundred eyes underwent MICS and CAP (50 eyes in each group). The treatment groups did not differ significantly in terms of preoperative mean best corrected visual acuity (6\\/24 +\\/- 4.3 lines and 6\\/20 +\\/- 4.4 lines in the MICS and the CAP groups, respectively; P = 0.65). Also, there was no significant difference in terms of postoperative UCVA at 1 h or at 2 weeks (mean +\\/- standard deviation UCVA 1 h postoperatively: MICS: 6\\/36 +\\/- 5.7 lines; CAP: 6\\/30 +\\/- 4.7 lines; P = 0.80; UCVA 2 weeks postoperatively: MICS: 6\\/10 +\\/- 1.9 lines; CAP: 6\\/10 +\\/- 2.2 lines; P = 0.90). However, nine eyes (18%) and one eye (2%) achieved a UCVA of C6\\/12 at 1 h following MICS and CAP, respectively, and this difference was statistically significant (P = 0.02). CONCLUSION: Mean UCVA at 1 h and at 2 weeks following cataract surgery was not significantly different between eyes undergoing MICS and CAP. However, a greater proportion of patients achieved a UCVA of C6\\/12 following MICS when compared with CAP.

Saeed, Ayman

2012-02-01

149

Remifentanil versus fentanyl in combination with midazolam for retrobulbar block in cataract surgery.  

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Remifentanil and fentanyl are both efficient and comparable opioid adjuncts to midazolam providing low injection pain and high satisfaction level with hemodynamic stability in cataract surgery under retrobulbar injection.

Oya Y. Cok

2008-04-01

150

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

International Nuclear Information System (INIS)

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

151

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

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Full Text Available 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 extracapsular cataract surgery to MSICS, one can perform a can-opener capsulotomy and prolapse the nucleus. However, it is safer and better to perform a capsulorrhexis and hydroprolapse the nucleus, as it makes the rest of the steps of MSICS comfortable. Use of trypan blue in white and brown cataracts makes the capsulorrhexis and prolapse simple and safe. Extra caution should be taken in cases with hypermature cataracts with weak zonules and subluxated cataracts.

Venkatesh Rengaraj

2009-01-01

152

Cataracts  

Medline Plus

Full Text Available ... reached by you and your doctor together. This reference summary will help you understand what cataracts are ... day and a shield at night. You should call your doctor if you have symptoms such as ...

153

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 ...

154

Cataract surgery at Aravind Eye Hospitals: 1988–2008  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 las...

Natchiar, G.; Rd, Thulasiraj; Meenakshi Sundaram, R.

2008-01-01

155

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish 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 adqu [...] irido 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 cirujanos 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 providi [...] ng 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 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.

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

2013-04-01

156

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish 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 durante 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. I [...] t 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 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.

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

157

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish 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 adqu [...] irido 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 cirujanos 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 providi [...] ng 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 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.

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

158

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish 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 durante 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. I [...] t 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 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.

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

2012-12-01

159

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 durante 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.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 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.

Henry Pérez González

2012-12-01

160

Endophthalmitis: controlling infection before and after cataract surgery  

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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

2008-03-01

 
 
 
 
161

Changes in intraocular pressure and anterior segment morphometry after uneventful phacoemulsification cataract surgery.  

LENUS (Irish Health Repository)

PURPOSE: To study changes in anterior segment morphometry after uneventful phacoemulsification cataract surgery, and to investigate whether there is a relationship between any observed changes and intraocular pressure (IOP) reduction after the procedure. METHODS: The anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), central corneal thickness (CCT), and IOP were measured in 101 non-glaucomatous eyes before and after uneventful phacoemulsification cataract surgery. RESULTS: After cataract surgery, the mean ACD, ACV, and ACA values increased by 1.08 mm, 54.4 mm(3), and 13.1 degrees , respectively, and the mean IOP (corrected for CCT) decreased by 3.2 mm Hg. The predictive value of a previously described index (preoperative ACD\\/preoperative IOP (corrected for CCT) or CPD ratio) for IOP (corrected for CCT) reduction after cataract surgery was confirmed, reflected in an r(2) value of 23.3% between these two parameters (P<0.001). Other indices predictive of IOP reduction after cataract surgery were also identified, including preoperative IOP\\/preoperative ACV and preoperative IOP\\/preoperative ACA, reflected in r(2) values of 13.7 and 13.7%, respectively (P<0.001 and P<0.001, respectively). CONCLUSIONS: Our study confirms the predictive value of the CPD ratio for IOP reduction after cataract surgery, and may contribute to the decision-making process in patients with glaucoma or ocular hypertension. Furthermore, two novel indices of preoperative parameters that are predictive for IOP reduction after cataract surgery were identified, and enhance our understanding of the mechanisms underlying IOP changes after this procedure.

Dooley, I

2012-02-01

162

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.

Yuan Rongdi

2011-03-01

163

Unusually delayed presentation of persistent Descemet’s membrane tear and detachment after cataract surgery  

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Full Text Available Melina I Morkin,1,2 Rehan M Hussain,2 Ryan C Young,2 Tracy Ravin,2 Sander R Dubovy,2 Eduardo C Alfonso2 1Department of Ophthalmology, Shiley Eye Center, University of California – San Diego, San Diego, CA, 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Abstract: A 51-year-old male who had undergone phacoemulsification in his left eye 11 months prior presented with complaint of sudden onset of blurred vision in the same eye. Review of his clinical course, slit-lamp exam, pachymetry, and specular endothelial microscopy led to the diagnosis of acute hydrops caused by Descemet’s membrane dehiscence at the site of the incision. He was initially managed with medical treatment and observation. In the subsequent months of follow-up, the corneal edema and the patient’s visual acuity did not improve. Intracameral gas injection was performed 7 months after presentation, but because of persistent corneal edema and nonattached Descemet’s membrane, penetrating keratoplasty was performed. Histopathologic examination confirmed the diagnosis. The patient has had a clear corneal graft since then. Although Descemet’s membrane detachment is a rather common complication after intraocular surgery, its unusually delayed presentation can also occur, and should not be confused with pseudophakic bullous keratopathy. Many mechanisms have been studied for the development of early tears and detachments after cataract surgery, but little is known about late presentations. The authors explore possible causes, and highlight the importance of instructing patients to avoid eye rubbing and any other type of trauma to the cornea after intraocular surgery. Keywords: Descemet’s membrane tear, detachment, cataract surgery, phacoemulsification

Morkin MI

2014-08-01

164

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

2010-01-01

165

Cataracts  

International Nuclear Information System (INIS)

Several months to years after exposure to ionizing radiation of the atomic bombs (A-bombs), some survivors developed cataracts. The characteristic clinical finding was a localized lenticular opacity on the inner surface of the posterior polar capsule presenting a polychromatic sheen, and punctate opacities or aggregations thereof in the subcapsular cortical layer of the posterior polar region. In the majority of the affected survivors, the degree of opacification of these radiation cataracts was minimal to moderate and remained unchanged. These cases had no other subjective disturbances associated with this condition. (auth.)

166

Adoption of intracameral antibiotic prophylaxis of endophthalmitis following cataract surgery: update on the ESCRS Endophthalmitis Study.  

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To determine the use of intracameral cefuroxime at the end of cataract surgery since the beneficial results were first reported by the European Society of Cataract and Refractive Surgeons Endophthalmitis Study Group in 2006, 250 ophthalmic surgeons affiliated with both public and private hospitals and clinics across Europe were surveyed. The questions regarded their awareness of the results of the ESCRS endophthalmitis study and their current use or non-use of intracameral antibiotics in their cataract procedures. Seventy-four percent of respondents said they always or usually use intracameral antibiotics in their cataract surgery procedures. The most frequently cited reasons for not using cefuroxime or other intracameral antibiotics was the lack of an approved commercial preparation and related anxieties regarding the risk of dilution errors and contamination. More than 90% of respondents said they would use cefuroxime if an approved single-unit dose product were commercially available. PMID:24355725

Barry, Peter

2014-01-01

167

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

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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. PMID:21723632

Weale, Martin

2011-07-01

168

RABBIT GENERAL ANESTHESIA FOR CATARACT SURGERY USING CISATRACURIUM AS NEUROMUSCULAR BLOCKING DRUG. CASE STUDY  

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Surgeries on rabbits are more and more frequently as they are used as pet animals and the owner is interested in their welfare. Cataract surgery is already a routine intervention in small animals as dogs and cats. This is why the aim of this study is to present a case study of a rabbit anesthesia for cataract surgery. Our subject was a three year old female laboratory rabbit which weight 2.07 kg. We premedicated him using butorphanol 0.4 mg/kg and midazolam 1 mg/kg subcutaneous 30 minutes bef...

Tutunaru, Alexandru Cosmin; S?onea, Alexandru; Sandersen, Charlotte

2012-01-01

169

Cataract surgery in Southern Ethiopia: distribution, rates and determinants of service provision  

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Background Cataract is the leading cause of blindness worldwide, with the greatest burden found in low-income countries. Cataract surgery is a curative and cost-effective intervention. Despite major non-governmental organization (NGO) support, the cataract surgery performed in Southern Region, Ethiopia is currently insufficient to address the need. We analyzed the distribution, productivity, cost and determinants of cataract surgery services. Methods Confidential interviews were conducted with all eye surgeons (Ophthalmologists & Non-Physician Cataract Surgeons [NPCS]) in Southern Region using semi-structured questionnaires. Eye care project managers were interviewed using open-ended qualitative questionnaires. All eye units were visited. Information on resources, costs, and the rates and determinants of surgical output were collected. Results Cataract surgery provision is uneven across Southern Region: 66% of the units are within 200 km of the regional capital. Surgeon to population ratios varied widely from 1:70,000 in the capital to no service provision in areas containing 7 million people. The Cataract Surgical Rate (CSR) in 2010 was 406 operations/million/year with zonal CSRs ranging between 204 and 1349. Average number of surgeries performed was 374 operations/surgeon/year. Ophthalmologists and NPCS performed a mean of 682 and 280 cataract operations/surgeon/year, respectively (p?=?0.03). Resources are underutilized, at 56% of capacity. Community awareness programs were associated with increased activity (p?=?0.009). Several factors were associated with increased surgeon productivity (p?2 years, working in a NGO/private clinic, working in an urban unit, having a unit manger, conducting outreach programs and a satisfactory work environment. The average cost of cataract surgery in 2010 was US$141.6 (Range: US$37.6–312.6). Units received >70% of their consumables from NGOs. Mangers identified poor staff motivation, community awareness and limited government support as major challenges. Conclusions The uneven distribution of infrastructure and personnel, underutilization by the community and inadequate attention and support from the government are limiting cataract surgery service delivery in Southern Ethiopia. Improved human resource management and implementing community-oriented strategies may help increase surgical output and achieve the “Vision 2020: The Right to Sight” targets for treating avoidable blindness. PMID:24245754

2013-01-01

170

Cataracts  

Medline Plus

Full Text Available ... before reaching the back of the eye, the light rays travel through a transparent substance called the vitreous. The ... cases of cataracts, eyeglasses may help temporarily. As time goes by, the lens of the eye can become so cloudy that it blocks light from reaching the retina. This can reduce vision ...

171

Cataracts  

Medline Plus

Full Text Available ... the eye 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 the eye ...

172

Causes of subnormal vision in patients following cataract surgery at a tertiary hospital in Kashmir.  

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Cataract surgery is aimed at restoring sight to near normal vision. This study, conducted at the Department of Ophthalmology, Government Medical College, Srinagar, is an attempt to determine the causes of subnormal vision in patients following cataract surgery at a tertiary hospital in Kashmir. One hundred patients who underwent cataract surgery with an unaided visual acuity of cataract extraction (ECCE), 30 underwent small incision cataract surgery (SICS) and 30 underwent phacoemulsification. Seventy-five percent of the patients who underwent ECCE had postoperative astigmatism with a mean astigmatism of 2.2 ± 0.81 diopters at 16 weeks, with the majority having with-the-rule astigmatism. In the SICS group, 17 (56.6 %) patients had a mean postoperative astigmatism of 0.75 ± 0.40 diopters, with the majority (82.3 %) having against-the-rule (ATR) astigmatism. In the phacoemulsification group, 13 (43.3 %) of the patients had a mean postoperative astigmatism of 0.48 ± 0.23 diopters with the majority having ATR astigmatism. Other causes of subnormal vision were pseudophakic ametropia, posterior capsular opacity and intraoperative complications like posterior capsular rent and vitreous loss. Postoperative astigmatism was the major cause of subnormal vision with greater astigmatism seen in the ECCE group. Therefore, procedures like smaller incision sutureless surgery and careful biometry are advocated to improve visual outcome and patient satisfaction. PMID:24522881

Ahangar, Andleeb; Sufi, Aalia Rasool; Nabi, Mushood; Rather, Muddasar Hassan

2014-10-01

173

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

2008-09-01

174

The Effect of Multivitamin/Mineral Supplements on Age-Related Cataracts: A Systematic Review and Meta-Analysis  

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Full Text Available Antioxidant vitamins supplements have been suggested as a strategy to decrease the risk of age-related cataract development. However, the results from observational studies and interventional trials of associations between antioxidant vitamins A, C, and E and cataract development have been inconsistent. We aim to evaluate the effectiveness of multivitamin/mineral supplements for decreasing the risk of age-related cataracts by conducting a systematic review and meta-analysis. In September 2013, we searched multiple databases to identify relevant studies including both cohort studies and randomized controlled trials (RCTs. A random-effects model was used to calculate the pooled relative risks (RR with a 95% confidence interval (CI. Twelve prospective cohort studies and two RCTs were included. Pooled results from the cohort studies indicated that multivitamin/mineral supplements have a significant beneficial effect in decreasing the risk of nuclear cataracts (RR: 0.73; 95% CI: 0.64–0.82, cortical cataracts (RR: 0.81; 95% CI: 0.68–0.94, and any cataracts (RR: 0.66; 95% CI: 0.39–0.93. In addition, there were no decreases in the risk of posterior capsular cataracts (RR: 0.96; 95% CI: 0.72–1.20 or cataract surgery (RR: 1.00; 95% CI: 0.92–1.08. The two RCTs demonstrated that multivitamin/mineral supplements could decrease the risk of nuclear cataracts. There is sufficient evidence to support the role of dietary multivitamin/mineral supplements for the decreasing the risk of age-related cataracts.

Li-Quan Zhao

2014-02-01

175

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

2012-01-01

176

Congenital cataract surgery during the early enlightenment period and the Stepkins oculists.  

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From antiquity through the Renaissance, congenital blindness was generally regarded as incurable, as noted in both medical and lay publications. The earliest reference to congenital cataract surgery that we identified, reported in 1663, referred to an 18-year-old female treated by English oculist John Stepkins (d. 1652). An examination of the literature related to the Stepkins family reveals the presence of male and female oculists during that period, including his daughter, Lady Theodosia Ivy. Eye waters attributed to Stepkins contained tutty (an oxide of zinc), roses, sugar candy, and other ingredients. Interestingly, John Thomas Woolhouse, the author of the next identified report of congenital cataract surgery in 1706, stated that he was related to Stepkins. Woolhouse reported by 1721 that he had performed 36 congenital cataract surgeries, with the youngest patient being 18 months of age. PMID:24810006

Leffler, Christopher T; Schwartz, Stephen G; Davenport, Byrd

2014-07-01

177

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

2012-07-01

178

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

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Full Text Available SciELO Public Health | Language: English 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, rehabilit [...] ation 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.

2012-07-01

179

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English 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, rehabilit [...] ation 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.

180

Surgical approaches to posterior polar cataract: a review  

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The aim of this study is to provide a comprehensive overview of surgical methods used in the emulsification of posterior polar cataracts (PPCs) that have been devised to minimize the risk of posterior capsule rupture (PCR) and its consequences. A Pubmed and Medline search of relevant literature on PPC was done. Only articles relevant to the treatment of PPC were included. The posterior capsule in eyes with PPC are known to have an abnormal adhesion to the polar opacity or a pre-existing weakness of the capsule that predisposes the eye to PCR. To circumvent the consequences of cleaving the abnormal adhesion, a majority of the surgeons use the anterior approach through the limbus, whereas some advocate the posterior approach through the pars plana. Emulsifying the nucleus and cleaving the central opacity of the PPC off the posterior capsule without disrupting its integrity provides optimal surgical outcomes. To achieve this, various modifications have been applied by surgeons during different phases of surgery. The advantages, disadvantages, complications, and results of each method have been discussed. Phacoemulsification is the preferred technique for removing PPC. This review will provide methods to avoid and /or deal with intraocular surgical difficulties that can arise during emulsification. Employing these would result in least ocular morbidity and satisfactory visual outcomes for the patient. This is particularly relevant given the major advancements in technology and refinements in surgical techniques in phacoemulsification. PMID:22441026

Vasavada, A R; Raj, S M; Vasavada, V; Shrivastav, S

2012-01-01

 
 
 
 
181

Towards achieving small-incision cataract surgery 99.8% of the time.  

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Full Text Available A surgical approach designed to reliably attain the modern goal of small incision cataract surgery 99.8% of the time is described. Phacoemulsification as well as a manual small incision technique is utilised to achieve the desired outcome as often as possible and for all types of cataracts. The logic, and required surgical steps are described and illustrated. This surgical technique allows the advantages of small incision surgery to be reliably achieved. The method is flexible and allows decisions and steps to be modified depending on the skill and comfort zone of the individual surgeon.

Thomas R

2000-01-01

182

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.

Twyana Shankha N

2011-01-01

183

Quality of life after first- and second- eye cataract surgery on community project in Lombok Island, West Nusa Tenggara, Indonesia  

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Full Text Available Background: This study aims to assess the quality of life and the time trade off-utility value of the first eye cataract surgery and the second eye cataract surgery in Lombok Island-Indonesia. Methods: This was an epidemiologic survey study on community of cataract surgery. Evaluations of quality of life (QoL and time trade-off (TTO were performed using questionnaire prior and three weeks after cataract surgeries who had either first (group A or second eye cataract surgery (group B. Personal data was noted especially on self-care, mobility, socially, and mentally status. Data was analyzed by chi-square test for categorical data and unpaired t-test or Mann-Whitney test for numeric data. Results: A total of 77 subjects was included in this study, there were 50 subjects in group A and 27 subjects in group B. Elements of QoL were improved after surgeries including self care, mobility, social, and mental status in both groups (p < 0.001. The modified TTO was accepted in 35 subjects in group A and 22 subjects in group B. Quality of life was improved in 46 patients in group A, there was further improvement in 22 patients in group B. The degree of patient’s expectation was good in 87% of all subjects. Conclusion: Second- eye cataract surgery showed further improvement in QoL despite better outcome of the first- eye cataract surgery. The outcome of cataract surgery conducted was relevant to the patient’s expectation. (Med J Indones. 2013;22:107-13Keywords: First and second cataract surgery, quality of life, senile cataract, time trade-off

Tjahjono D. Gondhowiardjo

2013-06-01

184

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

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Full Text Available Atsushi Kawahara,1 Daijiro Kurosaka,2 Akitoshi Yoshida31Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, 2Department of Ophthalmology, Iwate Medical University, Morioka, 3Department of Ophthalmology, Asahikawa Medical University, Asahikawa, JapanBackground: 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 (P<0.05 in the one-handed technique group than in the two-handed technique group.Conclusion: The results indicate that the corneal side port in two-handed cataract surgery has a rotating effect on the axis of astigmatism.Keywords: cataract surgery, corneal side port, surgically induced astigmatism

Kawahara A

2013-10-01

185

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

1998-01-01

186

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)

187

Variation of cataract surgery costs in four different graded providers of China  

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Full Text Available Abstract Background China has the largest population of cataract patients in the world. However, the cataract surgery rate per million remains low in China. We carried out a survey on costs of cataract surgery from four different graded providers in China and analyzed differences in cost among these clinics. Methods 1,189 patients were recruited for the study in four eye clinics, located in two provinces, Guangdong province in southern China and Hubei province in central China. The average cost of each cataract surgery episode was calculated including cost of intraocular lens, cost of drugs and facility cost. We also collected information on reimbursement and disposable annual income of local residents. Results Mean total cost per cataract intervention of four different providers varied considerably, ranging from US$ 1,293 in Union Hospital to US$ 536 in Jingshan County Hospital. In all providers, except for Jingshan County Hospital, the cost exceeded annual disposable income of local rural residents. As to the proportion of patients with reimbursement, the figure for Union Hospital was only 36%, while for other three clinics it was more than 60%. There was a significant difference between mean reimbursement ratios, with the highest ratio in Zhongshan Ophthalmic Center being 71%. Conclusions Significant differences in costs of cataract surgery were found among the 4 different graded providers. A part of the cost was borne by patients. Proportion of patients with reimbursement and mean reimbursement ratios were higher in economically developed regions than in economically developing regions. Much more financial support should be directed into the rural New Cooperative Medical Scheme to raise the reimbursement ratio in rural China.

Fang Jiahua

2010-09-01

188

Time-trend and variations in the proportion of second-eye cataract surgery  

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Full Text Available Abstract Background Despite recommendations for greater use of second-eye cataract surgery and the bilateral progression of the disease, there is a substantial proportion of unmet need for this treatment. Few studies have explored the factors associated with second-eye cataract surgery utilisation. The objective of our study was to estimate the proportion of second-eye cataract surgery, evaluate its time-trend, and explore differences in utilisation by patients' gender, age, and region of residence. Methods All senile cataract surgeries performed between 1999 and 2002 in the public health system of Catalonia (Spain were obtained from the Minimum Data Set. The proportion of second-eye surgery from November 2000 to December 2002 was calculated. The time-trend of this proportion was characterised through linear regression models with the logarithmic transformation of time. Results The proportion of second-eye surgery was 30.0% and showed an increasing trend from 24.8% (95% Confidence Interval [CI] 21.6; 26.1 in November 2000 to 31.8% (95% CI 31.4; 33.6 in December 2002. This proportion was 1.9% (95% CI 0.9; 2.9 higher in women (p Conclusion We predict greater utilization of second-eye surgery in patients aged 70 to 79 years and in women. A greater increase in the utilisation rates of second-eye surgery is expected in the regions with lower proportions and in older patients. The observed trend suggests that there will be a substantial proportion of unmet need for bilateral surgery.

Bernal-Delgado Enrique

2007-04-01

189

The effects of diazepam on blood pressure levels in cataract surgery  

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Full Text Available Objectives: To evaluate the effects of oral diazepam on blood pressure (BP alterations in patients that underwent cataract surgery under topical anesthesia. Methods: A total of 147 patients that underwent phacoemulsification surgery under topical anesthesia, were reviewed retrospectively. The study took place in the Department of Ophthalmology, Adnan Menderes University Medical Faculty, Aydin, Turkey, between January 2011 and July 2013. Patients were divided into 2 groups: Group 1: received 5 mg diazepam per oral one hour prior to surgery, and Group 2 (control group: none administered preoperatively. The BP readings of all patients were scanned through their files. Five readings were chosen for statistical analysis. The first reading was taken in the ophthalmology ward on the morning of the operation, the second was taken in the premedication room just before the surgery, 2 readings were taken intraoperatively and recorded as third and fourth values, and the fifth reading was recorded from those taken in the ophthalmology ward after surgery. Results: Group 1 had a mean age of 62.17±10.01 years, while the Group 2 had a mean age of 64.31 ±10.88 years. There were no differences between the 2 groups by means of systolic and diastolic BP levels measured preoperatively in the ophthalmology ward. Intraoperative systolic and diastolic BP levels were significantly higher in Group 2 (p<0.001. Conclusion: Elevated BP can undermine surgical outcomes; and may lead to unforeseen complications. To prevent the elevation of BP to risky levels in the intraoperative period, diazepam administration may be beneficial, even in normotensive patients. 

Harun Çakmak

2014-07-01

190

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

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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 tothe 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.

Madsen, Kristoffer Hougaard

2013-01-01

191

Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial  

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Background/aim: A third of elderly people fall each year. Poor vision is associated with increased risk of falls. The authors aimed to determine if first eye cataract surgery reduces the risk of falling, and to measure associated health gain.

Harwood, R. H.; Foss, A. J. E.; Osborn, F.; Gregson, R. M.; Zaman, A.; Masud, T.

2005-01-01

192

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

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Full Text Available 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 Rodrigo Pessoa

2010-01-01

193

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

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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 with a mild vasoconstrictive action.

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

2011-01-01

194

Combined Anterior Sclera Staphylectomy and Vitrectomy with Anterior Sclera Staphyloma and Vitreous Hemorrhage Occurring 38 Years after Cataract Surgery  

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Introduction. To report a case of anterior sclera staphyloma and vitreous hemorrhage occurring over 38 years after bilateral cataract surgery. Methods. A 58-year-old man presented with anterior sclera staphyloma and vitreous hemorrhage in the right eye, after bilateral cataract surgery, over 38 years ago. We performed combined anterior sclera staphylectomy and vitrectomy of right eye for anterior sclera staphyloma and vitreous hemorrhage. Results. Forty-eight months after the combined surgery...

Qinxiang Zheng; Ronghan Wu; Wensheng Li

2011-01-01

195

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

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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

2011-06-01

196

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

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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

2013-09-01

197

Application of hands chopping cataract surgery in patients with microcoria  

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Full Text Available AIM: To discuss the safety of hands chopping phacoemulsification in patients with microcoria cataract. METHODS:Hands chopping phacoemulsification with intraocular lens implantation was used for the microcoria cataract of 30 patients(32 eyes. Their visual acuity, pupil, and complication were observed in postoperative 1d,1wk and 1mo. RESULTS: Postoperative naked vision be or more than 0.3 were in 27 eyes(84.4%at one day, be or more than 0.3 were in 30 eyes(93.8%at one week, be or more than 0.5 were in 28 eyes(87.5%at one month. All pupil returned to round or oval. No synechia happened in postoperative 1mo. CONCLUSION:Hands chopping nucleus operation is safe and effective for uveitis combined with microcoria phacoemulsification.

Bing-Jie Zhang

2014-06-01

198

Ocular coherence tomography of symptomatic phototoxic retinopathy after cataract surgery: a case report  

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Full Text Available Abstract Introduction High-resolution ocular coherence computed tomography enables unprecedented visualization of the retinal microarchitecture. To the best of our knowledge, this is the first report of high-resolution ocular coherence tomography findings in the healed form of photic post-cataract retinopathy. Case presentation A 76-year-old Caucasian man complained of paracentral scotoma, persisting for six weeks after cataract surgery. Conclusion Ocular coherence tomography demonstrated a localized juxta-foveal area of retinal atrophy involving the photoreceptor layer, and the retinal pigment epithelium layer.

Yunis Muhammad H

2011-04-01

199

Clinical profile and visual outcome in cluster endophthalmitis following cataract surgery in Central India  

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Full Text Available The purpose of this study was to determine clinical presentation, microbiological spectrum and visual outcome of cluster endophthalmitis patients after cataract surgery in central India. The records of cluster endophthalmitis patients were retrospectively reviewed. Three clusters of patients were identified who had undergone vitreous biopsy followed by three-port pars plana vitrectomy with intraocular antibiotics and steroids. Good visual outcome was seen in eight (33% of 24 patients. Six patients had corneal infiltration. Smear positivity was 58% and culture positivity was 42%. There was significant association ( P < 0.001 between presenting vision of < 20/400 and growth in vitreous culture ( P = 0.006 with poor visual outcome. The association between type of surgery ( P = 0.6, duration of symptoms ( P = 0.64 and corneal infiltration ( P = 0.06 with visual outcome was not significant. Pseudomonas aeruginosa was the organism isolated in vitreous cultures. Thirty three percent patients benefit after appropriate vitreoretinal intervention in cluster endophthalmitis.

Malhotra Sumeet

2008-01-01

200

Cataracts  

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Full Text Available ... of the eye is made of water and protein molecules. As we age, sometimes the molecules clump ... drive you home after the surgery. Removal of Hard Lens This procedure is usually done under regional, ...

 
 
 
 
201

Cataracts  

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Full Text Available ... the retina. The retina changes light signals into electric signals. These electric signals are sent through the optic nerve to ... However, you should have somebody with you to drive you home after the surgery. Removal of Hard ...

202

Cataracts  

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... the retina. The retina changes light signals into electric signals. These electric signals are sent through the optic nerve to ... However, you should have somebody with you to drive you home after the surgery. Removal of Hard ...

203

Oral versus topical carbonic anhydrase inhibitors in ocular hypertension after scleral tunnel cataract surgery  

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Full Text Available Abdulmoghni Al-Barrag1, Motaher Al-Shaer1, Nabil Al-Matary2, Mahfoud Bamashmous11Ophthalmic Department, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Republic of Yemen; 2Ophthalmic Department, Military Hospital, Sana’a, Republic of YemenPurpose: To compare the effect of oral acetazolamide and topical 2% dorzolamide in prevention of ocular hypertension after scleral tunnel cataract surgery.Setting: Ophthalmic department, Sana’a University, Yemen Sana’a from March 2007 to October 2007.Methods: This prospective double-blind, randomized study included 150 eyes undergoing scleral tunnel cataract surgery with hard posterior chamber intraocular implantation. Methylcellulose was used as the viscoelastic in all surgery cases. Patients were assigned to one of three groups: group 1: topical gentamicin eye drops (control; n = 52; group 2: systemic acetazolamide 250 mg (n = 45; and group 3: topical 2% dorzolamide (n = 53. Acetazolamide patients received one 250 mg tablet, one hour before surgery, then half a tablet every eight hours. A topical dorzolamide 2% or gentamicin was applied in one drop one hour before surgery then every eight hours, for three days postoperatively. Intraocular pressures (IOP were measured by Goldman applanation tonometry one hour preoperatively and 16, 24, and 48 hours postoperatively. Results: At 16 hours, IOP between the three groups increased significantly with a statistically significant p-value of 0.008, but the mean IOP of acetazolamide patients was less than other groups. IOP nearly returned to the normal level 24 and 48 hours postoperatively, but this was not statistically significant (p = 0.452 and 0.138, respectively.Conclusion: Acetazolamide offers better IOP control than topical dorzolamide 2% in preventing ocular hypertension after scleral tunnel cataract surgery. Keywords: cataract surgery, ocular hypertension, viscoelastic, dorzolamide, intraocular pressure

Abdulmoghni Al-Barrag

2009-06-01

204

Comparison of different phaco techniques in coaxial micro-incision cataract surgery  

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Full Text Available AIM: To compare the efficiency of coaxial micro-incision cataract surgery(MICSperformed by 3 phacoemulsification techniques(phaco-chop, divide-and- conquer and stop-and-chop.METHODS: It was a perspective and randomized clinical trial. Totally 135 patients with age-related cataract were selected randomly and underwent MICS. According to the lens nuclear opacity(NOof LOCS? grading standards, it can be divided into 3 groups as NO2, NO3 and NO4 group. All groups were randomly subdivided into 3 groups(phaco-chop, divide-and-conquer and stop-and-chop group. The observation target included best-corrected visual acuity(BCVA, central corneal thickness(CCTand endothelial cell count(ECCbefore operation and 1mo postoperation, ultrasound time(UST, cumulative dissipated energy(CDE, estimated fluied used(EFUin operation and complications.RESULTS:In lens nuclear opacity NO4 coaxial micro-incision phacoemulsification, phaco-chop group showed significantly less UST, CDE and EFU than the divide-and-conquer and stop-and-chop groups(P0.05and the ratio of endothelial cell loss was significantly lower in the phaco-chop group than in the divide-and-conquer and stop-and-chop groups 1mo after surgery(P0.05. However, after 1mo surgery, BCVA and CCT among three chop technique groups in different lens nuclear opacity groups had no significant differences(P>0.05.CONCLUSION: All 3 techniques may be effective for coaxialmicroincision cataract surgery in mild and moderate nuclear opacity cataracts. However, in eyes with severe nuclear opacity cataract, the phaco-chop technique can be more effective for phacoemulsification, and less corneal endothelial damage.

Yan-Li Zhou

2014-04-01

205

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

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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

2000-07-01

206

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

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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

2001-07-01

207

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

DEFF Research Database (Denmark)

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, Sofie J; Heegaard, Steffen

2013-01-01

208

Effect of cataract surgery on retinal nerve fiber layer thickness parameters using scanning laser polarimetry (GDxVCC  

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Full Text Available Purpose: To study the effect of cataract extraction on the retinal nerve fiber layer (RNFL thickness, and assessment by scanning laser polarimetry (SLP, with variable corneal compensation (GDx VCC, at the glaucoma service of a tertiary care center in North India. Materials and Methods: Thirty-two eyes of 32 subjects were enrolled in the study. The subjects underwent RNFL analysis by SLP (GDx VCC before undergoing phacoemulsification cataract extraction with intraocular lens (IOL implantation (Acrysof SA 60 AT four weeks following cataract surgery. The RNFL thickness parameters evaluated both before and after surgery included temporal, superior, nasal, inferior, temporal (TSNIT average, superior average, inferior average, and nerve fiber index (NFI. Results: The mean age of subjects was 57.6 ± 11.7 years (18 males, 14 females. Mean TSNIT average thickness (?m pre- and post-cataract surgery was 49.2 ± 14.1 and 56.5 ± 7.6 ( P = 0.001. There was a statistically significant increase in RNFL thickness parameters (TSNIT average, superior average, and inferior average and decrease in NFI post-cataract surgery as compared to the baseline values. Mean NFI pre- and post-cataract surgery was 41.3 ± 15.3 and 21.6 ± 11.8 ( P = 0.001. Conclusions: Measurement of RNFL thickness parameters by scanning laser polarimetry is significantly altered following cataract surgery. Post the cataract surgery, a new baseline needs to be established for assessing the longitudinal follow-up of a glaucoma patient. The presence of cataract may lead to an underestimation of the RNFL thickness, and this should be taken into account when analyzing progression in a glaucoma patient.

Dada Tanuj

2010-01-01

209

The distribution of cataract surgery services in a public health eye care program in Nepal.  

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The cost-effectiveness of public health cataract programs in low-income countries has been well documented. Equity, another important dimension of program quality which has received less attention is analyzed here by comparisons of surgical coverage rates for major sub-groups within the intended beneficiary population of the Nepal blindness program (NBP). Substantial differences in surgical coverage were found between males and females and between different age groups of the same gender. Among the cataract blind, the surgical coverage of males was 70% higher than that of females. For both genders, the cataract blind over 55 received proportionately fewer services than younger people blind from cataract. Blind males aged 45-54 had a 500% higher rate of surgical coverage than blind males over 65. Blind females aged 35-44 had nearly a 600% higher rate of surgical coverage than blind females over 65. There was wide variation in overall surgical coverage between geographic zones, but little variation by terrain type, an indicator of the logistical difficulties in delivery of services. Members of the two highest caste groupings had somewhat lower surgical coverage than members of lower castes. Program managers should consider developing methods to increase services to women and to those over 65. Reaching these populations will become increasingly important as those most readily served receive surgery and members of the under-served groups form a growing portion of the remaining cataract backlog. PMID:10175620

Marseille, E; Brand, R

1997-11-01

210

Long-time visual functional results of cataract surgery on low vision patients  

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Full Text Available Eva I Mönestam, Britta M Lundqvist, Åsa C JonssonDepartment of Clinical Sciences/Ophthalmology, Umeå University, Umeå, SwedenBackground/aims: To assess longitudinal 5-year results of cataract surgery on low vision patients.Methods: In this prospective, long-time, observational case-series, we report the outcome regarding the subjective visual function (n = 35 assessed by a visual function questionnaire (VF-14 and the visual acuity (n = 30 of surviving low vision patients 5 years after surgery. We compare with data recorded on the same patients before surgery and 4 months postoperatively.Results: Five years after surgery, 57% had unchanged or better VF-14 score compared with preoperatively, and 37% compared with postoperatively. Maculopathy patients had a significantly larger deterioration 5 years after surgery compared with postoperatively (40.2 versus 51.7, p = 0.004, but for the glaucoma patients there was no significant change (52.6 versus 53.1. There were no significant associations between age of the patient and change in VF-14 score or change in visual acuity 5 years after surgery, neither compared with before surgery nor postoperatively.Conclusion: Results suggest a favorable functional outcome 5 years after cataract surgery on most low-vision patients. Glaucoma patients have a more stable outcome than patients with macular degeneration. The severity of the disease-process for each individual patient might be the most important factor affecting the long-time results.Keywords: low vision, cataract surgery outcome, long-time results

Eva I Mönestam

2008-03-01

211

Posturing after macular hole surgery: a review.  

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Since the first reports on surgical repair of macular holes, postoperative face-down posturing (FDP) has been part of the management regime. However, prone positioning is unpleasant for patients, and has adverse effects. Over the last decade some vitreoretinal surgeons have reduced the duration of FDP, or even abandoned it altogether. There have been few non-randomised, and even fewer randomised trials addressing this controversy. With high success rates for macular hole surgery and multiple different surgical strategies such as internal limiting membrane peeling, combining macular hole and cataract surgery, and different durations of gas tamponade, analysing the effects of individual factors is difficult. This paper discusses the mechanisms of surgical repair as well as the role of postoperative FDP, and reviews the studies that have attempted to determine its effect on the success of macular hole surgery. PMID:21778774

Chandra, Aman; Charteris, David G; Yorston, David

2011-01-01

212

Técnicas de chopping en cirugía de catarata microincisional Chopping techniques in micro-incision cataract surgery  

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Full Text Available En este trabajo se realiza una panorámica de la experiencia en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el uso de la técnica de cirugía de catarata microincisional (MICS, phaconit, microfaco o facoemulsificación bimanual, uno de los avances modernos de la cirugía de cataratas, que permite la realización de la cirugía, a través de incisiones de 1,8 mm o menos. Se discuten las particularidades de la aplicación de la tecnología de instrumental, software, máquinas de facoemulsificación y accesorios. Se describen las técnicas de facochop aplicadas al MICS, en particular de la técnica de multichop del doctor Curbelo diseñada en este centro y los resultados en pacientes operados entre los años 2004 y 2005 mediante MICS en nuestro institutoThis paper presented an overview of the experience accumulated by the Ocular Microsurgery Center of “Ramón Pando Ferrer” Cuban Institute of Ophthalmology in the use of micro-incision cataract surgery, Phaconit, Microphaco or Bimanual phacoemulsification, one of the advances of modern cataract surgery. This technique allows performing surgery through tiny incisions of 1,8 mm or less. The particularities in the application of instumental technology, software, phacoemulsification machines and accesories were discussed. Also the phacochop techniques applied to micro-incision cataract surgery, in particular the multichop technique designed by Dr. Curbelo in this center along with the results achieved in patients operated on from 2004 to 2005 through this procedure were described

Luis Curbelo Cunill

2006-06-01

213

Point prevalence of pseudoexfoliation syndrome in patients scheduled for cataract surgery in eye camps in Yemen  

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Full Text Available Purpose: To study the point prevalence of pseudoexfoliation syndrome (PXS among Yemeni patients in different governorates with age-related cataract scheduled for surgery. Settings: Eye camps organized by the Nibras Health Society to perform cataract surgeries during the years 2002-2006. All patients aged 40 years and above were included in the study. Materials and Methods: A total of 2535 eyes of 2535 patients from 13 governorates, scheduled for cataract surgery in eye camps, were included. All eyes underwent complete eye examination before the surgery and were evaluated for the signs of pseudoexfoliation material in the pupil, iris and lens capsule on dilated slit lamp examination. Results: The study found 495 of the 2535 eyes (19.53% with PXS with males more commonly affected than females (55.2 and 44.8%, respectively. The mean age of patients with PXS was 66.2 years while it was 64.6 years in non-PXS patients. The prevalence of pseudoexfoliation syndrome increased with age (10.1% in the age group of 41-50 years that increased to 28.8% in the age group of more than 81 years old. The rate of PXS detection in camps in 13 governorates ranged from 13.33 to 24.22% with an overall rate of 19.53%. The lowest rate was noticed in Sana?a and the highest in Al-Dhale governorate. Conclusion: This pilot study confirms that PXS was common in patients undergoing cataract surgery in Yemen with an increased detection rate with age. This study also highlights the prevalence of an ocular disease that is associated with systemic and ocular complications; however, further studies based on population studies are needed.

Al-Shaer Mutahar

2010-01-01

214

Knowledge of patients’ visual experience during cataract surgery: a survey of eye doctors in Karachi, Pakistan  

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Full Text Available Abstract Background Several recent studies have recommended that ophthalmologists must be aware of the visual sensations (and their associated anxiety/fear experienced by patients undergoing cataract surgery. We assessed the knowledge of a group of eye doctors in Pakistan regarding these phenomena. Methods This was a cross-sectional survey. Eye doctors (ophthalmologists, residents and medical officers attending the Ophthalmological Society of Pakistan Annual Conference 2011, in Karachi were invited to participate in the study. A self-administered structured questionnaire was used to examine their knowledge of visual sensations and their associated anxiety/fear experienced by patients during cataract surgery. Simple frequencies and proportions were calculated to describe the data. Results A total of 150 ophthalmologists, residents and medical officers were invited to participate in the study. Of these, 68 (45.3% responded. The mean age (±SD of the participants was 42.9 (13.2 years. The proportion of participants who thought that patients could experience visual sensations during cataract surgery under regional anaesthesia was 89.7% and that under topical anaesthesia was 73.5%. The most frequently cited sensations included: light perception, changes in light brightness, movements, instruments and surgeon’s hands or fingers. The eye doctors estimated that 38.9% and 64.3% patients would see at least something during cataract surgery under regional anaesthesia and topical anaesthesia, respectively. They also believed that 24.2%-36.9% of patients may experience anxiety/fear as a result of visual sensations during such surgery. Approximately half of the eye doctors did not think that retained vision was a source of fear or anxiety for the patients. While most of them acknowledged the importance of preoperative counselling in helping to alleviate such fear/anxiety, the majority of them did not regularly counsel their patients on what to expect during the surgery. Conclusion Our study reveals that a significant proportion of eye doctors do not have adequate knowledge of the visual phenomenon and their associated anxiety or fear, that patients can experience during cataract surgery. Targeted educational interventions are needed to increase awareness of this phenomenon among eye care professionals.

Tauqir Mohammad Zain

2012-11-01

215

Observation on the adverse reactions of different concentrations of povidone-iodine applied before cataract surgery  

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Full Text Available AIM: To evaluate the efficiency and safety of 50g/L povidone-iodine solution in preventing postoperative endophthalmitis through comparing the incidence of postoperative endophthalmitis and adverse reactions after conjunctival sac washing with povidone-iodine of different concentrations.METHODS: Totally 500 cataract patients were divided into 50g/L povidone-iodine group and 25g/L povidone-iodine group. All the operated eyes were observed during and after surgery.The patients' subjective discomfort was inquired and their signs of eyes were recorded. RESULTS: The eye irritation of 50g/L povidone-iodine group was more significant than 25g/L povidone-iodine group. No significant difference in the corneal epithelial loss and endophthalmitis was observed between two groups.CONCLUSION:Conjunctival sac washing with 50g/L povidone-iodine is an effective and safe measure to prevent endophthalmitis after cataract surgery.

Shan-Jun Wu

2013-12-01

216

Cataracts  

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Full Text Available ... Education Institute, Inc. [www.X-Plain.com] ot020104 Last reviewed: 01/09/2013 1 The cornea is ... Education Institute, Inc. [www.X-Plain.com] ot020104 Last reviewed: 01/09/2013 2 Diagnosis & Treatment Options ...

217

Cataracts  

Medline Plus

Full Text Available ... X-Plain.com] ot020104 Last reviewed: 01/09/2013 1 The cornea is the front, transparent part ... X-Plain.com] ot020104 Last reviewed: 01/09/2013 2 Diagnosis & Treatment Options Your doctor will take ...

218

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

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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 ...

Belousova, N. Y.

2011-01-01

219

Oral versus topical carbonic anhydrase inhibitors in ocular hypertension after scleral tunnel cataract surgery  

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Abdulmoghni Al-Barrag1, Motaher Al-Shaer1, Nabil Al-Matary2, Mahfoud Bamashmous11Ophthalmic Department, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Republic of Yemen; 2Ophthalmic Department, Military Hospital, Sana’a, Republic of YemenPurpose: To compare the effect of oral acetazolamide and topical 2% dorzolamide in prevention of ocular hypertension after scleral tunnel cataract surgery.Setting: Ophthalmic department, Sana’a Univ...

Motaher Al-Shaer; Mahfoud Bamashmous

2009-01-01

220

Two cases of Z syndrome with the Crystalens after uneventful cataract surgery.  

Science.gov (United States)

We report 2 cases of Z syndrome with the Crystalens AT50SE and AT52SE intraocular lenses (Eyeonics, Inc.) after uneventful cataract surgery. Both patients had subsequent neodymium:YAG laser capsulotomy treatment that remedied the complication. To our knowledge, these are the first reported cases of Z syndrome with the Crystalens AT50SE and AT52SE, a unique complication with this type of hinged accommodating intraocular lens. PMID:19006749

Yuen, Leonard; Trattler, William; Boxer Wachler, Brian S

2008-11-01

 
 
 
 
221

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

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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 prospective treatment for zonular weakness in such patients. Methods: A triangular capsular flap is cut from the anterior capsule with the base directed towards the zonular break area. Basal peripheral irid...

Alireza Ghaffariyeh; Tooraj Chamacham

2008-01-01

222

Cataracts  

Medline Plus

Full Text Available ... ot020104 Last reviewed: 01/09/2013 1 The cornea is the front, transparent part of the eye. ... eye. The capsule holds the lens in place. Cornea Iris Lens Vitreous Retina Macula After hitting the ...

223

Cataracts  

Medline Plus

Full Text Available ... com] ot020104 Last reviewed: 01/09/2013 2 Diagnosis & Treatment Options Your doctor will take a detailed ... treat them early if they happen. Document Outline Diagnosis & Treatment Options

224

Understanding Cataract Risk in Aerospace Flight Crew And Review of Mechanisms of Cataract Formation  

Science.gov (United States)

Induction of cataracts by occupational exposure in flight crew has been an important topic of interest in aerospace medicine in the past five years, in association with numerous reports of flight-associated disease incidences. Due to numerous confounding variables, it has been difficult to determine if there is increased cataract risk directly caused by interaction with the flight environment, specifically associated with added radiation exposure during flight. Military aviator records from the United States Air Force (USAF) and Navy (USN) and US astronauts at the National Aeronautics and Space Administration (NASA)/Lyndon B. Johnson Space Center (JSC) were evaluated for the presence, location and age of diagnosis of cataracts. Military aviators were found to have a statistically significant younger average age of onset of their cataracts compared with astronauts, however the incidence density of cataracts was found to be statistically higher in astronauts than in military aviators. USAF and USN aviator s cataracts were most commonly located in the posterior subcapsular region of the lens while astronauts cataracts were most likely to originate generally in the cortical zone. A prospective clinical trial which controls for confounding variables in examination technique, cataract classification, diet, exposure, and pharmacological intervention is needed to determine what percentage of the risk for cataracts are due to radiation, and how to best develop countermeasures to protect flight crews from radiation bioeffects in the future.

Jones, Jeffrey A.; McCarten, M.; Manuel, K.; Djojonegoro, B.; Murray, J.; Cucinotta, F.; Feiversen, A.; Wear, M.

2006-01-01

225

Prophylactic postoperative ketorolac improves outcomes in diabetic patients assigned for cataract surgery  

Science.gov (United States)

Objective To evaluate the prophylactic role of topical non-steroidal anti-inflammatory drugs in reducing the incidence of central macular edema (CME) in diabetic eyes post-cataract surgery. Patients and methods This study included 86 eyes (70 patients) with high risk characteristics for the development of CME after cataract surgery. All patients underwent phacoemulsification and intraocular lens implantation. Patients were divided into two equal groups (n = 43 [eyes]): a control group given topical dexamethasone 0.1%, four times/day for 12 weeks postoperatively and a study group given topical ketorolac tromethamine 0.4% twice daily in addition to topical dexamethasone 0.1% four times daily for 12 weeks. Patients were examined at 3, 6, and 12 weeks postoperatively for evaluation of CME development. The main study outcome was the change in the retinal fovea thickness measured with ocular coherence topography. Results Ten eyes developed CME (11.6%); eight eyes in the control group and only two eyes in the study group. Mean retinal fovea thickness was significantly higher in the control group compared to the study group. Moreover, eyes of the control group developed CME significantly earlier than those of the study group. Conclusion Prophylactic postoperative ketorolac 0.4% may have a role in reducing the frequency and severity of CME in diabetic eyes post-cataract surgery. PMID:23836953

Elsawy, Moataz F; Badawi, Nermine; Khairy, Hany A

2013-01-01

226

Effect of polyethylene glycol eye drops in management of dry eyes after cataract surgery  

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Full Text Available AIM: To evaluate the effect of polyethylene glycol eye drops on tear film break-up time and symptoms for dry eyes after cataract surgery.METHODS: Eighty patients with dry eyes secondary to cataract surgery who were treated in our hospital from January to August 2013 were randomly divided into group A and group B. Group A was treated with sodium hyaluronate eye drops for one week, and Group B was treated with polyethylene glycol eye drops for one week. The break-up time of tear film was measured and the subjective symptoms were graded before and after the treatment.RESULTS: The tear film break-up time of group A was respectively 3.87±1.12s and 4.21±1.06s before and after the treatment, with no significant difference(P>0.05; it was respectively 3.98±1.04s and 8.98±1.30s with significant difference for group B(PPPPCONCLUSION: Polyethylene glycol eye drops can extend tear film break-up time and improve symptoms of dry eyes. It is an effective drug in treatment of dry eyes after cataract surgery.

Dong-Mei Cai

2013-11-01

227

Use of a New Ocular Insert versus Conventional Mydriasis in Cataract Surgery  

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Background. To compare the efficacy and safety of a new ocular insert versus conventional mydriasis in cataract surgery. Methods. We selected 70 patients undergoing cataract surgery. Thirty five patients (Group 1) received instillation of mydriatic drops (tropicamide 1%, phenylephrine 10%, and cyclopentolate 1%) prior to surgery, and 35 patients (Group 2) had a Mydriasert insert (Théa Pharma) (0.28?mg of tropicamide and 5.4?mg of phenylephrine hydrochloride) placed in the inferior fornix. Pupil size before and after surgery, blood pressure, and heart rate were measured. Results. Before surgery, pupil diameter was 9.44 ± 1.17?mm in Group 1 and 9.05 ± 1.54 in Group 2 (P > 0.05). Twenty four hours after surgery, pupil diameter was 5.20 ± 1.54?mm in Group 1 and 3.33 ± 1.15 in Group 2 (P < 0.001). There were no statistically significant differences in blood pressure or heart rate between groups. Conclusions. The effect of the Mydriasert insert was similar to conventional mydriatic agents. Pupil size was restored to normal faster when using the Mydriasert insert compared with conventional mydriatic agents for pupil dilation. PMID:23819122

Torron, C.; Calvo, P.; Ruiz-Moreno, O.; Lecinena, J.; Perez-Inigo, A.

2013-01-01

228

Cataracts  

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Full Text Available ... for your specific condition. ©1995-2013, The Patient Education Institute, Inc. [www.X-Plain.com] ot020104 Last reviewed: 01/09/2013 5 This document is for informational purposes and is not intended to be a substitute ...

229

Severe generalised hypersensitivity reaction to topical neomycin after cataract surgery: a case report  

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Full Text Available Abstract Introduction Systemic hypersensitivity reactions to topical ophthalmic treatment occur rarely, but when they do they can be severe as highlighted by this case. Case presentation A post-operative cataract surgery patient developed a severe and generalised hypersensitivity reaction following topical treatment with Maxitrol (Dexamethasone and Neomycin eye drops. The patient reported a previous allergic reaction to Neomycin. Conclusion This case report emphasises the importance of a thorough drug and allergy history when patients are seen at pre-assessment or clerked in for surgery.

Ansari Imran A

2008-02-01

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Influence of phacoemulsification on five sites of corneal endothelium of senile cataract after anti-glaucoma surgery  

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Full Text Available AIM: To study the influence of phacoemulsification on five sites of corneal endothelium of senile cataract in patients after anti-glaucoma surgery. METHODS: Patients with cataract after anti-glaucoma surgery were selected, and the surgery of phacoemulsification was performed by a same skilled surgeon, The superior, inferior, central, nasal, temporal endothelium cells were observed with a non-contact endothelium scope on pre-operation and seventh day, first month, third month and sixth month of post-operation. RESULTS: After operation, there were obvious differences of corneal endothelium of every sites between two groups(P<0.01. CONCLUSION: Endothelium cells of senile cataract in patients after anti-glaucoma surgery are easier to be damaged in the phacoemulsification, so preoperative evaluation, surgery manner and postoperative treatment are very important.

Yong - Hua Li

2013-04-01

231

All-laser bladeless cataract surgery, combining femtosecond and nanosecond lasers: a novel surgical technique  

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Full Text Available Anastasios John KanellopoulosLaserVision gr Institute, Athens, Greece; New York University Medical School, New York, NY, USAPurpose: To report the safety and efficacy of a novel surgical technique using two lasers in cataract surgery.Methods: In this contralateral eye report, a 57-year-old female underwent cataract extraction. Two laser devices and a standard phacoemulsification, platform were used to conduct the procedures. First, a femtosecond laser was used to perform the corneal incision, capsulorhexis, and initial lens fragmentation in each eye. Following this, a nanosecond laser was used to enter the 2.8 mm incision, uni-axially, and complete the viscoelastic-divided nucleus fragment emulsification and removal in one eye. Standard phacoemulsification was used in the completion of the other eye. Posterior chamber foldable acrylic intraocular lenses were implanted in both cases. We evaluated perioperative acuity, refraction, keratometry, Scheimpflug tomography, intraocular pressure, endothelial cell counts, and total energy used with each laser in each case.Results: Corrected distance visual acuity improved from preoperative 20/60 and 20/70 to postoperative 20/20 in both eyes, with 6-month follow-up. In the right eye, the total intraocular energy used was 2 J by the femtosecond laser and 6 J by the phacoemulsification device. In the left eye, the nanosecond laser utilized the same energy of 2 J and the nanosecond laser 2.4 J (80 pulses of 30 mJ each. There were no other differences noted in intraocular pressure or endothelial cell counts.Conclusion: In this report, we introduce a bladeless all-laser cataract surgery extraction alternative technique, with several potential novel advantages: enhanced incision and capsulorhexis reproducibility, reduction in intraocular energy used, and elimination of the potential of thermal corneal injury.Keywords: LenSx® femtosecond laser, Cetus nanosecond laser, energy consumed, small-incision cataract surgery

Kanellopoulos AJ

2013-09-01

232

Survey of Japanese ophthalmic surgeons regarding perioperative disinfection and antibiotic prophylaxis in cataract surgery  

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Purpose To elucidate Japanese trends for perioperative disinfection and antibiotic selection during cataract surgeries. Methods Perioperative iodine use and antibiotic prophylaxis for cataract surgery were surveyed in eight regions in Japan by mail or through interviews from February 1 to March 1, 2014. Results We surveyed 572 surgeons, of whom 386 (67%) responded. Most of the surgeons (94%) used iodine compounds before surgery for periocular skin disinfection (povidone–iodine [PI]: 79%; polyvinyl alcohol-iodine [PAI]: 15%) or conjunctival disinfection (85%; PI: 36%; PAI: 49%). Preoperative conjunctival iodine was primarily used as an eye wash (irrigation: 95%) and less often as an eye drop (5%). It was determined that 31% of surgeons waited 30 seconds or more between periocular disinfection and conjunctival disinfection. During surgery, 14% of surgeons used iodine several times, including immediately before intraocular lens insertion, and 7% used the Shimada technique (repeated iodine irrigation). Preoperative antibiotic eye drops were used by 99% of surgeons, and antibiotics were added to the irrigation bottle by 22%. The surgeons reported use of subconjunctival antibiotic injections (23%), antibiotic ointments (79%), and intracameral antibiotics (7%: 22 moxifloxacin; 6 levofloxacin). All surgeons prescribed postoperative eye drops, with 10% initiating the drops on the day of surgery. Conclusion Iodine compounds are commonly used preoperatively, but few institutions use iodine compounds intraoperatively, particularly with repeated application. The selection of antibiotic administration and disinfection technique has to be at the surgeon’s discretion. However, intracameral antibiotic and intraoperative iodine compound use are techniques that should be widely recognized.

Matsuura, Kazuki; Mori, Takafumi; Miyamoto, Takeshi; Suto, Chikako; Saeki, Yusuke; Tanaka, Shigeto; Kawamura, Hajime; Ohkubo, Shinji; Tanito, Masaki; Inoue, Yoshitsugu

2014-01-01

233

Effects of Preoperative Intravenous Clonidine in Patients Undergoing Cataract Surgery: A Double-Blind, Randomized Trial  

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Objectives. The aim of this study was to assess the effects of clonidine on intraoperative analgesia, sedation, intraocular and blood pressure, arrhythmia, and ischemia. Methods. Forty patients undergoing cataract surgery were allocated into two groups. They were monitored with Holter machine, the pupil was dilated, and 30 minutes later, 20 patients received clonidine (4?µg/kg), while the other 20 patients were given a 0.9% saline intravenously. Twenty minutes later, 2% lidocaine gel was applied. There were assessed intraoperative analgesia, intraocular pressure, blood pressure, heart rate, and the occurrence of arrhythmias and myocardial ischemia. Results. Pain intensity was lower in G1 during the phacoemulsification, irrigation, aspiration, and intraocular lens implantation. The HR and BP were lower with clonidine. The IOP was lower with clonidine after 15 minutes and at the end of the surgery. Sedation was higher with clonidine. The incidence of arrhythmia was lower at the end of surgery with clonidine. The incidence of myocardial ischemia did not differ between the groups. Conclusions. Clonidine (4?µg/kg) before a phacoemulsification reduced the intensity of pain during cataract surgery. It also induced sedation, reduction of BP, HR, and incidence of arrhythmia at the end of the surgery, and did not alter myocardial ischemia. This trial is registered with Clinicaltrials.gov NCT01677351. PMID:25276415

Santiago, Ana Ellen Queiroz; Issy, Adriana Machado; Sakata, Rioko Kimiko

2014-01-01

234

Safety of prophylactic intracameral moxifloxacin ophthalmic solution after cataract surgery in patients with penetrating keratoplasty  

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Full Text Available AIM:To determine the safety of prophylactic intracameral moxifloxacin after cataract surgery in patients with penetrating keratoplasty (PKP.METHODS:In this retrospective study of consecutive patients who had phacoemulsification cataract surgery after PKP, were treated with intracameral moxifloxacin 0.5% ophthalmic solution (0.5 mg/0.1 mL. The main outcome measures were anterior chamber reaction, best corrected visual acuity (BCVA, corneal endothelial cell count (ECC, and central corneal thickness (CCT.RESULTS:Fifty-five patients were recruited (26 males, 29 females. The mean age was 54.36±4.97y (range 45-64y. All eyes had improved postoperative BCVA. The mean BCVA was 0.25 preoperatively and 0.57 postoperatively, which was statistically significant (P<0.001. One eye had 3+, 7 eyes had 2+, 12 eyes had 1+ and 8 eyes had trace amount of aqueous cells on the first day after surgery. All eyes had no anterior chamber cells at subsequent follow up examinations. Effective phacoemulsification time was 4.33±1.01s. The mean ECC was 2340.20 cells/mm2 preoperatively and 1948.75 cells/mm2 1mo postoperatively (P<0.001. The increase of 21.09 µm in postoperative pachymetry 1mo after surgery was statistically significant (P<0.001.CONCLUSION: No untoward effects were observed after intracameral injection of moxifloxacin (0.5 mg/0.1 mL in terms of anterior chamber reaction, CCT, ECC, and visual rehabilitation at the conclusion of cataract surgery in patients with PKP.

Osman Sevki Arslan

2014-10-01

235

Phaco-emulsification versus manual small-incision cataract surgery in South Africa  

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Full Text Available SciELO South Africa | Language: English Abstract in english OBJECTIVES: To compare the results of phaco-emulsification cataract surgery and manual small-incision cataract surgery. METHODS: Consecutive patients aged >50 years undergoing surgery for age-related cataract were recruited into a randomised prospective clinical trial. Randomisation was done using o [...] paque sequentially numbered envelopes opened by the surgeon immediately prior to surgery. The patients were seen after 1 day, 2 weeks, and 8 weeks. OUTCOME MEASURES: The primary outcome measure was the uncorrected visual acuity at week 8. The secondary outcome measures were the uncorrected visual acuity on day 1, the best corrected visual acuity at week 8, the refraction at week 8, and the intra- and postoperative complications. RESULTS: One hundred patients were recruited into each arm of the study. There was no difference in the incidence of intraocular complications (p=0.19). There was no difference in the day 1 visual acuities (p=0.28). However, both the uncorrected and the corrected week 8 visual acuities were better in the eyes that had phaco-emulsification (p=0.02 and p=0.03), and there was less astigmatism (p=0.001) at week 8 in the eyes that had phacoemulsification. CONCLUSIONS: While manual small-incision surgery has been recommended as an acceptable alternative to phaco-emulsification in middle- and low-income countries, we have found that the results of phaco-emulsification are better. Where appropriate, consideration should be given to encouraging a transition to phaco-emulsification in our Vision 2020 programmes in Africa.

Colin, Cook; Henri, Carrara; Landon, Myer.

236

Safety of prophylactic intracameral moxifloxacin ophthalmic solution after cataract surgery in patients with penetrating keratoplasty  

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AIM To determine the safety of prophylactic intracameral moxifloxacin after cataract surgery in patients with penetrating keratoplasty (PKP). METHODS In this retrospective study of consecutive patients who had phacoemulsification cataract surgery after PKP, were treated with intracameral moxifloxacin 0.5% ophthalmic solution (0.5 mg/0.1 mL). The main outcome measures were anterior chamber reaction, best corrected visual acuity (BCVA), corneal endothelial cell count (ECC), and central corneal thickness (CCT). RESULTS Fifty-five patients were recruited (26 males, 29 females). The mean age was 54.36±4.97y (range 45-64y). All eyes had improved postoperative BCVA. The mean BCVA was 0.25 preoperatively and 0.57 postoperatively, which was statistically significant (P<0.001). One eye had 3+, 7 eyes had 2+, 12 eyes had 1+ and 8 eyes had trace amount of aqueous cells on the first day after surgery. All eyes had no anterior chamber cells at subsequent follow up examinations. Effective phacoemulsification time was 4.33±1.01s. The mean ECC was 2340.20 cells/mm2 preoperatively and 1948.75 cells/mm2 1mo postoperatively (P<0.001). The increase of 21.09 µm in postoperative pachymetry 1mo after surgery was statistically significant (P<0.001). CONCLUSION No untoward effects were observed after intracameral injection of moxifloxacin (0.5 mg/0.1 mL) in terms of anterior chamber reaction, CCT, ECC, and visual rehabilitation at the conclusion of cataract surgery in patients with PKP. PMID:25349795

Arslan, Osman Sevki; Arici, Ceyhun; Unal, Mustafa; Cicik, Erdogan; Mangan, Mehmet Serhat; Atalay, Eray

2014-01-01

237

Tonometry in corneal edema after cataract surgery: dynamic contour tonometry versus Goldmann applanation tonometry  

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Full Text Available Anne Herr,1 Andreas Remky,2 Thalia Hirsch,1 Corinna Rennings,1 Niklas Plange1 1Department of Ophthalmology, RWTH Aachen University, Aachen, Germany; 2Augenbelegabteilung Krankenhaus Barmherzige Brueder, Regensburg, Germany Introduction: Intraocular pressure (IOP determination using dynamic contour tonometry (DCT has been considered to be independent of central corneal thickness (CCT, while Goldmann applanation tonometry (GAT is known to be influenced by various corneal properties. In this study, IOP was measured before and 1 day after cataract surgery using GAT and DCT to investigate the possible effects of corneal edema on IOP measurements. Methods: Thirty patients with advanced cataracts were included in a pilot study. IOP was measured using GAT and DCT before and 1 day after phacoemulsification. CCT was determined before and after surgery to quantify postsurgical corneal edema. Results: CCT increased significantly (by 89.7 ± 107.4 µm, P < 0.0001 1 day after surgery. No significant difference was found for IOP measurements using GAT and DCT before surgery (mean IOP GAT: 17.5 ± 5.7 mmHg; mean IOP DCT: 17.9 ± 6.4 mmHg; P = 0.67 and 1 day after surgery (mean IOP GAT: 16.1 ± 6.6 mmHg; mean IOP DCT: 16.8 ± 8.3 mmHg; P = 0.69. IOP values using GAT and DCT were significantly correlated before as well as 1 day after surgery (before surgery: r = 0.82, P ? 0.0001; after surgery r = 0.83, P < 0.0001. Bland–Altman plots showed a high variability in the difference in IOP measurements between methods before and 1 day after surgery. Conclusion: GAT and DCT seem to be equally valuable in IOP determination in postsurgical central corneal edema, although large differences between both methods are present in individual patients. IOP evaluation in corneal edema remains a difficult clinical challenge. Keywords: Goldmann applanation tonometry, dynamic contour tonometry, corneal edema, cataract surgery, intraocular pressure

Herr A

2013-05-01

238

An evaluation of 8-0 polyglycolic acid braided synthetic absorbable suture in cataract surgery.  

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This study describes the operative and postoperative performance of 8-0 polyglycolic acid braided suture, trademarked Dexon "s", in cataract surgery. The evaluation consists of a clinical comparison of 8-0 Dexon to the same suture in 7-0 size in 109 cataract surgical procedures. The 8-0 Dexon, like 7-0, gave high tensile strength, good knot security, batch-to-batch uniformity, relatively good pliability, and provoked minimal reaction while disappearing at a predictable rate of around 35 days. When compared to 7-0 Dexon, 8-0 produced less tissue drag, fibrillation, and reaction, while providing better pliability. However, the smaller suture possessed less tensile strength, and had an increased tendency to cut through tissue when tied too tightly. PMID:496189

Blaydes, J E

1979-06-01

239

Dexmedetomidine Causes Increased Hypotension in Older Adults When Used for Cataract Surgery Compared to Propofol  

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Full Text Available Purpose: This study evaluated the hemodynamic effects, suitability and safety of dexmedetomidine (DEX compared with propofol (PRO in older adults having outpatient cataract surgery under monitored anesthesia care. The patients, surgeon and the anesthesia staff evaluated satisfaction for both drugs.Method: This prospective, single blind, randomized study was conducted using forty-seven patients ?55 years old undergoing cataract surgery. The two patient groups received either i.v. dexmedetomidine 1 ?g/kg over 10 min; followed by maintenance i.v. infusion at 0.2 -0.7 ?g/kg/hr (DEX group, N = 24, or propofol infused between 25 -120 ?g/kg/min (PRO group, N = 23. Both agents were titrated to patient comfort. Results: Patients’ mean arterial pressures (SEM at baseline were 104.7 (2.6 and 107.5 (2.7 mmHg for the DEX and PRO groups, respectively (p = 0.45. At discharge the pressures were 78.1 (2.5 and 98.1 (2.6 mmHg in DEX and PRO groups, respectively (p 0.05. Patients’ heart rates (SEM at baseline were 74.8 (3.0 for the DEX group and 73.2 (2.8 bpm for the PRO groups (p = 0.71. At the time of discharge following surgery, the mean heart rate for the DEX group was 61.5 (2.2 bpm vs. 69.1 (2.3 bpm (p 0.05 for the PRO group. Three patients in the DEX group developed complications precluding discharge or requiring readmission while none of the patience in the PRO group had complications (p = 0.08. Patient and surgeon satisfaction scores were similar between the groups. Conclusion: Dexmedetomidine is a less suitable sedative compared with propofol use in older patients undergoing cataract surgery due to the decrease in hemodynamic parameters and noted increases in complication rates.

Irwin Gratz

2013-06-01

240

PREOPERATIVE ORAL CODEINE EFFECT ON POSTOPERATIVE CAUGH CONTROL IN CATARACT SURGERY  

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Full Text Available 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 150 ASA 1, 2 patient that were over 45 years old age. These patient have cataract surgery under GA in Farabi Hospital of Esfahan medical university. All of the patient were intubated under direct laryngoscopy. Patients that have more of one laryngoscope, difficult intubation, thraceal intubation prolonged more than 15 seconds and those which have opiate addiction. We divided the patients into two 75 patient group by randomized selection. This study is double blind and 30mg codeine phosphate and placebo has given to the patient one hour preoperatively. Heart rate and systolic and diastolic, blood pressure has been recorded preoperatively, three minutes after intubation and three minutes after extubation respectively. Caught has been counted and recorded immediately. Five minutes and 30 minutes after extubation and results in contorol group are compared with the results in another group. Discussion: According to the statistical analysis t-student test, chi-square and non parametric test and Pvalue only changes in heart rate after extubation has been different in two groups and other findings make no difference in two groups. There was not any significant difference between two groups about age, sex, duration of surgery, preoperative mean heart rate and blood pressure. There was not any difference about mean number of coughs between two groups and according to this study oral codeine phosphate has administered preoperatively has not any effect on reducing postoperative caught in patients who have GA and tracheal incubation for cataract surgery.

H SOLTANI NEZHAD

2003-03-01

 
 
 
 
241

RABBIT GENERAL ANESTHESIA FOR CATARACT SURGERY USING CISATRACURIUM AS NEUROMUSCULAR BLOCKING DRUG. CASE STUDY  

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Full Text Available Surgeries on rabbits are more and more frequently as they are used as pet animals and the owner is interested in their welfare. Cataract surgery is already a routine intervention in small animals as dogs and cats. This is why the aim of this study is to present a case study of a rabbit anesthesia for cataract surgery. Our subject was a three year old female laboratory rabbit which weight 2.07 kg. We premedicated him using butorphanol 0.4 mg/kg and midazolam 1 mg/kg subcutaneous 30 minutes before induction. To prevent sever bradicardia,we administered glycopyrrolate 0.01 mg/kg. Induction was realized using ketamine 10% and midazolam 0.5% mixed in the same volume and administered at a dose of 2 ml/kg. After induction the rabbit was intubated using blind technique and isoflurane was administered by the endotracheal tube. The rabbit was perfused at a rate of 20 ml/kg/h with Hartman solution, colloids and glucose all along anesthesia. To minimize the risk of cataract surgery we administered cisatracurium at a dose of 0,05 mg/kg as multiple boluses. Neuromuscular blockade was assessed using a standard peripheral nerve stimulator. Postoperative we administered enrofloxacine 5 mg/kg, meloxicam 0.2 mg/kg for postoperative analgesia and metoclopramide 0.5 mg/kg for digestive stimulation. Even if there is no dose given in literature for cisatracurium in rabbits, we concluded that it can be used with great success and with no incidence at a dose used for dogs and cats.

Alexandru Cosmin TUTUNARU

2012-01-01

242

Cost-effectiveness analysis of cataract surgery: a global and regional analysis / Chirurgie de la cataracte: analyse de coût-efficacité à l'échelle mondiale et régionale / Costoeficacia de la cirugía de la catarata: análisis mundial y regional  

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Full Text Available SciELO Public Health | Language: English Abstract in spanish OBJETIVO: Estimar los efectos en la salud de la población, los costos y la costoeficacia de determinadas intervenciones de cirugía de la catarata en zonas del mundo que presentan distintos perfiles epidemiológicos. MÉTODOS: Las estimaciones de la eficacia se basan en una revisión de la literatura qu [...] e tiene en cuenta factores como el fracaso operatorio, las complicaciones y el incumplimiento por parte de los pacientes. Se aplicó un modelo de población para seguir el impacto de la operacion de catarata a todo lo largo de la vida en los individuos que se habían sometido a tal intervención. Las estimaciones de costos están basadas en datos primarios reunidos en 14 subregiones epidemiológicas por los equipos regionales de cálculo de costos y en una revisión de la literatura. Se usaron funciones de costos no lineales para estimar los costos asociados a distintos niveles de cobertura geográfica. RESULTADOS: Las operaciones de cirugía intracapsular y extracapsular de la catarata son un instrumento costoeficaz para reducir el impacto de la ceguera por catarata. La cirugía extracapsular es más costoeficaz que la intracapsular en todas las regiones consideradas. Proporcionando cirugía extracapsular a un 95% de quienes la necesitan (cobertura del 95%) se evitarían más de 3,5 millones de años de vida ajustados en función de la discapacidad (AVAD) cada año a nivel mundial. La costoeficacia varía entre 57 dólares internacionales (I$) por AVAD en la Región de Asia Sudoriental de la OMS, donde hay una alta mortalidad general de niños y adultos, y I$ 2307 por AVAD en la Región del Pacífico Occidental de la OMS, donde hay una baja mortalidad general de niños y adultos. CONCLUSIÓN: La cirugía extracapsular de la catarata, asegurando un alto nivel de cobertura, es la alternativa más costoeficaz para restablecer la vista en todas las subregiones epidemiológicas consideradas. Se alienta a los analistas de los países de cada región a que sigan contextualizando los resultados incorporando los parámetros específicos de su país. Abstract in english 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 [...] erative failure, complications and patient non-compliance. A population model was applied to follow the lifelong impact on individuals having cataract surgery. Costing estimates are based on primary data collected in 14 epidemiological subregions by regional costing teams and on a literature review. Costings were estimated for different geographical coverage levels using non-linear cost functions. FINDINGS: Intra- and extra-capsular cataract surgeries are cost-effective ways to reduce the impact of cataract-blindness. Extra-capsular cataract surgery is more cost-effective than intra-capsular surgery in all regions considered. Providing extra-capsular cataract surgery to 95% of those who need it (95% coverage level) would avert over 3.5 million disability-adjusted life years (DALYs) per year globally. The cost-effectiveness ranges from 57 International dollars (I$) per DALY in the WHO South-East Asia Region where there is high overall child and adult mortality to I$ 2307 per DALY in the WHO Western Pacific Region where there is low overall child and adult mortality. CONCLUSION: Extra-capsular surgery for cataracts at a high level of coverage is the most cost-effective way of restoring sight in all epidemiological subregions considered. Analysts from countries within a region are encouraged to further contextualize the results based on their own country's specific parameters.

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

2004-05-01

243

Evaluation of nepafenac in prevention of macular edema following cataract surgery in patients with diabetic retinopathy  

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Full Text Available Rishi Singh,1 Louis Alpern,2 Glenn J Jaffe,3 Robert P Lehmann,4 John Lim,5 Harvey J Reiser,6 Kenneth Sall,7 Thomas Walters,8 Dana Sager91Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, 2The Cataract, Glaucoma, and Refractive Surgery Center, El Paso, TX, 3Duke Eye Center, Duke Reading Center, Duke University, Durham, NC, 4Lehmann Eye Center, Nacogdoches, TX, 5Houston Eye Associates, Houston, TX, 6Eye Care Specialists, Kingston, PA, 7Sall Research Medical Center, Artesia, CA, 8Texan Eye, Austin, TX, 9Alcon Research Ltd, Fort Worth, TX, USABackground: The purpose of this study was to evaluate nepafenac ophthalmic suspension 0.1% (Nevanac®; Alcon Research Ltd in the prevention of macular edema following cataract surgery in diabetic retinopathy patients.Methods: This was a multicenter, randomized, double-masked, vehicle-controlled study of 263 adult diabetic patients with nonproliferative diabetic retinopathy requiring cataract surgery. Patients were randomized (1:1 to instill nepafenac or vehicle three times daily beginning 1 day prior to surgery through day 90. Efficacy included the percentage of patients who developed macular edema (?30% increase in central subfield macular thickness from baseline and the percentage of patients with decreases of more than five letters in best-corrected visual acuity from day 7 to 90.Results: A significantly lower percentage of patients in the nepafenac group developed macular edema relative to patients in the vehicle group (3.2% versus 16.7%; P < 0.001. A significantly lower percentage of patients in the nepafenac group had best-corrected visual acuity decreases of more than five letters relative to patients in the vehicle group on day 30 (P < 0.001, day 60 (P = 0.002, and day 90 (P = 0.006. The mean central subfield macular thickness and mean percent change from baseline in macular volume were also significantly lower in the nepafenac group versus the vehicle group at days 14 through 90 (P ? 0.005. No safety issues or trends were identified when dosing was increased to 90 days that negatively impacted the favorable benefit/risk profile of nepafenac.Conclusion: Nepafenac demonstrated statistically significant and clinically relevant advantages compared with vehicle in preventing macular edema and maintaining visual acuity in diabetic patients following cataract surgery. These advantages were seen at multiple time points over the course of the 90-day therapy period. There was no clinically relevant increase in risk from 90 days dosing compared with 14 days. Therefore, with a similar safety profile and benefit in preventing macular edema and maintaining vision, the risk/benefit to the diabetic patient undergoing cataract surgery appears to be positive.Keywords: cataract extraction, diabetes, macular edema, nonsteroidal anti-inflammatory drug, topical, ocular surgery, retinopathy

Singh R

2012-08-01

244

The potential impact of a cataract surgery programme on the care of orphans and vulnerable children in Swaziland  

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Full Text Available SciELO South Africa | Language: English Abstract in english We aimed to evaluate the potential impact of a cataract surgery weeks after surgery, there was a sizable increase in the proportions programme at the Good Shepherd Hospital, Siteki, Swaziland, of subjects who were able to undertake self-care activities, attend on the care of orphans and vulnerable c [...] hildren in Swaziland. We to activities of daily living, undertake income-generating activities studied consecutive patients aged 50 years and older undergoing and care for children. Cataract surgery on elderly visually impaired surgery for age-related cataract who reported having children living patients has the potential to impact positively on the care of in their household. Of 131 subjects recruited, 65 (49.6%) were the orphans and vulnerable children. primary caregivers for the child(ren) in their household. Visual acuities measured 2 weeks after surgery significantly improved. Four weeks after surgery, there was a sizable increase in the proportions of subjects who were able to undertake self-care activities, attend to activities of daily living, undertake income-generating activities and care for children. Cataract surgery on elderly visually impaired patients has the potential to impact positively on the care of orphans and vulnerable children.

J, Pons; W, Mapham; B, Newsome; L, Myer; R, Anderson; P, Courtright; C, Cook.

2012-03-01

245

Ectopic intraocular lens: An unusual complication of cataract surgery  

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We wish to report an unusual complication of intraocular lens (IOL) insertion following uneventful phacoemulsification. After successful phacoemulsification surgery, a hydrophobic acrylic IOL was loaded in the injector for insertion into the capsular bag. During insertion, the IOL inadvertently extended into the corneal stromal lamella. The complication was recognized at a late stage, and the foldable acrylic lens was retrieved and reinserted correctly in the bag. The anterior chamber was made viscoelastically taut and was maintained in this state for 10 min, followed by a routine viscoelastic wash and air bubble injection. Cornea was slightly edematous with stromal haze, and the corneal thickness was 908 ?m. At the 1-month follow-up visit, the patient's vision was 20/40, the stromal haze had subsided, the corneal thickness was 572 ?m, and the patient was comfortable. Though it was unknown complication, following proper management patient recovered satisfactorily. PMID:25005208

Shah, Mehul A; Shah, Shreya A; Aggarwal, Parul M

2014-01-01

246

Hydrophilic Acrylic versus PMMA Intraocular Lens Implantation in Pediatric Cataract Surgery  

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Purpose To compare primary implantation of foldable hydrophilic acrylic with polymethylmethacrylate (PMMA) intraocular lenses (IOLs) in pediatric cataract surgery in terms of short-term complications and visual outcomes. Methods This randomized clinical trial included 40 eyes of 31 consecutive pediatric patients aged 1 to 6 years with unilateral or bilateral congenital cataracts undergoing cataract surgery with primary IOL implantation. Two types of IOLs including foldable hydrophilic acrylic and rigid PMMA were randomly implanted in the capsular bag during surgery. Primary posterior capsulotomy and anterior vitrectomy were performed in all eyes. Patients were followed for at least 1 year. Intra- and postoperative complications, visual outcomes and refractive errors were compared between the study groups. Results Mean age was 3.2±1.8 years in the hydrophilic acrylic group and 3.7±1.3 years in the PMMA group. Mean follow-up period was 19.6±5 (12–29) months. No intraoperative complication occurred in any group. Postoperative uveitis was seen in 2 (10%) eyes in the acrylic group versus 5 (25%) eyes in the PMMA group (P=0.40). Other postoperative complications including pigment deposition (30%), iridocorneal adhesions (10%) and posterior synechiae formation (10%), were seen only in the PMMA group. The visual axis remained completely clear and visual outcomes were generally favorable and comparable in the study groups. Conclusion In pediatric eyes undergoing lensectomy with primary posterior capsulotomy and anterior vitrectomy, hydrophilic acrylic IOLs are comparable to PMMA IOLs in terms of biocompatibility and visual axis clarity, and seem to entail less frequent postoperative complications. PMID:23198075

Panahi-Bazaz, Mahmoud-Reza; Zamani, Mitra; Abazar, Bijan

2009-01-01

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The probable associations for corticocapsular adhesions in patients undergoing cataract surgery: A clinic-based observational study  

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Full Text Available Background: Corticocapsular adhesions (CCA are frequently seen between lens capsule and adjacent cortical layer. During cataract surgery, in the presence of CCA, excessive efforts to rotate the nucleus can result in zonular damage. To reduce morbidity, identification of associations with CCA can be helpful in appropriately modifying the surgical procedure. Aim: To investigate probable associations with CCA in patients undergoing cataract surgery. Setting and Design: Iladevi Cataract and IOL research center. Case-control study. Materials and Methods: A single eye of 600 patients, 200 patients with CCA (cases and 400 patients without CCA (controls were considered. A CCA diagnosis was based on: (i preoperative presence of CCA on slit-lamp examination with visualization of furry surface of cortex during surgery; (ii preoperative absence of CCA on slit-lamp examination but intraoperative visualization of furry surface of cortex. Variables such as age, gender, type of cataract, grade of cataract, high myopia, diabetes mellitus and hypertension were studied. Statistical Analysis: Multivariate logistic regression was done. Results were presented as odds ratio (OR with 95% CI. Results: Mean age was 64.71 ± 9.10 years in cases and 59.27 ± 8.79 years in controls. Presence of CCA increased with age from 22% (n = 59 in 45 to 49 years to 70% (n = 110 in 70 to 79 years. An increase in age was associated with CCA by 3.3% (OR = 3.3%, P = 0.028. The odds of CCA for females were 83% higher ( P = 0.027. Presence of anterior cortical cataract increased odds of CCA by 9.5 times ( P = 0.001, while posterior cortical cataract increased odds by 3.3 times ( P = 0.001. Conclusion: Corticocapsular adhesions were strongly associated with cortical cataracts, increased age and female gender.

Vasavada Abhay

2008-01-01

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Conjunctival bacterial flora and antibiotic resistance pattern in patients undergoing cataract surgery  

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The purpose of this study was to evaluate the conjunctival bacterial flora and its antibiotic susceptibility pattern in eyes of patients undergoing cataract surgery. Conjunctival soap was obtained on the day of surgery before the application of topical anesthetic, antibiotic or povidone-iodine. Culture and antibiotic susceptibility tests were performed. The data was analysed with X/sup 2/ and T tests. Of the 170 patients 89 cases (52.4%) had positive cultures in the eyes. In 79 eyes (88.8%) found coagulase-negative Staphylococcus (CoNS). Eighty two cases (95.3%) of isolated Staphylococcus were susceptible to Amikacin, 86 (100%) sensitive to Ciprofloxacin and 42 (48.8%) sensitive to Ceftazidime. Average susceptibility and resistancy to antibiotics was 2.6 (+-1.8) antibiotics in women and 1.6(+-1.4) in men (P= 0.009). This study showed that the bacterium most frequently found in the conjunctival flora of the patients undergoing cataract surgery was CoNS. Isolates of this bacterium had low CoNS susceptibility rates to Caftazidime and Vancomycin and high susceptibility to Ciprofloxacin and Amikacin. (author)

249

Continuous curvilinear capsulorhexis involving zonular area in manual small incision cataract surgery  

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Full Text Available AIM: To evaluate the efficacy and safety of large sized continuous curvilinear capsulorhexis(CCCinvolving zonular area in manual small incision cataract surgery(MSICS. METHODS:Totally 1 443 cataract patients(1 965 eyesunderwent MSICS, in which large CCC up to 7-8mm were performed.The related conditions such as success rate of performing CCC, capsule rupture, corneal edema and visual acuity after surgery were recorded and statistically analyzed.RESULTS:In total of 1 965 eyes, 1 942 eyes(98.83%had successful CCC, 15 eyes(0.76%had a radial tear which could not be saved when performing CCC, 8 eyes(0.41%had anterior capsule opened with a cystotome or a scissor due to capsule membrane calcification. No posterior capsule rupture occurred, and intraocular lens was transplanted in all cases. Transient corneal edema was noted in 36 eyes(1.83%. One day after surgery, 1 650 eyes(83.97%had visual acuity ?0.5, 1 867 eyes(95.01%?0.3. No unstable intraocular lens was noted in all cases. CONCLUSION: Large CCC technique for MSICS is safe and reliable,not decreasing stability capsular bag and intraocular lens. It is of high originality despite zonular area is involved so that it is worthy of application in basic medical institutions.

Jian-Hua Gao

2014-06-01

250

Cataract surgery with a mid-infrared endo-laser system  

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With most current cataract surgery techniques, an intraocular lens (IOL) is implanted in the capsular bag to emetropize the eye for distance vision. Modern IOLs are made of flexible materials (e.g., silicone and acrylic elastomers) allowing the surgeon to fold and insert the IOL through a smaller limbal incision (4 mm), thus reducing the number of sutures. When using a scleral pocket technique, suturing of such small wounds might not be required. Recently, IOLs having 2 foci (multifocal IOLs) have been introduced. These implants give the patient a second focal plane at normal reading distance, but the double image reduces both visual acuity and contrast sensitivity. However, with all present surgical techniques, the patient loses the natural ability to accommodate. By directing laser energy into a flexible fiber, cataract removal might be performed endoscopically while minimizing trauma to healthy tissue. Bath successfully demonstrated the use of the 308 nm XeCl excimer laser for cataract removal. A significant drawback, however, lies in the fluorescence induced by the 308 nm laser pulses which may cause significant retinal damage. The use of UV radiation also raises serious concerns about carcinogenesis and cataractogenesis risk to both the patient and the surgeon.

Ren, Qiushi; Simon, Gabriel; Gailitis, Raymond P.; Parel, Jean-Marie A.

1992-08-01

251

Effect of heparin in the intraocular irrigating solution on postoperative inflammation in the pediatric cataract surgery  

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Full Text Available Yelda B Özkurt, Arzu Taskiran, Nadire Erdogan, Baran Kandemir, Ömer K Dog?anDepartment of Ophthalmology, Kartal Training and Research Hospital, Istanbul, TurkeyPurpose: To evaluate the influence of irrigation of the anterior chamber with heparin sodium on postoperative inflammation after pediatric cataract surgery. Setting: Kartal Training and Research Hospital, First Eye Clinic, Istanbul, Turkey.Design: Randomized prospective double-blind study.Methods: Fourteen consecutive eyes from 14 patients aged 8.9 ± 5.9 years, (range 3–18 years (group 1 and 19 eyes from 19 patients aged 9.1 ± 5.2 (range 1.5–18 years (group 2 underwent pediatric cataract surgery. Five patients in group 1 were between three and five years old. One patient was 1.5 years old and six patients in group 2 were between three and five years old. During the procedure, group 1 received anterior chamber irrigation with heparin sodium (5 IU/cc and 1 ml of heparin sodium (concentration 10 IU/ml added to the irrigating balanced salt solution (BSS Plus; Alcon Laboratories, Inc., Fort Worth, TX, USA while group 2 received BSS without heparin sodium only. Cases aged under three years received anterior vitrectomy in addition to posterior capsulorrhexis. One eye received anterior vitrectomy in group 1 and two eyes received anterior vitrectomy in group 2. Cases with preoperative complications were not included in the study. Early and late postoperative inflammatory complications, including fibrin formation, anterior and posterior synechia, cyclitic and pupillary membrane formation were recorded and compared.Results: Mild anterior chamber reaction was observed in three patients in Group 1, while nine cases in group 2 experienced marked anterior chamber reaction. In four of nine patients from group 2, anterior chamber reaction was severe and resulted in pupillary membrane and synechia despite treatment in the postoperative 7th day, while in all three cases in group 1, reaction disappeared by the 7th day.Conclusion: Anterior chamber irrigation with heparin during pediatric cataract surgery may minimize early inflammatory reaction and decrease the number of postoperative inflammatory related complications.Keywords: pediatric, cataract, surgery, inflammation

Yelda B Özkurt

2009-06-01

252

Symbolic algebra approach to the calculation of intraocular lens power following cataract surgery  

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We present a symbolic approach based on matrix methods that allows for the analysis and computation of intraocular lens power following cataract surgery. We extend the basic matrix approach corresponding to paraxial optics to include astigmatism and other aberrations. The symbolic approach allows for a refined analysis of the potential sources of errors ("refractive surprises"). We demonstrate the computation of lens powers including toric lenses that correct for both defocus (myopia, hyperopia) and astigmatism. A specific implementation in Mathematica allows an elegant and powerful method for the design and analysis of these intraocular lenses.

Hjelmstad, David P.; Sayegh, Samir I.

2013-03-01

253

Choroidal and macular thickness changes induced by cataract surgery  

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Full Text Available Manuel S Falcão,1,2 Nuno M Gonçalves,2 Paulo Freitas-Costa,1,3 João B Beato,2 Amândio Rocha-Sousa,1,2 Ângela Carneiro,1,2 Elisete M Brandão,2 Fernando M Falcão-Reis1,21Department of Sense Organs, Faculty of Medicine, University of Porto, 2Department of Ophthalmology of Hospital de São João, 3Department of Anatomy, Faculty of Medicine, University of Porto, Porto, PortugalBackground: The aim of this study was to evaluate the effect of uneventful phacoemulsification on the morphology and thickness of the macula, the submacular choroid, and the peripapillary choroid.Methods: In 14 eyes from 14 patients, retinal macular thickness, choroidal submacular thickness, and choroidal peripapillary thickness were measured preoperatively and at one week and one month after phacoemulsification using enhanced depth imaging spectral domain optical coherence tomography. Changes in thickness of the different ocular tissues were evaluated.Results: There was a statistically significant increase in mean retinal macular thickness at one month. In horizontal scans, the mean increase was +8.67±6.75 µm (P<0.001, and in vertical scans, the mean increase was +8.80±7.07 µm (P=0.001. However, there were no significant changes in choroidal morphology in the submacular and peripapillary areas one month after surgery. In vertical scans, there was a nonsignificant increase in choroidal thickness (+4.21±20.2 µm; P=0.47 whilst in horizontal scans a nonsignificant decrease was recorded (?9.11±39.59 µm; P=0.41. In peripapillary scans, a nonsignificant increase in mean choroidal thickness was registered (+3.25±11.80 µm; P=0.36.Conclusion: Uncomplicated phacoemulsification induces nonpathologic increases in retinal macular thickness probably due to the inflammatory insult of the surgery; however these changes are not accompanied by significant changes in choroidal thickness. In the posterior segment, the morphologic response to the inflammatory insult of phacoemulsification is mainly observed at the retinal level, and seems to be independent of choroidal thickness changes.Keywords: phacoemulsification, macular thickness, choroidal thickness, prostaglandins

Falcão MS

2013-12-01

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Relationship between endothelial cell loss and microcoaxial phacoemulsification parameters in noncomplicated cataract surgery  

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Full Text Available Mohamed AE Soliman Mahdy1,2, Mohamed Z Eid1, Mahmoud Abdel-Badei Mohammed3, Amr Hafez4,5, Jagdish Bhatia21Ophthalmic Department, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt; 2Ophthalmic Department, Rustaq Hospital, Rustaq, Sultanate of Oman; 3Research Institute of Ophthalmology, Cairo, Egypt; 4Magrabi Eye and Ear Center, Muscat, Sultanate of Oman; 5Ophthalmic Department, Al-Azhar University Hospital, Assuit, EgyptPurpose: To assess the relationship between postoperative endothelial cell loss and microcoaxial phaco parameters using Ozil IP (Alcon Laboratories, Inc, Fort Worth, TX in noncomplicated cataract surgery.Methods: In this prospective observational study, 120 consecutive cases of cataract patients with different grades of nuclear hardness underwent microcoaxial phacoemulsification through a 2.2-mm clear corneal incision. An Alcon Infinity Vision System with Ozil IP (Alcon Laboratories was used with an Ozil torsional handpiece and a Kelman-style 45° phacoemulsification tip. Patients underwent preoperative and postoperative central endothelial cell counts.Results: The study included 120 cases of age-related cataract whose mean age (standard deviation [SD] was 59.68 years (9.47. There was a highly statistically significant endothelial cell loss (P < 0.001. The endothelial cell loss ranged 11–1149 cells/mm2 with a median (interquartile range of 386 cells/mm2 (184.5–686 cells/mm2. The percentage of postoperative ECLoss% ranged from 0.48% to 47.8% with a median (interquartile range of 15.4% (7.2% to 26.8%. A significant positive correlation was found between the ECLoss% and different phaco parameters. The Spearman’s rank-order correlation coefficient values, rho, (? were as follows: CDE (? = 0.425, aspiration time (? = 0.176, and volume (? = 0.278. Also, ECLoss% was significantly correlated with the grade of nuclear opalescence (Kendall’s tau ? = 0.42.Conclusion: Microcoaxial phacoemulsification was efficient in removing noncomplicated cataracts; however a statistically significant endothelial cell loss was noted, especially with increased nuclear hardness. This endothelial cell loss was mostly related to the increased cumulative dissipated energy (CDE, aspiration time, and volume of balanced salt solution used.Keywords: cataract surgery, phacoemulsification, Ozil, endothelial cells, cumulative dissipated energy 

Soliman Mahdy MAE

2012-03-01

255

Comparison of the frequency of nausea and vomitting, patients, and surgeons, satisfaction based on different anesthesia techniques in cataract surgery  

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Full Text Available Background and purpose: Cataract surgery is the most frequent surgery in old patients. Forty six percent of people older than 75 years of age have cataract. These elderly patients frequently have associated diseases. It is important to select the best anesthetic method with least complications. This study compared 3 anesthetic methods. Regarding to patients, and surgens, comfort, frequency of nausea and vomiting in the patients undergoing cataract surgery.Materials and Methods: This cross sectional observational study with simple sample recruitment was performed on 120 patients divided in three groups of 40 cases, with general anesthesia, topical anesthesia +light IV sedation and local anesthesia + light IV sedation in summer 2004 in Feiz Medical Center. Data collected using check list. One way Anova and Chi-square tests were used to compare mean qualitative and frequency of qualitative variables. The level of statistical significance was set at P< 0.05.Results: There were significant differences in mean score of surgeons, and patients, comfort, mean severity of nausea after surgery and mean score of pain between 3 groups (P<0.001. There was no significance difference in frequency of vomiting after surgery between 3 groups (P=0.33Conclusion: It has been suggested that topical anesthesia +light IV sedation is a safe and effective method for cataract surgery.

Noryan Najaf Abadi

2006-01-01

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Survey of Japanese ophthalmic surgeons regarding perioperative disinfection and antibiotic prophylaxis in cataract surgery  

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Full Text Available Kazuki Matsuura,1 Takafumi Mori,2 Takeshi Miyamoto,3 Chikako Suto,4 Yusuke Saeki,5 Shigeto Tanaka,6 Hajime Kawamura,7 Shinji Ohkubo,8 Masaki Tanito,9,10 Yoshitsugu Inoue111Nojima Hospital, Kurayoshi, 2Department of Ophthalmology, School of Medicine, Fukushima Medical University, Fukushima, 3Department of Ophthalmology, Wakayama Medical University, Wakayama, 4Department of Ophthalmology, Tokyo Women’s Medical University, Tokyo, 5Department of Ophthalmology, School of Medicine, Fukuoka University, Fukuoka, 6Tonosho Central Hospital, Kagawa, 7Shiga University of Medical Science, Otsu, 8Department of Ophthalmology and Visual Science, Kanazawa University Graduate School of Medical Science, Kanazawa, 9Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, 10Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, 11Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University, Yonago, JapanPurpose: To elucidate Japanese trends for perioperative disinfection and antibiotic selection during cataract surgeries.Methods: Perioperative iodine use and antibiotic prophylaxis for cataract surgery were surveyed in eight regions in Japan by mail or through interviews from February 1 to March 1, 2014.Results: We surveyed 572 surgeons, of whom 386 (67% responded. Most of the surgeons (94% used iodine compounds before surgery for periocular skin disinfection (povidone–iodine [PI]: 79%; polyvinyl alcohol-iodine [PAI]: 15% or conjunctival disinfection (85%; PI: 36%; PAI: 49%. Preoperative conjunctival iodine was primarily used as an eye wash (irrigation: 95% and less often as an eye drop (5%. It was determined that 31% of surgeons waited 30 seconds or more between periocular disinfection and conjunctival disinfection. During surgery, 14% of surgeons used iodine several times, including immediately before intraocular lens insertion, and 7% used the Shimada technique (repeated iodine irrigation. Preoperative antibiotic eye drops were used by 99% of surgeons, and antibiotics were added to the irrigation bottle by 22%. The surgeons reported use of subconjunctival antibiotic injections (23%, antibiotic ointments (79%, and intracameral antibiotics (7%: 22 moxifloxacin; 6 levofloxacin. All surgeons prescribed postoperative eye drops, with 10% initiating the drops on the day of surgery.Conclusion: Iodine compounds are commonly used preoperatively, but few institutions use iodine compounds intraoperatively, particularly with repeated application. The selection of antibiotic administration and disinfection technique has to be at the surgeon’s discretion. However, intracameral antibiotic and intraoperative iodine compound use are techniques that should be widely recognized.Keywords: intracameral antibiotic, intraoperative iodine, antibiotic prophylaxis, cataract surgery, endophthalmitis

Matsuura K

2014-09-01

257

Effect of prior cataract surgery on the long-term outcome of selective laser trabeculoplasty  

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Full Text Available Tarek A Shazly1, Mark A Latina2, John J Dagianis3, Satyakant Chitturi41Ophthalmology, Massachusetts Eye and Ear Infirmary/Harvard Medical School, Boston, MA, USA; 2Reading Health Center, Reading, MA, USA; 3Nashua Eye Associates, Nashua, NH, USA; 4Andhra Medical College, Visakhapatnam, IndiaObjective: To determine if pseudophakia affects selective laser trabeculoplasty (SLT intraocular pressure (IOP lowering effect.Methods: A retrospective chart review was performed on 94 eyes of 75 consecutive patients who underwent SLT as primary treatment for ocular hypertension and primary open-angle glaucoma between 2002 and 2005 and completed at least 30 months follow up. Patients were excluded if they required additional glaucoma medications, laser, or ocular surgery during the follow-up period. Patients were categorized as phakics or pseudophakics. Independent-samples t-test was performed to compare the mean percentage of IOP reduction at 3, 6, 12, 18, and 30 months after SLT between the phakic and pseudophakic groups.Results: Seventy-six phakic and 18 pseudophakic eyes were included. IOP reduction in phakic group was 27.4% (2 week, 29.8% (3 months, 27.7% (9 months, 27.4% at (12 months and 27.3% at (30 months. In pseudophakic patients, the mean IOP reduction was 19.8% (2 weeks, 26.5% (3 months, 23.2% (9 months, 22.5% (12 months, and 25.9% (30 months. An independent-sample t-test compared the percentage of IOP reduction between the phakic and pseudophakic groups and revealed higher percentage of IOP reduction in the phakic group at 2 weeks by 7.6% (P = 0.01. P value for difference was 0.34 (3 months, 0.25 (6 months, 0.18 (9 months, 0.12 (12 months, 0.36 (18 months, and 0.7 (30 months after SLT.Conclusions: SLT response was delayed in pseudophakic compared to phakic patients, while the long-term effectiveness of SLT is the same in both groups.Keywords: intraocular pressure, pseudophakic, cataract surgery

Tarek A Shazly

2011-03-01

258

Clinical-epidemiological behaviour of patients after cataract surgery Comportamiento clínico - epidemiológico de operados de catarata  

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Full Text Available Background: Cataract is the leading cause of blindness in the world. Its only effective treatment is surgery, with a high rate of efficiency, but it is not always practiced due to several reasons that limit access to health services. Objective: To identify clinical and epidemiological behaviour of patients after cataract surgery. Methods: An observational, descriptive and cross-sectional study conducted in the "José Joaquín Palma" Ophthalmology Center in the town of San Cristóbal, Guatemala. We included all patients over 18 years old meeting the inclusion criteria who had had a cataract surgery between July and December 2007. The following variables were analyzed: age, sex, skin color, place of origin, ocular and systemic personal medical history, etiologic type of cataract and intra and immediate postoperative complications. Results: 63.3% of the patients are in the 60 years on age group, with a slight predominance of females (51.89% and most of them come from the rural areas (66.66%. Among personal medical histories myopia was detected (14.17% and among systemic medical histories there were arterial hypertension (25.98% and diabetes mellitus (22.04%. Senile cataract was more frequent (52.75%. The most frequent intraoperative complications were posterior capsule ruptures with or without vitreous loss (29.548% and 3.37% respectively and corneal edema in the immediate postoperative (5.48%. Conclusions: The results of clinical and epidemiological characterization of patients after cataract surgery included in this series do not differ from those of similar studies, except for the personal glaucoma history.Fundamento: la catarata es la primera causa de ceguera en el mundo; su único tratamiento efectivo es la cirugía, que tiene un alto índice de eficiencia, y que no siempre se practica debido a diversas razones que limitan el acceso a servicios de salud.
Objetivo: identificar el comportamiento clínico-epidemiológico de pacientes operados de catarata.
Métodos:
estudio observacional, descriptivo y transversal realizado en el Centro Oftalmológico “José Joaquín Palma”, del poblado San Cristóbal, en Guatemala. Se incluyeron todos los pacientes mayores de 18 años operados de catarata entre julio y diciembre de 2007 que cumplieron los criterios de inclusión. Se analizaron las variables: edad, sexo, color de la piel, lugar de procedencia, antecedentes patológicos personales oculares y sistémicos, tipo etiológico de catarata y complicaciones trans y posoperatorias inmediatas.
Resultados: el 63,3 % de los pacientes pertenecen al grupo de edades de 60 años y más, con discreto predominio del sexo femenino (51,89 % y franca procedencia del sector rural (66,66 %. Entre los antecedentes patológicos personales oftalmológicos se observó la miopía (14,17 % y entre los sistémicos la hipertensión arterial (25,98 % y la diabetes mellitus (22,04 %. La catarata senil tuvo mayor frecuencia (52,75 %. Las complicaciones transoperatorias más frecuentes fueron la ruptura de la cápsula posterior con y sin salida de vítreo (29,5 % y 3,37 % respectivamente, así como el edema corneal en el posoperatorio inmediato (5,48 %.
Conclusiones:
los resultados de la caracterización clínico-epidemiológica de los pacientes operados de catarata incluidos en esta serie no se diferencian de los de estudios similares, con excepción del antecedente patológico personal de glaucoma.

Juan C. Medina Perdomo

2010-12-01

259

Situation analysis of cataract surgery in poverty-stricken region of Yixing in Jiangsu  

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Full Text Available AIM: To explore the feasibility and evaluation on prevention of blindness in poverty-stricken region of Yixing led by the People's Hospital.METHODS: By respectively comparing poverty-relief(hereafter referred to as povertypatients in poverty-stricken region with the patients in urban district(hereafter referred to as urbanin the following aspects: the situation of visual blindness and the visual disability before surgery and the situation of vision rehabilitation and getting rid of visual disability after operation, and then the differences were analyzed as the standard: blindness was vision less than 0.05, visual disablity was vision less than 0.3 and vision rehabilitation was postoperative vision equal to or more than 0.05 and getting rid of visual disability was postoperative vision equal to or more than 0.3. The differences were compared between the cataract surgery situation in poverty-stricken region led by our hospital and the requirements of “The prevention of blindness project for millions of poor cataract patients” during the twelfth five-year. RESULTS: There were 72 cases in the poverty group, including 41 cases of blindness and 70 cases of visual disability, while totally 210 cases were in the urban group, including 111 cases of visual blindness and 200 cases of visual disability. There were no difference between the poverty group and urban group in the visual blindness(?2=1.344, P?2=0.146, P?2=0.236, P?2=0.846, PCONCLUSION: “The prevention of blindness project for millions of poor cataract patients” has been carried out smoothly in our hospital which proves that we do have the ability to undertake the prevention of blindness in our city, but there is still some deficiency to be improved.

Huan Yang

2014-05-01

260

The problem of the iridal prolapse during the cataract surgery in patients administering the Tamsulosin  

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Full Text Available Introduction: Tamsulosin is alfa 1a-adrenergic antagonist administered to patients with prostatic hypertrophy. It causes the relaxation of the smooth muscles of prostate and urinary bladder and results in symptom alleviation. However, Tamsulosin side effect reflects in the atony of pupil's dilatory muscle, and accordingly, the iris during the phacoemulsification becomes folded and prolapses through the phacoemulsification incision. Moreover, there is no possibility of sufficient pupil dilatation because of the predominating effect of the pupillary m. sphincteris. In order to manage the iridal prolapse during the surgery, a special high-cohesive visco-elastic as well as multi-positioned iridal retractors are being used. Case report: This is a case report of three patients. Common to all of them was that they were all males in the advanced age, had benign prostatic hypertrophy, received Tamsulosin and underwent cataract surgery by phacoemulsification. In all three patients, adequately dilated pupils required for unobstructed performance of phacoemulsification could not be achieved by regular medicaments. In addition, in all three cases, the iris prolapsed through the incision during the surgical intervention. Upon applying the viscoelastic and deepening of the anterior ocular chamber as well as after the placement of iridal retractors in different positions, the operation was successfully brought to an end. Conclusion: In patients administering the Tamsulosin, cataract phacoemulsification is more frequently associated with complications. A special problem is a constant iridal prolapse through the incision. Unfortunately, no so far described method for managing this problem has been fully successful, what was confirmed in our case reports as well. Therefore, the operation for cataract in these patients should be carried out only by most experienced and skillful surgeons.

Jovanovi? Miloš

2011-01-01

 
 
 
 
261

Intracameral anesthesia for cataract surgery: a population-based study on patient satisfaction and outcome  

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Full Text Available Inger Westborg,1,2 Eva Mönestam1 1Department of Clinical Sciences/Ophthalmology, Umeå University, Umeå, Sweden; 2Eye Clinic, Sunderby Hospital, Luleå, Sweden Purpose: To evaluate if the standard anesthetic regimen – topical combined with intracameral anesthesia without sedation – in a population-based cohort of unselected cataract surgery cases is adequate, optimal, and good practice, or if improvements are necessary. Methods: We conducted a prospective, observational study on all cases of cataract surgery during a 1-year period at one institution (n=1249. Data were collected from the patients’ records. Outcome measures were use of preoperative sedation, type of anesthesia, complications, and adverse events. In a subgroup of patients (n=124 satisfaction with the anesthetic regimen was evaluated using a short questionnaire. Results: Most cases (90%, 1125/1249 had combined topical and intracameral anesthesia without sedation. Patients who chose preoperative sedation (midazolam hydrochloride sublingually were significantly younger and more often female (P=0.0001 and P=0.011, respectively. In the questionnaire subgroup, the median pain score after surgery was 0.7 (visual analog scale, 0–10. A pain score of 1.9 or less was reported by 76% of the patients. Patients reporting a pain score of 2 or more had sedation and additional anesthetics more often. No significant difference was found regarding age, sex, pulse rate, oxygen saturation, first or second eye surgery, or adverse intraoperative events for patients with pain scores of 1.9 or less and 2 or more. Conclusion: This large population-based series of small-incision phacoemulsification surgery shows that combined topical and intracameral anesthesia without sedatives is well tolerated for most phacoemulsification patients. It is also effective in cases when complications or adverse events occur. It is important to be responsive to the individual patient’s needs and adjust operating procedures if necessary, as there were a few patients who experienced insufficient anesthesia. Keywords: anesthesia, local/methods, phacoemulsification, cataract extraction, humans, prospective observational studies

Westborg I

2013-10-01

262

Comparative efficacy of topical tetraVisc versus lidocaine gel in cataract surgery  

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Full Text Available Abstract Background To compare the clinical efficacy of lidocaine 2% with tetracaine 0.5% for cataract surgery. Methods In a randomized, multi-surgeon, controlled clinical trial,122 consecutive cataract cases eligible for topical anesthesia, were randomly assigned to receive lidocaine 2% gel (1 ml or tetracaine solution 0.5% (TetraVisc, 0.5 ml before clear corneal phacoemulsification. Main outcome measure was visual analog scale (0 to 10, which was used to measure intra-operative pain. Secondary outcome measures included patients' discomfort due to tissue manipulation and surgeon graded patients' cooperation. Duration of surgery and intra-operative complications were also recorded. Results The mean age in TetraVisc (TV group was 70.4 years and in the lidocaine gel group (LG it was 70.6 years (p = 0.89. Patient reported mean intra-operative pain scores by visual analog scale were 0.70 ± 0.31 in TV group and 1.8 ± 0.4 in LG group (P Conclusion Topical TetraVisc solution was superior to lidocaine 2% gel for pain control in patients undergoing clear corneal phacoemulsification. Lidocaine 2% gel is similar to TetraVisc in patient comfort and surgeon satisfaction. Trial Registration Clinical trials number: ISRCTN78374774

Gupta Shailesh K

2009-08-01

263

Topical Latanoprost Does Not Cause Macular Thickening after Uncomplicated Cataract Surgery  

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Purpose To explore changes in central macular thickness (CMT) after a two-month period of glaucoma therapy with topical latanoprost after uneventful phacoemulsification. Methods Forty-one eyes of 31 patients with primary open angle or pseudoexfoliative glaucoma who required glaucoma medications after cataract surgery were prospectively enrolled. All eyes had undergone uneventful phacoemulsification with intraocular lens implantation at least 4 months before initiation of latanoprost. After a complete ophthalmic examination, spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) were performed at baseline before starting latanoprost. All eyes received latanoprost for 2 months, and clinical examinations were repeated one and two months afterwards; OCT and FA were repeated after 2 months. Outcome measures were CMT and loss of more than 2 lines of best corrected visual acuity (BCVA). Results Mean patient age was 71.6±7.8 years. Intraocular pressure decreased from 21.5±3.4 mmHg to 14.4±2.6 mmHg (p0.05 for all comparisons). Conclusion Topical use of latanoprost later than 4 months after uncomplicated cataract surgery does not seem to predispose to increased macular thickness or CME and may safely be used in this setting. PMID:23503128

Moghimi, Sasan; Zandian, Mehdi; Latifi, Golshan; Amini, Heydar; Eslami, Yadollah; Zarei, Reza; Fakhraie, Ghasem; Nouri-Mahdavi, Kouros

2012-01-01

264

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

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Full Text Available 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 groups: standard scleral buckling and standard three-port deep vitrectomy. Successful treatment was defined as improvement in vision (minimum of 2 lines in Snellen chart, anatomic reattachment and prevention of post-operative proliferative vitreo-retinopathy (PVR. The prognostic role of pre-operative and intra-operative conditions of the affected eye was also evaluated. Twenty-six of fifty-six eligible patients underwent scleral buckling and thirty had deep vitrectomy. Anatomic reattachment was achieved in 18 (69.2% cases in scleral buckling group and 19 (63% cases in vitrectomy group. Improvement in visual acuity was achieved in 76.9% and 83.3% and PVR occurred post-operatively in 23.1% and 16.7%, respectively. The differences were not statistically significant, and pre- and intra-operative ocular conditions did not prove to be prognostic factors, either. Scleral buckling and primary deep vitrectomy seem to have comparable outcomes in terms of anatomic reattachment and visual improvement in patients with pseudophakic and aphakic retinal detachment. Failure to achieve anatomic reattachment and visual improvement or PVR occurred in about one third and one fifth of the cases respectively, irrespective of the technique used. This warrants further research to improve treatment results

"H. Faghihi

2004-06-01

265

Emotional factors prior to cataract surgery Fatores emocionais antecedentes à cirurgia de catarata  

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Full Text Available PURPOSE: Identification of emotional factors related to daily difficulties and surgical treatment among patients with cataract at a university hospital. METHODS: A cross-sectional study was carried out by means of a questionnaire, elaborated based on a previous study. The sample consisted of patients seen at the cataract unit of the ophthalmology clinic of a university hospital. RESULTS: The sample consisted of 110 individuals of both sexes (34.5% men; 65.5% women between the ages of 43 and 89 (average 69.0 ± 10.3 years; 26.4% had never attended school, 59.1% had primary education, and 87.3% had no payed occupation. Most of the patients reported daily difficulties due to their ocular condition (82.7%, and 54.0% reported fear of visual loss. Doubt as to the outcome (32.7%, distress (26.4%, and sadness (25.5% were reported. CONCLUSIONS: Most of the patients reported difficulties in daily activities as a consequence of cataract. Fear was the predominant feeling related to undergoing surgery. The findings suggest the need for implementing intervention courses for emotional preparation for facing daily activities and cataract surgery.OBJETIVO: Identificar fatores emocionais relacionados às dificuldades cotidianas e ao tratamento cirúrgico entre portadores de catarata de hospital universitário. MÉTODOS: Realizou-se estudo observacional transversal descritivo, por meio de questionário estruturado, aplicado por entrevista, elaborado a partir de estudo exploratório. A amostra foi formada por pacientes atendidos pelo setor de catarata da clínica oftalmológica de um hospital universitário. RESULTADOS: A amostra foi constituída por 110 sujeitos de ambos os sexos (34,5% homens; 65,5% mulheres, com idade entre 43 e 89 anos, ± 10,3 anos. Quanto à escolaridade, 26,4% nunca freqüentaram escola, 59,1% se distribuíram entre 1ª e 8ª série (1º grau; 87,3% não exerciam atividade remunerada. A maior proporção dos entrevistados referiu dificuldades cotidianas devido à afecção ocular (82,7%. Quanto ao medo em relação à cirurgia de catarata, 54,0% mencionaram medo de perder a visão. Foram registrados sentimentos/significações em relação ao procedimento cirúrgico: dúvida quanto ao resultado (32,7%, angústia (26,4%, tristeza (25,5%. CONCLUSÕES: A maioria dos entrevistados referiu dificuldades nas atividades cotidianas como conseqüência da catarata. Medo foi sentimento predominante entre os respondentes. Esses fatos sugerem necessidade de implementação de ações junto a pacientes, visando preparo emocional para enfrentamento das atividades cotidianas e da cirurgia de catarata.

Roberta Marback

2007-01-01

266

Cancelamento de cirurgias de catarata em um hospital público de referência / Cancellation of cataract surgery in a public hospital  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Analisar a incidência e causas de cancelamento de cirurgias de catarata em um hospital público de referência. MÉTODOS: Trata-se de um estudo retrospectivo em que foram analisados o número de cancelamentos de facectomias durante o ano de 2009. Foram analisados sexo, idade, tipo de procedime [...] nto suspenso (facoemulsificação ou extração extracapsular do cristalino), tipo de anestesia, convênio (Sistema Único de Saúde ou convênio/particular) e motivo de suspensão da cirurgia (causas clínicas, institucionais ou pessoais). RESULTADOS: Foram agendadas no período 2.965 cirurgias de catarata, havendo 650 cancelamentos (21,92%). Dentre as principais razões para a suspensão do procedimento destacaram-se as causas clínicas (86,90%). Os meses de inverno apresentaram os maiores índices de suspensão de cirurgias de catarata. CONCLUSÃO: A taxa de cancelamento de cirurgia de catarata em serviços públicos parece ser a mesma que há 10 anos. A principal causa de suspensão deve-se por condições clínicas (hipertensão, diabetes, falta de exames, etc.). Abstract in english PURPOSE: To report the incidence and causes of cataract surgery cancellations in a public hospital. METHODS: This is a retrospective study, which examined the number of cancellations of cataract surgery during 2009. We analyzed the type of procedure suspended (phacoemulsification or extracapsular ex [...] traction), type of anesthesia, gender, age, covenant (public/private) and the main reasons for suspension of the surgeries (clinical causes, institutional or personal). RESULTS: We analyzed 2,965 scheduled cataract surgeries, with 650 cancellations (21.92%). The main reason for the suspension of the procedure was clinical causes (86.90%). The winter months had the highest suspension rates of cataract surgery. CONCLUSION: The cancellation rate of cataract surgery in Brazilian public system seems to be the same as 10 years ago. The main cause of the suspension should be in clinical conditions (hypertension, diabetes, lack of exams, etc.).

Micheli Patrícia de Fátima, Magri; Rodrigo França de, Espíndola; Marcony Rodrigues de, Santhiago; Elisabeth Frolich, Mercadante; Newton, Kara Júnior.

267

Cancelamento de cirurgias de catarata em um hospital público de referência Cancellation of cataract surgery in a public hospital  

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Full Text Available OBJETIVO: Analisar a incidência e causas de cancelamento de cirurgias de catarata em um hospital público de referência. MÉTODOS: Trata-se de um estudo retrospectivo em que foram analisados o número de cancelamentos de facectomias durante o ano de 2009. Foram analisados sexo, idade, tipo de procedimento suspenso (facoemulsificação ou extração extracapsular do cristalino, tipo de anestesia, convênio (Sistema Único de Saúde ou convênio/particular e motivo de suspensão da cirurgia (causas clínicas, institucionais ou pessoais. RESULTADOS: Foram agendadas no período 2.965 cirurgias de catarata, havendo 650 cancelamentos (21,92%. Dentre as principais razões para a suspensão do procedimento destacaram-se as causas clínicas (86,90%. Os meses de inverno apresentaram os maiores índices de suspensão de cirurgias de catarata. CONCLUSÃO: A taxa de cancelamento de cirurgia de catarata em serviços públicos parece ser a mesma que há 10 anos. A principal causa de suspensão deve-se por condições clínicas (hipertensão, diabetes, falta de exames, etc..PURPOSE: To report the incidence and causes of cataract surgery cancellations in a public hospital. METHODS: This is a retrospective study, which examined the number of cancellations of cataract surgery during 2009. We analyzed the type of procedure suspended (phacoemulsification or extracapsular extraction, type of anesthesia, gender, age, covenant (public/private and the main reasons for suspension of the surgeries (clinical causes, institutional or personal. RESULTS: We analyzed 2,965 scheduled cataract surgeries, with 650 cancellations (21.92%. The main reason for the suspension of the procedure was clinical causes (86.90%. The winter months had the highest suspension rates of cataract surgery. CONCLUSION: The cancellation rate of cataract surgery in Brazilian public system seems to be the same as 10 years ago. The main cause of the suspension should be in clinical conditions (hypertension, diabetes, lack of exams, etc..

Micheli Patrícia de Fátima Magri

2012-10-01

268

Cancelamento de cirurgias de catarata em um hospital público de referência / Cancellation of cataract surgery in a public hospital  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Analisar a incidência e causas de cancelamento de cirurgias de catarata em um hospital público de referência. MÉTODOS: Trata-se de um estudo retrospectivo em que foram analisados o número de cancelamentos de facectomias durante o ano de 2009. Foram analisados sexo, idade, tipo de procedime [...] nto suspenso (facoemulsificação ou extração extracapsular do cristalino), tipo de anestesia, convênio (Sistema Único de Saúde ou convênio/particular) e motivo de suspensão da cirurgia (causas clínicas, institucionais ou pessoais). RESULTADOS: Foram agendadas no período 2.965 cirurgias de catarata, havendo 650 cancelamentos (21,92%). Dentre as principais razões para a suspensão do procedimento destacaram-se as causas clínicas (86,90%). Os meses de inverno apresentaram os maiores índices de suspensão de cirurgias de catarata. CONCLUSÃO: A taxa de cancelamento de cirurgia de catarata em serviços públicos parece ser a mesma que há 10 anos. A principal causa de suspensão deve-se por condições clínicas (hipertensão, diabetes, falta de exames, etc.). Abstract in english PURPOSE: To report the incidence and causes of cataract surgery cancellations in a public hospital. METHODS: This is a retrospective study, which examined the number of cancellations of cataract surgery during 2009. We analyzed the type of procedure suspended (phacoemulsification or extracapsular ex [...] traction), type of anesthesia, gender, age, covenant (public/private) and the main reasons for suspension of the surgeries (clinical causes, institutional or personal). RESULTS: We analyzed 2,965 scheduled cataract surgeries, with 650 cancellations (21.92%). The main reason for the suspension of the procedure was clinical causes (86.90%). The winter months had the highest suspension rates of cataract surgery. CONCLUSION: The cancellation rate of cataract surgery in Brazilian public system seems to be the same as 10 years ago. The main cause of the suspension should be in clinical conditions (hypertension, diabetes, lack of exams, etc.).

Micheli Patrícia de Fátima, Magri; Rodrigo França de, Espíndola; Marcony Rodrigues de, Santhiago; Elisabeth Frolich, Mercadante; Newton, Kara Júnior.

2012-10-01

269

Improvement of corneal fluorescein staining in post cataract surgery of diabetic patients by an oral aldose reductase inhibitor, ONO-2235  

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Aim: While the mechanism in the pathogenesis of diabetic corneal disease is unclear, aldose reductase has been implicated in corneal disease. The effects of an oral aldose reductase inhibitor (ARI) on the ocular surface of diabetic patients after cataract surgery were studied.

Fujishima, H.; Tsubota, K.

2002-01-01

270

Correção do astigmatismo na cirurgia da catarata / Surgical correction of astigmatism during cataract surgery  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVOS: Avaliar a eficácia das incisões periféricas relaxantes limbares (IPRL) na redução do astigmatismo pré-operatório durante a cirurgia de catarata. MÉTODOS: Foram estudados prospectivamente 103 olhos de 103 pacientes submetidos as IPRL, utilizando o nomograna de Nichamin durante a cirurgia d [...] e catarata pela facoemulsificação. Após o 1º e 6º mês foram avaliadas as mudanças no astigmatismo topográfico, na indução do astigmatismo e no índice de sucesso. Os pacientes foram separados em dois grupos segundo o tipo de astigmatismo no pré-operatório (a favor da regra e contra a regra) e estudados separadamente. RESULTADOS: Ocorreram diferenças estatisticamente significativas entre os valores dos astigmatismos topográficos no pré e pós-operatório nos dois grupos. Verificou-se indução de 1,10 ± 0,9 dioptrias e 37% de índice de sucesso no grupo de astigmatismo a favor da regra e 1,70 ± 0,80 dioptrias e 51% de índice de sucesso no grupo de astigmatismo contra a regra após o 6º mês de seguimento. CONCLUSÃO: A incisão periférica relaxante limbar é efetiva na redução do astigmatismo pré-existente durante a cirurgia da catarata. O procedimento mostrou ser seguro e de fácil realização. O nomograma de Nichamim na nossa experiência hipocorrige o astigmatismo planejado em ambos os grupos estudados. Abstract in english PURPOSE: To evaluate the effect of peripheral limbar relaxing incisions (PLRI) in the reduction of the astigmatism during cataract surgery. METHODS: We studied prospectively 103 eyes of 103 patients submitted to PLRI, using the Nichamim nomogram during cataract surgery by phacoemulsification. After [...] the first and sixth month we analized the changes in astigmatism topography, induction of astigmatism and sucess rate. The patients were divided into two groups according to the astigmatism (with-the-rule and against-the-rule), and studied separately. RESULTS: There was a statistically significant change in the mean astigmatism topography in the preoperative and postoperative periods in both groups. There was an induction of 1.10 ± 0.9 D and 37% of sucess rate in the with-the-rule group and 1.70 ± 0.80 D and 51% of sucess rate in the against-the-rule group after six months of follow-up. CONCLUSIONS: The peripherical relaxing limbal incisions (PLRI) are effective in reducing the preoperative astigmatism during cataract surgery. The procedure is safe and easy. The Nichamin nomogram caused hypocorrection in both types of preoperative astigmatism.

Edison Ferreira e, Silva; Fernando Cançado, Trindade.

2007-08-01

271

Correção do astigmatismo na cirurgia da catarata Surgical correction of astigmatism during cataract surgery  

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Full Text Available OBJETIVOS: Avaliar a eficácia das incisões periféricas relaxantes limbares (IPRL na redução do astigmatismo pré-operatório durante a cirurgia de catarata. MÉTODOS: Foram estudados prospectivamente 103 olhos de 103 pacientes submetidos as IPRL, utilizando o nomograna de Nichamin durante a cirurgia de catarata pela facoemulsificação. Após o 1º e 6º mês foram avaliadas as mudanças no astigmatismo topográfico, na indução do astigmatismo e no índice de sucesso. Os pacientes foram separados em dois grupos segundo o tipo de astigmatismo no pré-operatório (a favor da regra e contra a regra e estudados separadamente. RESULTADOS: Ocorreram diferenças estatisticamente significativas entre os valores dos astigmatismos topográficos no pré e pós-operatório nos dois grupos. Verificou-se indução de 1,10 ± 0,9 dioptrias e 37% de índice de sucesso no grupo de astigmatismo a favor da regra e 1,70 ± 0,80 dioptrias e 51% de índice de sucesso no grupo de astigmatismo contra a regra após o 6º mês de seguimento. CONCLUSÃO: A incisão periférica relaxante limbar é efetiva na redução do astigmatismo pré-existente durante a cirurgia da catarata. O procedimento mostrou ser seguro e de fácil realização. O nomograma de Nichamim na nossa experiência hipocorrige o astigmatismo planejado em ambos os grupos estudados.PURPOSE: To evaluate the effect of peripheral limbar relaxing incisions (PLRI in the reduction of the astigmatism during cataract surgery. METHODS: We studied prospectively 103 eyes of 103 patients submitted to PLRI, using the Nichamim nomogram during cataract surgery by phacoemulsification. After the first and sixth month we analized the changes in astigmatism topography, induction of astigmatism and sucess rate. The patients were divided into two groups according to the astigmatism (with-the-rule and against-the-rule, and studied separately. RESULTS: There was a statistically significant change in the mean astigmatism topography in the preoperative and postoperative periods in both groups. There was an induction of 1.10 ± 0.9 D and 37% of sucess rate in the with-the-rule group and 1.70 ± 0.80 D and 51% of sucess rate in the against-the-rule group after six months of follow-up. CONCLUSIONS: The peripherical relaxing limbal incisions (PLRI are effective in reducing the preoperative astigmatism during cataract surgery. The procedure is safe and easy. The Nichamin nomogram caused hypocorrection in both types of preoperative astigmatism.

Edison Ferreira e Silva

2007-08-01

272

Clinical research on visual performance and pseudophakic accommodation of Tetraflex accommodative intraocular lens in cataract surgery  

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Full Text Available AIM: To obverse visual acuity, pseudophakic accommodation, visual performance after implantation of the Tetraflex accommodative intraocular lens(IOLin patients with age-related cataract.METHODS: Case -control study. Forty-eight patients(seventy-two eyeswith age-related cataract received phacoemulsification and implantation of artificial intraocular lens in our department during March 2010 to December 2012. The patients were randomly divided into 2 groups: Tetraflex group( 23 cases 35 eyesand SA60AT group(25 cases 37 eyes. All patients were assessed for visual acuity, accommodation amplitude and contrast sensitivity visual acuity in 1, 3 and 6mo after the surgery. The indexes were analyzed by SPSS 13.0 statistics software.RESULTS: There were no statistically significant differences in uncorrected distance visual acuity(UCDVAand best-corrected distance visual acuity(BCDVAbetween the two groups(P>0.05; while there were statistically significant differences in uncorrected near visual acuity(UCNVAand distance-corrected near vision acuity(DCNVA(PP>0.05. The Tetraflex group has best accommodative amplitude than the SA60AT group(PP>0.05. The Tetraflex group had higher rate of spectable independence than the SA60AT group(82.9% vs 16.2%(PCONCLUSION: Tetraflex provides an excellent distance and near visual acuity, good amplitude of accommodation and decrease the dependence of spectacle, and improve the visual performance. But its long-term effect remains to be observed.

Jun-Yi Xie

2013-07-01

273

Acetazolamide-induced cilio-choroidal effusion after cataract surgery: unusual posterior involvement  

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Full Text Available Romualdo Malagola, Loredana Arrico, Rossella Giannotti, Luigi PattavinaDepartment of Ophthalmology, University of Rome "La Sapienza," Rome, ItalyAbstract: Idiosyncratic reactions to a large number of drugs have been reported to cause choroidal detachment and secondary angle-closure glaucoma (ACG. We report a case of bilateral acute ACG and peculiar choroidal effusion following administration of oral acetazolamide immediately after cataract surgery. Few cases of acute secondary ACG with choroidal effusion and anterior shift of the lens-iris diaphragm have been associated with acetazolamide compared with other sulfonamides. As far as we are aware, posterior involvement with retinal folds and papillary edema due to acetazolamide has not been described before.Keywords: acetazolamide, cilio-choroidal effusion, acute ACG, papillary edema, retinal folds

Malagola R

2013-01-01

274

Case Payment and the Adoption of New Technology?An Empirical Study of Cataract Surgery in Taiwan.  

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Full Text Available Background: Case payment for cataract surgery with Government Employee Insurance(GEI was implemented at Chang Gung Memorial Hospital (CGMH inMarch 1994, and fee-for-service (FFS was retained for cataract inpatientswith or without other health insurance. We examined the impact of thischange in the reimbursement policy from FFS to case payment on the healthcare provider's practice behavior towards a new emerging technology, usingcataract surgery as an example.Methods: Secondary data analysis was performed using 1 year of CGMH data before(period 1, from March 1993 to February 1994 and after (period 2, fromMarch 1994 to February 1995 implementing the new policy. Inpatientrecords for cataract surgery using either extracapsular cataract extraction(ECCE, the old technology or phacoemulsification (Phaco, the new technologywere included. Logistic regression models were employed to assesshow case payment affected the health care provider's adoption of new technology.Results: The percentage of cases treated using the new Phaco technology grew fromperiod 1 (6.6% to period 2 (23.6% among all 4 study groups, despite Phacobeing more expensive than ECCE. More importantly, the increment ratio ofPhaco use from periods 1 to 2 was the smallest for GEI patients (3.26-foldwhen compared with the other 3 groups (4.16-5.29-fold.Conclusions: Both new technology and cost containment strategies should be taken intoaccount when setting up a reimbursement policy.

Yi-Chou Chuang

2004-05-01

275

Postoperative IOP prophylaxis practice following uncomplicated cataract surgery: a UK-wide consultant survey  

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Full Text Available Abstract Background In order to minimise postoperative intraocular pressure (IOP rise, after routine uncomplicated cataract surgery, prophylaxis may be adopted. Currently, there are no specific guidelines in this regard resulting in wide variation in practice across the UK. We sought to document these variations through a questionnaire survey. Methods A questionnaire was sent to all consultant ophthalmic surgeons in the UK. Results 62.6% of surgeons did not use any IOP lowering agents. 37.4% surgeons routinely prescribed some form of medication. The majority (86.8% used oral diamox. 20.6% of surgeons said they based their practice on evidence, 43.3% on personal experience, and 17.6% on unit policy. Surprisingly, among the two groups of surgeons (those who gave routine prophylaxis, and those who did not the percentages of surgeons quoting personal experience, unit policy, or presence of evidence was strikingly similar. The timing of the first postoperative IOP check varied from the same day to beyond 2 weeks. Only 20.2% of surgeons had ever seen an adverse event related to IOP rise; this complication is thus very rare. Conclusion This survey highlights a wide variation in the practice and postoperative management of phacoemulsification cataract surgery. What is very striking is that there is a similar proportion of surgeons in the diametrically opposite groups (those who give or do not give routine IOP lowering prophylaxis who believe that there practice is evidence based. The merits of this study suggests that consideration must be given to drafting a uniform guideline in this area of practice.

Dhillon Baljean

2005-10-01

276

A study of patient satisfaction after cataract surgery with implantation of different types of intraocular lenses  

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Full Text Available Abstract Background The implementation of capitated payment has driven medical institutions through developing balance billing for medical services. By exploring the patients’ decision-making factors on different self-pay items, a reference for the pricing and sales strategy for the related products can be formed. The major purposes of this study were to analyze the determinants of preoperative selection and postoperative satisfaction with implantation of different types of intraocular lenses in cataract surgery. Methods This cross-sectional study consisted of 127 patients that were 50 years of age and older, and who had phacoemulsification with intraocular lens implantation in both eyes. Data were collected by using a structured questionnaire. The following parameters were measured: access to medical care, attitude towards receiving medical products at one’s own expense, overall patient satisfaction and postoperative visual clarity. Results The results showed that the patient’s gender, educational level and economic status influenced the type of intraocular lens chosen. Patients in the insurance group cared about access to medical care, and patients in the balance billing group cared about product differentiation. ANOVA results showed no statistically significant differences in the overall satisfaction of the patients among the groups with different types of intraocular lenses. Patients that received cataract surgery with implantation of multifocal intraocular lenses had better vision when trying to view smaller objects and when looking at objects under strong light. Conclusions Manufacturers should increase the number of differences between their products, and health care providers can then recommend the appropriate intraocular lens in accordance with the needs or demands of their patients, and also by keeping in mind the financial constraints of their patients.

Wei Ching-Kuo

2012-10-01

277

Risk of Cataract Surgery in HIV-Infected Individuals: A Danish Nationwide Population-Based Cohort Study  

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Background.?Premature aging has been suggested a risk factor for early death in patients infected with human immunodeficiency virus (HIV). Therefore, the risk of age-related diseases, such as cataracts, should be increased in this population. In a nationwide, population-based cohort study we assessed the risk of cataract surgery in HIV-infected individuals compared with the general population.Methods.?We identified 5315 HIV-infected individuals from a Danish national cohort of HIV-infected individuals and a population-based age- and sex-matched comparison cohort of 53?150 individuals. Data on cataract surgery were obtained from the Danish National Hospital registry. Cumulative incidence curves were constructed. Incidence rate ratios (IRRs) and impact of immunodeficiency, highly active antiretroviral therapy (HAART), and treatment with abacavir, tenofovir, protease inhibitors, and nonnucleoside analogue reverse-transcriptase inhibitors (NNRTIs) were estimated by Poisson regression analyses and adjusted for age, sex, and calendar year.Results.?HIV-infected individuals had a higher risk of cataract surgery than the comparison cohort (adjusted IRR, 1.87; 95% confidence interval (CI): 1.50-2.33). The highest risk was found in patients with a CD4 cell count ?200 cells/?L (adjusted IRR before HAART initiation, 3.11 [95% CI, 1.26-7.63]; adjusted IRR after HAART initiation, 4.74 [95% CI, 2.60-8.62]). In patients not receiving HAART and those receiving HAART with a CD4 cell count >200 cells/mL the adjusted IRRs were 0.60 (95% CI: 0.22-1.61) and 1.87 (95% CI: 1.46-2.39). Treatment with abacavir, tenofovir, protease inhibitors, or NNRTIs did not increase the risk substantially.Conclusions.?HIV-infected individuals have an increased risk of cataract surgery. The risk is mainly associated with immunodeficiency and HAART, but accelerated aging cannot be excluded as part of the possible explanation.

Rasmussen, Line D; Pedersen, Court

2011-01-01

278

Evaluation of ultrasonic biomicroscopy results in anterior eye segment before and after cataract surgery  

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Full Text Available Ali Simsek,1 Süleyman Ciftci21Department of Ophthalmology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey; 2Department of Ophthalmology, Diyarbakir Training and Research Hospital, Diyarbakir, TurkeyBackground: The aim of this study was to assess the value of ultrasonic biomicroscopy in reporting decreases in intraocular pressure resulting from changes in anterior chamber depth and angle after phacoemulsification and intracapsular lens implantation in patients with cataract.Methods: This prospective interventional case series included 50 eyes of 50 consecutive subjects operated at the same center. Patients with eye disease affecting visual acuity, a history of eye surgery, corneal surface irregularities, a pupil diameter < 5 mm after preoperative dilation, aged younger than 35 years, posterior capsule perforation, iris dialysis during surgery, intensive postoperative corneal edema, and inability to attend adequate follow-up were excluded. Intraocular pressure, anterior chamber depth and angle, and corneal thickness were measured before and one month after surgery.Results: The mean preoperative intraocular pressure was 14 mmHg and postoperatively was 11 mmHg. Mean anterior chamber depth preoperatively was 2.8 mm and increased to 3.7 mm postoperatively. The mean anterior chamber angle was measured as 27° preoperatively and as 42° postoperatively.Conclusion: After phacoemulsification and intracapsular lens implantation, ultrasonic biomicroscopy showed that the iris diaphragm had shifted backwards, widening the angle of the anterior chamber and decreasing intraocular pressure.Keywords: anterior chamber depth, anterior chamber angle, ultrasonic biomicroscopy

Ciftci S

2012-11-01

279

Corneal Graft and Cataract Surgery in Patients with Moderate to Severe Intellectual Disability  

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Background: Intraocular surgery in patients with intellectual disability can be hazardous. Our aim was to determine the outcomes of surgery on all such patients seen in a consultant-led service, and to assess the overall risks and benefits. Materials and Methods: A retrospective chart review of patients with moderate to severe intellectual…

Cooke, C. A.; Frazer, D. G.; Jackson, A. J.

2006-01-01

280

Gender and use of cataract surgical services in developing countries  

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Full Text Available OBJECTIVE: To determine, from the existing literature, cataract surgical coverage rates by sex and the proportion of cataract blindness that could be eliminated if women and men had equal access to cataract surgical services. METHOD: Methodologically sound population-based cataract surveys from developing countries were identified through a literature search. Cataract surgical coverage rates were extracted from the surveys and rates for women were compared to those for men. Peto odds ratios were calculated for each survey and a meta-analysis of the surveys was performed. FINDINGS: From a literature review and meta-analysis of cataract surveys in developing countries, we found that the cataract surgical coverage rate was 1.2-1.7 times higher for males than for females. For females, the odds ratio of having surgery, compared to males, was 0.67 (95% confidence interval (CI: 0.60- 0.74. Despite their lower coverage rate, females accounted for approximately 63% of all cataract cases in the study populations, and if they received surgery at the same rates as males, the prevalence of cataract blindness would be reduced by a median of 12.5% (range 4-21%. CONCLUSION: Closing the gender gap could thus significantly decrease the prevalence of cataract blindness, and gender-sensitive intervention programmes are needed to improve cataract surgical coverage among females.

Lewallen Susan

2002-01-01

 
 
 
 
281

Fototraumatismo macular en cirugía de catarata / Light-induced maculopathy in cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Casos clínicos: Caso 1: varón de 82 años intervenido de catarata mediante facoemulsificación e implante de lente Tecnis® Z 9000 en su ojo derecho (OD), bajo anestesia tópica. La duración de la cirugía fue de 14 minutos sin complicaciones. Caso 2: mujer de 60 años con glaucoma primario de ángulo abie [...] rto (GPAA) bilateral avanzado, intervenida sin complicaciones de catarata mediante facoemulsificación e implante de lente Tecnis® Z 9000 en su ojo derecho, bajo anestesia peribulbar. La duración de la cirugía fue de 36 minutos. Al mes de la cirugía ambos pacientes evidenciaron escotoma paracentral inferior y escasa mejora de la agudeza visual (AV). La angiografía fluoresceínica (AGF) de ambos casos reveló cambios en el epitelio pigmentario de la retina compatibles con un posible fototraumatismo macular intraoperatorio. Discusión: La maculopatía por fototoxicidad es una complicación descrita tras cirugía de catarata. El que las propiedades físicas de estas nuevas lentes de polisiloxano favorezcan el fototraumatismo retiniano en determinadas condiciones lumínicas han de ser aclaradas. Abstract in english Case report: Case 1: An 82-year-old man who underwent an uncomplicated phacoemulsification and IOL implantation (Tecnis® Z 9000 lens) in his right eye under topical anaesthesia. Surgery lasted 14 minutes. Case 2: A 60-year-old woman with bilateral advanced primary open angle glaucoma who underwent a [...] n uncomplicated phacoemulsification and IOL implantation (Tecnis® Z 9000 lens) in her right eye under peribulbar anaesthesia. Surgery lasted 36 minutes. One month after surgery both patients noted a para-central scotoma and impaired vision. Fluorescein angiography in both cases revealed retinal pigment epithelial changes compatible with intra-operative light-induced maculopathy. Discussion: Light-induced maculopathy has been reported following cataract surgery. Whether physical properties of these new polysiloxane lenses contribute to retinal susceptibility to phototoxicity under certain light conditions needs to be elucidated.

P, Gómez-Faíña; A-T, Ruiz Viñals; A, Antón López; D, Nahra Saad; J-A, Buil Calvo; M, Castilla Céspedes.

282

Fototraumatismo macular en cirugía de catarata Light-induced maculopathy in cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Casos clínicos: Caso 1: varón de 82 años intervenido de catarata mediante facoemulsificación e implante de lente Tecnis® Z 9000 en su ojo derecho (OD, bajo anestesia tópica. La duración de la cirugía fue de 14 minutos sin complicaciones. Caso 2: mujer de 60 años con glaucoma primario de ángulo abierto (GPAA bilateral avanzado, intervenida sin complicaciones de catarata mediante facoemulsificación e implante de lente Tecnis® Z 9000 en su ojo derecho, bajo anestesia peribulbar. La duración de la cirugía fue de 36 minutos. Al mes de la cirugía ambos pacientes evidenciaron escotoma paracentral inferior y escasa mejora de la agudeza visual (AV. La angiografía fluoresceínica (AGF de ambos casos reveló cambios en el epitelio pigmentario de la retina compatibles con un posible fototraumatismo macular intraoperatorio. Discusión: La maculopatía por fototoxicidad es una complicación descrita tras cirugía de catarata. El que las propiedades físicas de estas nuevas lentes de polisiloxano favorezcan el fototraumatismo retiniano en determinadas condiciones lumínicas han de ser aclaradas.Case report: Case 1: An 82-year-old man who underwent an uncomplicated phacoemulsification and IOL implantation (Tecnis® Z 9000 lens in his right eye under topical anaesthesia. Surgery lasted 14 minutes. Case 2: A 60-year-old woman with bilateral advanced primary open angle glaucoma who underwent an uncomplicated phacoemulsification and IOL implantation (Tecnis® Z 9000 lens in her right eye under peribulbar anaesthesia. Surgery lasted 36 minutes. One month after surgery both patients noted a para-central scotoma and impaired vision. Fluorescein angiography in both cases revealed retinal pigment epithelial changes compatible with intra-operative light-induced maculopathy. Discussion: Light-induced maculopathy has been reported following cataract surgery. Whether physical properties of these new polysiloxane lenses contribute to retinal susceptibility to phototoxicity under certain light conditions needs to be elucidated.

P Gómez-Faíña

2005-05-01

283

Resultados de la cirugía de catarata por microincisiones / Results of cataract surgery by microincisions  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se realizó un estudio descriptivo, prospectivo de corte transversal, cuyo universo estuvo constituido por todos los pacientes (ojos) con diagnóstico de catarata presenil y senil que recibieron tratamiento quirúrgico con la técnica conocida como cirugía de catarata por microinsiciones en el Centro de [...] Microcirugía Ocular en el período comprendido entre enero de 2004 y enero de 2005. Se seleccionó una muestra mediante un muestreo simple aleatorio de 27 pacientes donde la mayoría de los estudiados presentaban más de 48 años de edad; la agudeza visual con corrección alcanzada mejoró como promedio en 5 líneas en la cartilla de Snellen, con un astigmatismo inducido promedio de 0.15 D, el tiempo promedio de ultrasonido utilizado fue menor de 1 min, proporcional a la dureza del núcleo y la pérdida en la densidad celular endotelial fue del 10,58 %. Se presentó un bajo número de complicaciones donde fueron las más frecuentes la ruptura de cápsula posterior y la salida de vítreo Abstract in english A descriptive, prospective and cross-sectional study was carried out with all the patients (eyes) with diagnosis of presenile and senile cataract that received surgical treatment with the technique known as cataract surgery microincisions at the Centre of Ocular Microsurgery from January 2004 to Jan [...] uary 2005. 27 patients were selected by randomized simple sampling. Most of the studied individuals were over 48 years old. The visual acuity with correction attained improved as an average in 5 lines according to Snellen's test, with an average induced astigmatism of 0.15 D. The average time of ultrasound used was lower than a minute, proportional to the nucleus' hardness. The loss in the endothelial cellular density was of 10.58 %. There was a low number of complications. The rupture of the posterior capsule and the vitreous projection were the most common compllicatio

Juan R, Hernández Silva; Luis, Curbelo Cunill; Carmen M, Padilla González; Meysi, Ramos López; Marcelino, Río Torres.

2005-06-01

284

General versus regional anaesthesia for cataract surgery: effects on neutrophil apoptosis and the postoperative pro-inflammatory state.  

LENUS (Irish Health Repository)

At clinically relevant concentrations, volatile anaesthetic agents influence neutrophil function. Our hypothesis was that sevoflurane would inhibit neutrophil apoptosis and consequently influence the postoperative pro-inflammatory state. In order to identify selectively the effect of the anaesthetic agent sevoflurane, we studied patients undergoing minimally stimulating (cataract) surgery randomly allocated to receive either sevoflurane (n = 11) or local anaesthesia (n = 12). Venous blood samples were taken immediately prior to anaesthesia and at 1, 8 and 24 h thereafter. The rate of neutrophil apoptosis, plasma concentration of cytokines and differential white cell count were measured. The rates of neutrophil apoptosis and plasma concentrations of IL-1beta, TNF-alpha and IL-8 at each time point were similar in the two groups. IL-6 concentrations increased significantly and to a similar extent compared to preanaesthetic levels at 8 and 24 h. This study demonstrates that sevoflurane does not influence the rate of neutrophil apoptosis, cytokine concentrations and neutrophil count following cataract surgery.

Goto, Y

2012-02-03

285

Corneal astigmatism change and wavefront aberration evaluation after cataract surgery: "Single" versus "paired opposite" clear corneal incisions  

Science.gov (United States)

Background: Correcting the pre-existing astigmatism is an optimal goal in cataract surgery. The aim of this study is to compare the astigmatic correcting effect of a single regular 3.2 mm clear corneal incision (CCI) with paired opposite CCI in cataract patients and effect of these incisions on optical aberrations using the wavefront quantitative analysis. Materials and Methods: This was a randomized controlled trial study undertaken in an ophthalmology referral center on 50 patients planned for cataract surgery who were randomized to either single 3.2 mm CCI or paired opposite CCI group. Post-operative evaluation was performed at 12 weeks and included refraction, keratometery, corneal topography and wavefront analysis. Corneal astigmatism and post-operative values were compared in two groups. Results: The mean pre-operative corneal astigmatism was 2.58 ± 1.03 D in the single incision group and 2.70 ± 0.94 D in the paired opposite incisions group. After 12 weeks of surgery, the corneal astigmatism was reached to 2.15 ± 0.82 D in single incision group and 1.63 ± 1.21 in the paired opposite incisions group. There was a statistically significant difference in two arms of treatment regarding to surgically induced astigmatism after 3 months. The mean post-operative total and higher order aberrations and values were not significantly different in two groups. Conclusion: The results of our study showed that paired opposite incisions is an effective procedure for reducing pre-existing corneal astigmatism in cataract surgery. Paired incisions did not show any beneficial effect regarding wavefront aberrations compared with conventional single incision method.

Razmjoo, Hasan; Koosha, Nima; Vaezi, Mohammad Hadi; Rahimi, Behrooz; Peyman, Alireza

2014-01-01

286

Conjunctival endogenous microbiota in patients submitted to cataract surgery Microbiota endógena conjuntival em pacientes submetidos à cirurgia de catarata  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Bacterial isolation, identification and antimicrobial susceptibility tests were carried out in ocular material collected with swab and polimethylmethacrylate (PMMA) or silicone intraocular lenses (IOL) from forty six patients submitted to cataract surgery. Seventy six isolates and seven different microorganisms were identified. Coagulase-negative staphylococci (CNS) were the predominant microorganisms isolated from swabs (71.4% of cases), PMMA lenses (81.3%) and silicon lenses (77.8%). Coagul...

Locatelli, Claudete I.; Sérgio Kwitko; Amauri Braga Simonetti

2003-01-01

287

Evaluation of the American Society of Cataract and Refractive Surgery intraocular lens calculator for eyes with prior radial keratotomy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

David L DeMill, Maylon Hsu, Majid MoshirfarJohn A Moran Eye Center, University of Utah, Salt Lake City, UT, USABackground: The purpose of this study was to evaluate the American Society of Cataract and Refractive Surgery (ASCRS) intraocular lens (IOL) calculator for eyes with prior radial keratotomy and assess the accuracy of its methods in predicting IOL power in patients with previous radial keratotomy.Methods: This retrospective study included data from 15 eyes with previous radial keratot...

Dl, Demill; Hsu M; Moshirfar M

2011-01-01

288

Peribulbar anesthesia for cataract surgery: Effect of lidocaine warming and alkalinization on injection pain, motor and sensory nerve blockade  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Aim: To compare self-reported pain and efficacy of warmed, alkalinized, and warmed alkalinized lidocaine with plain 2% lidocaine at room temperature for peribulbar anesthesia in cataract surgery. Materials and Methods: Through a prospective, single-blinded, randomized, controlled clinical trial 200 patients were divided into four groups. They received either lidocaine at operating room temperature 18°C, control group (Group C), lidocaine warmed to 37°C (Group...

Jaichandran Venkatakrishnan; Vijaya Lingam; George Ronnie; InderMohan Bhanulakshmi

2010-01-01

289

Ethical issues with cataract surgery in patients with macular degeneration. A graduating resident’s view poin  

Directory of Open Access Journals (Sweden)

Full Text Available Modern cataract surgery is considered to be a successful procedure, with a low complication rate. During cataract surgery, a patient's cloudy natural lens is removed and replaced with an artificial intraocular lens implant to restore the lens's transparency. The goal of cataract surgery is to achieve improvement in visual acuity necessary to help the patient with activities of daily living and improve the quality of their life. Macular degeneration is a multifactorial syndrome with different causative factors that results in a loss of vision in the center of the visual field (the macula because of damage to the retina, being a major cause of blindness in the elderly over 50 years in the western world. Macular degeneration can make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow the development of other everyday activities. It occurs in “dry” and “wet” forms. The decision to perform cataract surgery in patients with macular degeneration presents with ethical issues and dilemmas for the surgeons involved in the care of the patient with posterior segment problems like macular degeneration. Good doctor-patient communication is essential to get the most benefit from the ophthalmologist, who provides care that is scientific, considerate, and compassionate. The ophthalmologist should serve as the patient’s advocate, marshaling his resources for the patient’s benefit, to maintain the quality of patient life. A biopsychosocial approach is philosophically very close to a systemic view and the development of adequate communication skills is now an aim of training programs, because a good medical care should be a partnership between patient and doctor

Rajiv D. Sha

2011-06-01

290

Late surgical complications to endophthalmitis after cataract surgery in the post-EVS era  

DEFF Research Database (Denmark)

BACKGROUND: To compare the risk of surgical complications after primary surgical intervention for postoperative endophthalmitis after cataract surgery (PE) in cases that underwent a pars plana vitrectomy (PPV) or a vitreous tap (VT) in Denmark in the calendar period 1 January 2000 to 30 June 2011. METHODS: Retrospective, register- and chart-based study. RESULTS: A total of 121 PE cases were identified and followed up to 12.8 years. The overall risk of surgical complications in PE cases that underwent a PPV and a VT was 24.2 and 36.7 %, respectively. This difference was non-statistically significant (p?=?0.18). In all, 9.9 % of the PE cases had more than one surgical complication, and 97 % of the primary surgical complications occurred within the first 5 months. There was no statistically significant difference in the risk of retinal detachment (p?=?0.45), surgery for PE (p?=?0.22), intraocular lens removal (p?=?0.19), or removal of the eye (p?=?0.69) between the two groups. PE cases that underwent a VT had a statistically significantly higher risk of surgery for vitreous opacities (p?=?0.047) compared to a PPV. CONCLUSIONS: In all, 27.3 % of all cases developed a surgical complication after primary surgical intervention for PE. If a PE case did not have a surgical complication within the first 5 months, it was highly unlikely that a new surgical complication would occur. A VT was not associated with a statistically significantly higher overall risk of surgical complications compared to a PPV.

Solborg Bjerrum, SØren; Kiilgaard, Jens Folke

2014-01-01

291

Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure. Case presentation A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a shallow anterior chamber five days after uneventful cataract surgery. Initially, slit lamp examination provided only limited information due to severe corneal edema. After resolution of corneal edema with systemic glaucoma therapy, a complete fibrin membrane was observed across the pupil by slit lamp examination. Anterior segment optic coherence tomography clearly revealed a thin fibrin membrane covering the entire pupillary space, a shallow anterior chamber, and a deep posterior chamber. The intraocular lens was not observed by anterior segment optic coherence tomography. In contrast, ultrasound biomicroscopy, which has superior penetration depth, was able to visualize the intraocular lens deep in the posterior chamber. Injection of tissue plasminogen activator into the anterior chamber resulted in complete fibrinolysis and released the pupillary block. Conclusion This case suggests that ocular anterior segment imaging modalities, especially ultrasound biomicroscopy, serve as powerful diagnostic tools to identify mechanisms of acute angle closure glaucoma, which is often accompanied by poor intraocular visibility. This is the first reported case of fibrin pupillary-block glaucoma after cataract surgery successfully treated with intracameral tissue plasminogen activator.

Yoshino Hideaki

2012-03-01

292

Cirugía de cataratas con el uso de la crioanestesia en la técnica de Blumenthal / Cataracts surgery with the use of cryoanesthesia in the Blumenthal technique  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Fundamento: La anestesia en cirugía de cataratas ha evolucionado simultáneamente a la técnica quirúrgica. La cirugía de pequeña incisión ha popularizado el uso de la anestesia tópica, la cual permite llevar a cabo la cirugía con una excelente tolerancia por parte del paciente. Objetivo: Analizar los [...] resultados de la cirugía de cataratas con crioanestesia mediante la técnica de Blumenthal en pacientes aquejados de catarata senil. Método: Se realizó un estudio explicativo sobre los resultados de la cirugía de cataratas con crioanestesia por la técnica de Blumenthal en el Servicio de Oftalmología del Hospital Docente Clínico Quirúrgico «Manuel Ascunce Domenech» desde diciembre de 2005 a agosto de 2006. El universo estuvo constituido por todos los pacientes con este diagnóstico con criterio quirúrgico a los que se les aplicó un formulario creado al efecto basado en la revisión bibliográfica y el criterio de expertos. Se estudiaron las variables sexo, estadio de la catarata, tiempo de exposición a la anestesia y grado de satisfacción del paciente. Resultados: La mayor cantidad de pacientes estuvo comprendida en el grupo de 70 a 79 años de edad, hubo menor efectividad con la técnica anestésica en los grupos de edades más jóvenes, no existió diferencia con respecto al sexo, aunque el masculino mostró menos efectividad en la técnica anestésica con una proporción de 2:1. Conclusiones: La catarata hipermadura disminuyó la validez de la técnica anestésica, la prolongación del tiempo quirúrgico con relación al estadio de la catarata redujo la eficacia de la técnica anestésica y tres de cada cinco pacientes evaluaron la técnica como excelente o buena. Abstract in english Background: The anesthesia in cataracts surgery has simultaneously evolved to the surgical technique. The surgery of small incision has popularized the use of topical anesthesia, which allows carrying out the surgery with excellent tolerance by the patient. Objective: To analyze the results of the c [...] ataracts surgery with cryoanesthesia by means of Blumenthal technique in patients suffering senile cataract. Method: An explicative study about the results of the cataracts surgery with cryoanesthesia by means of Blumenthal technique in the Ophthalmology service at «Manuel Ascunce Domenech» Surgical Clinic Educational Hospital from December 2005 to August 2006. The universe was constituted by all the patients with diagnosis of surgical criterion, to which was applied a formulary created to the effect based on the bibliographic review and experts criterion. Sexes, cataract stage, exposure time to anesthesia and satisfaction grade of the patient, were the variables studied. Results: The higher quantity of patients was comprised in the group of 70 to 79 years, there was less effectivity with the anesthetic technique in the younger age groups, there was no difference regarding to sex, though the masculine showed less effectivity in the anesthetic technique with a proportion of 2:1. Conclusions: The hypermature cataract diminished the validity of the anesthetic technique, prolongation of surgical time related to the cataract stage reduced the anesthetic technique effectiveness and three out of five patients assessed the technique as excellent or good.

Taimys, Payán Hechavarría; Lázara Mairelys, Molinet Vega; José Manuel, García Martínez.

2008-10-01

293

Facoemulsificación en ojos post-vitrectomía pars plana / Phacoemulsification cataract surgery in vitrectomized eyes  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Determinar las complicaciones intra y postoperatorias en ojos de pacientes post-vitrectomizados que ameritan cirugía de catarata con técnica de facoemulsificación. Método: Estudio prospectivo, longitudinal observacional y descriptivo en 25 ojos de 25 pacientes, previa vitrectomía pars plan [...] a que requerían cirugía de catarata. Variables prequirúrguicas: edad, sexo, ojo afectado, capacidad visual, patología vitreorretiniana, características morfológicas del segmento anterior tales como grado de opacidad del cristalino, características de la cámara anterior y de la pupila. Variables intraoperatorias: técnica, tiempo de facoemulsificación y complicaciones intraoperatorias. Variables post-operatorias: Complicaciones y capacidad visual. Seguimiento no menor de 6 meses. Resultados: El tiempo promedio entre la vitrectomía pars plana y la facoemulsificación fue de 18,5 meses. La silicona fue el material de tamponamiento utilizado con mayor frecuencia 44%. Hallazgos biomicroscópicos: miosis 28% y sinequias posteriores 24%. El tiempo promedio de facoemulsificación: 2,26 minutos. Complicaciones intraoperatorias: cámara anterior inestable 24% y el desgarro de la capsulorrexis anterior 12%. La complicación post-operatoria más frecuente fue la placa subcapsular posterior 28% y el edema corneal 16%. Conclusiones: La facoemulsificación en ojos con vitrectomía pars plana previa que ameriten cirugía de catarata, es una técnica bastante segura y efectiva. El cirujano debe familiarizarse con los hallazgos y modificaciones anatómicas que sufren estos ojos. La rehabilitación visual por lo general va a estar limitada por la patología vitreo-retiniana de base. Abstract in english Objective: This study focuses on determining the intra- and post-operative complications stemming from technical difficulties, anatomical aspects, intraoperatory management and visual outcome of post-vitrectomized patients that undergo phacoemulsification. Method: In this prospective, longitudinal, [...] observational and descriptive study phacoemulsification was performed in 25 post-vitrectomized eyes that required cataract surgery. Pre-surgical variables: sex, age, affected eye, visual accuity, underlying vitreoretinal disease, anterior segment morphological findings such as: cataract density and pupil alterations. Intrasurgical variables: characteristic of anterior chamber and pupil, phacoemulsification technique and time and the presence of complications. Post-surgical variables were also registered: visual capacity and the presence of complications. Minimum six-month follow-up period. Results: The average interval between pars plana vitrectomy and phacoemulsification was 18.5 months. Silicone oil was the most frequent tamponade used in our serie (44%). Biomicroscopical findings were miosis 28% and posterior synechies 24%. The average interval of phaco time was 2.26 minutes. The intraoperative findings were fluctuations in the anterior chamber depth (24%) and anterior capsular tears (12%). The postoperative complications most frequently seen were posterior capsular plaque (28%) and corneal edema (16%). Conclusions: Phacoemulsification is a safe and effective technique in eyes after pars plana vitrectomy that require cataract surgery. The surgeon must be aware of the morphological and anatomical findings of these eyes. Visual rehabilitation will generally be determined by the presence of an underlying vitreo-retinal pathology.

M, Suárez-Tatá; J, Villaseñor-Díez; LM, Suárez-Tatá; AM, Suárez-Licona; LM, García-Garduño; H, Quiroz Mercado; J, Villar Kuri.

294

Facoemulsificación en ojos post-vitrectomía pars plana Phacoemulsification cataract surgery in vitrectomized eyes  

Directory of Open Access Journals (Sweden)

Full Text Available Objetivo: Determinar las complicaciones intra y postoperatorias en ojos de pacientes post-vitrectomizados que ameritan cirugía de catarata con técnica de facoemulsificación. Método: Estudio prospectivo, longitudinal observacional y descriptivo en 25 ojos de 25 pacientes, previa vitrectomía pars plana que requerían cirugía de catarata. Variables prequirúrguicas: edad, sexo, ojo afectado, capacidad visual, patología vitreorretiniana, características morfológicas del segmento anterior tales como grado de opacidad del cristalino, características de la cámara anterior y de la pupila. Variables intraoperatorias: técnica, tiempo de facoemulsificación y complicaciones intraoperatorias. Variables post-operatorias: Complicaciones y capacidad visual. Seguimiento no menor de 6 meses. Resultados: El tiempo promedio entre la vitrectomía pars plana y la facoemulsificación fue de 18,5 meses. La silicona fue el material de tamponamiento utilizado con mayor frecuencia 44%. Hallazgos biomicroscópicos: miosis 28% y sinequias posteriores 24%. El tiempo promedio de facoemulsificación: 2,26 minutos. Complicaciones intraoperatorias: cámara anterior inestable 24% y el desgarro de la capsulorrexis anterior 12%. La complicación post-operatoria más frecuente fue la placa subcapsular posterior 28% y el edema corneal 16%. Conclusiones: La facoemulsificación en ojos con vitrectomía pars plana previa que ameriten cirugía de catarata, es una técnica bastante segura y efectiva. El cirujano debe familiarizarse con los hallazgos y modificaciones anatómicas que sufren estos ojos. La rehabilitación visual por lo general va a estar limitada por la patología vitreo-retiniana de base.Objective: This study focuses on determining the intra- and post-operative complications stemming from technical difficulties, anatomical aspects, intraoperatory management and visual outcome of post-vitrectomized patients that undergo phacoemulsification. Method: In this prospective, longitudinal, observational and descriptive study phacoemulsification was performed in 25 post-vitrectomized eyes that required cataract surgery. Pre-surgical variables: sex, age, affected eye, visual accuity, underlying vitreoretinal disease, anterior segment morphological findings such as: cataract density and pupil alterations. Intrasurgical variables: characteristic of anterior chamber and pupil, phacoemulsification technique and time and the presence of complications. Post-surgical variables were also registered: visual capacity and the presence of complications. Minimum six-month follow-up period. Results: The average interval between pars plana vitrectomy and phacoemulsification was 18.5 months. Silicone oil was the most frequent tamponade used in our serie (44%. Biomicroscopical findings were miosis 28% and posterior synechies 24%. The average interval of phaco time was 2.26 minutes. The intraoperative findings were fluctuations in the anterior chamber depth (24% and anterior capsular tears (12%. The postoperative complications most frequently seen were posterior capsular plaque (28% and corneal edema (16%. Conclusions: Phacoemulsification is a safe and effective technique in eyes after pars plana vitrectomy that require cataract surgery. The surgeon must be aware of the morphological and anatomical findings of these eyes. Visual rehabilitation will generally be determined by the presence of an underlying vitreo-retinal pathology.

M Suárez-Tatá

2004-11-01

295

Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Jian-Guo Wu, Rui-Hua Wei, Ai-Hua Liu, Xiao-Xu Zhou, Guo-Ling Sun, Xiao-Rong LiTianjin Medical University Eye Center, Tianjin, ChinaBackground: The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery.Methods: We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15. In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15. The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit.Results: Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01, and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ? 0.05.Conclusion: This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.Keywords: pars plana vitrectomy, contact lens, silicone ring, cataract surgery

Li X-R

2011-06-01

296

Macular Edema After Cataract Surgery In Eyes Without Pre-operative Central-involved Diabetic Macular Edema  

Science.gov (United States)

Objective To estimate the incidence of central-involved macular edema (ME)16 weeks following cataract surgery in eyes with diabetic retinopathy (DR) without definite central-involved diabetic macular edema (DME) preoperatively. Methods In a multicenter, prospective, observational study, participants (N = 293) with DR without definite OCT central subfield (CSF) thickening underwent cataract surgery. The primary outcome was development of central-involved ME defined as; (1) OCT CSF thickness ? 250?m (time domain) or ? 310?m (spectral domain) with ?1 step increase in logOCT CSF thickness pre-operative to the 16-week visit; (2) ?2-step increase in logOCT CSF pre-operative to 16-week visit; or (3) non-topical treatment for ME received before the 16-week visit with either of the OCT criteria met at the time of treatment. Results Median participant age was 64 years with median visual acuity letter score of 69 (Snellen equivalent 20/40). Forty-four percent of eyes had history of prior treatment for DME. Sixteen weeks postoperatively, central-involved ME was noted in 0% (95%CI: 0-20%) of 17 eyes with no pre-operative DME. Of eyes with non-central involved DME, 10% (95%CI: 5-18%) of 97 eyes without central involved DME and 12% (95%CI: 7-19%) of 147 eyes with possible central involved DME at baseline progressed to central-involved ME. History of DME treatment was significantly associated with central-involved ME development (P<0.001). Conclusion In eyes with DR without concurrent central-involved DME, presence of non-central DME immediately prior to cataract surgery, or history of DME treatment, may increase risk of developing central-involved ME 16 weeks after cataract extraction. PMID:23599174

Baker, Carl W.; Almukhtar, Talat; Bressler, Neil M.; Glassman, Adam R.; Grover, Sandeep; Kim, Stephen J.; Murtha, Timothy J.; Rauser, Michael E.; Stockdale, Cynthia

2014-01-01

297

Stereo-PIV study of flow inside an eye under cataract surgery  

Science.gov (United States)

We measured velocity distributions in the anterior chamber of porcine eyes under simulated cataract surgery using stereoscopic particle image velocimetry (stereo-PIV). The surface of the cornea was detected based on the images of laser-induced fluorescent light emitted from fluorescent dye solution introduced in a posterior chamber. A coaxial phacoemulsification procedure was simulated with standard size (standard coaxial phacoemulsification) and smaller (micro coaxial phacoemulsification) surgical instruments. In both cases, an asymmetric flow rate of irrigation was observed, although both irrigation ports had the same dimensions prior to insertion into the eye. In cases where the tip of the handpiece was placed farther away from the top of the cornea, i.e., closer to the crystalline lens, direct impingement of irrigation flow onto the cornea surface was avoided and the flow turned back toward the handpiece along the surface of the corneal endothelium. Viscous shear stress on the corneal endothelium was computed based on the measured mean velocity distribution. The maximum shear stress for most cases exceeded 0.1 Pa, which is comparable to the shear stress that caused detachment of the corneal endothelial cells reported by Kaji et al. in Cornea 24:S55-S58, (2005). When direct impingement of the irrigation flow was avoided, the shear stress was reduced considerably.

Sakakibara, Jun; Yamashita, Masaki; Kobayashi, Tatsuya; Kaji, Yuichi; Oshika, Tetsuro

2012-04-01

298

Diplopía postcirugía de catarata con anestesia subtenoniana / Diplopia after sub-tenon's anesthesia for cataract surgery  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Estudiar las características del estrabismo secundario a la cirugía de catarata con anestesia subtenoniana; su tratamiento y pronóstico. Método: Ocho enfermos sin estrabismo previo presentaron diplopía inmediatamente después de la cirugía de catarata; cinco de ojo izquierdo, tres de ojo de [...] recho. La exploración con cover test, prismas y ducción activa y pasiva mostró estrabismo restrictivo: siete de componente vertical y uno horizontal. La desviación media fue de 17,5 DE: 9,84 dioptrías prismáticas (rango 5-35) en la mirada al frente. La posición máxima de desviación fue en supraversión en siete, y en levoversión en otro. Todos tenían diplopía invalidante. Se considera buen resultado si desaparecía la diplopía con el tratamiento. Resultados: Cuatro casos recibieron tratamiento quirúrgico, en uno sólo se inyectó toxina botulínica y en tres se pusieron prismas. La toxina botulínica se empleó como primera opción en cuatro casos y sólo fue eficaz en un enfermo. De los cuatro casos operados, tres necesitaron dos cirugías y un paciente sólo un tiempo quirúrgico. Se consiguió buen resultado en los ocho pacientes tratados. El tiempo medio de evolución fue de 10,12 DE: 5,46 meses. Conclusiones: La anestesia subtenoniana puede provocar un estrabismo restrictivo y una diplopía muy invalidantes que no se resuelven espontáneamente. El recto inferior es el músculo más frecuentemente afectado. La cirugía muscular es necesaria para resolver el problema en la mitad de los casos. Se consiguen buenos Resultados quirúrgicos. Abstract in english Purpose: To study the clinical signs, treatment and prognosis of strabismus after sub-Tenon’s anesthesia for cataract surgery. Methods: Eight patients without previous strabismus developed incommitant diplopia immediately after cataract surgery; the left eye was affected in five patients and the rig [...] ht eye in three. Restrictive strabismus was diagnosed with the cover test, prisms, and active and passive ductions in all cases. In seven cases the deviation was vertical and in one patient it was horizontal. The average deviation was 17.5 S.D. 9.84 (range 5-35) prismatic dioptres in primary position. The deviation increased looking upward in seven cases, and looking sideways to the left in the other. It was considered to be a good result if the diplopia disappeared after treatment. Results: Botulinum toxin was the first treatment applied in four patients, but only one showed a good response and required no further therapy. Strabismus surgery was required in four cases, and prisms were adapted in three. Three patients required two strabismus operations. A good result was achieved in all cases, with the average time interval being 10.12 (SD 5.5) months. Conclusions: Sub-Tenon’s anesthesia may result in restrictive strabismus and incommitant diplopia which does not resolve spontaneously. The inferior rectus is the most commonly affected muscle. Strabismus surgery is required to resolve the diplopia in half of the cases. Good results have been achieved in all patients.

P., Merino; N., Muñoz-Sanz; P., Gómez-de-Liaño; B., Gutiérrez-Partida; O., Seijas-Leal.

2006-03-01

299

Diplopía postcirugía de catarata con anestesia subtenoniana / Diplopia after sub-tenon's anesthesia for cataract surgery  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Estudiar las características del estrabismo secundario a la cirugía de catarata con anestesia subtenoniana; su tratamiento y pronóstico. Método: Ocho enfermos sin estrabismo previo presentaron diplopía inmediatamente después de la cirugía de catarata; cinco de ojo izquierdo, tres de ojo de [...] recho. La exploración con cover test, prismas y ducción activa y pasiva mostró estrabismo restrictivo: siete de componente vertical y uno horizontal. La desviación media fue de 17,5 DE: 9,84 dioptrías prismáticas (rango 5-35) en la mirada al frente. La posición máxima de desviación fue en supraversión en siete, y en levoversión en otro. Todos tenían diplopía invalidante. Se considera buen resultado si desaparecía la diplopía con el tratamiento. Resultados: Cuatro casos recibieron tratamiento quirúrgico, en uno sólo se inyectó toxina botulínica y en tres se pusieron prismas. La toxina botulínica se empleó como primera opción en cuatro casos y sólo fue eficaz en un enfermo. De los cuatro casos operados, tres necesitaron dos cirugías y un paciente sólo un tiempo quirúrgico. Se consiguió buen resultado en los ocho pacientes tratados. El tiempo medio de evolución fue de 10,12 DE: 5,46 meses. Conclusiones: La anestesia subtenoniana puede provocar un estrabismo restrictivo y una diplopía muy invalidantes que no se resuelven espontáneamente. El recto inferior es el músculo más frecuentemente afectado. La cirugía muscular es necesaria para resolver el problema en la mitad de los casos. Se consiguen buenos Resultados quirúrgicos. Abstract in english Purpose: To study the clinical signs, treatment and prognosis of strabismus after sub-Tenon’s anesthesia for cataract surgery. Methods: Eight patients without previous strabismus developed incommitant diplopia immediately after cataract surgery; the left eye was affected in five patients and the rig [...] ht eye in three. Restrictive strabismus was diagnosed with the cover test, prisms, and active and passive ductions in all cases. In seven cases the deviation was vertical and in one patient it was horizontal. The average deviation was 17.5 S.D. 9.84 (range 5-35) prismatic dioptres in primary position. The deviation increased looking upward in seven cases, and looking sideways to the left in the other. It was considered to be a good result if the diplopia disappeared after treatment. Results: Botulinum toxin was the first treatment applied in four patients, but only one showed a good response and required no further therapy. Strabismus surgery was required in four cases, and prisms were adapted in three. Three patients required two strabismus operations. A good result was achieved in all cases, with the average time interval being 10.12 (SD 5.5) months. Conclusions: Sub-Tenon’s anesthesia may result in restrictive strabismus and incommitant diplopia which does not resolve spontaneously. The inferior rectus is the most commonly affected muscle. Strabismus surgery is required to resolve the diplopia in half of the cases. Good results have been achieved in all patients.

P., Merino; N., Muñoz-Sanz; P., Gómez-de-Liaño; B., Gutiérrez-Partida; O., Seijas-Leal.

300

Prioritisation of patients on waiting lists for hip and knee arthroplasties and cataract surgery: Instruments validation  

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Full Text Available Abstract Background Prioritisation instruments were developed for patients on waiting list for hip and knee arthroplasties (AI and cataract surgery (CI. The aim of the study was to assess their convergent and discriminant validity and inter-observer reliability. Methods Multicentre validation study which included orthopaedic surgeons and ophthalmologists from 10 hospitals. Participating doctors were asked to include all eligible patients placed in the waiting list for the procedures under study during the medical visit. Doctors assessed patients' priority through a visual analogue scale (VAS and administered the prioritisation instrument. Information on socio-demographic data and health-related quality of life (HRQOL (HUI3, EQ-5D, WOMAC and VF-14 was obtained through a telephone interview with patients. The correlation coefficients between the prioritisation instrument score and VAS and HRQOL were calculated. For the reliability study a self-administered questionnaire, which included hypothetic patients' scenarios, was sent via postal mail to the doctors. The priority of these scenarios was assessed through the prioritisation instrument. The intraclass correlation coefficient (ICC between doctors was calculated. Results Correlations with VAS were strong for the AI (0.64, CI95%: 0.59–0.68 and for the CI (0.65, CI95%: 0.62–0.69, and moderate between the WOMAC and the AI (0.39, CI95%: 0.33–0.45 and the VF-14 and the CI (0.38, IC95%: 0.33–0.43. The results of the discriminant analysis were in general as expected. Inter-observer reliability was 0.79 (CI95%: 0.64–0.94 for the AI, and 0.79 (CI95%: 0.63–0.95 for the CI. Conclusion The results show acceptable validity and reliability of the prioritisation instruments in establishing priority for surgery.

Moharra Montse

2008-04-01

 
 
 
 
301

Application of stratified emulsion splitting technology in highly hard nuclear cataract surgery  

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Full Text Available AIM:To explore safety and effectiveness of stratified emulsion splitting technology in highly hard nuclear cataract ultrasonic emulsification. METHODS: Totally 43 cases(47 eyesof highly hard nuclear cataract was performed cataract extraction combined IOL implantation with stratified emulsion splitting cataract ultrasonic emulsification technology. RESULTS:Postoperative visual acuity 1 day, 1 week and 1 month best-corrected visual acuity ?0.5 was accounted for 70.21%, 87.23% and 89.36%. Intraoperative capsule rupture was found in 2 eyes. Corneal mild edema was found in 7 eyes(14.89%after the first l day post-operation. CONCLUSION:Stratified emulsion splitting technique has a practical application with little tissue damage, low capsular rupture rate and few complications for highly hard nuclear cataract patients and can bring a desirable outcome.

Hui Na

2013-04-01

302

Influencia de la longitud axial en el resultado refractivo tras cirugía de catarata / Influence of axial length in refractive outcome after cataract surgery  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Analizar la influencia de la longitud axial (LA) y la edad en el resultado poscirugía de las cataratas en términos de agudeza visual sin corrección (AVsc), con corrección (AVcc) y refracción subjetiva. Método: Estudio clínico retrospectivo de 171 ojos sometidos a cirugía no complicada de c [...] ataratas, en los que se analizó el resultado refractivo (AV y refracción posquirúrgica final) en función de su LA previa a la cirugía (LA 25 mm) y la edad del sujeto ( 60 años). Resultados: Después de la cirugía se ha encontrado una AVsc de 0,6 ± 0,33 y una AVcc de 0,93 ± 0,23 con un valor esférico medio posquirúrgico de 0,89 ± 0,78 dioptrías (D). No se han encontrado diferencias en la AVsc, AVcc y refracción en ninguno de los grupos de edad. Se han encontrado diferencias estadísticamente significativas (ANOVA, p = 0,004 con corrección de Bonferroni) entre los tres grupos de longitud axial; la diferencia mayor se da en sujetos con LA entre 22 y 25 mm. Los ojos con LA 25 mm, 0,23 ± 1,15 D. Conclusiones: La LA influye en el resultado refractivo y en la AVsc después de la cirugía de cataratas. Los ojos con LA menor de 22 mm consiguen peores resultados refractivos tras la cirugía. Abstract in english Purpose: To analyse the influence of axial length (AL) and age on refractive outcome after cataract surgery in terms of uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and subjective refraction. Methods: A retrospective review of 171 consecutive cases of uncomplicated cataract [...] surgery was done. The refractive outcome was analysed (UCVA, BCVA and postoperative retraction) according AL before surgery (AL 25 mm) and age ( 60 years). Results: After surgery mean UCVA was 0.6 ± 0.33 Diopters (D) and mean BCVA was 0,93 ± 0,23 D. Mean refractive outcome was 0.89 ± 0.78 D. There were no significant differences in post-operative UCVA, BCVA and refraction between the three age groups. There were statistically significant differences (p = 0.004) in UCVA between the three AL groups. The group with AL between 22 and 25 mm had better UCVA. Mean refractive outcome was -0.95 ± 1.91 D in the group with AL 25 mm. Conclusions: AL influences refractive outcome and UCVA after cataract surgery. Eyes with AL

V. de, Juan; R., Martín; I., Pérez; J. M., Herreras.

2010-04-01

303

Influencia de la longitud axial en el resultado refractivo tras cirugía de catarata Influence of axial length in refractive outcome after cataract surgery  

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Full Text Available Objetivo: Analizar la influencia de la longitud axial (LA y la edad en el resultado poscirugía de las cataratas en términos de agudeza visual sin corrección (AVsc, con corrección (AVcc y refracción subjetiva. Método: Estudio clínico retrospectivo de 171 ojos sometidos a cirugía no complicada de cataratas, en los que se analizó el resultado refractivo (AV y refracción posquirúrgica final en función de su LA previa a la cirugía (LA 25 mm y la edad del sujeto ( 60 años. Resultados: Después de la cirugía se ha encontrado una AVsc de 0,6 ± 0,33 y una AVcc de 0,93 ± 0,23 con un valor esférico medio posquirúrgico de 0,89 ± 0,78 dioptrías (D. No se han encontrado diferencias en la AVsc, AVcc y refracción en ninguno de los grupos de edad. Se han encontrado diferencias estadísticamente significativas (ANOVA, p = 0,004 con corrección de Bonferroni entre los tres grupos de longitud axial; la diferencia mayor se da en sujetos con LA entre 22 y 25 mm. Los ojos con LA 25 mm, 0,23 ± 1,15 D. Conclusiones: La LA influye en el resultado refractivo y en la AVsc después de la cirugía de cataratas. Los ojos con LA menor de 22 mm consiguen peores resultados refractivos tras la cirugía.Purpose: To analyse the influence of axial length (AL and age on refractive outcome after cataract surgery in terms of uncorrected visual acuity (UCVA, best corrected visual acuity (BCVA and subjective refraction. Methods: A retrospective review of 171 consecutive cases of uncomplicated cataract surgery was done. The refractive outcome was analysed (UCVA, BCVA and postoperative retraction according AL before surgery (AL 25 mm and age ( 60 years. Results: After surgery mean UCVA was 0.6 ± 0.33 Diopters (D and mean BCVA was 0,93 ± 0,23 D. Mean refractive outcome was 0.89 ± 0.78 D. There were no significant differences in post-operative UCVA, BCVA and refraction between the three age groups. There were statistically significant differences (p = 0.004 in UCVA between the three AL groups. The group with AL between 22 and 25 mm had better UCVA. Mean refractive outcome was -0.95 ± 1.91 D in the group with AL 25 mm. Conclusions: AL influences refractive outcome and UCVA after cataract surgery. Eyes with AL < 22 mm have a worse refractive outcome.

V. de Juan

2010-04-01

304

Finding community solutions to improve access and acceptance of cataract surgery, optical correction and follow up in children in Malawi  

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Full Text Available Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with cataract. The objectives of the study were to understand the social, psychological and physical consequences of blindness in families, to understand why some parents with blind children access services and others do not, and to explore factors related to decision making within families that prevent access to health care services. Methodology: A mixed methodology quantitative and qualitative community study of blindness in children conducted in southern Malawi to compare “Doers”: families with blind children from the same communities who had attended cataract surgical services with “Non-doers” versus families with blind children from the same communities who had not attended services. Individual, family, community socio-cultural and economic characteristics and other qualitative data on knowledge, perceptions, and beliefs were recorded and analyzed thematically, based on grounded theory. Results: A total of 53 in-depth interviews of parents; 21 in-depth interviews of children; 15 focus group discussions with community members; 62 children’s clinical eye examinations, and 4 case studies were conducted over the study period. Doer families were likely to have a reliable source of income, have better housing and live closer to health centres than non-doer families. Visual acuity among doers was better than non-doers. Conclusion: This research has highlighted reasons why some families who have children with cataract are likely to be delayed to seek surgical intervention. Comprehensive counseling modules targeting such families need to be developed to increase acceptance and access to children’s cataract surgical services.

Khumbo Kalua

2013-09-01

305

Small Incision Cataract Surgery (SICS with Clear Corneal Incision and SICS with Scleral Incision – A Comparative Study  

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Full Text Available Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3% was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of >0.50D was in 82.5% subjects of group A and 52.8% subjects of group B at 1st week. At 6th week postoperative astigmatism of less than 1D was in 79.95% subjects of Group A and 83.34% subjects of Group B. About 20% subjects in Group A and only 3.3% in Group B showed astigmatism of more than 1D and these differences on both the occasions were statistically significant. Conclusion: The post operative visual outcome was better in SICS with scleral incision (group B than in SICS with clear corneal incision (Group-A.

Md Shafiqul Alam

2014-01-01

306

Cambios morfológicos maculares tras cirugía de cataratas: factores de riesgo Morphological macular changes after cataract surgery: risk factors  

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Full Text Available Objetivos: Analizar cambios en la morfología macular tras cirugía no complicada de cataratas y su correlación con la edad y la hipertensión arterial. Métodos: Se realizaron medidas del volumen macular total (TMV, volumen foveal (FOVOL y espesor foveal (FOV con OCT3 Stratus® en pacientes sometidos a cirugía de catarata antes de la cirugía, el día después y un mes después de la misma. Los datos fueron analizados utilizando SPSS 15.0 software. Resultados: Se incluyeron 114 ojos de 114 pacientes. Los valores medios de TMV, FOVOL y FOV en el subgrupo con Signal Strength por encima de 6, antes de la cirugía de catarata fueron 6,59 DE 0,67 µm³; 0,16 DE 0,02 µm³ and 204,97 DE 29,79 µm. Un mes después de la cirugía de cataratas las mediciones fueron TMV: 6,93 DE 0,56 µm³; FOVOL: 0,17 DE 0,06 µm³ y FOV: 218,07 DE 87,60 µm. Encontramos diferencias estadísticamente significativas (PObjective: To analyze morphological macular changes after uncomplicated cataract surgery and their correlation with age and arterial hypertension. Methods: Total macular volume (TMV, foveal volume (FOVOL and foveal thickness (FOV in patients who had undergone cataract surgery were measured using OCT3 Stratus® before surgery, the day after the intervention and one month later. The data were analyzed using SPSS 15.0 software. Results: The study group was composed of 114 eyes from 114 patients. The mean TMV, FOVOL and FOV in the subgroup of patients with signal strength over 6 before cataract surgery were 6.59 (SD0.67 µm³; 0.16 (SD0.02 µm³ and 204.97 (SD29.79 µm. One month after surgery the measurements were TMV: 6.93 (SD0.56 µm³; FOVOL: 0.17 (SD0.06 µm³ and FOV: 218.07 (SD87.60 µm. We found statistically significant differences (P<0.05 in TMV, but not in FOVOL or FOV. The group of patients under 74 years showed a greater increase in TMV. Patients with arterial hypertension did not show an increase in TMV or FOV compared to patients without arterial hypertension. Conclusions: We found a sub-morphological macular oedema one month after uncomplicated cataract surgery, with age being a risk factor for developing a greater increase in TMV. Arterial hypertension does not seem to be a risk factor for these changes.

J. Pareja-Esteban

2009-12-01

307

Training a cataract surgeon  

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Full Text Available Training in cataract surgery is one of the key factors needed to ensure high quality cataract surgery with good visual outcomes and patient satisfaction. The training has to impart the right skills to the right person by the right trainer and in the right environment.

M Babar Qureshi

2014-07-01

308

Gestión de riesgos asociados a cirugía de catarata mediante plan de cuidado estandarizado / Risk management associated to cataract surgery by means of standardized care plan  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish La cirugía de catarata es uno de los procedimientos quirúrgicos más practicados en todo el mundo. Los altos volúmenes de operaciones diarias, la complejidad de los cuidados y las presiones del trabajo global hacen inevitable en ocasiones la aparición de efectos adversos en este proceder. Estudios pr [...] evios han demostrado que algunos de estos efectos adversos están relacionados con los cuidados enfermeros. Por esta razón se realizó una investigación cualitativa en el Hospital «Lucía Iñiguez Landín» durante el primer trimestre de 2010, con el objetivo de diseñar un plan de cuidados estandarizado para gestionar los riesgos asociados a cirugía de catarata. A partir de la revisión documental sobre el proceso de atención de enfermería en este proceder quirúrgico y las taxonomías enfermeras vigentes en la actualidad se realizaron talleres de actualización. Los foros de discusión, grupos focales y talleres fueron los métodos utilizados para alcanzar este propósito. Se propone un plan de cuidado estandarizado para gestionar riesgos asociados a la cirugía de catarata tomando en cuenta las taxonomías de la Asociación Norteamericana de Diagnósticos de Enfermería, la Clasificación de Resultados de Enfermería y la Clasificación de Intervenciones de Enfermería., los riesgos del cuidado en cada momento específico del perioperatorio y la posición del enfermero que realiza estos cuidados. Abstract in english Cataract surgery is one of the commonest surgical procedures all over the world. High volume day-care surgery, the complexity of care, and overarching performance pressures may result in unsatisfactory outcomes for that surgical procedure. Previous studies has shown that many adverse events from cat [...] aract extraction are related to nurses care. A qualitative research was carried out al Lucía Iñiguez Hospital in the first quarter of 2010 to design a standard care plan for management of risk associated to cataract surgery througt document review of nurse care process in this surgical procedure and up to date nursing taxonomies. Discussion forums, workshops and focal groups were the methods used to achieve that goal. A standard nursing care plan for management of risks associated to cataract surgery is proposed taking into account taxonomies from North American Nursing Diagnosis Association, Nursing Outcomes Clasification and Nursing Intervention Clasification, the risks of every perioperative period and the position of the nurse responsible for specifical cares.

Aymara, Cruz Almaguer; Fidel, Ricardo Suárez; Ilza, Zaldivar Rodriguez; Marcia, Campo Gonzales; Zolanyi, Ramirez Silva; Maydelín, Cruz Bermúdez.

2010-12-01

309

Comparison of Tramadol and Pethidine for Postanesthetic Shivering in Elective Cataract Surgery  

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Full Text Available Background: Postoperative shivering is a common event of unknown etiology with an incidence of 5-65%. This study intended to compare the efficacy of tramadol with that of pethidine in controlling postanesthetic shivering. Methods: This double-blind clinical trial was performed on 300 consecutive patients underwent general anesthesia for elective cataract surgery. Intravenous tramadol 1 mg/kg or pethidine 0.5 mg/kg was administered for alternate subjects who developed postanesthetic shivering. They were monitored in the recovery room for 1 hour and the cessation time of shivering, recurrence of the event, duration of recovery, respiratory depression, nausea, vomiting, and arterial O2 saturation were recorded. Results: One hundred and twenty patients (40% had postanesthetic shivering. In the tramadol group, shivering terminated within 8 minutes after injection (mean 5 min. They had not recurrence of shivering, respiratory depression, reduction in SpO2 and nausea or vomiting during recovery. In the pethidine group, shivering terminated within 13 minutes (mean 9 min after injection, but in 10 patients it recurred after 30 minutes. In this group 28 patients had respiratory depression, reduction in SpO2, nausea and vomiting but none of them needed any medication. Conclusion: Tramadol is superior to pethidine as it induced a faster termination of postanesthetic shivering and did not entail adverse effects on the respiratory system and SpO2, recurrence of shivering or nausea and vomiting. Easy availability and minimum monitoring requirements are other advantages of tramadol. Keywords: Postoperative Shivering, General Anesthesia, Postoperative Complications, Tramadol, Pethidine.

H Zahedi

2004-10-01

310

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

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Full Text Available 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 prospective treatment for zonular weakness in such patients. Methods: A triangular capsular flap is cut from the anterior capsule with the base directed towards the zonular break area. Basal peripheral iridotomy (PI is performed in the same zone through corneal paracentesis. The tip of the capsular flap is caught with capsular forcept which is guided through both PI and corneal paracentesis. The tip of the flap is fixed in corneal stroma with a full thickness 10/O suture. After the lens implantation, the triangular anterior capsular flap is sutured in PIat iris edges and residues of flap in the anterior chamber are cut along the iris plane. Sutures from cornea along with the cut part of the flap are removed. This technique may be more practical in ECCE but it is very difficult to perform in Phacoemulsification. In this condition, a very tiny iris clip can be used instead of suturing to grasp the capsular flap in PI site and suspend it from the iris.Results: This flap prevents dislocation of bag contents into vitreous and the possibility of vitreous loss through zonular defect and is a reliable support for PC/IOL. We can perform zonuloplasty in one quadrant zonal defect or 2-4 quadrants in the cases like Marfan Syndrome. Conclusion: Zonuloplasty is an innovative surgical procedure in cases with zonular instability more than 1/4 quadrant when CTR is ineffective.

Alireza Ghaffariyeh

2008-05-01

311

Increasing the volume of cataract surgery: an experience in rural China  

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Full Text Available Cataract: the situation in ChinaEighteen per cent of the world’s blind people live in China. The country is home to one of the world’s largest populations of blind people, an estimated 6.6 million. Cataract is the number one cause of blindness in China, accounting for nearly 50 per cent of all cases. China is also estimated to have the world’s most rapidly ageing population. By 2020, the country’s elderly population is expected to increase by 90 per cent and reach 240 million people. In 2005, about 600,000 cataract operations were performed in China, compared to 1.5 million LASIK operations. The cataract surgical rate (CSR in China is around 450-460, compared to 3,700 in India.

Leshan Tan

2006-12-01

312

Influence of two types of cataract surgery on corneal endothelial cells  

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Full Text Available AIM: To compare the effects of small incision extracapsular cataract extraction and phacoemulsification on corneal endothelial cells. METHODS: Eighty-two age-related cataract cases(82 eyesfrom March 2011 to October 2011, were randomly divided into two groups: phacoemulsification group(group Aand small incision extracapsular cataract extraction group(group B. Corneal edema after operation and changes in corneal endothelial cells in different stages before and after operation were observed. RESULTS: In both groups,there was significant difference in the data of corneal endothelial cell density before and after operation(PPPCONCLUSION: Phacoemulsification causes less damage to corneal endothelial cells and less postoperative corneal edema than small incision extracapsular cataract extraction.

Li-Ping Chen

2013-11-01

313

Influence of head flexion on intraocular pressure, cardiovascular, and respiratory responses in patients undergoing cataract surgery after endotracheal intubation  

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Full Text Available Background: In cataract surgery, the periorbital area is prepared anddraped after induction of general anesthesia and endotracheal intubation (ETI.For this purpose, the patient’s head and neck is usually flexed 30 to 45degrees. Neck flexion causes displacement of the endotracheal tube tip towardthe carina. Stimulation of the tracheal mucosa may cause bucking, increasedintraocular pressure (IOP, laryngospasm and/or bronchospasm, during lightanesthesia. Laryngeal constriction and all components of the tracheal responsemay affect end-tidal carbon dioxide pressure (PETCO2 and peripheral arterialhemoglobin oxygen saturation (SpaO2. Thus, in the current study, weinvestigated the influence of head and neck flexion on heart rate (HR, systolicand diastolic blood pressure (SAP and DAP, SpaO2, PETCO2, and IOP in patientsundergoing cataract surgery with endotracheal intubation during generalanesthesia.Patients and Methods: The present prospective study comprised patientsaged from 40 to 80 year with 106 American Society of Anesthesia (ASA physicalstatus I and II. Anesthesia was induced with thiopental sodium, lidocaine andfentanyl. Atracurium 0.5 mg/kg was administered to facilitate trachealintubation. HR, SAP, DAP, SpaO2, PETCO2, and IOP were measured at 1, 2, and 5minutes after head flexion.Results: Mean SAP, DAP, IOP, and HR was increased after ETI and headflexion compared with baseline values. PETCO2 and SpaO2 were decreased after ETIand at 1, 2 minutes after head flexion compared with baseline values.Conclusion: In patients undergoing cataract surgery during generalanesthesia, endotracheal tube movement caused changes in head and neck positionresulting in significant effects on heart rate, systolic and diastolic bloodpressures, laryngeal reflexes, SpaO2, PETCO2, and intraocular pressure.

MR Safavi

2007-11-01

314

A Clinical Study Of Post – Operative Complications Of Cataract Surgery At A Rural Hospital.  

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Full Text Available Purpose: To study the post–operative complications encountered with cataractextraction in rural hospital, to know the incidence of various complications and toknow how best the complications can be minimized and how successfully thesecomplications can be treated..Methods: A proforma will be filled for each patient selected randomly which willinclude Personal details of the patient, Details of surgery, Details of discharge, Detailsof complications observed on 1st post- operative day and on 1stfollow-up at 7 days(1stweek and on 2ndfollow-up at 40days.(6 weeks. From a period of January 1st 2011 toOctober 31st 2012.the research and the statistics will be carried out on the data in themonth of November 2012.Results: This study has been undertaken to find out the incidence of postoperativecomplications of cataract surgery in 3034 patients in a rural hospital. Complicationsseen on the first postoperative day were 359 (11.83%. Striate keratopathy was themost common complication seen in 198 cases (6.53%. Residual Cortex was thesecond most common complication noted postoperatively with incidence of 1.62%. Inour study hyphema was present in 1.35% cases. Corneal edema was seen in 1.12% inour study .Early postoperative uveitis was noted in 1.02% of cases. Iris prolapse wasseen in 0.13%. Shallow anterior chamber was noted in 0.07%, at the end of first weeki.e. the 7th postoperative day, 0.69% patients had persistent iritis.Corneal edema was present in 0.30% of patients. Iris prolapse was present in 0.20%We encountered only 1 (0.03% patient with endophthalmitis (IPD no. 177918. At 6weeks postoperative, IOL malposition was noted in 0.49% patients. Loose sutures werenoted in 0.13% cases.Cystoid macular edema was seen in 0.13%. Postoperativereactivation of herpes was seen in 2 patients.1 case each of bullous keratopathy and irisincarceration were also noted in the study. Posterior capsular opacification was notedin 308 (10.15% patients.Conclusion : The post-operative complications noted were less compared to thepercentage of complications reported elsewhere. Hence a rural hospital with screeningcamps with proper care of the patients post-operatively would prove helpful ineradicating treatable blindness and a good post-operative care would help in fasterrecovery of patient’s visual acuity.

Karad H T1, Gitte T R2, Gandhi S S3 and Chavan P P4

2012-06-01

315

Comparison of the Efficacy of Subtenon with Peribulbar Local Anesthesia without Hyaluronidase in Patients Undergoing Cataract Surgery  

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Objective: To compare the efficacy of subtenon with peribulbar local anesthesia without hyaluronidase in patients undergoing cataract surgery. Study Design: A randomized controlled trial. Place and Duration of Study: Eye B Unit, Khyber Teaching Hospital, Peshawar, from October 2009 to October 2010. Methodology: Patients undergoing cataract surgery were divided into two groups. Group A received subtenon anesthesia and group B received peribulbar anesthesia. Pain score, akinesia and intraocular pressure were compared in the two groups. Statistical Package for Social Sciences-14.0 was used for data analysis. Results: There were 304 patients, 152 patients in each group. At the time of injection, there was less pain in group A as compared to group B (p < 0.001). At the time of surgery and till 90 minutes after administration of anesthesia, there was no significant difference in pain between the 2 groups (p = 0.999 and 0.59 respectively). Group A had better akinesia as compared to group B (p = 0.04). There was a greater rise in mean intraocular pressure just after injection in group B as compared to group A (p < 0.001); in both groups, the intraocular pressure declined to its base level 10 minutes after the injection (p = 0.52). Conclusion: Subtenon anesthesia is less painful at the time of its administration, provides better akinesia and leads to smaller rise in intraocular pressure just after the injection than peribulbar anesthesia. (author)

316

Evaluation of the American Society of Cataract and Refractive Surgery intraocular lens calculator for eyes with prior radial keratotomy  

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Full Text Available David L DeMill, Maylon Hsu, Majid MoshirfarJohn A Moran Eye Center, University of Utah, Salt Lake City, UT, USABackground: The purpose of this study was to evaluate the American Society of Cataract and Refractive Surgery (ASCRS intraocular lens (IOL calculator for eyes with prior radial keratotomy and assess the accuracy of its methods in predicting IOL power in patients with previous radial keratotomy.Methods: This retrospective study included data from 15 eyes with previous radial keratotomy and subsequent cataract surgery. The average central power and Humphrey Atlas methods from the ASCRS IOL calculator, along with an average IOL power produced from an average of these two methods (ASCRS average, were compared. Primary outcome measures for each method were mean arithmetic and absolute IOL prediction error, variance in mean arithmetic IOL prediction error, and the percentage of refractive outcomes within ±0.50, ±1.00, ±1.50, and ±2.00 diopters (D.Results: The average central power method and the ASCRS average were significantly more accurate than the Humphrey Atlas method in terms of mean absolute IOL prediction error (1.03 D and 1.02 D versus 1.53; P = 0.04 and P = 0.01, respectively. In addition, the average central power method and ASCRS average produced a higher percentage of refractive outcomes within ±0.50 D when compared with the Humphrey Atlas method (60% and 46.67% versus 0%, respectively. A comparison of the average central power method and the ASCRS average demonstrated a smaller variance and higher percentage of patients within ±1.00 D when using the ASCRS average.Conclusion: The ASCRS calculator for eyes with prior radial keratotomy is an easily accessible and valuable online tool for calculating IOL power in patients with previous radial keratotomy. We found that the ASCRS average produced by the calculator provided the best IOL prediction. We recommend using it with the addition of 1.00 to 1.50 D to its IOL power prediction.Keywords: radial keratotomy, cataract, intraocular lens calculator, American Society of Cataract and Refractive Surgery

DeMill DL

2011-08-01

317

Effect of Biometric Characteristics on the Change of Biomechanical Properties of the Human Cornea due to Cataract Surgery  

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Purpose. To determine the impact of biometric characteristics on changes of biomechanical properties of the human cornea due to standard cataract surgery using biomechanical analysis. Patients and Methods. This prospective consecutive cross-sectional study comprised 54 eyes with cataract in stages I or II that underwent phacoemulsification and IOL implantation. CH, CRF, IOPg, and IOPcc intraocular pressure were measured by biomechanical analysis preoperatively and at 1 month postoperatively. Changes (?) were calculated as preoperative value versus postoperative value. Biometrical data were extracted from TMS-5 (CSI and SAI), IOLMaster (AL), and EM-3000 (CCT and ECC) preoperatively. Results. The average values of the changes were ?CH = ?0.45 ± 1.27?mmHg, ?CRF = ?0.88 ± 1.1?mmHg, ?IOPg = ?1.58 ± 3.15?mmHg, and ?IOPcc = ?1.45 ± 3.93?mmHg. The higher the CSI the smaller the decrease in CH (r = 0.302, P = 0.028). The higher the CCT the larger the decrease in CRF (r = ?0.371, P = 0.013). The higher the AL the smaller the decrease in IOPg (r = 0.417, P = 0.005). The higher the AL, SAI, and EEC the smaller the decrease in IOPcc (r = 0.351, P = 0.001; r = ?0.478, P < 0.001; r = 0.339, P = 0.013). Conclusions. Corneal biomechanical properties were affected by comprehensive factors after cataract surgery, including corneal endothelium properties, biometry, and geometrical characteristics. PMID:24987697

Langenbucher, Achim; Gatzioufas, Zisis; Seitz, Berthold; El-Husseiny, Moatasem

2014-01-01

318

Antibioterapia tópica preoperatoria en la cirugía de cataratas Preoperative eye-drop antibiotherapy in cataract surgery  

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Full Text Available Objetivo: Conocer la efectividad de varios antibióticos en colirio para eliminar la flora conjuntival de los pacientes que se operan de cataratas y diferenciar los fracasos del tratamiento debidos a la falta de sensibilidad «in vitro» de las bacterias, de otras posibles causas. Método: Estudio retrospectivo de la flora conjuntival preoperatoria de 4.876 pacientes consecutivos; análisis de su sensibilidad «in vitro» agrupando las bacterias en ocho categorías; comparación de los porcentajes de susceptibilidad de la flora total a 5 antimicrobianos. Evaluación de la eficacia de los tratamientos con colirio de un solo antibiótico (Aureomicina, Cloranfenicol, Gentamicina, Norfloxacina ó Rifamicina, de sensibilidad probada, en los pacientes con bacterias conjuntivales patógenas. Resultados: La sensibilidad «in vitro» de nuestra flora a Rifampicina (83,9% y Cloranfenicol (84,4% fue similar (pObjective: To ascertain the effectiveness of various antibiotic eye-drops in eradicating the preoperative conjunctival bacteria of patients undergoing cataract surgery and to differentiate the failure of these treatments due to the lack of «in vitro» sensibility from other possible causes. Methods: Retrospective study of the preoperative conjunctival flora of 4876 consecutive patients; «in vitro» sensibility was analysed by grouping bacteria into eight categories; the susceptibility percentages of the total conjunctival flora to five antibacterial agents were compared. The effectiveness of the eye-drop treatment with a single sensitive tested antibiotic (Aureomicin, Chloramphenicol, Gentamicin, Norfloxacin or Rifamicin was evaluated in patients with pathogen bacteria. Results: The «in vitro» sensibilities of Chloramphenicol (84.4% and Rifampicin (83.9% were similar (p<0.01 and statistically higher than those of the other antibiotics. Nevertheless, the Chloramphenicol pathogen bacterium treatment failed in 21.2% of cases, in spite of being «in vitro» sensitive. Gentamicin presented the best effectiveness for eradicating Staphylococcus Aureus and Gram (- rods. Aureomicin had the best effectiveness against Streptococcus and Gram (- diplococci. Rifamicin was the most effective for eradicating the whole predominant Gram (+ flora. The effectiveness of all five antibiotics decreased when there was more than one pathogen. Conclusions: None of the five antibiotic monotherapies maintains the patients’ conjunctive free of pathogen bacteria 48 hours after finishing the treatment; however, there are bacterial patrons whose treatment could be optimised. The existence of polimicrobial flora decreases the effectiveness of the treatment.

E Fernández Rubio

2004-05-01

319

Cambios morfológicos maculares tras cirugía de cataratas: factores de riesgo / Morphological macular changes after cataract surgery: risk factors  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivos: Analizar cambios en la morfología macular tras cirugía no complicada de cataratas y su correlación con la edad y la hipertensión arterial. Métodos: Se realizaron medidas del volumen macular total (TMV), volumen foveal (FOVOL) y espesor foveal (FOV) con OCT3 Stratus® en pacientes sometidos [...] a cirugía de catarata antes de la cirugía, el día después y un mes después de la misma. Los datos fueron analizados utilizando SPSS 15.0 software. Resultados: Se incluyeron 114 ojos de 114 pacientes. Los valores medios de TMV, FOVOL y FOV en el subgrupo con Signal Strength por encima de 6, antes de la cirugía de catarata fueron 6,59 DE 0,67 µm³; 0,16 DE 0,02 µm³ and 204,97 DE 29,79 µm. Un mes después de la cirugía de cataratas las mediciones fueron TMV: 6,93 DE 0,56 µm³; FOVOL: 0,17 DE 0,06 µm³ y FOV: 218,07 DE 87,60 µm. Encontramos diferencias estadísticamente significativas (P Abstract in english Objective: To analyze morphological macular changes after uncomplicated cataract surgery and their correlation with age and arterial hypertension. Methods: Total macular volume (TMV), foveal volume (FOVOL) and foveal thickness (FOV) in patients who had undergone cataract surgery were measured using [...] OCT3 Stratus® before surgery, the day after the intervention and one month later. The data were analyzed using SPSS 15.0 software. Results: The study group was composed of 114 eyes from 114 patients. The mean TMV, FOVOL and FOV in the subgroup of patients with signal strength over 6 before cataract surgery were 6.59 (SD0.67) µm³; 0.16 (SD0.02) µm³ and 204.97 (SD29.79) µm. One month after surgery the measurements were TMV: 6.93 (SD0.56) µm³; FOVOL: 0.17 (SD0.06) µm³ and FOV: 218.07 (SD87.60) µm. We found statistically significant differences (P

J., Pareja-Esteban; J.P., Moreno-Arrones; P., Drake-Rodríguez-Casanova; C., Gutiérrez-Ortiz; M.A., Teus.

2009-12-01

320

High-resolution genotyping of Pseudomonas aeruginosa strains linked to acute post cataract surgery endophthalmitis outbreaks in India  

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Full Text Available Abstract Background Investigation of two independent outbreaks of post cataract surgery endophthalmitis identified the reservoir of epidemic strains of P. aeruginosa. Methods Patient isolates cultured from vitreous fluid of all the nine cases and from the peripheral devices of phacoemulsification machine were subjected to high-resolution Fluorescent Amplified Fragment Length Polymorphism (FAFLP analysis. Results FAFLP based genotyping of the isolates confirmed nosocomial transmission. Although biochemical characterization and antibiotic susceptibility profiles grouped all the isolates together, FAFLP based genotyping revealed that, all the outbreak isolates were derived from 2 different strains, with independent origins. One group of isolates was traced to phacoprobe and the second one to the internal tubing system of the phacoemulsification machine used in cataract surgery. In silico analysis indicated possible evolution in both the clusters of P. aeruginosa isolates due to genetic polymorphisms. The polymorphisms were mapped to gene products (cell envelope, outer membrane proteins possibly having significant role in pathogenesis. Conclusion The present study is probably the first one to apply FAFLP typing successfully to investigate outbreaks of postoperative endophthalmitis (POE in an ophthalmic setting, which was able to identify the source, and helped to make rational decisions on sterilization procedures that halted more cases of infection in these hospitals.

Mansoori Tarannum

2005-12-01

 
 
 
 
321

[Rehabilitation methods for children with complicated cataract].  

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The work deals with the results of surgical treatment of 155 patients, who had uveal cataract, by method of facoemulsification with artificial crystalline lens transplanting. The age of the sick varied from 3 to 15 as a result of a complex treatment, involving determination of ethnic factor in the development of uveal cataract, before- and after-operation conservative medical treatment, surgical treatment of abscuration ambliopia 78.1% children and the keenness of sight 0.4 and 68.7% got binocularious sight. The study lot of posttraumatic cataract affected children included 189 patients, from them 68 with stationary cataract, 87 with intumescent cataract and 34 with postoperatorial aphakia. Age from 2 to 15 years. 76.3% cases of evolution without postoperatorial complications, in 13.7% intraoperatorial were observed different complications. The work presents the results of surgical treatment 196 of children, who had innate cataract, by the method of facoasoriation with soft intra-eyepiece lens transplanting from 133 patients who had two-sided cataract, 63 had monolateral cataract. All children underwent laser simulation and videocomputer auto-training in post-operation period. As a result of the treatment, 66.8% patients got the amelioration of sight with 0.4, and 58% got binocular sight. The children's age varied between 6 months and 15 years. This article presents a review of the treatment results of 213 children with posttraumatic, congenital and complicated cataracts. The rehabilitation of the patients with the lens pathology includes a complex of measures of early diagnosis, surgery, optimal correction, medical treatment before and after surgery, the prophilaxis and treatment of complications. This approach permits to increase the visual acuity in 83.8% and to restore the binocular vision in 71.4% patients. PMID:21137197

Ivanov, G; Cu?nir, V; Septichina, Natalia; Cu?nir, Vitalie

2010-01-01

322

Prevalence of myopic shifts among patients seeking cataract surgery / Prevalencia de cambios miópicos en pacientes con catarata  

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Full Text Available SciELO Argentina | Language: English Abstract in spanish La cirugía moderna de facoemulsificación del cristalino tiene una recuperación muy rápida. La elección correcta del lente intraocular que se coloca en la cirugía permite, muchas veces, anticipar si el paciente va a precisar anteojos luego de la cirugía. Este estudio analiza una muestra de pacientes [...] con catarata, mostrando la frecuencia relativa de cambios miópicos que permiten a los pacientes ver de cerca sin lentes antes de la cirugía. Se estudiaron retrospectivamente una serie de pacientes consecutivos que realizaron cirugía electiva de catarata. El cambio refractivo miópico fue documentado comparando las prescripciones antiguas con la medición subjetiva al momento del estudio. Los sujetos fueron agrupados de acuerdo a la presencia o ausencia de cambios miópicos, y se estudiaron las proporciones con respecto a su grado de opacidad nuclear. La edad promedio de los 229 sujetos estudiados fue de 71.5 ± 10.4 años, 109 (47.6%) varones. Se halló un cambio miópico, definido como un cambio mayor de - 0.5 dioptrías, en 85 (37.1%, IC95%: 30.8-43.4%). El porcentaje de sujetos con cambio miópico fue significativamente mayor en aquellos que tenían mayor opacidad nuclear al tiempo del examen. En este estudio de pacientes no seleccionados que buscaban realizar cirugía de catarata, más de un tercio tuvo cambios miópicos en la refracción. Si el paciente lograba ver bien de cerca antes de la cirugía, esto debería ser tenido en cuenta a la hora de elegir un correcto lente intraocular para que el sujeto no pierda este beneficio de la catarata. Abstract in english 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 anal [...] yses 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.

Rafael, Iribarren; Guillermo, Iribarren.

323

Cataract (image)  

Science.gov (United States)

A cataract is a cloudy or opaque area in the lens of the eye. Cataracts usually develop as a person gets older and ... substances can also accelerate the development of a cataract. Cataracts can cause visual problems such as difficulty ...

324

Are cataracts associated with osteoporosis?  

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Full Text Available Arie Y Nemet,1 Joel Hanhart,2 Igor Kaiserman,3,4 Shlomo Vinker5,6 1Department of Ophthalmology, Meir Medical Center, Kfar Saba, 2Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, 3Department of Ophthalmology, Barzilai Medical Center, Ashkelon, 4Faculty of Health Sciences, Ben Gurion University, Be'er Sheba, 5Department of Family Medicine, Clalit Health Services, Rehovot, 6Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel Background: Calcium is considered an important factor in the development of both osteoporosis and cataract. This study evaluated the association between osteoporosis and cataracts. Objective: To evaluate the prevalence of osteoporosis among patients undergoing cataract surgery, and the association between the two. Patients and methods: This was a retrospective observational case-control study, conducted in the Central District of Clalit Health Services (a district of the largest health maintenance organization in Israel. All Clalit members in the district older than 50 years who underwent cataract surgery from 2000 to 2007 (n=12,984 and 25,968 age- and sex-matched controls comprised the sample. Electronic medical records of all patients in the study were reviewed. The main outcome measure was the prevalence of osteoporosis and the odds ratio of having osteoporosis among cataract patients compared with controls. Results: Demographically, 41.8% were men with a mean age of 68.7 ± 8.2 years. A logistic regression model for osteoporosis showed that age, female sex, higher socioeconomic class, smoking, chronic renal failure, hyperthyroidism, rheumatoid arthritis, inflammatory bowel diseases, and cataract are all associated with increased prevalence of osteoporosis. Obesity is a protective factor for osteoporosis. In all age-groups, osteoporosis was more prevalent in cataract patients than in the control group. Conclusion: Among other well-known risk factors, osteoporosis is associated with the presence of cataracts. Common pathophysiological associations with both conditions, such as calcium imbalance, hormonal abnormalities, and shared genetic predisposition, are discussed. Keywords: cataract, osteoporosis, risk factors

Nemet AY

2013-10-01

325

LASIK-LASEK en defectos refractivos poscirugías de catarata / LASIK-LASEK in refractive defects after cataract surgeries  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish INTRODUCCIÓN: El tratamiento de la catarata es quirúrgico, se logran muy buenos resultados en la recuperación visual de los pacientes; no obstante, después de ella pueden encontrarse resultados inesperados. El propósito de este estudio fue evaluar las características de las personas estudiadas según [...] su edad, los valores biométricos y queratométricos previos a la cirugía por catarata, la cirugía refractiva, y la técnica de excímer láser empleada en los pacientes operados, desde mayo de 2005 a julio de 2007, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer. MÉTODOS: Se realizó un estudio descriptivo, longitudinal y prospectivo de los pacientes operados de catarata que tuvieron un defecto refractivo residual -error o sorpresa refractiva-, a los cuales se les realizó cirugía por láser excímer. Se evaluaron las características de las personas estudiadas según su edad, los valores biométricos y queratométricos previos a la cirugía por catarata, y a la cirugía refractiva, así como la técnica de excímer láser empleada. RESULTADOS: En este estudio se obtuvo un predominio de las edades entre 40 y 59 años, la sorpresa refractiva más frecuente fue la miopía, la longitud axial indujo una sorpresa refractiva, coadyuvada por el error queratométrico, el LASIK prevaleció como técnica refractiva y logró corregir las sorpresas refractivas halladas. CONCLUSIONES: La sorpresa refractiva presente en todos los pacientes fue la miopía. Se demostró que la longitud axial indujo una sorpresa refractiva y que esta fue la más importante en nuestros resultados, derivada del error queratométrico, a pesar de ser este último poco significativo. Abstract in english INTRODUCTION: The treatment of cataract is surgical, very good results in visual recovery of patients are achieved; however, some unexpected results may appear after surgery. The purpose of this study was to evaluate the characteristics of the studied persons by their age, the biometric and keratome [...] tric values before the cataract surgery, the refractive surgery and the excimer laser technique used in patients who were operated on from May 2005 to July 2007 at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology. METHODS: A prospective, longitudinal and descriptive study was conducted in those patients operated on from cataract, who developed a residual refractive defect - error or refractive surprise- and were performed an excimer laser surgery. The characteristics of the studied persons by their age, the biometric and keratometric values prior to the cataract surgery and the refractive surgery as well as the used excimer laser technique were evaluated. RESULTS: This study revealed the prevalence of the 40-59 years-old age group, the most frequent refractive error was myopia, the axial length induced a refractive surprise contributed by the keratometric error; LASIK was the refractive technique that managed to correct the found refractive surprises. CONCLUSIONS: The refractive surprise present in all the patients was myopia. It was shown that the axial length induced a refractive surprise that was the most important outcome derived from a keratometric error, despite the latter being not significant.

Juan Raúl, Hernández Silva; Maricela, Trujillo Blanco; Marcelino, Río Torres; Meisy, Ramos López; Luis, Curbelo Cunill; William G., Trujillo Blanco.

326

LASIK-LASEK en defectos refractivos poscirugías de catarata / LASIK-LASEK in refractive defects after cataract surgeries  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish INTRODUCCIÓN: El tratamiento de la catarata es quirúrgico, se logran muy buenos resultados en la recuperación visual de los pacientes; no obstante, después de ella pueden encontrarse resultados inesperados. El propósito de este estudio fue evaluar las características de las personas estudiadas según [...] su edad, los valores biométricos y queratométricos previos a la cirugía por catarata, la cirugía refractiva, y la técnica de excímer láser empleada en los pacientes operados, desde mayo de 2005 a julio de 2007, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer. MÉTODOS: Se realizó un estudio descriptivo, longitudinal y prospectivo de los pacientes operados de catarata que tuvieron un defecto refractivo residual -error o sorpresa refractiva-, a los cuales se les realizó cirugía por láser excímer. Se evaluaron las características de las personas estudiadas según su edad, los valores biométricos y queratométricos previos a la cirugía por catarata, y a la cirugía refractiva, así como la técnica de excímer láser empleada. RESULTADOS: En este estudio se obtuvo un predominio de las edades entre 40 y 59 años, la sorpresa refractiva más frecuente fue la miopía, la longitud axial indujo una sorpresa refractiva, coadyuvada por el error queratométrico, el LASIK prevaleció como técnica refractiva y logró corregir las sorpresas refractivas halladas. CONCLUSIONES: La sorpresa refractiva presente en todos los pacientes fue la miopía. Se demostró que la longitud axial indujo una sorpresa refractiva y que esta fue la más importante en nuestros resultados, derivada del error queratométrico, a pesar de ser este último poco significativo. Abstract in english INTRODUCTION: The treatment of cataract is surgical, very good results in visual recovery of patients are achieved; however, some unexpected results may appear after surgery. The purpose of this study was to evaluate the characteristics of the studied persons by their age, the biometric and keratome [...] tric values before the cataract surgery, the refractive surgery and the excimer laser technique used in patients who were operated on from May 2005 to July 2007 at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology. METHODS: A prospective, longitudinal and descriptive study was conducted in those patients operated on from cataract, who developed a residual refractive defect - error or refractive surprise- and were performed an excimer laser surgery. The characteristics of the studied persons by their age, the biometric and keratometric values prior to the cataract surgery and the refractive surgery as well as the used excimer laser technique were evaluated. RESULTS: This study revealed the prevalence of the 40-59 years-old age group, the most frequent refractive error was myopia, the axial length induced a refractive surprise contributed by the keratometric error; LASIK was the refractive technique that managed to correct the found refractive surprises. CONCLUSIONS: The refractive surprise present in all the patients was myopia. It was shown that the axial length induced a refractive surprise that was the most important outcome derived from a keratometric error, despite the latter being not significant.

Juan Raúl, Hernández Silva; Maricela, Trujillo Blanco; Marcelino, Río Torres; Meisy, Ramos López; Luis, Curbelo Cunill; William G., Trujillo Blanco.

2008-12-01

327

Implicaciones sociales, tecnológicas y éticas de los resultados insatisfactorios en la cirugía de catarata Social, technological and ethical implications of unsatisfactory outcomes in cataract surgery  

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Full Text Available A nivel mundial, la catarata constituye la principal causa de ceguera evitable. Su alta prevalencia como causa de ceguera está muy asociada a la pobreza. La cirugía es el único tratamiento verdaderamente efectivo y constituye el proceder quirúrgico más practicado en países desarrollados, pues presenta una adecuada relación coste-beneficio. Contradictoriamente, los estudios de base poblacional efectuados en los últimos años han revelado que existen resultados insatisfactorios en el 40 % de las operaciones de catarata efectuadas en países subdesarrollados. Se exponen en este trabajo algunos elementos históricos y tecnológicos relacionados con este tipo de operación. Se analizan las principales causas de los resultados insatisfactorios y los dilemas éticos asociados a los mismos. Se recomienda la necesidad de evaluar los impactos de las operaciones de catarata como tecnologías sanitarias con efectos positivos y negativos tras su aplicación.Worldwide, cataract is the leading cause of avoidable blindness. Its high prevalence as a cause of blindness is associated to poverty. Surgery is the only effective treatment and most performed surgical procedure in developed countries, with an adequate cost-benefit relationship. Contradictorily, recently conducted population-based surveys have revealed unsatisfactory outcomes in 40 % of cataract surgeries practiced in developing countries. Besides dealing with some of the historical and technological issues related to cataract surgery, the author analyzes the main causes and ethical dilemma associated to those outcomes, and recommends evaluating the impacts of cataract surgery as a technology with positive or negative effects after its application.

Fidel Saúl Ricardo Suárez

2010-08-01

328

Comparison Of Surgically Induced Astigmatism Following Non Phaco Small Incision Cataract Surgery With Different Sites And Sizes Of Incision  

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Full Text Available Purpose: To compare surgically induced astigmatism following non Phaco smallincision cataract surgery with different sites and sizes of incision.Methods: One hundred and thirteen eyes of 112 patients that underwent small incisioncataract surgery by the same surgeon with implantation of a poly methyl methacrylateintraocular lens between 2008 and 2009 were included in this study, after performingtests and necessary investigations for fitness for cataract surgery under peribulbaranaesthesia. The patients were followed at 1 week, 6 weeks and 6 months. Visualacuity and keratometry readings were taken on each follow-up.Results: The magnitude of late postoperative astigmatism at the end of 6 months withsuperior-temporal incision was 0.54 D, 0.58D, 0.72D with 5.5mm, 6mm and 6.5mmsize of incisions respectively, with temporal incision 0.7D, 0.95D and 1.1 D with5.5mm, 6mm and 6.5mm size of incisions respectively and with superior incision 1.02D, 1.25D and 1.33D with 5.5mm, 6mm and 6.5mm size of incisions respectively.Conclusion : Difference in an uncorrected visual acuity post-operatively at the end of6 months was statistically significant in the groups and was better in supero- temporalgroup and 5.5mm size of incision. While considering induced astigmatism with respectto different sizes of incision it was found that the lower the size of incision, the lowerwas the astigmatism. Induced astigmatism was lower in 5.5 mm size of incision ascompared to 6.5 mm size.

Karad H T1, Gitte T R2, Gandhi S S3 and Chavan P P4

2012-12-01

329

Changing Recovery Discharge Method in Elderly Undergoing Cataract Surgery by TIVA in Nikoukari Hospital, an Ophthalmic Center  

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Full Text Available While age increases, some procedures such as cataract are needed to be done as outpatient. Anesthesia should be such that the turn over of discharge is rapid. The objective of this study is to change recovery discharge method in elderly undergoing cataract surgery by TIVA in our hospital. Nightly patients in 2 groups more than 65 years old and ASA physical status II, III were studied. The induction of anesthesia performed with bolus dose of remifentanil 1 ?g kg-1 and propofol 2 mg kg-1 and the intubation was done after cisatracorium 0.15 mg kg-1. In group ?g/kg/min were infused. In group 2, a mixture of N2O+O2 50% each and isoflurane 1.5% were given to the patients. The criteria to be discharged from recovery were recorded in 2 groups. The age and gender were equal in both groups. Some data like duration of the surgery, return of breathing and the extubation time made no difference in both groups. From the end of surgery to the time of discharge from recovery all data such as eye opening, stating name and the time of ability to discharge had significant differences between 2 groups (p<0.0005. Total 15 patients in TIVA group and 22 in group isoflurane received ephedrine. The results of this study show that the time of recovery discharge in TIVA group using remifentanil and propofol is more rapid than isoflurane. This could result to a better turn over in the operating rooms.

2008-01-01

330

Nucleofragmentação horizontal: uma nova técnica para a cirurgia de catarata Horizontal nucleofragmentation: a new technique for cataract surgery  

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Full Text Available OBJETIVOS: Estudar in vitro a eficácia de um par de instrumentos na divisão de núcleos extraídos por meio da técnica extracapsular. MÉTODOS: A amostra foi constituída de 47 núcleos obtidos de facectomias extracapsulares. Foram classificados em maduros (4+ e imaturos (1 a 3 +, de pacientes com acuidade visual variando de 20/60 à percepção luminosa. Um par de instrumentos, desenvolvido por um dos autores, foi utilizado para fragmentação. Para tal, foi idealizado suporte constituído de gel e metilcelulose sobrejacente. RESULTADOS: A média de idade foi de 67,38 anos sendo que a maior parte dos pacientes (66% possuía acuidade visual inferior a 20/400. Um percentual de 42,6% das cataratas eram maduras. A fixação e segmentação foram fáceis em 95,7% e 91,5% dos núcleos, respectivamente. CONCLUSÃO: O par de instrumentos idealizados é eficaz em executar a fixação e segmentação dos núcleos.PURPOSE: To study in vitro the efficacy of a pair of instruments designed to capture and split human nuclei obtained from extracapsular surgeries. METHODS: The sample is a compound of 47 cataract nuclei. They were classified as mature (4+ and immature (1 to 3+, and the visual acuity ranged from 20/60 to light perception. The instruments were used to split the nuclei. A methylcellulose over a gel base was made for this purpose. RESULTS: The average age was 67,38 years. Most patients (66%, had a visual acuity less than 20/400. 42,6% of the cataracts were mature. The capturing and splitting was easily done in over 90% of the nuclei. CONCLUSIONS: The designed instruments are effective to capture and split cataract nuclei.

Sérgio Jacobovitz

2003-06-01

331

Genetics Home Reference: Hypomyelination and congenital cataract  

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... OMIM Genetic disorder catalog Conditions > Hypomyelination and congenital cataract On this page: Description Genetic changes Inheritance Diagnosis ... Reviewed July 2009 What is hypomyelination and congenital cataract? Hypomyelination and congenital cataract is an inherited condition ...

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Genetics Home Reference: Hyperferritinemia-cataract syndrome  

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... Research studies OMIM Genetic disorder catalog Conditions > Hyperferritinemia-cataract syndrome On this page: Description Genetic changes Inheritance ... Glossary definitions Reviewed August 2012 What is hyperferritinemia-cataract syndrome? Hyperferritinemia-cataract syndrome is a disorder characterized ...

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Cirugía de cataratas por facoemulsificación aplicando la técnica de prechop / Use of prechop technique in phacoemulsification cataract surgery  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Objetivos: aplicar la técnica de prechop en la cirugía de catarata por facoemulsificación y describir sus resultados. Métodos: estudio descriptivo y prospectivo en 295 pacientes (ojos) con diagnóstico de catarata senil atendidos en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", entre ener [...] o y diciembre de 2010. Se analizaronlas variables: mejor agudeza visual corregida y sin corregir, conteo celular endotelial, hexagonalidad, coeficiente de variabilidad, astigmatismo resultante, tiempo efectivo de ultrasonido y complicaciones. Resultados: la pérdida celular endotelial fue de 14,2 %. La hexagonalidad promedio posoperatoria, de 50,99 %. El coeficiente de variabilidad promedio preoperatorio fue de 32,37 % y cambió a 30,43 % en el posoperatorio. El astigmatismo posoperatorio promedio fue de 1,48 dioptría con una inducción de 0,51 dioptría. El tiempo efectivo de ultrasonido estuvo por debajo de los 2 minutos en el 80 % de los casos. La mejor agudeza visual sin corregir preoperatoria fue de 0,14 como promedio y mejoró a 0,43 en el posoperatorio, mientras que la mejor agudeza visual corregida, de 0,29 en el preoperatorio mejoró a 0,82. La complicación transquirúrgica más frecuente fue la rotura de la cápsula posterior y la posquirúrgica, el edema corneal. Conclusiones: la opción de realizar la técnica de prechop para emulsificar el cristalino representa una ventaja para la cirugía de cataratas, sobre todo en pacientes con cristalinos duros por la poca repercusión para el endotelio corneal. Existe una mejoría importante de la agudeza visual sin corregir y con corrección después de la cirugía. Abstract in english Objective: to use the prechop technique in the phacoemulsification cataract surgery and to describe the final results. Methods: descriptive and prospective study of 295 patients (eyes) with senile cataract diagnosis, who were seen at ¨Ramón Pando Ferrer¨ Cuban Institute of Ophthalmology from January [...] to December 2010. The analyzed variables were best corrected and uncorrected visual acuity and endothelial cell count, hexagonality, variability coefficient, refractive astigmatism, effective ultrasound time and complications. Results: the endothelial cell loss was 14.2 %. The postoperative average hexagonality was 50.99 %. The preoperative variability coefficient averaged 32.37 but changed to 30.43 % after surgery. Postoperative average astigmatism was 1.48 D, with induction of 1.51 D. The effective ultrasound time was less than 2 minutes in 80 % of cases. Best uncorrected visual acuity preoperatively was 0.14 and improved to 0.43 in the postoperative phase, but the best corrected visual acuity was 0.29 before surgery and rose to 0.82. The most frequent transurgical complication was rupture of the posterior capsule corneal whereas the corneal edema prevailed after surgery. Conclusions: phacoemulsification using prechop technique is an advantage for the cataract surgery, with an important improvement of final uncorrected and corrected visual acuity, and a very good choice in patients with hard cataract because of the lower impact on the corneal endothelium.

Belkys, Rodríguez Suárez; Juan Raúl, Hernández Silva; Eneida de la Caridad, Pérez Candelaria; Ana María, Méndez Duque de Estrada; Iraisi, Hormigó Puertas; Imalvet, Santiesteban García.

2013-04-01

334

Cirugía de cataratas por facoemulsificación aplicando la técnica de prechop / Use of prechop technique in phacoemulsification cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Objetivos: aplicar la técnica de prechop en la cirugía de catarata por facoemulsificación y describir sus resultados. Métodos: estudio descriptivo y prospectivo en 295 pacientes (ojos) con diagnóstico de catarata senil atendidos en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", entre ener [...] o y diciembre de 2010. Se analizaronlas variables: mejor agudeza visual corregida y sin corregir, conteo celular endotelial, hexagonalidad, coeficiente de variabilidad, astigmatismo resultante, tiempo efectivo de ultrasonido y complicaciones. Resultados: la pérdida celular endotelial fue de 14,2 %. La hexagonalidad promedio posoperatoria, de 50,99 %. El coeficiente de variabilidad promedio preoperatorio fue de 32,37 % y cambió a 30,43 % en el posoperatorio. El astigmatismo posoperatorio promedio fue de 1,48 dioptría con una inducción de 0,51 dioptría. El tiempo efectivo de ultrasonido estuvo por debajo de los 2 minutos en el 80 % de los casos. La mejor agudeza visual sin corregir preoperatoria fue de 0,14 como promedio y mejoró a 0,43 en el posoperatorio, mientras que la mejor agudeza visual corregida, de 0,29 en el preoperatorio mejoró a 0,82. La complicación transquirúrgica más frecuente fue la rotura de la cápsula posterior y la posquirúrgica, el edema corneal. Conclusiones: la opción de realizar la técnica de prechop para emulsificar el cristalino representa una ventaja para la cirugía de cataratas, sobre todo en pacientes con cristalinos duros por la poca repercusión para el endotelio corneal. Existe una mejoría importante de la agudeza visual sin corregir y con corrección después de la cirugía. Abstract in english Objective: to use the prechop technique in the phacoemulsification cataract surgery and to describe the final results. Methods: descriptive and prospective study of 295 patients (eyes) with senile cataract diagnosis, who were seen at ¨Ramón Pando Ferrer¨ Cuban Institute of Ophthalmology from January [...] to December 2010. The analyzed variables were best corrected and uncorrected visual acuity and endothelial cell count, hexagonality, variability coefficient, refractive astigmatism, effective ultrasound time and complications. Results: the endothelial cell loss was 14.2 %. The postoperative average hexagonality was 50.99 %. The preoperative variability coefficient averaged 32.37 but changed to 30.43 % after surgery. Postoperative average astigmatism was 1.48 D, with induction of 1.51 D. The effective ultrasound time was less than 2 minutes in 80 % of cases. Best uncorrected visual acuity preoperatively was 0.14 and improved to 0.43 in the postoperative phase, but the best corrected visual acuity was 0.29 before surgery and rose to 0.82. The most frequent transurgical complication was rupture of the posterior capsule corneal whereas the corneal edema prevailed after surgery. Conclusions: phacoemulsification using prechop technique is an advantage for the cataract surgery, with an important improvement of final uncorrected and corrected visual acuity, and a very good choice in patients with hard cataract because of the lower impact on the corneal endothelium.

Belkys, Rodríguez Suárez; Juan Raúl, Hernández Silva; Eneida de la Caridad, Pérez Candelaria; Ana María, Méndez Duque de Estrada; Iraisi, Hormigó Puertas; Imalvet, Santiesteban García.

335

Second eye cataract surgery: perceptions of a population assisted at a university hospital Cirurgia de catarata no segundo olho: percepção de população atendida em Hospital Universitário  

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Full Text Available OBJECTIVE: To identify daily life difficulties perceived by patients suffering from senile cataract before and after second eye cataract surgery. METHODS: Longitudinal prospective study with 84 patients consecutively seen within the framework of the Cataract Project, with visual acuity equal to or higher than 20/30 in the pseudophakic eye, and equal to or lower than 20/40 with the best possible optical correction in the cataractous eye. A questionnaire was applied during an interview. RESULTS: Before surgery, 60.7% complained about visual impairment (moderate or marked; after surgery, 92.8% had no difficulty. Routine activities, mobility, and leisure activities were significantly altered after surgery (P =.001. CONCLUSION: According to the patients' perceptions, there was a significant reduction in visual difficulties after second eye cataract surgery.OBJETIVO: Identificar dificuldades na vida diária percebidas por pacientes com catarata senil, antes e após a cirurgia de catarata no segundo olho. MÉTODOS: Estudo longitudinal prospectivo de 84 pacientes consecutivos atendidos por "Projeto Catarata", com acuidade visual maior ou igual a 20/30 no olho pseudofácico e menor ou igual a 20/40 with the best possible optical correction no olho com catarata. Aplicou-se questionário por entrevista. RESULTADOS: Antes da cirurgia 60,7% declararam dificuldade visual (média ou muita; após, 92,8% nenhuma dificuldade. Atividades rotineiras, de mobilidade e lazer alteraram-se significativamente após a cirurgia (p= 0,001. CONCLUSÃO: Na percepção dos pacientes, após a cirurgia de catarata do segundo olho houve redução importante das dificuldades visuais.

Amaryllis Avakian

2005-10-01

336

Torsional mode phacoemulsification: Effective, safe cataract surgery technique of the future  

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Purpose: To compare various outcome measures using torsional mode and longitudinal mode in the phacoemulsification of cataract with different nuclear densities. Setting: Magrabi Eye Hospitals, Kingdom of Saudi Arabia. Design: A randomized comparative clinical study. Materials and Methods: This study includes 200 eyes of 156 patients (100 in the ultrasound longitudinal "US" group and 100 in the torsional group). All eyes received AcrySof® single piece intraocular lens (Alcon ...

El-Moatassem Kotb Ahmed; Gamil Mohamed

2010-01-01

337

Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time  

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Masahiko Shimura1, Toru Nakazawa2, Kanako Yasuda1, Takashi Shiono3, Kohji Nishida21Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Japan; 2Department of Ophthalmology and Visual Science, Tohoku University Graduate School of Medicine, Sendai, Japan; 3Department of Ophthalmology, Shiono Eye Center, Sendai, JapanPurpose: This study compares the effect of topical diclofenac with that of betamethasone against postoperative increase of intraocular pressure (IOP) after cataract ...

Kohji Nishida; Takashi Shiono; Kanako Yasuda; Toru Nakazawa; Masahiko Shimura

2008-01-01

338

Cataract - close-up of the eye (image)  

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This photograph shows a cloudy white lens (cataract) over the pupil. Cataracts are a leading cause of decreased vision in older adults, but children may have congenital cataracts. With surgery, the ...

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Cataract Surgery: Fraud, Waste, and Abuse. A Report by the Chairman of the Subcommittee on Health and Long-Term Care of the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.  

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This report is a summary of the findings from the Subcommittee on Health and Long-Term Care of the United States House of Representatives Select Committee on Aging investigation of cataract surgery and the use of intraocular lenses (IOL's) in the United States. The document provides background on the definition and treatment of cataracts and…

Congress of the U.S., Washington, DC. House Select Committee on Aging.